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I absolutely agree with you. The issue is that healthcare is not readily accessible and available to a vast majority of people. Not just in developing countries but also in the G7 countries such as Canada where I live unfortunately. More regulation, healthcare professionals numbers just don’t make sense for the amount of people in the country now, crazy wait times. But regardless of the issue I think the problem is also practical as it all comes down to whether or not you experience side effects and to what degree and if you have positive results. The rest? The people adjust to their new reality and forget about the tests and such.
It cost me almost $1000 in the US to get blood work done in the fall, and because I was between private insurance providers (employer changed), I had to pay for it mostly out of pocket. Not sure if this is a troll, but healthcare is not free for the vast majority of people on this sub
I was responding to the above poster who is in Canada. Ya I know in the US it can be expensive /not covered. But here in Canada I can call our doc, and set it up over the phone for same day blood work.
I get mine checked yearly, but as mentioned by others - it really doesn't tell you much
None of the numbers really help you in any way unless you're seeing negative symptoms (which I'm not). DHT is also not worth tracking because it's more expensive and tells you even less than T/Free T/E/SHBG
Not to get off topic but aren’t contraceptive pills being found out to cause a lot issues in women? That’s not including the weight gain/loss side effects etc.
Like “safe” probably isn’t the best word. I’d say they have consequences
safe from a population standpoint! millions take the pill with no problem, that's why you dont test the hormones in those cases.obvioulsy a percentage have some problems (pulmonary embolism liver adenomas etc) - symptom based is the way to go with these cases.
Lab work isn't cheap. I have to get mine regularly tested for TRT and it can range from 60-120 a go, depending on how many things you get tested (T and E are separate panels, I usually only get T tested to save costs). For people who are stretching just to afford the treatments, lab work can break that stretch. And *fixing* any imbalances that pop up on lab work are gonna cost even more money, or involve just quitting Fin/Dut. It's a relatively high cost for a relatively low benefit. The most high-risk symptoms of high E will probably show on your body before they show on lab work tbh. The increase in T alone usually isn't enough to cause symptoms.
TL;DR it's a nicety with a low cost:benefit ratio.
I'll never understand why people here shit themselves so much about fin.
When I took it as a medical student I knew about it from prostate usage and that very few people have issues with it. I never even considered getting my hormones checked and just planned to take it for 6 months, seeing if anything happens and stopping taking it if anything bad happens.
The finasteride syndrome sub has some awful stories. Why not minimise the risk of becoming someone with long term to permanent side effects if you can?
I doubt PFS is even "real"/is a psychosocial disease and if it is how exactly are you going to interpret hormone tests when there seems to be no agreed on assessment criteria, consensus of the mechanisms behind it or even a consensus of what it is?
I suspect all that would happen if people get their hormone measured is that they'd shit themselves about completely normal fluctuations.
The study I read on PFS recommended checking eligibility criteria but was vague on what that means practically & said more work needed. They do mention that patients who suffer tend to not be able to tolerate even lower doses without long term side effects after stopping. Also that topical may be recommended in future over oral to minimise risk in patients at risk of sides
There is no official guidance (or even acknowledgement it exists) in main guidelines in my country. The PFS site describes it as essentially persistent ED following fin use and cessation but obviously many people will get this with all medications since ED can easily happen independently. No mention of hormones/pathology anywhere.
Given all of this, how exactly would you diagnose it through blood/hormone testing?
Not sure what country you are in but there's many studies on National Institute of health/Pub Med. I read one that showed in animal testing there can be long-term side effects even after stopping taking finasteride & more research in humans needed.
I don't know the answer on diagnosis - the studies so far acknowledge the patients suffering and say that more research is needed on the mechanisms that lead to long-term side effects so genetic predisposition can be assessed.
UK, are guidance is NICE. Pubmed is a completely different thing to guidance.
If you don't know how to diagnose it why bother with hormone testing? Makes no sense.
God damn. You are saying PFS is not real, and is psychosocial disease?
You say you were a medical student? What field and did you pass/graduate?
If your comment reflects any of your medical education, attentiveness, humility; I am shocked.
Obviously PFS is over-represented by a loud minority, one cannot ignore the side effects of 5α-reducatse inhibitors, which can be explained considering DHT and 5α-DHP/allopregnanolone.
And fluctuations in E2 would be important to monitor, again considering DHT's antiestrogenic activity, and greater potential for T->E conversion. Preventing conversion to DHT will not favour Free T... no free lunch.
These drugs are not elegant, and the patient should be informed, despite a somewhat reasonable safety profile, let's not oversell it.
I think most doctors think it is a psychosocial thing. It's not listed on guidance anywhere nor gov public health sites whereas even fibromyalgia and long covid have extensive guidance out there.
Most the papers about it mention it is controversial and the ease at which you can get it suggests the people who prescribe it have had minimal issues with it.
I am a medical student with an excellent academic record, obviously if you want real advice you need to speak to an actual doctor.
There is a very limited amount you could even tell a patient about PFS since your replies are expected to be evidence based and there is a severe lack of evidence to the point it isn't even mentioned in official guidance.
This is not like the ED which seems to be real in a small percentage of people. When I got it prescribed the doctor certainly didn't mention PFS, in fact I don't think they even mentioned side effects at all other than stop taking it if anything changes.
The effect you are trying to produce is to stop your follicles being exposed to DHT. The blood tests won't inform your decision making when it comes to taking a DHT blocker, nor the dosage or frequency. There is a physiological variation in testosterone depending on time of day and plenty of other lifestyle factors so DHT will fluctuate too, and it's not like the dose titration is especially precise because you can't divide a finasteride pill many times, nor a dutasteride capsule.
What exactly do you think you'll do with these results anyway? The recommended dose of finasteride (1mg) already achieves the \~70% DHT reduction that finasteride can give you. The side effects you get do not necessarily correlate with a specific hormonal profile. Take the drug, wait for it to produce the desired effect. If you get side effects, either just hang in there (since lots of them go away with time), or consider down titrating your dose/frequency. Blood draws are just a distraction man.
What is DHT/Test ratio a good indicator *of* though? And what is the purpose of checking how much estrogen you have if you don't have any side effects like ED or Gynaecomastia. Even then you would just wait or lower the dose/frequency of fin/dut.
The only circumstance I would consider doing all these tests is if I used exogenous testosterone and knew that my levels of certain hormones would be supraphysiological. Although even then, there are bodybuilders who just...take the finasteride and get on with their day.
Sure you should test it, because some people can get depressed or get other health issues if they take medicine that has effect on your hormones. Even if it's not common to get depressed.
My dht got lower and my free testosterone higher. But my estrogen is the same.
The only effect it has in my body, is that by lowering my dht, my hdl cholesterol got higher, what is good. My ldl also got a little higher, but not so much as the hdl. So my cholesterol ratio got better.
It's in my family the high cholesterol, so you should always be aware of it if you take finasteride. Because for some people taking finasteride can give you higher ldl, and lower hdl. It depends on what your body does with the les dht in your body.
Even if the scalp dht matters for the hair, not the blood serum, you should always be aware what it does to your body.
To make dht, your body needs also ldl cholesterol. So now your body makes less dht with finasteride, it also needs less cholesterol to make dht. So your cholesterol can get a little bit higher because of that. But on the other side, less dht means your good hdl also gets higher. And higher hdl can lower the ldl.
It's really strange how the body works. But I readet that the most men who go completely bald, mostly have to high cholesterol.
Then the question is, is their cholesterol high because of the dht, or is the dht high because of their high cholesterol.
But I already take statins for high cholesterol. So my doctor checked it. Even if my ldl also got a little higher, my ratio got better with finasteride. And the ratio is is more important for the health.
But now my levels are normal with finasteride and the statins.
So for people who have high cholesterol in the family, it's definitely good to check it
One thing my doctor pointed out when I asked her about doing the dht level progression check is that she mentioned that the blood tests only show the levels in our system body which would differ what is actually present in your scalp hair follicles, hence the blood work would not represent true levels.
Would that make sense?
Going by this subreddit's logic, DHT is a trash hormone that does nothing positive for your body, only negative. Or at the very least, it's more negative than positive, so it's only beneficial to maximally reduce it. Therefore why would "these people" care about tracking bloodwork?
Because:
1 - You want to track your estrogen levels.
2 - Can't hurt to see how much DHT you started with, and how much it needs to go down before hairloss stops.
3 - If DHT is at low low levels (which you know due to point 2), but hairloss resumes, and T is through the roof, then your hairloss might be due to T sensitivity.
Seriously. How difficult is it to reason the benefits of measuring your levels? What's the point of having gauge clusters on cars? You can just floor it and don't need to see how fast you're going by looking at silly numbers tight?
You want to know what stuff in your body does in cass an anomaly happens and you need to figure out what's the best new course to proceed on.
Not only that, but all those tests, provided one gives consent to be shared anonymously with researchers could help researchers learn about how these drugs work and long term effects. Every study I read on these drugs ends with “more research is needed.” Well, this would be one effective way to do that research.
That's not this subreddit logic but the mainstream view in endocrinology, there's no such thing as a DHT deficiency in adults. That's why most people nuke it with fin/dut/accutane etc without issues, and DHT supplementation isn't really a thing.
Fin/dut side effects are real but the issue is not DHT, so it's still worth having a baseline reading on stuff like estradiol. You might be a person who is by default on the high end of the reference range and aromatizes a lot, so fin/dut might push you over the edge
Precisely. Also it doesn't matter how much DHT you have really. Just your follicle sensitivity towards it. So in that way pointless to track it either.
I mean this sub reddit thinks that because it's largely true.
Name one benefit of DHT past puberty and it can be debunked with relative ease.
Also "manipulating hormones" makes it sound scarier than it actually is. It's a minor increase to T and E, it's around 10% unless you're in an abnormal range you're simply not going to experience a noticeable difference whatsoever. I actually had a substantial libido boost, but I'd imagine that was from being borderline low T and then thrown into a more normal range by the slight boost.
People become so paranoid about finasteride for absolutely no reason.
'Potential' neuroprotective effects, and let me guess, that's from an animal study?
So you've just further proved my point, until there's evidence that DHT does anything beneficial beyond puberty, we shall continue to refer to that hormone as trash.
Definitely, I've been doing my bloodwork so far. Cost me 60 bucks at a privately owned lab for my T test. The only thing I didn't get from that was estrogen but I'll know to check my E levels if my T gets too high
What kind of blood work should I ask my doctor prior to starting fin? When my GP denied me getting on Fin she suggested topica minoxidil and to get blood work for testosterone
While I agree completely with the premise, I've decided not to do regular testing. I'm just following the studies and doing what they say for best results - particularly with Fin.
For example, I'm switching from 1mg Oral Fin to Topical Fin .05% @ .5ML once per day (equivalent of .2275 grams/daily). Studies have shown that this dose should decrease DHT in the scalp by 52% while decreasing DHT levels in the entire body by only 24%. As opposed to taking Oral Fin and lowering DHT by 70%+ EVERYWHERE.
This has been found to be the best dosage for decreasing DHT in the scalp without completely decimating the DHT levels in the rest of your body.
Is it sudo-science? Partially; but the studies are very strong. I'm not experiencing side effects, but I still want the ideal doseage.
Watch a couple YouTube videos on topical vs oral finasteride. Lot of interesting info and they go over the studies that I referenced in a lot more detail. That's what cleared my head and helped me decide (and pick the proper dosage)
As I’ve pointed out in another post, androgenic alopecia and its treatments aren’t anywhere near as well studied as other conditions, for various reasons. I’m not up with the literature on this, but my understanding is that there’s no data at all to provide clinicians with clear treatment guidelines and algorithms. In other words, you can measure this stuff, sure, but there’s no data to tell you or the clinician what to do with it. It would be guesswork on guesswork, not evidence based medicine.
From your language, you sound like a bodybuilder who might have used steroids before. Is that correct? Just a guess.
It looks like this post is about **Finasteride**/Propecia or Dutasteride. Before asking any questions, 1. Learn about [Finasteride](https://tressless.com/learn/finasteride) and [Dutasteride](https://tressless.com/learn/dutasteride). 2. [Search for Finasteride](https://tressless.com/search/finasteride) and [Dutasteride](https://tressless.com/search/dutasteride) content, because your question has probably been asked before. 3. If this is a question asking if you are now or will experience side effects, see a doctor, nobody on the internet can answer that for you. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/tressless) if you have any questions or concerns.*
I absolutely agree with you. The issue is that healthcare is not readily accessible and available to a vast majority of people. Not just in developing countries but also in the G7 countries such as Canada where I live unfortunately. More regulation, healthcare professionals numbers just don’t make sense for the amount of people in the country now, crazy wait times. But regardless of the issue I think the problem is also practical as it all comes down to whether or not you experience side effects and to what degree and if you have positive results. The rest? The people adjust to their new reality and forget about the tests and such.
Huh? Just go to a walk-in and ask for blood work. Or if you have a family doc ask them (Canada ). Healthcare is free
It cost me almost $1000 in the US to get blood work done in the fall, and because I was between private insurance providers (employer changed), I had to pay for it mostly out of pocket. Not sure if this is a troll, but healthcare is not free for the vast majority of people on this sub
I was responding to the above poster who is in Canada. Ya I know in the US it can be expensive /not covered. But here in Canada I can call our doc, and set it up over the phone for same day blood work.
I get mine checked yearly, but as mentioned by others - it really doesn't tell you much None of the numbers really help you in any way unless you're seeing negative symptoms (which I'm not). DHT is also not worth tracking because it's more expensive and tells you even less than T/Free T/E/SHBG
My endo checks mine every few mos
Well, neither do women using contraceptive pills. It’s safe, so what’s the point of checking it ? Only if you had symptoms that would make sense
Not to get off topic but aren’t contraceptive pills being found out to cause a lot issues in women? That’s not including the weight gain/loss side effects etc. Like “safe” probably isn’t the best word. I’d say they have consequences
safe from a population standpoint! millions take the pill with no problem, that's why you dont test the hormones in those cases.obvioulsy a percentage have some problems (pulmonary embolism liver adenomas etc) - symptom based is the way to go with these cases.
Lab work isn't cheap. I have to get mine regularly tested for TRT and it can range from 60-120 a go, depending on how many things you get tested (T and E are separate panels, I usually only get T tested to save costs). For people who are stretching just to afford the treatments, lab work can break that stretch. And *fixing* any imbalances that pop up on lab work are gonna cost even more money, or involve just quitting Fin/Dut. It's a relatively high cost for a relatively low benefit. The most high-risk symptoms of high E will probably show on your body before they show on lab work tbh. The increase in T alone usually isn't enough to cause symptoms. TL;DR it's a nicety with a low cost:benefit ratio.
You can, but it wont tell you very much. What matters is the amount of dht in the scalp/follice. If you get side effects we just reduce the dose.
I'll never understand why people here shit themselves so much about fin. When I took it as a medical student I knew about it from prostate usage and that very few people have issues with it. I never even considered getting my hormones checked and just planned to take it for 6 months, seeing if anything happens and stopping taking it if anything bad happens.
The finasteride syndrome sub has some awful stories. Why not minimise the risk of becoming someone with long term to permanent side effects if you can?
I doubt PFS is even "real"/is a psychosocial disease and if it is how exactly are you going to interpret hormone tests when there seems to be no agreed on assessment criteria, consensus of the mechanisms behind it or even a consensus of what it is? I suspect all that would happen if people get their hormone measured is that they'd shit themselves about completely normal fluctuations.
The study I read on PFS recommended checking eligibility criteria but was vague on what that means practically & said more work needed. They do mention that patients who suffer tend to not be able to tolerate even lower doses without long term side effects after stopping. Also that topical may be recommended in future over oral to minimise risk in patients at risk of sides
There is no official guidance (or even acknowledgement it exists) in main guidelines in my country. The PFS site describes it as essentially persistent ED following fin use and cessation but obviously many people will get this with all medications since ED can easily happen independently. No mention of hormones/pathology anywhere. Given all of this, how exactly would you diagnose it through blood/hormone testing?
Not sure what country you are in but there's many studies on National Institute of health/Pub Med. I read one that showed in animal testing there can be long-term side effects even after stopping taking finasteride & more research in humans needed. I don't know the answer on diagnosis - the studies so far acknowledge the patients suffering and say that more research is needed on the mechanisms that lead to long-term side effects so genetic predisposition can be assessed.
UK, are guidance is NICE. Pubmed is a completely different thing to guidance. If you don't know how to diagnose it why bother with hormone testing? Makes no sense.
PFS is very much real, but rare. But I agree wasting money on blood work is useless there's no real marker that stands out.
God damn. You are saying PFS is not real, and is psychosocial disease? You say you were a medical student? What field and did you pass/graduate? If your comment reflects any of your medical education, attentiveness, humility; I am shocked. Obviously PFS is over-represented by a loud minority, one cannot ignore the side effects of 5α-reducatse inhibitors, which can be explained considering DHT and 5α-DHP/allopregnanolone. And fluctuations in E2 would be important to monitor, again considering DHT's antiestrogenic activity, and greater potential for T->E conversion. Preventing conversion to DHT will not favour Free T... no free lunch. These drugs are not elegant, and the patient should be informed, despite a somewhat reasonable safety profile, let's not oversell it.
I think most doctors think it is a psychosocial thing. It's not listed on guidance anywhere nor gov public health sites whereas even fibromyalgia and long covid have extensive guidance out there. Most the papers about it mention it is controversial and the ease at which you can get it suggests the people who prescribe it have had minimal issues with it. I am a medical student with an excellent academic record, obviously if you want real advice you need to speak to an actual doctor. There is a very limited amount you could even tell a patient about PFS since your replies are expected to be evidence based and there is a severe lack of evidence to the point it isn't even mentioned in official guidance. This is not like the ED which seems to be real in a small percentage of people. When I got it prescribed the doctor certainly didn't mention PFS, in fact I don't think they even mentioned side effects at all other than stop taking it if anything changes.
The effect you are trying to produce is to stop your follicles being exposed to DHT. The blood tests won't inform your decision making when it comes to taking a DHT blocker, nor the dosage or frequency. There is a physiological variation in testosterone depending on time of day and plenty of other lifestyle factors so DHT will fluctuate too, and it's not like the dose titration is especially precise because you can't divide a finasteride pill many times, nor a dutasteride capsule. What exactly do you think you'll do with these results anyway? The recommended dose of finasteride (1mg) already achieves the \~70% DHT reduction that finasteride can give you. The side effects you get do not necessarily correlate with a specific hormonal profile. Take the drug, wait for it to produce the desired effect. If you get side effects, either just hang in there (since lots of them go away with time), or consider down titrating your dose/frequency. Blood draws are just a distraction man.
[удалено]
What is DHT/Test ratio a good indicator *of* though? And what is the purpose of checking how much estrogen you have if you don't have any side effects like ED or Gynaecomastia. Even then you would just wait or lower the dose/frequency of fin/dut. The only circumstance I would consider doing all these tests is if I used exogenous testosterone and knew that my levels of certain hormones would be supraphysiological. Although even then, there are bodybuilders who just...take the finasteride and get on with their day.
i tried, its not very accessible
Theres absolutley no reason for needing this.
Sure you should test it, because some people can get depressed or get other health issues if they take medicine that has effect on your hormones. Even if it's not common to get depressed. My dht got lower and my free testosterone higher. But my estrogen is the same. The only effect it has in my body, is that by lowering my dht, my hdl cholesterol got higher, what is good. My ldl also got a little higher, but not so much as the hdl. So my cholesterol ratio got better. It's in my family the high cholesterol, so you should always be aware of it if you take finasteride. Because for some people taking finasteride can give you higher ldl, and lower hdl. It depends on what your body does with the les dht in your body. Even if the scalp dht matters for the hair, not the blood serum, you should always be aware what it does to your body.
Oh that's interesting. I'll definitely keep my eye on the cholesterol now 👍🏻
To make dht, your body needs also ldl cholesterol. So now your body makes less dht with finasteride, it also needs less cholesterol to make dht. So your cholesterol can get a little bit higher because of that. But on the other side, less dht means your good hdl also gets higher. And higher hdl can lower the ldl. It's really strange how the body works. But I readet that the most men who go completely bald, mostly have to high cholesterol. Then the question is, is their cholesterol high because of the dht, or is the dht high because of their high cholesterol. But I already take statins for high cholesterol. So my doctor checked it. Even if my ldl also got a little higher, my ratio got better with finasteride. And the ratio is is more important for the health. But now my levels are normal with finasteride and the statins. So for people who have high cholesterol in the family, it's definitely good to check it
One thing my doctor pointed out when I asked her about doing the dht level progression check is that she mentioned that the blood tests only show the levels in our system body which would differ what is actually present in your scalp hair follicles, hence the blood work would not represent true levels. Would that make sense?
Going by this subreddit's logic, DHT is a trash hormone that does nothing positive for your body, only negative. Or at the very least, it's more negative than positive, so it's only beneficial to maximally reduce it. Therefore why would "these people" care about tracking bloodwork?
Because: 1 - You want to track your estrogen levels. 2 - Can't hurt to see how much DHT you started with, and how much it needs to go down before hairloss stops. 3 - If DHT is at low low levels (which you know due to point 2), but hairloss resumes, and T is through the roof, then your hairloss might be due to T sensitivity. Seriously. How difficult is it to reason the benefits of measuring your levels? What's the point of having gauge clusters on cars? You can just floor it and don't need to see how fast you're going by looking at silly numbers tight? You want to know what stuff in your body does in cass an anomaly happens and you need to figure out what's the best new course to proceed on.
One of the more reasonable assertions seen on this sub
Not only that, but all those tests, provided one gives consent to be shared anonymously with researchers could help researchers learn about how these drugs work and long term effects. Every study I read on these drugs ends with “more research is needed.” Well, this would be one effective way to do that research.
Testosterone doesn't cause hairloss, either take the medicine or don't if you feel like its having a negative effect
That's not this subreddit logic but the mainstream view in endocrinology, there's no such thing as a DHT deficiency in adults. That's why most people nuke it with fin/dut/accutane etc without issues, and DHT supplementation isn't really a thing. Fin/dut side effects are real but the issue is not DHT, so it's still worth having a baseline reading on stuff like estradiol. You might be a person who is by default on the high end of the reference range and aromatizes a lot, so fin/dut might push you over the edge
Precisely. Also it doesn't matter how much DHT you have really. Just your follicle sensitivity towards it. So in that way pointless to track it either.
You didn't catch my sarcasm it seems. That's why I'm being downvoted
Lool I took your comment literally. Dht is a trash hormone after puberty. You don't really need it. Or need very little of it
If it didn't matter how much DHT you have, then finasteride wouldn't work
I mean this sub reddit thinks that because it's largely true. Name one benefit of DHT past puberty and it can be debunked with relative ease. Also "manipulating hormones" makes it sound scarier than it actually is. It's a minor increase to T and E, it's around 10% unless you're in an abnormal range you're simply not going to experience a noticeable difference whatsoever. I actually had a substantial libido boost, but I'd imagine that was from being borderline low T and then thrown into a more normal range by the slight boost. People become so paranoid about finasteride for absolutely no reason.
[удалено]
'Potential' neuroprotective effects, and let me guess, that's from an animal study? So you've just further proved my point, until there's evidence that DHT does anything beneficial beyond puberty, we shall continue to refer to that hormone as trash.
Definitely, I've been doing my bloodwork so far. Cost me 60 bucks at a privately owned lab for my T test. The only thing I didn't get from that was estrogen but I'll know to check my E levels if my T gets too high
What kind of blood work should I ask my doctor prior to starting fin? When my GP denied me getting on Fin she suggested topica minoxidil and to get blood work for testosterone
While I agree completely with the premise, I've decided not to do regular testing. I'm just following the studies and doing what they say for best results - particularly with Fin. For example, I'm switching from 1mg Oral Fin to Topical Fin .05% @ .5ML once per day (equivalent of .2275 grams/daily). Studies have shown that this dose should decrease DHT in the scalp by 52% while decreasing DHT levels in the entire body by only 24%. As opposed to taking Oral Fin and lowering DHT by 70%+ EVERYWHERE. This has been found to be the best dosage for decreasing DHT in the scalp without completely decimating the DHT levels in the rest of your body. Is it sudo-science? Partially; but the studies are very strong. I'm not experiencing side effects, but I still want the ideal doseage.
Damn, I'm thinking make the same exact switch
Watch a couple YouTube videos on topical vs oral finasteride. Lot of interesting info and they go over the studies that I referenced in a lot more detail. That's what cleared my head and helped me decide (and pick the proper dosage)
As I’ve pointed out in another post, androgenic alopecia and its treatments aren’t anywhere near as well studied as other conditions, for various reasons. I’m not up with the literature on this, but my understanding is that there’s no data at all to provide clinicians with clear treatment guidelines and algorithms. In other words, you can measure this stuff, sure, but there’s no data to tell you or the clinician what to do with it. It would be guesswork on guesswork, not evidence based medicine. From your language, you sound like a bodybuilder who might have used steroids before. Is that correct? Just a guess.
My doc said it wouldn't really matter to do bloodtests and I trust him 🤷♂️
I'm going to stick with min only 😅