Switched from fin to dut, how to tell if it's shedding or lost of hair - BaldTruthTalk.com
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  1. #1
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    Default Switched from fin to dut, how to tell if it's shedding or lost of hair

    I've been on fin for the last 12 years, it has helped maintain my hair for the most part. However, I've only recently learned about dut, so I added it to my fin regime. I'm taking both daily for the last 5 months.

    I've lost a lot of hairs in the crown area. My MPB is kind of visible right now. But I do see many tiny hairs in the frontal area.

    How do I tell if it's shedding, or it's lost of hair due to taking both med?

    I'm switching to just taking dut right now, and dropping fin completely.

  2. #2
    IAHRS Recommended Hair Transplant Surgeon Paul Shapiro, MD's Avatar
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    BaldingHelpMe
    I know there has been some reports of dutasteride and/or finasteride causing hair loss. In my practice I have never seen this. Also I have not seen this reported in the medical literature. Lastly it does not make sense to me that ones DHT would contribute to hair loss. I have noticed that Male Patter Hair loss in most men is not a gradual process but seems to go in stages. There is a stage of hair loss followed by a plateau. You stated that you were thinning on Finasteride so you are most likely in a stage of hair loss. Hopefully by switching to Dutasteride some of that hair loss will start to grow back.
    Finasteride only blocks one of the enzymes which convert Testosterone to DHT while Dutasteride blocks two of the enzymes. That is why Dutasteride will lower the DHT level greater then Finasteride. There is no need to take both at one time.
    There has been a study which shows that the higher dose of Dutasteride one take the more hair growth is seen. The dose that seemed best was 2.5 mg a day which is high and expensive. What dose are you taking?
    I agree that you should just switch to Dutateride and see give it time to work. If you are only taking .5 mg you may want to increase the dose to at least 1mg a day.
    I hope this is helpful
    Dr Paul
    Paul Shapiro, MD
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    Dr. Shapiro,
    First off, I have heard so many wonderful things about you, Ron and your entire clinic and the results give me great hope. Could you please explain the CONSTANT anecdotal evidence for finasteride induced inflammation, followed by hair loss. Several people on this forum and many other forums complain of severe itching, burning and tingling after being on fin for just a couple months and hair loss following that in the area of sensation. I didn't fully understand or believe this until it happened to me and it is still something I am going through. I had a HT done, just in the LEFT side of my head, around the hairline and about 2-3 inches behind, where I was thinning. Since being on finasteride for 6 months, EVERY night I notice burning and tingling primarily in the area of the transplant and I have lost A LOT of hair in that area. I just don't understand this drug. Thank you.

  4. #4
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    FYI - I had the transplant 2 YEARS ago

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    Quote Originally Posted by Paul Shapiro, MD View Post
    BaldingHelpMe
    I know there has been some reports of dutasteride and/or finasteride causing hair loss. In my practice I have never seen this.
    Dr Paul,

    Thank you for your reply. I'm not saying fin and/or dut causing hair loss, I'm saying is there a chance taking both causing hair loss. I've been on fin for the last 12 years, I've never seen shedding in the crown like this.

    I'm taking only 0.5mg dut daily at the moment, completely dropping fin. If taking 1mg dut daily, that would be taking two pills a day, would that be okay to do so?

  6. #6
    IAHRS Recommended Hair Transplant Surgeon Paul Shapiro, MD's Avatar
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    BaldingHelpMe:
    Just to review. Both Finasteride and Dutasteride work by blocking an enzyme called 5 alpha reductase which is the enzyme in our body that converts Testosterone into Dihydrotestosterone. There are two types of alpha reductase in our body, type I and Type II. Finasteride is a potent inhibitor of the type 2 reductase and mild inhibitor of type 1 reductase. Dutasteride is a potent inhibitor of both. If you are taking Dutasteride there is no need to take Finasteride since the Dutasteride blocks the type 2 receptor to a greater extent than Finasteride. So taking them both would be no different than taking only Dutasteride. If you want to take 1 mg of Dutasteride you can take two pills at one time, or one pill twice a day, which ever you prefer.
    As Jamesstt11 stated he has experience of hair loss from alpha reductase inhibitors. I use to be a Family Physician before doing hair transplants. One thing I saw is that there are people who react differently to medication then we would expect them to. We call this idiopathic response. For example I have had patients who Valium caused them to be hyper instead of calming. Fortunately these situations are very rare but unfortunately we usually cannot come up with a medical explanation. Maybe this is what he is experiencing. But it has to be very rare.
    Let me know how taking the Dutasterid goes. Remember it takes 3 to 6 months before you know if you are having a good clinical response to the medication.
    Dr Paul
    Paul Shapiro, MD
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    Paul,
    Recently my shedding seems to be subsiding a bit and while I do get scalp sensations, they seem to be minimal. At 6.5 months, would you, in your professional opinion recommend to keep on finasteride, despite the fact I have lost a bit of hair while on it? I am also starting to see some new hair grow where it wasn't before. I DON'T mean to clog up this thread with my personal issues, I just thought my own predicament could be helpful here.

  8. #8
    IAHRS Recommended Hair Transplant Surgeon Paul Shapiro, MD's Avatar
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    Jamesst11
    As you can see I cannot come up with a medical explanation for your experience.
    I have seen your threads and what you and the few others have reported. I know how frustrating this can be because we have no medical explanation at this time.
    What I do know is that there are articles that show that there is an inflammatory component to Androgenetic Alopecia in both men and women. We just had our annual meeting of the International Society of Hair restoration Surgery in Chicago. One of the talks was given by Dr. Bernard P. Nusbaum, from Miami. His talk was focused on Women with hair loss and he cited an article in which 33 of 52 female patients with androgenetic alopecia had significant microscopic evidence of inflammation. Some of these female patients experience the same sensation as you describe. I also in my practice have seen one male patient and a few female patients who have described itching, tingling, accompanying their hair loss. But I have never seen this correlated with taking a 5 alpha reductase inhibitor.
    Dr Nusbaum treated female patients with a combination of topical minoxidil, retinoic acid, corticosteroids and laser therapy and got some very good results. Maybe this type of treatment could be helpful to you.
    In most patients a 5 alpha reductase inhibitor should reduce inflammation but there may be a select group of patients where it can stimulate inflammation. This is just a guess.
    Sorry I cannot be more helpful
    Paul Shapiro, MD
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    Thanks Paul,
    It's o.k., endless research has also led me to the conclusion that this is very poorly understood. I suppose the most intriguing aspect of my shedding on finasteride is that it is only really happening where I had the hair transplants 2 YEARS ago.. This is ALSO the only area on the scalp I am having the sensations. Every single sensation and area of hair loss is EXACTLY correlated with the area of hair transplantation. It's just really weird. I thought I had already lost most of my hair in that area months after the HT, but now even more is falling out... hmmm...

  10. #10
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    Quote Originally Posted by Paul Shapiro, MD View Post
    BaldingHelpMe:
    Just to review. Both Finasteride and Dutasteride work by blocking an enzyme called 5 alpha reductase which is the enzyme in our body that converts Testosterone into Dihydrotestosterone. There are two types of alpha reductase in our body, type I and Type II. Finasteride is a potent inhibitor of the type 2 reductase and mild inhibitor of type 1 reductase. Dutasteride is a potent inhibitor of both. If you are taking Dutasteride there is no need to take Finasteride since the Dutasteride blocks the type 2 receptor to a greater extent than Finasteride.
    Dr Paul,

    Thanks so much for your reply. The problem is, I've been on fin for the last 12 years, it has help kept my hair for the most part, and I've never experienced shedding like this before. My crown area is very visible now.

    However, I got greedy and added dutasteride to my daily regime, and I had a big shed. Since dut has such a long half-life, I've decided just completely drop fin, and go forward with dutasteride daily now. I'm really gambling with my life, if I go bald, my life is over.

    If you think I should stop dut, and take fin only, please let me know.

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