Start fin and min at the same time or separately?

[JDW]

Thanks for the response I will give a double dose of Dut a go and see what happens.
Thanks

[PatientlyWaiting]

Same time I would say. Because they work differently, and they work well together.

[Herbaliser]

There are some patients who do not respond to these medications. The studies showed that 90% of patients respond to Finasteride. You may be in that 10% who don't respond. What I would suggest is to stop the finasteride and start Dutasteride at a higher dose. In the studies on Dutasteride they used up to 2.5 mg a day and saw more growth on that dose. I know it is expensive. This may help.
There is no need to take Finasteride if you are taking a large dose of Dutasteride.
Also I would suggest seeing a dermatologist that specializes in hair and possible getting a biopsy. Sometimes other dermatological conditions such as diffuse Alopecia Areata and Difuse LPP can look like Male Pattern Balding.
Hope this is helpful.

Can you please provide us the studies?
Who made the studies, and how many where participating in this study?
And you are suggesting to take Dutastaride! at a higher dose, and i really hope as a surgeon as you are to think twice what you are recommending.

[BaldingEagle]

Can you please provide us the studies?
Who made the studies, and how many where participating in this study?
And you are suggesting to take Dutastaride! at a higher dose, and i really hope as a surgeon as you are to think twice what you are recommending.

He's a doctor and has a reputation to uphold. Not to mention a lucrative career at risk. I highly doubt he would risk his reputation if he wasn't confident in his advice.

You're starting to get ridiculous man. Criticizing a doctor with a very good reputation for no other reason but your own distrust.

You have zero expertise or credentials and you push your silly home remedy that has only anecdotal evidence based on you and you alone.

Starting to seem like you have an agenda...

[Balding Bad]

Here are my answers to the questions posted today.
When using both Finasteride and Minoxidil the shed should be about the same as using only one. It would not be double the shed. And don’t worry, if you do shed, it usually is not a large percentage of hair. We shed about 100 hairs a day naturally and don’t even notice it. The shedding may make you look a bit thinner, but not significantly thinner in most cases. And in 3 months you will look thicker. If the shed bothers you, using cover up like DermMatch can help. But if you are exteremely worried about shedding I would just start the Finasteride and wait 3 to 6 months to start the Minoxidil.
The reason for the shed is that some of your hairs that are in the growing stage when stimulated to grow more by these medications go into the resting phase and shed. This resting phase last about 3 months. But only some of the growing hairs do this. We are not exactly sure why.
Ketokonalzole is an antifungal agent which also has an anti-inflammatory effect. We don’t know why it helps prevent hair loss in some patients, but it is not as effective as Minoxidil.
As I said if a patient is very worried about the shedding I would start Finasteride first. Since it will block the formation of DHT which is the cause of male pattern hair loss it is much more affective then Minoxidil. And studies have shown that the sooner one starts Finastgeride the better it is for hair loss. Then if you want to try Minoxidil down the road you can start it.
I have a lot of patients that are only on Finasteride because they do not like the hassle of Minoxidil or it irritates their scalp.
One can start both together, of start the Finastride first. I consider Minoxidil an adjunct in helping thicken hair. The only patients I have only on Minoxidil are ones who cannot tolerate Finastride and female patients.
I hope this is helpful
Dr Paul

Hi Dr. Paul, many thanks for the thorough reply, it's greatly appreciated. Your response has lessened my paranoia with the potential double shed.

Although I'm curious, does the shed happen with everyone and if so typically at one point does it begin?

I am supposed to be receiving my Min before my Fin, so not sure if I should start right away or wait until I receive my Fin (which I'm not too sure when that's going to be).

Regardless thank you for your response!

[Paul Shapiro, MD]

Blading Bad
No the shed does not happen in everyone. I am on Dutasteride and never had a shed. As to when it starts, Usually in a few months. But I have seen it start sooner or later. Even as far out as 4 months. You may as well start the Min when you get it. But you can also wait.
That is up to you

[JohnMPB]

Dr. Shapiro what have your results been like on dutasteride? Were you on Finasteride before? How long have you been on each respectively.

[Paul Shapiro, MD]

As you can see from my photo I am lucky and I do not have much hair loss at 60. The only area I follow is my frontal temporal angle. On Finasteride I saw no change. O Dutasteride it thickened up. I don't look at my crown so I can not comment on if there is a difference or not.

[Herbaliser]

He's a doctor and has a reputation to uphold. Not to mention a lucrative career at risk. I highly doubt he would risk his reputation if he wasn't confident in his advice.

You're starting to get ridiculous man. Criticizing a doctor with a very good reputation for no other reason but your own distrust.

You have zero expertise or credentials and you push your silly home remedy that has only anecdotal evidence based on you and you alone.

Starting to seem like you have an agenda...

Heīs a doctor, as my sister in law that is a real doctor.
Why do you think he has a good reputation in a forum like this seriously? To earn money of hair loss and promoting the drugs for obvious reasons.
And yeas the drugs he claims to be using is for other reasons in the first place, and why canīt he stand up for heīs claims, and answer seriously to confronting questions also?

You guys really are puppets.

[jamesst11]

Heīs a doctor, as my sister in law that is a real doctor.
Why do you think he has a good reputation in a forum like this seriously? To earn money of hair loss and promoting the drugs for obvious reasons.
And yeas the drugs he claims to be using is for other reasons in the first place, and why canīt he stand up for heīs claims, and answer seriously to confronting questions also?

You guys really are puppets.

Herbaliser,
I think we are all intelligent enough to understand where you are coming from. I personally have a masters degree in the subject and was a professor of it for years. Once again, most of us are smart enough not to blindly trust all pharmaceutical companies, the FDA and most doctors and that is WHY people are on here, being skeptical, hesitant and asking a lot of questions. WE also want to ACTUALLY stop our hair loss as it is a devastating condition, for some life-hindering or even life ending. There has NEVER been a documented report of any one reversing or stopping AGA with natural, herbal treatments, I am sorry, the evidence just does not exist.
Just like st. john's wort can SLIGHTLY help increase mood in CERTAIN people, some people would be doomed, literally doomed, living a life of gut twisting anxiety and depression without xanax or another strong MAN MADE compound. Does that mean that I recommend taking these? NO. It means that sometimes the scales are balanced in a way where taking an EDUCATED risk is necessary. How can you, a seemingly intelligent adult not agree with this? Do you think that every single person's scenario is the same as yours? My own GF takes xanax and, despite knowing what I know about bio, I would never ask her to reconsider... The alternative is her being awake every hour of the night in cold sweats with mind crippling anxiety.. So, what's your advice for her? an herbal concoction? maybe a therapist? Well, she's tried it all.
THE SAME goes with hair loss. You preach to us so hard that we are puppets and living in a box, yet by doing so, you become your own accusation. SOME PEOPLE on here CANNOT SLEEP, go out in PUBLIC, and are devastated, ashamed and afraid of their situation. SO? ONCE AGAIN I ASK... take a completely unproven herbal formula? see a therapist? or maybe they should be like you and just not care so much about it? That's pretty easily said man.

My point is this - For those living in hell, that have become victims of hair loss itself or a bad hair transplant, that have tried everything else, TAKE THE RISK. But, do it smart and do it slow. and, if there's one thing you can manage, it's your expectations.

As for what you're saying about Dr. Shapiro, just stop because you have NO knowledge of the man or his clinic. They have a strong reputation for giving solid advice and helping people. If DUT has worked for him, then that is just that, nothing more. It has worked for a lot of people. I advise spending more time researching this topic rather than just talking about it.

[Herbaliser]

Herbaliser,
I think we are all intelligent enough to understand where you are coming from. I personally have a masters degree in the subject and was a professor of it for years. Once again, most of us are smart enough not to blindly trust all pharmaceutical companies, the FDA and most doctors and that is WHY people are on here, being skeptical, hesitant and asking a lot of questions. WE also want to ACTUALLY stop our hair loss as it is a devastating condition, for some life-hindering or even life ending. There has NEVER been a documented report of any one reversing or stopping AGA with natural, herbal treatments, I am sorry, the evidence just does not exist.
Just like st. john's wort can SLIGHTLY help increase mood in CERTAIN people, some people would be doomed, literally doomed, living a life of gut twisting anxiety and depression without xanax or another strong MAN MADE compound. Does that mean that I recommend taking these? NO. It means that sometimes the scales are balanced in a way where taking an EDUCATED risk is necessary. How can you, a seemingly intelligent adult not agree with this? Do you think that every single person's scenario is the same as yours? My own GF takes xanax and, despite knowing what I know about bio, I would never ask her to reconsider... The alternative is her being awake every hour of the night in cold sweats with mind crippling anxiety.. So, what's your advice for her? an herbal concoction? maybe a therapist? Well, she's tried it all.
THE SAME goes with hair loss. You preach to us so hard that we are puppets and living in a box, yet by doing so, you become your own accusation. SOME PEOPLE on here CANNOT SLEEP, go out in PUBLIC, and are devastated, ashamed and afraid of their situation. SO? ONCE AGAIN I ASK... take a completely unproven herbal formula? see a therapist? or maybe they should be like you and just not care so much about it? That's pretty easily said man.

My point is this - For those living in hell, that have become victims of hair loss itself or a bad hair transplant, that have tried everything else, TAKE THE RISK. But, do it smart and do it slow. and, if there's one thing you can manage, it's your expectations.

As for what you're saying about Dr. Shapiro, just stop because you have NO knowledge of the man or his clinic. They have a strong reputation for giving solid advice and helping people. If DUT has worked for him, then that is just that, nothing more. It has worked for a lot of people. I advise spending more time researching this topic rather than just talking about it.

Donīt you think i know what iīm talking about?
YEAS my syster in law knows about these drugs, and would never in here life recommend or prescribe them for hair loss period.
I feel sorry for you also, but seriously do a reality check, and figure out the forums profit reasons.

Seriously a doctor recommending dut for hair loss, without hesitation should not be considered as a doc .
But then again is the US we are talking about, so profits before health at any cause.

[Balding Bad]

Hi Dr. Shapiro -- so both my minoxidil and finasteride has finally arrived. I am prepared to make the plunge with both, however I must confess I am now extremely hesitant and cautious with beginning finasteride.

My friend who has been on finasteride for 6+ years has had extremely great results and has experienced none of the sexual side effects, which is why I decided to order it in the first place, however after reading about the potential sexual side effects and watching YouTube testimonials of depressed, regretful, and broken individuals who have experienced said sexual side effects, I must admit that this is very worrisome to me.

Anyways, my question is if I happen to unfortunately succumb to the sexual side effects of finasteride and if I was to cease taking it, would I lose any potential regrowth or would I be able to retain it since I intend on staying on minoxidil indefinitely? Would the minoxidil sort of counter-act or help maintain what I was able to keep with finasteride?

[Paul Shapiro, MD]

I understand your nervousness and you need to weigh risk benefits. I can not do that for you. If the risk of side effects makes you so nervous maybe it is not worth the benefit of taking it.
If you stop taking finasteride, Minoxidil will not counter-act the effect of stopping the finasteride. What ever effect Minoxidil has to keep your hair in place will continue so you will look fuller. But not as full as both together. The regrowth from Finasteride will start to shed. Minoxidil may help keep some of the regrown hair, but most of it will shed.
Dr Paul

[Balding Bad]

So it has begun.

Just started using Minoxidil last night! I'm excited and nervous, however definitely more excited. I'm hoping for positive results.

Still holding off on Finasteride and probably will continue holding off for the foreseeable future.