Just obtained my first Avodart pills, some questions/concerns

[GoldenMane]

Age 29
Hair loss started (probably about 23, gradual diffuse thinning/recession became very noticable at 27 when I started treatment. I was a diffuse thinning NW2.5 before treatment. Still NW2.5 or so, but significantly thicker and better coverage now.

finasteride for 22 months.
minoxidil 5% once a day for 20 months, twice a day for 2 months and 10% once a day on my hairline/temples for 2 weeks.
Nizoral for about 10 years.

Good regrowth and thickening, 100% coverage but still less thick than in my early 20s. Thinner than I would like at my hairline (under bright lights/sunlight can see through the front of my hairline, and my temple recession is still rather pronounced and cuts into my hairline.

Now I want to try dutasteride, specifically for thickening at my my hairline, and ideally for my hairline to widen/fill out a bit more.

I have just obtained 28 Avodart tablets, but before I take them I have several reservations.

1. Shedding. Will I experience significant shedding if I start Avodart? I had a significant amount when I first tried finasteride. I work as a teacher so it's very difficult for me to be shedding/thinning so publicy. Is it possible that since I'm already on finasteride, I won't shed?

2. Long term prospects. Some people say you should stick with finasteride until it stops working, save dutasteride as a fall back to buy some extra years at the end. Is this true? If finasteride stops working after 5 years and dutasteride buys an extra 5, who is to say that starting with dutasteride wouldn't have bought 10 years? Is t not better to minimise follicle exposure to DHT as early as possible by using the more effective drug?

Is this due to upregulation? That number of active binding sites on the cell membranes is increased as a result of lower DHT exposure, or is this something taht would happen regardless over time anyway?

I want a stronger hairline now, but I don't want to sacrifice my late 30s/40s.

3. I'm thinking of starting by using it twice a week, with finasteride the other days. I know it has a crazy long half life so might this be enough? My doctor will only prescribe me 28 pills max per prescription and I won't have time to go back to him for several months.

I'm aware that for some of these questions there is still a huge degree of certainty. I'm also aware that everyone responds differently, some regrow hairline, some do not. But I would be very interested in hearing from someone with experience.
I'm not concerned about side effects. If this doesn't improve my hairline, I'll probably get a transplant next year.

 

[bekims cousin]

I started dutasteride in June 2004, I was 28, it stopped my hair loss but not much regrowth, 11 years later, still doing okay.

Why don't you go for 10% or even 15% minoxidil twice a day, if you want regrowth.

 

[GoldenMane]

Thanks for the reply! Did you ever try finasteride or just go straight to dutasteride? How was your hair before/now? It stopped your hair loss for 11 years?

Yes I have considered upping my minoxidil dose, but 10 and 15% is quite expensive. I wear my hair long so minoxidil application is a little difficult, I tend to use larger amounts because some is lost on my hair. I also wonder if dutasteride may be better at preserving my hair long term, lower DHT exposure now could be a good thing long term, however I am still concerned about upregulation, if that is indeed why finasteride/dutasteride eventually stop working...

Should I start on dutasteride now? Or should I put it in the cupboard and wait a few years?

If dutasteride makes no difference, could switching back to finasteride maintain what I have?

 

[bekims cousin]

I tried finasteride for a year, really should have tried it for longer but after a year it had not halted the onset, so I went straight to dutasteride.

I was a NW2 by the time I started dutasteride and has kept me a NW2 for 11 years and counting.

 

[GoldenMane]

If it hadn't halted your progress after one year then it probably wasn't inhibiting enough DHT, I don't think more time would have made a difference, good to hear that dutasteride did work for you though, and for so long! That's certainly good news. Since finasteride has worked for me, I hope dutasteride works even better. Have you noticed any thinning or recession in the last 11 years?

 

[Wolf Pack]

This should be a good experiment for the forum if you document your progress with pictures. The way I see it, is going on dutasteride can do no harm. If it improves things you can stay on it, if it is the same as finasteride for you (which is may be), then go back to finasteride. I saw a trial which said it grows about 20-30% more than finasteride and better halting powers. But these are general rules, some people grow more than even minoxidil just on finasteride. There shouldn't be a shed with any 5AR inhibitor, just ride it out if so.

I don't believe in that nothing to fall back on approach. In fact once finasteride wears away after however long it takes, I don't see much dutasteride making much difference. The guy above found finasteride was not strong enough from the onset, that's a different issue entirely.

Twice a week is just right. Although a person got results adding it once a week but I feel 0.5 mg once a week works out to less than 0.1 mg per day which is less effective than Proscar. The long half life is only established once dutasteride reaches a steady state, ie not from 1 pill weekly.

I have a similar plan in my mind at some point perhaps, but still growing on finasteride slowly. 11 years for the guy above is not that long. I know a Doctor personally who has been on finasteride since 1999 with little change to his hair. finasteride trials show you're above baseline at 10 years 9/10 people. I reckon dutasteride could maintain for 3 decades in certain people, that would be impressive.

Good luck.

 

[Mja017]

Good luck man. Are you still in Japan? I responded to one of your updates about a year ago asking about Asia. I'm in Korea right now and in a similar position with finasteride, contemplating adding dutasteride. I recently learned that it was approved to treat hair loss here. Can I ask, how much a prescription for dutasteride is over there? I assume it'd be somewhat similar here, proscar cost me about 32,000₩ for 4 month supply (Only $30USD + $10 doctor bill [christ I love the affordability of medical care here]).

 

[bekims cousin]

If it hadn't halted your progress after one year then it probably wasn't inhibiting enough DHT, I don't think more time would have made a difference, good to hear that dutasteride did work for you though, and for so long! That's certainly good news. Since finasteride has worked for me, I hope dutasteride works even better. Have you noticed any thinning or recession in the last 11 years?

Not really, maybe a little but I am nearly 40, dutasteride was approved by the FDA in 2001?

I think I am the last person on the forum that has been using it for this long.

If Global was still around, he would be the longest. I think he would be on his 12 or 13 year mark.

 

[GoldenMane]

Good for you Mja! Epik program or Hagown? I have some sort of health insurance here, so I pay about 1000 yen ($10 US) to see a doctor, and another 2000 yen for the medication. Problem is that doctors will only give one month (28 tablets) at time so you have to go back every month.

Actually yesterday I decided to hold off on dutasteride for now. I just don't want to deal with months of shedding while I'm teaching here, it would really ruin my experience. Maybe I'll wait until I finish here next march and have a few months at home. I have no idea how much of a difference it may make, but I would literally be in hell for probably 3-4 months of shedding, right now I can't deal with that, especially not when I have to stand in front of teenagers next to NW1 dudes in their 40s all day. I took one capsule, hope it doesn't cause a shed...

I've also recently started 10% minoxidil, I feel like I should give that a chance first. If I get more hairline regrowth, I won't know whether it would be down to the dutasteride or minoxidil, so that's no way to conduct an experiment. One addition at a time. Not to mention, I have my two year check up/update with my hair loss doctor and it would be difficult to accurately gauge progress if shedding.

good to hear your hair is still holding strong bekims cousin!

 

[Oriol]

bekims cousin any side effects? you take it ED?

i've been on Avodart for some years now, but not as many as you. I think i'm on it for almost 8 years.

 

[bekims cousin]

bekims cousin any side effects? you take it ED?

i've been on Avodart for some years now, but not as many as you. I think i'm on it for almost 8 years.

ED, only got sides in the beginning, do you have any side effects?

 

[Oriol]

Maybe only watery semen sometimes, i think it's the only thing

 

[CliffLee]

I'm thinking of adding dutasteride and a higher dosage of minoxidil. I too want to make further gains around the hairline area which is still a little thinner. finasteride has drastically improved my hairs appearance but now, at the the 1.5yr mark, I feel that it has run its course.

Keep us updated !