Nervous to switch from finasteride to dutasteride

[nejihyuga18]

I am 27 y/o and have been on fin since age 23. It has slowed down my hair loss, but not halted it and definitely no regrowth. So I am considering switching to dutasteride. My doctor agreed to prescribe it for me, but said he can’t give me recommendations on how to take it (it is not fda approved in US).

 

I desperately want to avoid HT as long as I can, but am scared to go on the dutasteride. Particularly the sexual side effects, infertility and gynecomastia.
 

I actually have had surgery for gyno already, but my surgeon warned me that there is 1% chance it could return. 
 

If anyone can share their experience switching from fin to dut, would appreciate it. How did you make the transition? Did you switch immediately or taper it in? If so, what dosing regimen did you use to transition fin to dut? And please give your honest experience with side effects as well, thanks.

[Chrisno]

Hey man, a few comments from me:

• If you are on Fin without sides, likely you will also be fine on Dut. But there is a higher chance of sides, because Dut lowers DHT even more
• Did you have pubertal gyno, or did you experience gyno as an adult? If you do not have significantly increased estradiol on Fin, you will likely also be fine on Dut. However, please note that if you are borderlining high estradiol (E2) when Dut can push you over and you can develop gyno again. Best way is to check your blood work with a sensitive E2 test - if you are in the US this is possible. If you can get the sensitive test (not the regular one) that's the way to go.

Edited June 28, 2023 by Chrisno

[HappyMan2021]

Dutasteride is not some boogeyman medication. All it is is a better, stronger, more efficient version of Fin.

If you have zero sides on Fin, you WILL NOT have sides on Dut. 

Trust me, I made the upgrade myself. 

[Gatsby]

My 'lay opinion' is that if you have been on finasteride for four years with no side effects then there is very little likelihood that dutasteride will cause a problem. If and it's a very minute 'if' that you do see sides then just go back on finasteride. All the best.

[nejihyuga18]

1 hour ago, Chrisno said:

Hey man, a few comments from me:

• If you are on Fin without sides, likely you will also be fine on Dut. But there is a higher chance of sides, because Dut lowers DHT even more
• Did you have pubertal gyno, or did you experience gyno as an adult? If you do not have significantly increased estradiol on Fin, you will likely also be fine on Dut. However, please note that if you are borderlining high estradiol (E2) when Dut can push you over and you can develop gyno again. Best way is to check your blood work with a sensitive E2 test - if you are in the US this is possible. If you can get the sensitive test (not the regular one) that's the way to go.

So I think I had slight pubertal gyno, but it didn’t get bad until I was on fin. So I’m guessing the fin made it worse. That’s why I’m hesitant with dut. Otherwise, no sides with fin. I’ll definitely ask my doctor for the sensitive E2 test, thank you 

[nejihyuga18]

My estradiol when I last checked it was 27.3 pg/mL and apparently the normal range is 7.6-42.6. 
 

however my testosterone was high at 928 ng/DL which is probably because I’m on fin and it’s preventing test from converting to DHT. 
 

not sure if this is something to consider before dutasteride

[Chrisno]

Your current E2 level is fine. I highly doubt fin made it worse if you are on that level. Unless, of course, you are ultra sensitive to E2 for gland growth. Did you gain weight? Are you overweight / obese? It might not be true gyno, only stubborn chest fat. Gyno is a hard gland, not fat.

I would talk with an endocrinologist before you make the switch, to rule out any other issues.

[nejihyuga18]

27 minutes ago, Chrisno said:

Your current E2 level is fine. I highly doubt fin made it worse if you are on that level. Unless, of course, you are ultra sensitive to E2 for gland growth. Did you gain weight? Are you overweight / obese? It might not be true gyno, only stubborn chest fat. Gyno is a hard gland, not fat.

I would talk with an endocrinologist before you make the switch, to rule out any other issues.

Yeah it could be that I’m just sensitive to it. And no it was definitely true gyno. I got the glands removed last summer and even the surgeon was surprised with how much glandular tissue came out. He said 99% chance it’ll never come back but when I told him I’m on finasteride, he said that can definitely increase the chances 

[Melvin- Admin]

Your test levels are really high. If you’re not getting sides with fin, you’re probably fine on dut. But there’s a threshold. I would say 0.5mg 3x a week to start would be good. Monitor yourself, check your bloodwork regularly and slowly up the frequency.

[nejihyuga18]

6 minutes ago, Melvin- Moderator said:

Your test levels are really high. If you’re not getting sides with fin, you’re probably fine on dut. But there’s a threshold. I would say 0.5mg 3x a week to start would be good. Monitor yourself, check your bloodwork regularly and slowly up the frequency.

Is my test levels being that high a bad thing? Like is it the reason I have more hair loss or that I got gyno?  Sorry I don’t know what high test levels mean in terms of clinical effect of it

[Curious25]

Some theories suggest that testosterone can also play a role in androgenic alopecia, albeit to a lesser extent than DHT. 
 

Or - you could just have follicles that are extremely sensitive to DHT, and the ~70% reduction finasteride provides isn’t quite sufficient in halting your hair loss. 
 

There are some anecdotes online of people incorporating dutasteride once or twice a week, in replacement of taking finasteride on that particular day/s - could be a good way to start tapering in to it. Because of the extremely large half life of dutasteride, some people feel that daily consumption is unnecessary anyway.

I myself I take fin 6 days a week, and dut 1 day a week - I started that regime three months ago in the hope of experiencing some further regrowth - so i’m hopeful to see some benefits towards the end of the year. Let’s see. 

 

However I echo the above sentiments, if you are fine on fin, you will likely be fine on dut. 

[Melvin- Admin]

10 hours ago, nejihyuga18 said:

Is my test levels being that high a bad thing? Like is it the reason I have more hair loss or that I got gyno?  Sorry I don’t know what high test levels mean in terms of clinical effect of it

High test levels is a good thing, do you know what your free test levels are? Gyno happens because your testosterone is converting to estrogen through aromatization. Inhibiting DHT can have this secondary effect, as the test isn’t converting to DHT. That said, you can take an aromatase inhibitor to prevent the conversion of estrogen.

[12345]

On 6/29/2023 at 9:38 AM, Melvin- Moderator said:

High test levels is a good thing, do you know what your free test levels are? Gyno happens because your testosterone is converting to estrogen through aromatization. Inhibiting DHT can have this secondary effect, as the test isn’t converting to DHT. That said, you can take an aromatase inhibitor to prevent the conversion of estrogen.

is it safe for men to take aromatase inhibitors on a daily basis? i have only heard of bodybuilders/athletes taking it while on steroids 

[KenzoTenma]

I hope I am not interfering and are also having a question to fin-->dut. Would you recommend to check hormone levels first, before switching medication? Is estradiol the only important hormon to check? 

[Heisenberg]

On 7/2/2023 at 3:10 AM, 12345 said:

is it safe for men to take aromatase inhibitors on a daily basis? i have only heard of bodybuilders/athletes taking it while on steroids 

I think you're taking a big risk with anything that messes with your hormones, and every drug carries a risk of side effects sadly.