Why is the recommended finasteride dosage for treating BPH 5 mg?

whatevr

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If 1 mg and 1.25 mg and everything above is equally effective, then why is the dose for prostate issues 5 mg?
 

g.i joey

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i think it has a therapeutic effect on prostate with the higher dosages, i could be wrong though just assuming.
 

Afro_Vacancy

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The flat response curve of finasteride refers only to DHT levels in the blood.
 

shulk

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good question.

I think this is because there is more variation in result on lower dosages. For some people it would be enough, for some it is not. At 1mg it works for pretty much everyone and the return is more consistent. The way to even this out is by including more people in the testing groups.

The Japanese way of thinking is not too strange if you look at the study though. You start at 0.2mg, if it proves not to be enough you up the dose with another 0.2mg up to the point of 1mg max. By straight jumping on 1mg a lot of people are on a higher dose than needed. Most people in Japan still ask for 1mg right away though, this is because it has the highest succes rate and basically shows a pretty line in the chart bellow (from an interview with a Japanese hospital). A lot of people don't want to take chances when it comes to their hair, that is understandable.

The image they refer to is the following and is taken from the following Japanese study:
http://www.ncbi.nlm.nih.gov/pubmed/15319158
20101020031648062.png
 

Ventures

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Maybe 0.25 mg finasteride dose is similar to 1 and 1.25 mg doses in terms of hair regrowth, because 0.25 mg contains enough molecules to block all scalp DHT.

And when it it comes to BPH, you need more finasteride. molecules cause there is greater concentration of DHT in prostate tissue than in scalp. Please, correct me if I am wrong.

I think it's wise to start with 0.25 mg dose first year(s) and then to upp to 0.5mg and 1mg dose.
 

Afro_Vacancy

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how is .05 more than .2, something is definitely off here.

The correct way to read the graph is that they're equal within the margin of error. The effectiveness is the same, but you get small variations due to small number statistics. If one person rolls two dice 100 times, they might get "7" 18 times, and the other person 16 times, but they're really rolling the same dice and playing the same odds.

Really, 0.05, 0.20, 1.00, and 5.00 mg all produce an equal effect on DHT levels in the scalp, the finasteride response curve is completely flat. Your scalp is thus saturated in finasteride for all doses of 0.05 mg or greater. However, at 0.01 mg the effectiveness is much lower than at 0.05 mg. Note that they only measured the response at 0.01 and 0.05 mg but not at 0.02, 0.03, and 0.04 mg. We don't know where the declining response happens.

In contrast, the blood DHT level does look like it falls off between 0.05 and 0.20 mg, the former gives you a 50% reduction and the latter a 70% reduction. If you assume that blood DHT levels are what causes side effects, then to decrease your side effects you need to go below 0.20 mg/daily. But again, they only measure 0.05 and 0.20 mg, they don't measure any of the numbers in between and thus we don't know where the flat response curve begins.

If we make the (rational) assumption that the best dose of finasteride is whatever dose maintains a ~70% reduction in DHT but minimizes the offset in blood DHT, then that is some dose between 0.01 and 0.05 mg daily.

It is impossible to cut a pill this small, your only solution would be a solution, pun intended :) You'd have to crush the finasteride tablets into fine powder, and dissolve them in everclear, and drink something like a teaspoon a day.
 

whatevr

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Yeah, but then you have people like me who don't even maintain on 1.25, so forget about 0.05 and such... And tbh, I wouldn't want to take my chances with anything below 1 mg either.
 

Afro_Vacancy

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Yeah, but then you have people like me who don't even maintain on 1.25, so forget about 0.05 and such... And tbh, I wouldn't want to take my chances with anything below 1 mg either.

If you don't maintain with 1.25 then you won't maintain with 5.00 or 25.00 either. What this means is that a 65% reduction in scalp DHT is not enough for you to maintain.
 

whatevr

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Yep, I'm aware of that. Hence I will jump on dutasteride this summer.
 

shulk

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Really, 0.05, 0.20, 1.00, and 5.00 mg all produce an equal effect on DHT levels in the scalp, the finasteride response curve is completely flat.


I don't think this is true, this would assume that every person reacts the same to DHT inhibition and/or produces the same amount of DHT.

An example:
Person A: reacts to 0.05mg 100%, reacts to 0.2 100%, reacts to 1mg 100%. The response is "flat"
Person B: reacts to 0.05mg 80%, reacts to 0.2 100%, reacts to 1mg 100%. Response is relatively flat.
Person C: reacts to 0.05mg 60%, reacts to 0.2 80%, reacts to 1mg 100%. Response is not flat at all.

If you where to take 1mg, you'd now have a 100% success rate, at doses below, the success rate drops.

I assume the drake study groups where too small to even out enough. 0.05 got more A persons in total. 0.2 got more B persons in total.

When you look at the Japanese study chart it displays a difference in effect between 0.2 and 1mg. If it was truly flat for everyone it should not have done this.

By jumping straight on 1mg you waste the possibility that you are a type A person, but improve your overall chances for succes. At least, this is how i interpret these studies at this time.

God speed to the type D persons!
 

Afro_Vacancy

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Correction, the difference between 0.20 and 1.00 mg in the Japanese study is not statistically significant. If you look at day 48, which is the last data points, the difference between the two is roughly ~70% of the 1-sigma error combined in quadrature, assuming that they are showing 1-sigma and not 2-sigma error bars. Further, the difference is roughly ~5% of the amplitude of the effect, even though the dosage is 500% higher.

I would expect that the finasteride response curve would be linearly shifted due to body weight.
 

shulk

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well you seem to know more about statistics, i am only using my own logic. My datamining/statistic classes where a joke :fun:.

Why are you on 1.25mg of finasteride though?
 

whatevr

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You asking me?

Simply cause I cut a 5 mg Proscar pill into quarters.
 

Afro_Vacancy

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well you seem to know more about statistics, i am only using my own logic. My datamining/statistic classes where a joke :fun:.

Why are you on 1.25mg of finasteride though?

Because I had neglected to update it, thank you for reminding me. I also updated my signature.

Anyhow, if someone wants to try this, finasteride is lipophilic, which means it can dissolve in fats and oils.
http://www.extremepeptides.com/blog/finasteride-part-2/

1) Crush ~7.5 mg of finasteride into a fine powder, really fine, as fine a spossible;
2) Dissolve it very carefully in a little bit of oil, using a spoon or something to mix it well;
3) get 750 ml of an oil (e.g. pumpkin seed oil, olive oil, etc) , which is the standard bottle size, and dissolve it fully, mix and shake well.
4) Have a teaspoon a day. This gives you a supply of 150 days.
5) If you do 10mg of finasteride in 1 litre of oil, you have a supply for 200 days.

That is the minimum demonstrated effective dose: 0.05 mg daily, for which you have the same scalp inhibition but serum DHT levels are reduced by 50% rather than 70%. The same source material shows no benefit to 0.01 mg daily, with no experimentation being done on 0.02, 0.03, and 0.04 mg daily.
 

whatevr

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You know, I wanted to do something like this with Dutasteride. My idea was to get several grams of Dutasteride powder, and then mix it with some 96% ethyl alcohol.

Math would go like this:
Daily dose = 0.5 mg, 1 g of powder = 2000 doses = 5.47 years, due to dutasteride shelf life buy at most only 0.5 g of powder
And then...
Mix 0.5 mg / mL, so 500 mg powder mixed with 1 liter of ethyl alcohol. Over 2 and a half years of treatment. One dropperful would equal daily dose.

Only problem is I don't know where to get legit dutasteride powder. There are some on Alibaba but I don't know if I can trust that.
 

Afro_Vacancy

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You know, I wanted to do something like this with Dutasteride. My idea was to get several grams of Dutasteride powder, and then mix it with some 96% ethyl alcohol.

Math would go like this:
Daily dose = 0.5 mg, 1 g of powder = 2000 doses = 5.47 years, due to dutasteride shelf life buy at most only 0.5 g of powder
And then...
Mix 0.5 mg / mL, so 500 mg powder mixed with 1 liter of ethyl alcohol. Over 2 and a half years of treatment. One dropperful would equal daily dose.

Only problem is I don't know where to get legit dutasteride powder. There are some on Alibaba but I don't know if I can trust that.

Do we have the same level of infomation on dutasteride?
Is dutasteride soluble in alcohol?
Why not just crush dutasteride pills?
 

whatevr

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Do we have the same level of infomation on dutasteride?
Is dutasteride soluble in alcohol?
Why not just crush dutasteride pills?

See here: Solubility:Soluble in ethanol (44 mg/ml), methanol (64 mg/ml), polyethylene glycol 400 (3 mg/ml), and DMSO (62 mg/ml at 25° C 117mM). Insoluble in water.

Well, because price. If I have to buy dutasteride pills I might as well just eat them as usual. Costs me 30 EUR a month.

Powder would be much cheaper. On Alibaba the prices are around 150USD for 5 grams. So that's about 30 dollars for 5 years of treatment.

Even if you bought it on SigmaAldrich which is a lot more expensive you'd still only pay about 50 cents per day which is half of what you'd pay for the pills.
 
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