Balding Blog

Hi, Dr Rassman.

I’m a caucasian male, 30 years old.

Can thyroid problems hasten or kick start the balding process? I’ve been diagnosed with hypothyroidism and have experienced early signs of MPB around the same time. No member of my immediate family has severe hair loss and certainly hadn’t lost any by age 30.

If propecia’s half life is so short, and only reduces DHT in the body modestly, for only part of the day, why then can it be so effective at treating hair loss? Are there other, hidden attributes to Propecia that we do not yet understand that is helping millions of men stave off the shiny dome?

Thanks, Doc. You have a great site, and I’m a daily reader!!

Thyroid problems can precipitate hair loss and hair texture.

You are correct in stating that Propecia’s half life is short (about 4-5 hours). That is why you need to take it everyday. There is also tissue fixation of the drug that probably reflects a longer tissue hair life (not easy to measure) that may hold the effects on the hair follicles. The testing on hair regrowth and hair counts were done with various doses from 20mgs per day down to less than 1 mg per day. The results were published showing that the 1mg dose was as good as a higher dose in treating hair loss. As many of you know, finasteride is packaged in a 5mg dose as Proscar (or generics), which is used for treating prostate disease. Seeing as how Propecia is the same medication, it may also help your prostate health.

Propecia reportedly works best regrowing recent hairloss, but what is considered recent? Hair lost the last 6 months? The last year? Longer?

Propecia (finasteride 1mg) works best for men who are actively losing hair. If you are totally bald, it will not regrow hair. Propecia works best if you have many miniaturized hairs, if you are under 30 years old, and if the hair loss has occurred over less than 2 years (this does not necessarily mean that it won’t work with more chronic hair loss, though). I often write about getting a miniaturization study to document a starting point, particularly before you get on a drug to treat your loss.

I’m 23 years old with early frontal thinning but am currently a NW2. So I been on Propecia for 7 months now and everything is the same! By now I assume I should have seen if my hair was getting thicker or regrowing so I guess I should be happy if I just get to maintain. Now my question is if I won’t get any regrowth or my miniaturized hairs won’t get thicker are my chances to maintain my hair the way it is right now lower for 5 years which is the number of years for most men!? Because I read something that your hair count increases the most the first year and then gets less and less each year. So if I get nothing this year, I mean in like 5 years I will definitely look thinner although probably better then without Propecia but still thinner and I don’t want that.

The peak result from Propecia seems to occur by about 18 months, then some loss is common in the hair counts done by the drug company, Merck, in their FDA studies (over a 5 year study period). Some people have held their hair for years, while others slide in the hair counts. I can’t say for sure how you’ll respond to the medication, so I wouldn’t know how you’ll be 5 years on. I don’t know of any data that shows regrowth (or lack thereof) from Propecia correlating to the length of time the medication can halt your hair loss.

I started taking propecia when i began noticing my hairline receding and hair becoming thin in the crown. About 1 year later i decided to give dutasteride ago. Throughout both medications my testosterone increased quite alot, causing increased libido to such a degree that i was getting an erection almost 3 times a day compared to almost never (unless needed) when i wasnt on the medication. i have been taking these medications now for 3 years and my testosterone shows no sign of of decreasing back to normal.

My question is, if i am taking medications to reduce as much DHT as i can and my medications are actually increasing my testosterone which inturn is creating more DHT as its a by product isnt it a paradox and useless. I have however heard that this increased testosterone isnt almost a momentary thing that may last a while because my bodys thinking ‘we need to make more testosterone’ due to the decrease caused by the medication.

Thanks NHI Team

Few men will complain of an increased libido or an increase in the frequency of erections. As you noted that the increase in erection function has been now two years since you started it, I would imagine that it will continue. How do you know your testosterone levels increased? Did you have them measured before and after you are taking Propecia and/or dutasteride? These blood levels need to be compared to the normal values established by the lab testing you.

The connection with your sex drive and the DHT block from the drugs you are taking, and possible increased levels of testosterone are unclear. Without knowing testosterone levels before and after you started taking the DHT, I can not tell you much. I personally think that you are going overboard with analysis here, and should just enjoy the moments as long as everything is working well.