I've just had a transplant and don't want to take Finasteride

[Portugal]

I am 51 and had a transplant 2 weeks ago. I tried finasteride 3 times about 10 years ago but had terrible side effects. I got really depressed and lost my libido. My hair got really thick so it was tough to stop but I valued my health more than my hair. The clinic said because Im 51 I dont need to take finasteride even though it would be ideal. They are going to give me topical minoxidil and PRP and said this will be ok. I will also take saw palmetto, Omega 3 and MSM. Will I likely regret not taking finasteride? Is there another option?

[gaz9318054]

No one needs to take Finasteride, but if you don't take some kind of 5α-reductase inhibitor, your risk of experiencing further hair loss around the transplanted hairs is significantly higher, and your risk of experiencing regret would follow suit.

If you experienced significant undesirable side effects with Finasteride, talk to your doctor about trying a lower dosage, or using an alternative medication such as Dutasteride.

[asterix0]

It is part of the tradeoff some of us unfortunately have to deal with.

Try topical finasteride or dutasteride maybe that will help if you can't tolerate oral. 

[Maorizio]

4 hours ago, Portugal said:

I am 51 and had a transplant 2 weeks ago. I tried finasteride 3 times about 10 years ago but had terrible side effects. I got really depressed and lost my libido. My hair got really thick so it was tough to stop but I valued my health more than my hair. The clinic said because Im 51 I dont need to take finasteride even though it would be ideal. They are going to give me topical minoxidil and PRP and said this will be ok. I will also take saw palmetto, Omega 3 and MSM. Will I likely regret not taking finasteride? Is there another option?

Honestly if you’re 51 you can skip finasteride 

[Berba11]

At 51 your hair loss will be a lot slower and more stable. If you do lose more hair then you may have to chase it down with more surgery but that's the trade off. If your donor resources allow for it then it shouldn't be a problem.

Oral minoxidil would be better than topical (and less hassle), and you can save yourself the money in spending on PRP - it's not going to do anything, frankly. No harm in taking Saw Palmetto, Biotin and other supplements. Whether it'll actually help your hair is another matter of course.

[Gatsby]

What is/was your Norwood scale? If it was say Norwood 6 then you have far more less to potentially lose than a Norwood 2/3 for example. I'm also in the same boat @Portugal in that I can't tolerate finasteride orally or topically. Topical finasteride is something you could try because many people who get side effects on oral finasteride don't get side effects on topical finasteride. What I do take is oral minoxidil and it has made a huge difference in thickening my hair and beard. All the best.

[Melvin- Admin]

Have you considered topical finasteride? I know @BHRClinic can prescribe and ship it anywhere in the EU. I would definitely try taking a topical. 

[Cooper48]

I got a lot of sides from oral fin.  I started topical 3 months ago and the sides are definitely better.  I wouldn't say they are nonexistent but I think I can manage.  Definitely worth a shot to keep from losing around the transplanted area. 

[Portugal]

14 hours ago, Maorizio said:

Honestly if you’re 51 you can skip finasteride 

The problem is Im on a low dose of testosterone replacement and I have definitely experienced significant thinning since I started on TRT a year ago so Im guessing that would contine

 

[Gatsby]

If you were on TRT (and I’m assuming it’s a health requirement for you) then to be honest I wouldn’t have had a hair transplant two weeks ago. 

[asterix0]

@Portugal did you by any chance measure DHT levels before and after you started TRT? 

[Portugal]

39 minutes ago, asterix0 said:

@Portugal did you by any chance measure DHT levels before and after you started TRT? 

No Ive never had DHT levels. I get bloods done for my hormones but never DHT. 

 

[LT3D]

1 hour ago, Portugal said:

No Ive never had DHT levels. I get bloods done for my hormones but never DHT. 

 

Systemic DHT levels aren't very useful for hair loss as DHT is a paracrine/intracrine hormone. My question is, have you tried fin while on TRT?

[Portugal]

1 hour ago, LT3D said:

Systemic DHT levels aren't very useful for hair loss as DHT is a paracrine/intracrine hormone. My question is, have you tried fin while on TRT?

No I haven't. I tried it 3 times but it was 10 years ago and each time I felt severely depressed, lost my libido completely and felt like there was no life in my old man downstairs. What are your thoughts about trying it again whilst on TRT?

[LT3D]

14 minutes ago, Portugal said:

No I haven't. I tried it 3 times but it was 10 years ago and each time I felt severely depressed, lost my libido completely and felt like there was no life in my old man downstairs. What are your thoughts about trying it again whilst on TRT?

This is purely speculative on my part, but I think the reason why some men get bad side effects on finasteride is because their test levels are low or lower than normal, but not so low that they are fully symptomatic. And a big part of their androgen load is comprised of their DHT.

The moment they nuke their DHT, they are left with low-ish test and low DHT. Their free test will go up some, but not enough to make up for the androgenicity that DHT provided. So the low test/androgen symptoms begin.

On TRT, assuming you're dialed in and you feel great, the androgen load should be optimal. I can tell you from my experience, when I started finasteride, and later dutasteride, my libido went much higher and I even have blood work showing the increase in my free test. It tapered off back to normal after a while. But I think when you're exogenously injecting test, it's a different equation with DHT-reducing drugs.

Just my two cents.

[Portugal]

1 hour ago, LT3D said:

This is purely speculative on my part, but I think the reason why some men get bad side effects on finasteride is because their test levels are low or lower than normal, but not so low that they are fully symptomatic. And a big part of their androgen load is comprised of their DHT.

The moment they nuke their DHT, they are left with low-ish test and low DHT. Their free test will go up some, but not enough to make up for the androgenicity that DHT provided. So the low test/androgen symptoms begin.

On TRT, assuming you're dialed in and you feel great, the androgen load should be optimal. I can tell you from my experience, when I started finasteride, and later dutasteride, my libido went much higher and I even have blood work showing the increase in my free test. It tapered off back to normal after a while. But I think when you're exogenously injecting test, it's a different equation with DHT-reducing drugs.

Just my two cents.

Thats makes logical sense. The only thing I would add to this equation (and this really complicates the trouble shooting) is that I was diagnosed with Hashimotos disease a couple of month ago with hypothyroidism (symptoms of which are hair loss, low libido, low testosterone). So my thought is that treating my low testosterone with TRT is merely papering over the cracks and what I should be doing is treating the thyroid and auto immune condition. I had a consult with a functional doctor who specialises in hashimotos and thyroid and he wants me to make some lifestyle changes and start taking NDT (non desicated thyroid) and coming off the TRT slowly. Any thoughts on this?

[LT3D]

2 minutes ago, Portugal said:

Thats makes logical sense. The only thing I would add to this equation (and this really complicates the trouble shooting) is that I was diagnosed with Hashimotos disease a couple of month ago with hypothyroidism (symptoms of which are hair loss, low libido, low testosterone). So my thought is that treating my low testosterone with TRT is merely papering over the cracks and what I should be doing is treating the thyroid and auto immune condition. I had a consult with a functional doctor who specialises in hashimotos and thyroid and he wants me to make some lifestyle changes and start taking NDT (non desicated thyroid) and coming off the TRT slowly. Any thoughts on this?

I mean, this is really getting into the weeds of things and I'm not really qualified to say one way or another. There is a really great FB group - TRT and hormone optimization. Worth exploring that to learn more about your condition and how to navigate it.

[Gatsby]

4 hours ago, Portugal said:

Thats makes logical sense. The only thing I would add to this equation (and this really complicates the trouble shooting) is that I was diagnosed with Hashimotos disease a couple of month ago with hypothyroidism (symptoms of which are hair loss, low libido, low testosterone). So my thought is that treating my low testosterone with TRT is merely papering over the cracks and what I should be doing is treating the thyroid and auto immune condition. I had a consult with a functional doctor who specialises in hashimotos and thyroid and he wants me to make some lifestyle changes and start taking NDT (non desicated thyroid) and coming off the TRT slowly. Any thoughts on this?

@Portugal I would definitely be guided by your doctor/specialist on this. All the best.

[Lenzman]

Amazing I didn’t even know topical versions exist. I’m getting on it also 👍