Finasteride losing effectiveness after 17 months, building up tolerance or what? (Blood Tests)

[GRme11]

Here is my thread with a lot of information : https://www.gourmetstylewellness.com/intera...-hormones-kinda-messed-up-need-advice.128404/

I will get straight into the point according to my title. So, I have been using oral Finasteride for 17 months (I am using as well Minoxidil for almost 3 years and topical Finasteride for almost 2 years as well). In the beginning, I started noticing a thickening into my existing hair, etc. From February though, I started losing the thickening and my hair are feeling thin as well (and my pictures that I am taking, are not lying to me). In either case, not as good as before. From my latest blood tests, it seems that my body have adjusted to Finasteride and build up a tolerance. Even if hormones are fluctuating a lot throughout the day, my blood tests results are making me very worried about drug efficacy. Here, I will report my full log of DHT/Androgens related blood tests:

August 2019: Started Topical Finasteride:Baseline levels of DHT: 541 pg/ml
Otober 2019: DHT levels:302 pg/ml
January 2020: DHT levels:298 pg/ml-After starting Oral Finasteride as well ( I was already on it for about 3 weeks-0.5mg 3 times/week)
May 2020: DHT levels:313 pg/ml-I jumped into 1mg daily from 31st of March. I jumped to 0.5mg everyday from mid February
June 2020: DHT levels:283 pg/ml- I even tested 3a-Diol-G which is far a strongest indicator than DHT alone. 3a-Diol-G is a major DHT metabolite and it can converts back to DHT as well. It came low at 1.3 ng/ml while the range is: 3.4-22.
September 2020: DHT levels: 383 pg/ml
January 2021: DHT levels: 550 pg/ml !!! Back to baseline!-I checked as well my PSA levels and it was 0.23 ng/ml but I don't have baseline levels unfortunately.
May 2021 (Latest): I skipped DHT this time and tested only 3a-Diol-G. I got a result of: 16.1 this time!!! It makes sense, doesn't it? Higher DHT->Higher metabolite->Higher Androgenicity overall. I assume that my DHT is still high!

So, these results are pretty worrying for me. I know that sensitivity matters most, I know that hormones can fluctuate a lot, but you can see that something negative is happening here. What should I do? Should I jump to dutasteride? Should I continue with finasteride? I really don't know..

Thank you very much for your time, appreciate it!

 

[GRme11]

Anyone’s opinion? Thank you.

 

[DuncanOP]

What is the name of the test? From the baseline level, I will assume that is not ELISA and that is good, since ELISA typically give me strange results.

Your DHT seens a little high, but the important is the DHT that go to the scalp.

I think you should check if you are shedding or the hair still thining, that is more important than the exam results to conclude if finasteride is working or not.

But if you are afraid of it, maybe add another capsule of finasteride from other company

 

[GRme11]

What is the name of the test? From the baseline level, I will assume that is not ELISA and that is good, since ELISA typically give me strange results.

Your DHT seens a little high, but the important is the DHT that go to the scalp.

I think you should check if you are shedding or the hair still thining, that is more important than the exam results to conclude if finasteride is working or not.

But if you are afraid of it, maybe add another capsule of finasteride from other company

Hello and thanks for responding.

I don’t know the type of test. I know that scalp DHT and sensitivity matters most, but these indications from my blood tests are pretty worrying. As I mentioned above, hair quality it’s not the same as before, especially when it’s comes to thickening. Also, I can now see small and miniaturized hair in my left temple for example, that they were bigger and stronger before. Seems like the miniaturization has started again. I am using original Propecia brand.

 

[DuncanOP]

Since the miniaturization is starting again (and exams are displaying a little high result), I think you should go to a dermatologist as sooner as possible. Hopeful he will recommend to use something more strong, like dutasteride, then it will be enough to hold the baldness process.

 

[GRme11]

I want to hear more opinions before I decide what to do. So, if you have some spare time, please share your opinion. I would highly appreciate it. Thank you.

 

[GRme11]

Any further recommendations? Thank you.

 

[ManeTaine]

Any major life changes? Stress/Poor sleep/Diet, etc around the same time you started noticing changes? It very well could be your body has gotten acclimated to it. Did you do the tests the same time of day/under as similar conditions as the first time? You could try bumping finasteride to 1.25mg daily or switching to dutasteride/topical dutasteride (depending how well you tolerate finasteride) or adding something like RU if you're open to it.

It's also possible you've maxed out minoxidil growth at the current dosage as it was masking the hair loss previously.

 

[GRme11]

Any major life changes? Stress/Poor sleep/Diet, etc around the same time you started noticing changes? It very well could be your body has gotten acclimated to it. Did you do the tests the same time of day/under as similar conditions as the first time? You could try bumping finasteride to 1.25mg daily or switching to dutasteride/topical dutasteride (depending how well you tolerate finasteride) or adding something like RU if you're open to it.

It's also possible you've maxed out minoxidil growth at the current dosage as it was masking the hair loss previously.

1) I started correcting some vitamin deficiencies that I have (e.g Vitamin D3)
2) I really think that the resistance phenomenon could be possible.
3) Tests were performed every morning as it should, same conditions, etc and I was taking my Propecia as well, the night before. I’ve never missed a dose.
4) Like I said, I was thinking to add Dutasteride once a week with Finasteride as well and see how it goes.
5) Yes, minoxidil plateau makes sense as well.

Thank you very much for responding.

 

[jazz1]

You switch medication brand with the Finasteride?

 

[GRme11]

You switch medication brand with the Finasteride?

Nope. I started with the original Propecia brand. Never changed.

Thanks for responding.

 

[Mustang]

This guy is having awesome results. His protocol also includes oral dutasteride, minoxidil and dermarolling so it can't be attributed to topicals. Since he was wearing a wig for many years before this I suspect orals only didn't work great in the past and it's the combination giving him this drastic changes but I am speculating.

His protocol:

- I've been with Dr. Mwamba's topical dutas and mesotherapy dutas for 2 months, I am very happy.

- I have less than 2 months with dutas and oral minoxidil.

- I started to medicate in April (finasteride and topical minoxidil) after 4 years using prostheses.

- I use dermaroller several times a week

Go for the hair!

A hug colleagues and happy summer!'

https://www.hairestorationetwork.com/topic/59956-keep-and-fight/

 

[jazz1]

That’s awesome results.

 

[GRme11]

Please, any further suggestions/recommendations? Thank you.

 

[GRme11]

If it was me I would contact the website/seller and question the legitimateness of that Finasteride given that it's not reducing your DHT levels. I would consider also testing it or trying different places were you are getting it from - depending on your financial situation. I am not sure I have seen anyone with their DHT levels unchanged after starting the medication or how possible it's to develop this type of resistance.

Anyway if everyrhing is correct then you need to upgrade the game, possibly with dutasteride mesotherapy leaving ur serum levels relatively normal and possibly avoiding the same scenario.

Thanks for responding.
I am buying Finasteride/Propecia from a legit good local pharmacy. I believe being fake is not a possibility. Also, my DHT levels dropped as they should, so I guess legitimacy is not a problem. I have seen/read cases that DHT didn't drop at all, and this is more inexplicable. I will try to do another blood test in a different lab. Yes, you can see that for everyone, something is different, like the reaction, responsiveness, etc. I was thinking something like topical dutasteride at the beginning, combined with my current treatment.

Read here as well if you have some spare time:https://www.gourmetstylewellness.com/intera...-hormonal-route-hair-life.109288/post-1999376

 

[lanko]

you may have very active 5AR. It could be worth switching to dutasteride, though i would still take finasteride for the first few months as dutasteride takes time to build up in your system .
I've also had high DHT on finasteride, above normal ranges and continued to have hair loss. I switched to duta and it's been a bit over a year and the hair loss seems to be stabilized. My DHT is within normal ranges now on duta, not low like one would expect. I know of one other person with a similar experience. Though our baselines were crazy high @ >3k pg/ml

 

[GRme11]

you may have very active 5AR. It could be worth switching to dutasteride, though i would still take finasteride for the first few months as dutasteride takes time to build up in your system .
I've also had high DHT on finasteride, above normal ranges and continued to have hair loss. I switched to duta and it's been a bit over a year and the hair loss seems to be stabilized. My DHT is within normal ranges now on duta, not low like one would expect. I know of one other person with a similar experience. Though our baselines were crazy high @ >3k pg/ml

Thank you for responding and for sharing your experience. I am already considering Dutasteride.

 

[GRme11]

My hair feels very thin and fine, like multiple thin threads I can't explain better. Even the sound when I am breaking a hair sounds like cutting a thread. Again, I tried topical dutasteride on Monday, and I again had the same thin feeling as my previous 3 applications that I tried (https://www.gourmetstylewellness.com/intera...de-case-assessment-thread.128798/post-2005417 f*** scalp T if it's the case, just f*** it!). I lost the thickness and the volume that Propecia gave me. I receded again on my temples, and my hair feels lifeless. I don't know if I should continue with dutasteride, but what are my options? I have to try something! (Is a double-edged sword because of scalp T). How they destroyed me like this mentally, I couldn't even believe it. Sooner or later, I can see that I will go all-in.

 

[Mustang]

So you are saying that one application of topical dutasteride took away the volume that Finasteride gave you?

Androgenic alopecia doesn't work that way. It takes months to see any change on the hair cycle, shaft diameter.

If Free scalp T is indeed your issue then an anti androgen (CB or Fluridil) would be the only thing that would help.

 

[GRme11]

Topical Dutasteride induced Telogen Effluvium/Hormonal Imbalance? I am now thinning on the donor area+sides. I am about two months into topical Dutasteride 3 times per week 0.1%(consistent use). This was not the case a few months back since Finasteride thickened pretty good my sides and donor area. It seems that Dutasteride triggered something. I feel that my hormones could be further out of whack. Even when I started applying for the first week, I became more emotional, and I started crying at random times, more furious, etc. Anyone else experienced this thinning all over? Thank you.