Dear Doctor
I’ve been taking propecia for a few months now and have just recently started taking green tea capsules I heard it worked as a DHT blocker, but I saw in your book that natural DHT blockers such a saw palmetto can counteract propecia. could Green tea have the same effect.
It is possible, but probably not at reasonable doses of green tea.
Doctor,
When quiting minoxidil do the dependent hairs fall out all around the same time,say within the same few weeks? Or do they fall out a little at a time over months? And when would it be safe to assume all dependent hairs are out? After 3 months?
If you restart minoxidil after 3 or 4 months what are the odds of salvaging any lost hairs, going by what you’ve seen in your practice?
You say that minoxidil and propecia work differently, but if DHT eventually overtakes minoxidil as you say then why wouldn’t Propecia protect minoxidil dependent hairs if you stopped minoxidil. Since it’s really DHT that’s causing the hair to fall out?
Thanks..
BTW, I appreciate that a transplant surgeon advocate 2 drugs that could be considered your competition.
I practice good medicine and always give the best, safest, and least invasive solutions for hair loss. If medication can solve the problem, I’d rather a patient go that route. Surgery should never be the first resort.
There is no rule with regard to hair loss from withdrawal of either finasteride or minoxidil. Generally the hair is lost slowly over 3-4 months, and not all at once. Restarting the medication never gets you exactly back to where you were, but if you realize you made a mistake and want to get back on the drug, you should see benefits from that point on. The action of minoxidil (Rogaine) and finasteride (Propecia) is different so when you withdraw either, the other medication will not prevent the hair loss that can occur. Minoxidil is a drug that grows hair as a side effect, while Propecia blocks the effect of DHT. A person on minoxidil can still lose hair from DHT influences, and that is not blocked by minoxidil. Stopping minoxidil will result in the loss of those hairs grown from it — but that is due to stopping the medication, not DHT.
Can a potential natural supplement not be a DHT blocker in vitro (in a petri dish) but be a DHT blocker in vivo (in the body)?
Also, if Propecia only blocks about 70% of type II 5 alpha reductase, why doesn’t it block the rest if finasteride is meant to block 5ARII?
Is MPB only about blocking DHT or is there more to the story? For example, if we could block 100% of DHT, would our hair loss be blocked?
The things we see in petri dishes and live animal subjects do differ, however, I would want to know specifically what you are asking (a directed question of course).
There is more to balding than DHT alone, but the more of the receptor that is blocked, the better the drug will work. That is why many people like dutasteride as the block gets up to 85% or more, but as I’ve pointed out — at what price? If you became sterile from a high DHT block (I am not saying that it will happen, but lets say hypothetically) the outcome is priceless (negatively speaking).
How do you determine benefit from a treatment if there has never been regrowth and further loss? I’ve used 2% minoxidil once a day for many years with out regrowth and continued loss. I continued on the assumption the loss might have been worse without treatment. But that’s just a guess. How do I know if I’m just wasting time and money? Do you assume that after many years the hair is going to become minox dependent regardless what the seen results are and quiting is a bad idea?
This is the problem that many people have. If you stop the medication and nothing happens, then the medication was having no impact… but if you stop the medication and the existing miniaturized hairs were dependent upon the medication, then reactive hair loss from withdrawal will be the problem. Most of the time restarting the medication does not return you to same status as before you stopped the medication. It’s kind of a guess that you have to make.
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Hello,
I am 25 years old and have a gradually receding hairline around the temples and thinning hair for about the past two years, but I’ve been wary of getting propecia because of the health risks, and I thought about Rogaine Foam, but I heard that it it smelled and led to shedding, among other things. Since I’m trying to hang on to everything I have left, I didn’t want to take the risk of incurring significant shedding with Rogaine, as well as no promise I’d grow any hair back around my temples or forehead, so I did nothing but occasionally browse message boards until I came across information on Revita. It seemed like just what I was looking for; a shampoo that would at least reduce hair loss/thining. Well, I started using Revita about 5 weeks ago, and the first time I used it, leaving it on my hair for 2.5 minutes, then approx. 4 minutes, and my hair seemed a little thinner, but shinier. The next day I got a haircut so my hair was a little shorter and I continued using Revita 5-6 days a week, for the prescribed times, and I’ve noticed I’ve shed a couple 1-4 hairs just about every time I use it. This has been exceedingly disturbing, but I’m not sure if it’s just something that has to happen before it starts working better . . . I don’t know.
My theory – the reason I’m still using it – is that the hairs that are shedding are the ones closet to my forehead and temples and these are the real light hairs that already seemed on the verge of falling off. So I’m thinking that maybe just keeping the shampoo in the hair for so long and then rinsing it out is causing the weaker hairs to come off b/c of the contact. I’m hoping it’s just the weak hairs that will shed and the healthier hairs will become even healthier. But so far, I’ve seen none of the benefits promised by the company.
Thank you very much
I need to make this very, very clear to everyone — there is no shampoo currently available on the market that can regrow your hair. None!
This Revita product contains ketoconazole, which is a volumizer and can increase the hair shaft diameter by about 7%. This increase in shaft diameter may look like you have more hair and in fact, considering that fullness is a result of numbers and thickness of hair, you will have more hair that produces more fullness. Any shampoo that uses ketoconazole will have the same effect. By keeping it on for a few minutes before washing it off, the ketoconazole probably does a better job with thickening the hair shaft.
For those keeping score, ketoconazole is the active ingredient in Nizoral, and is a commonly used antifungal medication and dandruff treatment.
Dr, I have been taking Propecia for 10 years. If the drug would indeed stop working, what exactly would happen? Would I have some form of telogen shed? Or would the loss be gradual? The reason that I ask is because I am going through a severe shedding phase that began in September of 2008 and it continues until now. I have indeed ordered the “generic” drug from overseas the past couple of years. Could the overseas drugs be bogus and this is the reason I began shedding again?
There’s two possible problems — the generic you bought overseas could be fake, or your finasteride dosage could just be starting to finally lose the fight to your genes. I often talk about a tug of war of sorts, where Propecia works on one side of the rope and your genes work against it. The genetic side appears to be slowly winning. Talk to your doctor about increasing your dosage to 2mg daily and see if that helps.
Whatever you do, do not stop the drug! You’ve taken the medication successfully for 10 years now, and it hasn’t stopped working for you… but if it’s not due to fake overseas medication, then it’s not slowing the hair loss as well as it was before. Stopping it completely will likely result in a massive catch-up hair loss situation occurring.
Why isn’t minoxidil taken orally? I’ve always been under the impression that drugs taken orally (like Propecia) get to the root of the problem as opposed to ones topically. For instance, if caffeine theoretically helped hair loss, I would think consuming caffeine would work better than putting caffeine on one’s head.
Minoxidil was originally used as an oral anti-hypertensive medication for the treatment of high blood pressure. It was unpredictable in its use so it was abandoned, but people taking it (women) would notice face and body hair appearing from the oral pills. That is why it is not used orally today, as it has a tendency to drop blood pressure. That even occurs when you apply it topically, as some of the medication is absorbed into the body after a skin application.
Okay, let’s say theoretically that saw palmetto does in fact help to block DHT. My question is, how the hell did they figure out that saw palmetto berries reduce DHT and not other berries out there such as cranberries and/or bilberries?
Saw palmetto has been around for hundreds of years and has been used successfully for treating prostate enlargement. Native Americans used saw palmetto to relieve urinary symptoms in older men who had difficulty in urinating. It has been shown to reduce prostate size and it is used quite frequently in Europe.
There are many potential side effects of saw palmetto, including abdominal pain, diarrhea, nausea and vomiting, erectile dysfunction, breast tenderness and loss of libido. That is the connection that made people think that there is a DHT blockade in process, as so much seems to parallel finasteride’s side effects. Some think that since finasteride works for the prostate and hair, then if saw palmetto works for prostate issues it must also work for treating hair loss. Unfortunately, saw palmetto has never been studied in any well planned clinical endeavor for treating hair loss.
Dear Doctor ,
i am thinking of buying nanominox fms , a product which combines minoxidil sulfate , finasteride and Ketoconazole. Do you think it is safe to use this topical solution on a daily basis? I would appreciate, if you could help me on that issue.
I have no experience with the combination of medications in Nanominox FMS. I am skeptical with it, because finasteride has not been shown to work through the skin. I suspect the FDA would, have a problem with any claims of a hair loss treatment from the manufacturer in the use of finasteride as a topical. Minoxidil is well known as a FDA approved topical treatment, and ketoconazole is a good antifungal medication that seems to make hair appear thicker. More info at their site. With regard to safety, your guess is as good as mine.
Dr. i wanted your suggestion about taking finasteride 5mg. i wanted your advice for not having finasteride 1 mg in our country bangladesh. the available finasteride is 5mg named “Prosfin”. you have researched the producing company name is “BEXIMCO”. you have found that they are producing finasteride 1mg named “Recur”. but 1thing u don’t know that “Beximco” has recently stopped production of recur. the Prosfin can’t be cut into 4 pieces, and at present i am taking Prosfin (Finasteride 5mg), 1 tablet/3 days. Now the concern is that taking finasteride 5mg 1/3days,can it cause any potential affect if i want to take a child, or want to have sexual intercourse while she is pregnant? can it affect the child? all things i am talking about taking finasteride 5 mg 1 table/3 days. i would not ask you these things if i could get finasteride 1 mg, or could break the 5 mg tablet. your blog is very informative.
This is an interesting problem. I’ve written to the drug company to find out more about their 1mg finasteride possibly being discontinued. For now, I suppose you might consider grinding the pill into a powder and taking 1/5th of that per day, assuming that the pill is the 5mg finasteride tablet. Make sure you keep it dry or it will pick up moisture.
Remember, the pill is not meant to be cut and the drug companies have designed it that way — so it’s not going to be an easy task.
