Hair Loss Continues On Finasteride & Minoxidil!
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- Опубликовано: 1 июл 2023
- Hello Everyone I'm Dr Parissis I work in London, UK in partnership with Feller and Bloxham Medical in Great Neck, New York.
To book a consultation with me , visit fellermedical.com/ and submit an enquiry for a consultation in the UK.
Get in contact: drparissis@gmail.com 
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Fighting the Norwood Reaper is a full time commitment and he never sleeps.
You can kill him by shaving off your head.
@@ytsux9259 And in the same shot, killing your dating life.
Hey, there are actually some papers on the longterm effectevnis from finasterid over a time period of 10 years. Haircafe got a great video showing the papers. its called "why finasteride stops hair loss forever". from the data we can pretty much assume that for most patients finasterid will be enoug to stop hairloss. overall u see the sooner u start the better the resulst are
I’m 24, started taking finasteride at 22, even though i did not have any significant recession, my hairline went , in linear way, like 1cm back and i noticed some of the hair getting weaker, that’s why i decided to start finasteride and suplements, since then I didn’t notice any progression on the hairloss, but this video alerted me to not have big expectations. If i I lose more hair, then so be it, until then I’ll do what i can since I don’t experience any side effect from the medication.
6:00 a good explanation that putting up with a negative finasteride experience may not be worth it in the end due to the endocrine system rearranging its functions to work around finasteride's effects
Thanks for your helpful video.
No problem Kevin!
My blind ass thought Gary Linkov got hair transplant for a second
deadass thought u was Matthew McConaughey
Me too
Maybe the young Matthew. The current Matthew is a 50yo man. 🤣
Well yall are on drugs 😮
Alright alright alright lol
Actually, they did a few studies on Japanese and other men over the course of ten years on Finasteride and the vast majority had no further profession of noticeable hair loss. Hair loss is a lot like heart disease in the sense of time of exposure = further progression or the degree of progression of the disease. We know that if we keep LDL and AppB very low from a young age that heart disease can be almost entirely prevented. Whereas if an older persons lowers their LDL at 60 they until 80 they don’t entirely prevent their risk of heart attack, but they do lower it and probably as years to their life. With hair loss, the longer you wait the more hair you lose and the harder it is to regain ground due to DHT having more time on the hair follicles. So time of exposure to DHT also dictates the degree of hair loss and possibly regrowth they can see once they get on Finasteride. The earlier they get on it the better and less hair loss. I think these internet examples are the few extreme cases of the very very genetically sensitive to DHT folk who need a stronger DHT reducer like Dutasteride. So it can give the impression that there are all these common stories of ppl taking Finasteride and it not working but it’s mainly because it’s concentrated on the internet giving that impression. It’s probably a few percent who need a stronger drug and so they wrote about it on Reddit whereas the millions who are fine on it and have not lost more aren’t writing about it as much because why would they need to? They’re getting on with their busy lives. Just some perspective to consider.
You’ve raised an important point here that statins are an excellent medication that have significantly reduced morbidity & mortality and there is excellent data to show this. Wilt et al’s meta-analysis looking at 25 studies which included 69,000 patients showed a 23% reduction in mortality associated with Coronary Heart Disease (CHD) with statin therapy. This is an incredible statistic and this is why we put patients on statins because it is an excellent drug. However, it does not reduce mortality completely.
There is also very good evidence for finasteride as a medication that slows down hair loss by blocking 66% of DHT at the 1mg/day dose. However, the aim of this video was to suggest that Finasteride alone does not completely stop hair loss. Whilst statins significantly reduce the risk of CHD mortality, there is still a risk of CHD mortality despite statin therapy. Almost nothing in medicine is true in all cases. This message allows patients to have realistic expectations for finasteride and any medication. In the case of hair loss, this may allow patients to combat hair loss with for example the use of further medications or psychologically prepare for hair transplant surgery if it is bothering them to that extent in the future.
You’ve also raised an interesting point about the best age to start finasteride and hence duration of taking it and I will make a video on this topic in the near future.
@@DrParissis
Yes, statins do not reduce mortality completely, as there are other factors. But I am speaking in relation to heart disease death itself. If we don’t get heart disease then we may live longer, but eventually we will all die of old age or whatever.
The data on reduced risk of death from heart attacks and heart disease itself is promising, but even this can be misunderstood because most people who start statin drugs start later on in life when they already have developed Atherosclerotic Cardiovascular Diseases. But despite this, if they get on statins they still can see a major reduced risk. But this can give the false impression that risk cannot be reduced even greater. But now we know it can from the latest research.
We know that since Atherosclerotic Cardiovascular Diseases is a progressive disease that happens over the course of one’s life, beginning early on, that the time of exposure to high LDL and ApoB is what matters.
For example, some people have genetic mutations in the PCSK9 gene giving them naturally very low levels of LDL cholesterol. These people with these mutations do not get heart disease like normal people do. This is actually how the pharmaceutical industry came up with the idea of PCSK9 drugs, which are a newer generation of LDL lowering drugs. These drugs effectively cripple the PCSK9 gene to lower LDL in people without the mutation.
So when we study those populations we see far a far greater reduction heart disease risk. About 80% relative to the normal population. And this is because people with the PCSK9 gene have had much lower exposure to LDL cholesterol over the course of their lifetimes. And since most LDL carries the ApoB tag, causes Atherosclerotic Cardiovascular Diseases, they have an earlier start to less exposure time in contrast to the much older people who have to start statins after they’ve had 3-5 or more decades or exposure to high LDL levels. We also know from autopsy evidence that babies begin developing fatty streaks in the arteries, etc. We also have evidence of young mummies who died from Atherosclerotic Cardiovascular Diseases.
So the reduction in risk from staying in those studies do not do justice to what could be achieved if people had very low LDL levels early on in life. We would probably see an 80% or so reduction in risk or more, like we see with people who have genetic mutations to have naturally vey low LDL levels.
If we started people on cholesterol reducing drugs early on in life, you would see a much greater risk reduction. But now the new research is showing that even less than 150 is high cholesterol. The new normal is 100. But the evidence shows that Atherosclerotic Cardiovascular Diseases still develops at those levels. And it really needs to be below 70 or less, ideally. Or ApoB below 40. And if those levels are very low, it’s extremely rare to develop Atherosclerotic Cardiovascular Diseases.
Same with DHT. We know that people who have genetic mutations in the AR2 enzyme to produce almost no DHT virtually never go bald or even come close to it.
Why? Time of exposure. Same with heart disease. They had low exposure to DHT from puberty and birth so therefore less time of DHT’s progressive effects on the hair follicle.
Most normal people not born with that genetic mutation and who are genetically sensitive to DHT get started on finasteride *after* they noticed hair loss. Most of the time it is at least 10-15 years after slowly losing hair. The process of hair loss is very slow and progressive at first and it actually begins after puberty or not long after but it doesn’t become noticeable to most normal people until they hit 30 or so, or in the more rare extreme cases where they are very sensitive it is sped up and they notice it by their mid 20’s, etc.
But after puberty the rate of new hairs growing is still occurring at a faster rate than the rate that DHT is destroying the hair follicles. But as years go on and more hair follicles are destroyed and don’t grow back, the rate of hair loss from DHT begins to exceed the rate at which new follicles regrow since less hair is growing back due to DHT destroying the follicles. So by 30 or so it is easier to notice for most people. But by the time you can notice it with the naked eye you’ve already lost a significant amount of hair, which is what happened slowly over the course of that decade or so since puberty and DHT is higher, etc.
So just like with heart disease, people get on a statin and reduce risk but they already have damage from the previous 5-6 decades of exposure to high LDL. This is why risk is reduced greatly but not further and why some still die eventually from heart attacks or heart disease.
And similarly, people who get on hair loss drugs already have lost a significant amount of hair because they already had a decade or more of exposure to high DHT whereas if they were on Finasteride from puberty they likely wouldn’t see further hair loss in any noticeable way, hair like those born with the A5R2 gene mutation. And a subset of those people who are even more genetically sensitive would need to be on Dutasteride because the baseline reduction Finastride gives isn’t enough for them. But in both scenarios they already had a decade or two or more of exposure to DHT.
But people with the 5AR2 genetic mutation never go bald and people with the PCSK9 gene rarely die heart disease at much much lower rates than the statin trials. They have a risk reduction of about 80% relative to the normal population. But even then, if you get LDL much lower, the risk of developing Atherosclerotic Cardiovascular Diseases is almost negated entirely. If we look at populations with an ApoB of less than 40, there is essentially no Atherosclerotic Cardiovascular Diseases. They don’t have the time of exposure to high LDL and ApoB levels that normal people have.
So look at populations that have very low AppB and LDL from birth so those are more reliable than the statin drug trials for accessing lifetime risk. And similarly, you see the same parallel in people with almost no exposure to DHT from puberty and birth having virtually no balding.
Both heart disease and hair loss are progressive diseases that begin from birth/puberty and time of exposure is what matters the most.
The Japanese study I mentioned which follows thousands of men for a decade showed no further hair loss in the vast majority of men and even continued hair regrowth in a large number of them over ten years. And another similar study. So there is evidence that in the majority who use it, the drug can stop hair loss in its tracks for most men who use it. The individuals on Reddit are probably the minority have severely sensitive individuals who need a stronger drug. But we should never base our opinion on on line anecdotes compared to larger scale longer term studies like the ones that followed patients for a decade. Also keep in mind that there are many on Reddit taking the drug who also say they’ve had it completely stop and have been on it for many years, but they’re drown out by the ones saying the opposite because it’s 1) concentrated online (law of large numbers), giving it an impression that it’s more common than it’s not and 2) it gets our attention more than the ones saying their hair loss has stopped, since the concern of most on the drug is will further hair loss happen for most of them.
Thus, I would say that the evidence suggests Finasteride does stop hair loss almost completely or completely for most men taking the recommended dose. That does not mean that in every individual case where a Doctor treats a patient that he can promise him his hair loss will completely stop on the drug because that doctor has no idea if that patient is one of the few individuals who is more sensitive to DHT than most men who have hair loss and may therefore need a stronger drug or not, and also it depends on the progression of his hair loss already.
But we can’t say, based on the evidence, that for the majority of men who use the drug that it won’t stop hair loss. That’s just not what the data suggests. We need more data, yes, but what we currently have says it does stop it for a majority of men who take the 1mg dose daily.
That’s an excellent analogy and very important distinction. Great comment
Japanese men barely go bald to begin with
@@78percent34 They go bald less than other populations perhaps, but that doesn’t matter because they were following the ones who were balding. So even if Japanese men bald less on average than Western men, it doesn’t matter as much because they were following a subset of population that was balding, not those who make up the majority of the Japanese not really balding. There were other long term studies in other populations as well.
Cant use minoxidil anymore. Minoxidil influences heart and blood pressure too much.😮
Stupid people on reddit will say they’re losing ground but never show photos before treatment (baseline) and current
Really think you should promote applying Minoxidil daily along with Dutasteride taken once daily. I'm 67, and this combination definitely works.
Hi Peter thanks for sharing. I agree I’ve seen many patients benefit from this combination. However, the message I do want to emphasise is how, depending on your genetics, hair loss still continues on these medications but at a slower rate.
@@garrett3174 -Thanks, I take Dutasteride one pill a day, and apply Minoxidil only once per day. I struggled with thinning hair after 46 years old even in spite of applying Minoxidil every day. When I started using Finasteride once a day, and continued using Minoxidil, my hair came back fully. I switched to Dutasteride at age 64 because Finasteride lost a bit of its efficacy.
Might be my age.
@@petermusto3704 Did you experience any side effects? I am very worried about taking Finasteride. I read too many bad stories.
Best combination is Dutasteride 0.5 mg and Oral Minoxidil 5 mg. works. I'm 68, and these 2 Medication work well.
They definitely work well - although there is a not an insignificant percentage of men who get side effects with both of these high doses. So it often needs to be tailored to their response. I am glad you have benefited from this however!
i was on finasteride for 5 years, been on dutasteride for 8 months and my hair loss has continued
Well it also depends on your lifestyle. Are you in a high stress work environment? Are you always lacks of sleep. There are people who do not have an mpb genes but has hair receeding because of stress and lacks of sleep. And even though you have dht blocker there are other reasons for hairloss.
Follow no fap for a month and see if you got any improvement
@@xyz123_45No fap is a myth.
Can finasteride cause a shedding phase?
Except getting topical finasteride in the uk is stupidly difficult
Hims manual sons any of these mate finasteride minoxidil topical it's easy to get I think oral are better not that I've taken it but topical is more messy
Hairloss forums are never the good place to know evidences from because hair loss is hard to be evaluated, making people self report stupidly. Lots of broscince in such feedbacks which just come from superficial understanding that dht still left so they're losing which might not be true as metabolism might not work that simply.
Oh I just noticed you're transplant shill kinda
I been taking dutasteride and minoxidil for almost a year and I have been losing my hair more and more every day. What should I do?
Hi there. Sorry to hear that. I would say that these medications can take a long time to work sometimes. If you’re still noticing loss you could ensure that you are not missing doses and that you are properly massaging the minoxidil into your scalp . Otherwise I would watch and wait and remember that you can always get excellent results with hair transplant surgery.
I’ve been on fin for more than 18 months and I’m still losing ground on the same rate. Switched to dutasteride last week.
and today? any sides from dut?
agressive bro
@@floatingcolors5964 no sides yet
im in the same situation I'm thinking of continuing finasteride and adding in dut once a week
@@pablogats4627ne too
Im on minoxidil with .5mg dutasteride derma pen and recession slowed down but im still seeing a lot of hair falling out
I say stop using the derma pen. It does more harm than good especially with long term use.
If all the medication reduces dht and does not eliminate it this is more about math then medicine. Meaning, it slows down the hair loss and does not stop or reverse it. There are some exciting new treatments coming to market to regrow hair.
That’s simply not true and not how it works. DHT only has to be taken below a certain threshold to prevent hair loss. All of the many studies on finasteride fully preventing or regrowing hair proves what you’re saying is wrong.
Then why does finasteride thicken up and regrow hair in around 50% of people
It will reduce DHT and allow your body to remove some of the DHT in the hair shaft allowing for thicker hair. Works MUCH better on the crown of head than the front hairline. NO ONE grew back their hair from finasteride in dead follicles. FYI micro needling helps.@@annexgaming1856
@@annexgaming1856 in absence of DHT, hair miniaturization stops, and if the hair is like 0-50% miniaturized, it might recover back to its original thickness, and will come across as more thickness.
@@princejoseph8280 what if it’s gone past 50%?
I'm 58, I don't have any bald spots but my hair has thinned considerably from my 20's and 30's. The hair on top is getting thinner and I'm not a fan. I'd like to restore some thickness. I don't want to take Finasteride due to potential side effects. Do you recommend taking just topical Minoxidil with maybe Saw Palmetto? I'm worried about taking oral Minoxidil and I don't think my Doctor would prescribe it anyway. Saw Palmetto can also have side effects I'm reading. Thanks for the video.
What is saw palmetto please
@@wolves1980 It's an herb. There are RUclips videos about this subject.
Saw Palmetto does 2 tenths of fuck all. Get on Finasteride, stop being a pussy. Side effects occur in 2-5% of people which is nothing.
Oral minoxidil is better and far far cheaper and less messy than topical minox - buy 5%"topical" minox any brand, count how many drops from dropper for 1 ml (=50mg Minox), divide 50 by number drops that gives you mg of minox pet drop, aim for 1.5 - 2.5 mg minox per dose dropped under your tongue each night.
@@JohnSmith-sj2dk Another drinking topical idiot.
Made me worse and fast and year later still not back to normal wish i never bothered
you just had to keep going
Twice daily topical RU58841 (5 mg RU powder per ml of Minoxidil combined) has worked better for me (no hair fall at all) and had less sexual side effects than 1.25 mg daily Finasteride and 5% Topical minox 2 daily - btw currently taking 1 drop 5% minox (40 drops per 1 ml) = ~ 1,25 mg oral minox per day.
There is some research behind topical RU58841 working against MPB although I would like to see more. I do agree that inhibiting the androgen receptor directly , as RU58841 does, is a logical way to prevent MPB.
5mg RU is too low. Standard dose is 50mg a day
@@wasteman3259 50 mg is very expensive and would leave you with a limp noodle. might as well take oral finestride, as that also gives you a limp noodle...
but mixed with Minoxidil makes the hair oily for so long. isnt it dangerous to contaminate your pillow and get RU systemic with ur mouth and maybe eyes?
Is orally taken minoxidil a good idea?
New video on this topic : ruclips.net/video/MPDwNLeNsLA/видео.html
@ParissisMedical ty so much for your indepth researching, has made me think twice about it now until more accurate trials have been conducted.
Was wondering also if there is any research on combining with finestride?
alcohal free minoxidil it's help to hair growth?
Alcohol free is great! The benefit is it does not dry out your scalp.
Where can you buy this?
hey bud what do you think of oral minoxidil ? I hear it’s far superior compared to 5% topical minoxidil , your thoughts on oral minoxidil with oral finasteride ? Do you know if upping the dose of finasteride blocks more dht ?
@@Bag514hello. There is research to show that Oral Minoxidil is just as effective as topical and it has a very good side effect profile. I will post a video in more detail.
5mg of finasteride only blocks slightly more DHT production (1%-5%) than 1mg so this is why 1mg is the recommend dose for MPB.
@@Bag514 be careful not to damage your heart with oral. Check Haircafe channel for more information on that
Is there any 2. 5mg dose dutasteride?
What do you need 2.5mg for? U got a ballon for a prostate? 1mg is enough to inhibit serum 5α-dht by 95%, remember that you have a spike of testosterone when on dut that has enough androgenicity to cause hairloss as well.
@@heavymetalfoe Bro,as we age ,hairs of those who have MPB become more and more sensitive to DHT .So,this small 5% DHT which cant be blocked can also make things worse.So, I just want to know whether there are any doses avaiable which can block DHT fully
@@ritankardas6801 This is not true. The 10 year study on finasteride debunks this and shows that the idea of 5 alpha reductase imhibitors losing efficacy over time is bs
@@heavymetalfoeu need to block scalp dht, and 2.5 mg of dut blocks it by 80% while 0.5 blocks it by 50%
2.5 mg dutasteride Blocks like 99% Serum dht.
speak further away from the mic next time
You will lose some hair in the beginning of the treatment.
The main issue of AGA (male pattern baldness) is the tension of the scalp muscles, wich they restrict the bloodflow to the hair follicles... that's why cronic streess leads to hair fall in man and women.
HAHAHAHAHHA BLÜDFLÓW THEORY
@@ToeTV247 doesn't minoxidil activate blood flow towards the scalp ?
@@ToeTV247 It is not just a theory. There has been research about improvement on patients using scalp botox.
Finasteride and minoxidil will never be enough long term... your kidneys, lungs, liver, all your organs need to be healthy or you body will stop growing your hair to heal the organs. you need proper nutrition as well. No cigarettes, vaping, alcohol(at least severely limit those things) Also MINDSET. Just read the Bible Proverbs 23:7 says, "For as a man thinks in his heart, so is he." If you associate yourself with being the hair loss guy you will continue to lose your hair.
You have got to be sh*tting me lol. So if a bald man prays to god, his hair will grow back?
@@phodacbitchno but i think he is saying keep taking your meds and stop obsessing over it.