Month: June 2013

I’m considering upping my dose of finasteride. When I began taking it 18 years ago I took the full 5mg daily. About 6 years ago I started taking 1mg Propecia, and I feel it has not maintained my hair as well.

Now, I’ve read the argument, and seen the graph explaining that finasteride suppresses DHT at a rate that platoes at about ~70% DHT for 1mg to 5mg. So the suppression rate of DHT is no better for 5mg of finasteride than for 1 mg. My question is this, if the amount of DHT suppressed by 1mg – 5mg finasterde is virtually the same, why BPH patients proscribed 5mg instead of 1 mg? If purpose of the medication is to reduce the amount of DHT wouldn’t 1 mg be as effective in the treatment of BPH, if dosages of 1mg – 5mg produce the same effect on DHT concentration?

For this reason I’m skeptical of doctors who say that increasing my dose of finasteride won’t produce better results (as I believe I’ve had before). Can you tell me where my reasoning is wrong?

Thanks a lot.

When drug doses are assessed, they are tested against large, statistically valid populations who have symptoms. The effectiveness of a drug is determined by balancing the safety of the drug.

In the case of finasteride, huge populations of balding men were given graded doses from as small as 0.25mg to as large as 5mg, and the researchers looked for what dose produced the best response with the least side effects.

For balding, although the drug worked well in ranges of 1-5mg, the 1mg dose produced essentially the same results as the 5mg dose with the least side effect. The same approach was done for those with benign prostatic hyperplasia (BPH) and the conclusions were that the 5mg dose was the most effective dose for that disease.

Snippet from the article:

Some men who take the drug finasteride (Propecia) to slow a receding hair line may also find it reduces their interest in drinking alcohol, new research reveals.

Almost two-thirds of the men in the study noticed they were drinking less alcohol than before taking Propecia, said study researcher Dr. Michael Irwig, an endocrinologist and assistant professor of medicine at George Washington University School of Medicine.

But the decrease in drinking seen in the study may not be found in all men who use the popular hair-loss treatment. (A higher dose of finasteride is also prescribed to men for an enlarged prostate, and is sold as Proscar.)

The study, which was aimed at better understanding the drug’s sexual side effects, looked at only younger men, ages 46 and under, who had quit taking the medication for male-pattern hair loss for at least three months, yet continued to experience effects such as a reduced sex drive and erectile dysfunction.

Read the rest — Baldness Drug Curbs Men’s Interest in Alcohol, Study Suggests

The study was of 83 men that claimed to have persistent sexual side effects after stopping finasteride, with 65% of them stating they drank less booze now, 32% stating no change in their drinking, and 3% stating they drank more.

I’m not sure if the study looked into the personal lives of these men to find out if there were other possible reasons for their drinking habits to change (lifestyle or psychological), but the findings were worth posting here. The study is fairly ambiguous about whether alcohol and finasteride are definitively linked, and the article points out that there was no control group. For what it’s worth, I don’t recall any patients ever mentioning a change in alcohol consumption to me.

Past studies by the same researcher, Dr Irwig, have been written about here before.

I’ve been on Propecia since April last year. However, my hair loss is continuing at a slow pace. I know that I might’ve been worse off without Propecia, but could it be possible that Propecia only really fully kicks in and loss stopping takes more than a year? Thanks.

My standard answer is to wait at least a year, but some people see benefits of hair loss reduction almost immediately and hair growth in 6 months. Everyone is different, though.