Finasteride & Dutasteride AMA | The Gillett Health Podcast #52

[@icyrunner2070]

This video deserve 1M+ views

[@crownzac]

I can’t believe how many meaningful infos you delivered in just one video! Thanks a lot for answering my questions. I think you are among the most knowledgeable scientists on this topic, do not stop to deliver this type of content! Hope to meet you one day 🙏🏼

[@frankarcobello3149]

You two guys are the greatest thank, keep up the good work

[@WillKonn-h5u]

Great video! I started topical Fin 1-2% about 6 years ago and then transitioned to topical Dut 2% for the last 3 or so years. I have found there to be a big change since using topical Dut with hair growth. I had some great crown coverage with topical Fin but when I switched to topical Dut it filled in even more. I have never taken an oral product so cant speak to side effects but have never had any side effects with Fin/Dut. I would for sure recommend topical dutasteride because the growth that I have seen with no sides.

[@tim6366]

What brand topical Duta are you using?

[@Fozoli145]

Please can you discuss how to resolve or avoid sensitivity issues in the penis caused by low dose dutasteride use

[@mgscolieri]

Thank you for a fantastic podcast! My questions were presented at 32:33, and I apologize if they weren't articulated clearly. I'll try to rephrase them here: Have you encountered a significant number of patients who suffered sexual side effects from oral finasteride but then switched to oral dutasteride and didn't experience these side effects? I experience fewer side effects when combining saw palmetto with finasteride compared to using finasteride alone. In the video, you mentioned that it makes sense theoretically when considering the enzymes that saw palmetto inhibits. I'm trying to identify which enzymes saw palmetto inhibits as it doesn't seem well researched. Could you expand on how they might work together (finasteride and saw palmetto)? Since I experience fewer side effects with oral saw palmetto and oral finasteride, I plan to try oral dutasteride to further decrease side effects, hoping for a potential libido improvement, as many seem to experience when adding dutasteride! Thanks again!

[@danielche2349]

Following

[@BritishProudnShit]

Hi, you tried dut yet?

[@gilletthealth]

We will re visit these questions soon.

[@Jim-oc3sp]

Following. I used Finasteride for 7 years and it stopped my hair loss 100% but lowered my libido. It seem to stop working so I switched to .5mg/day Dutasteride. No sides whatsoever but after 10 months, still losing hair daily. I've also been on oral Minoxidil (5mg/day) for over a year. Body hair grows thick and hair on sides of head and back grow thick and fast but on top miniaturizing steadily with no improvement in site. HELP!

[@frazer9]

Does fin or dut effect beard in adult males who have already developed their beard​@@gilletthealth

[@dosedependant]

Hi, this is great info! Can you link to the reference(s) indicating the 2.5-4x inhibition of the type II isoenzyme by finasteride over dutasteride. You mentioned a typo or mistake in a paper's reference, however all articles I've found reference the better inhibition by dustasteride over finasteride on the type II (2.5x better). I would want to lock this down before trying to stack these two effectively. Thanks both!

[@floatingcolors5964]

great content, thank you guys!

[@chuckschookmovies6512]

With the topical dut dosing, you said a strength and frequency but I was wondering the actual dose like 1ml 5ml if we need to go higher would you lower the dosage?

[@icyrunner2070]

I would assume they would mean a 1ML solution as that is standard

[@the1toblame485]

This is not a new study, but you guys should review the current literature surrounding topical melatonin for AGA. Interesting stuff!

[@sandspants]

And the use of 17-a Estradiol!

[@crownzac]

Please can you talk more in depth on how to switch from daily finasteride to low dose oral dutasteride maintaining finasteride efficacy, but improving libido? How to avoid a serious shedding after switching to dut, due to the time dutasteride takes to build up in the body ?

[@crownzac]

Please answer this question 🙏🏼

[@david029014]

I want to know this too???

[@Merth667]

Excellent video! Do u guys do video consultations? I am from europe and can get the perscriptions, i just want your opiniom.

[@crownzac]

What is the benefit of stacking dutasteride over finasteride (ex. 6 finasteride and 1 fut per week) compared to a low dose of dutasteride (ex. 2-3 capsules per week)?

[@TheRevaknight]

You will get more potent type 1 and 3 5AR inhibition with dutasteride and more potent type 2 5AR inhibition with finasteride. I am looking at taking both daily soon after consulting with Gillet health

[@alyuksel348]

@@TheRevaknightdid you start with DUT twice a week ? What was your method ?

[@Jim-oc3sp]

@@TheRevaknight Interesting. Usually its assume that "Dutasteride works better for hair loss than Finasteride", but you are stating that Finasteride is actually better at one of the 5AR inhibition? Can you expand on that?

[@HVagoge1]

Hi, I enjoyed the video though I am a bit confused at 15:26 regarding fin vs dut inhibition of type 2. I can’t see any links discussing this further. In the paper “Marked Suppression of Dihydrotestosterone in Men with Benign Prostatic Hyperplasia by Dutasteride, a Dual 5α-Reductase Inhibitor” it states “The IC50 for type 1 5α-reductase is 0.7 and 81.0 nM for dutasteride and finasteride, respectively, and for type 2 5α-reductase, 0.05 and 0.16 nM, respectively” Is this information incorrect? as it suggests dutasteride is three times stronger than finasteride. If 5AR type 2 appears to be more closely implicated in hair loss and finasteride is stronger in inhibiting it that raises questions as to why dutasteride 0.5mg is superior to finasteride 1mg. Thanks.

[@ramonpollacco1231]

i have this exact same question. did you find an answer, please? in addition, going off what they are saying in the video, if dutasteride is best at inhibiting type 1 and 3 while finasteride is best at inhibting just type 2, then you could make an argument for stacking the two drugs together daily for best results going back to the point you made in your comment, to me it is very unusual how dutasteride has time and time again been proven superior in the evidence compared to the finasteride, even though we know that the most important isoenzyme as far as hair is concerned is the type 2

[@cameronkeeley3362]

Great information, thank you for all that you both do! If I was prescribed .25% topical dutasteride, is that still something that should be done 2-3x a week (generally speaking)? Or is there room to bump up the frequency?

[@MrDavid8460]

Thanks for the valuable info

[@danielche2349]

Can you share the study that shows dutasteride reduces Allopregnanolone less than finasteride? That doesn’t make sense to me mechanistically since there is no evidence that there is 5ar type 2 in the brain, which is what finasteride blocks. Theoretically finasteride should have no effect on brain neurosteroids

[@icyrunner2070]

Also curious about this study

[@fl5072]

Am I understanding correctly that 0.5mg dut every 5 days results in the ~60% dht reduction in serum? As I am on 0.25mg fin every other day so I can achieve a 60% dht reduction, if I switch to dut, would 0.5mg dut once a week and progressing to every 5 days be a good protocol. Thank you for the great information.

[@ericostovani2725]

Wow, what a GREAT and informative video!!! Dr. Gillette and Practitioner O Hara, I COMMEND your great work!!! You two ate GOLD together!!! I have the understanding that Finasteride reduces Pregnenolone. My question hwo long should one go after their last dose of Finasteride so it would not affect/reduce Pregnenolone levels.

[@gilletthealth]

Thank you for the comment. We will revisit these questions soon.

[@ericostovani2725]

Thank you Kyle and James!!! Looking forward to it :) @@gilletthealth

[@jeremym1288]

Was reading a study 6 months after discontinuing oral dutasteride the sperm count was still lower than the initial count by 23%....does this show the effects of dutasteride are irreversible?

[@talkatz9647]

Hey guys, I want to switch from finasteride to dutasteride which brand should I use, generic dutasteride from the cvs pharmacy would be fine?

[@jaybrodi9029]

I have been on 1mg Dutasteride for 15 months with not a full recovery (diffuse thinner). Should I increase Dutasteride dosage or introduce a topical antiandrogen? I want to attempt everything before using greasy minoxidil. Do I just need to deal with scalp DHT or scalp testosterone? Please help

[@OA-10]

Use minoxidil

[@benchabanehocine7809]

@jaybrodi9029 Hello. Please tell me bro, did you have excessive hair shedding before starting oral dutasteride? How did it work with you? I have tried finasteride for one year and I kept shedding huge amounts of hair, and my hair overall hair density has decreased a lot. Now, 3months on dutasteride and I am shedding same or more amount of hair. It's so confusing.....

[@Jim-oc3sp]

Same, not seeing improvement

[@GlobalWarming1845]

Great information, thank you! One question I had is you seemed to mention a couple times about taking fin and dut at the same time in some instances. If I’ve been on 1mg fin for years now and looking to increase effectiveness, would it be beneficial to consider just doing dut two days a week + fin 5 times a week?

[@beace4436]

is there any way dutasteride can make hair worse? i've been on fin for 5 years, added dut over a year ago and lost a lot of ground.

[@alyuksel348]

How much dutasteride are you taking ? Why did you switch

[@jackjaskowiak]

1x a week?

[@beace4436]

@@jackjaskowiak no daily

[@OA-10]

Maybe

[@beace4436]

@@OA-10 daily

[@DigitalRaider1]

Frequency of oral dutasteride you suggested... 1 every 10 days. 1 every 14 days. 1 per week. Is there a recommended dose?

[@gerbilkicker]

How can melatonin help prevent grey hairs?

[@Fozoli145]

Thanks for the great information. So would 0.5mg dut once every 2 weeks still be beneficial for hair loss?

[@gilletthealth]

Thank you for the comment. We will re visit these questions soon.

[@Fozoli145]

@@gilletthealththanks. Please could you discuss how to avoid or overcome penis glans sensitivity issues whilst taking fin/dut. Also sleep issues.

[@rodolfo...]

Can Dutasteride be used in women with diffuse thinning? Is ketoconazole a meaningful DHT inhibitor? Some promote it like that. Does DHT inhibition raise testosterone levels?

[@gilletthealth]

Thank you for the comment. We will revisit these questions soon.

[@1990art]

Hi, I have question regarding the finasteryd side effect on libido and numbness in genital area. I have heard on another Dr. Gillett podcasts that is caused by the fact that the penile skin is somewhat different that the skin on the rest of the body. So is there a possibility to re-activate DHT receptors in genitals and in whole body, so that the DHT binds to it better and maybe alleviate the post finasteryde syndrome?

[@Yiahi65]

There’s a small possibility that dihydroboldenone is strong enough to reactive binding affinity. That’s what I’ve been using and cycling for pfs.

[@bartekszelag4458]

@@Yiahi65 so it is working only when using? no long term effects?

[@gilletthealth]

Thank you for the comment. We will revisit these questions soon.

[@adamlapier4520]

Couldn't the increased inhibition of type 1 5ar on dutasteride lead to a higher rate of neurological side effects, as type 1 is active in the brain?

[@jetlibe]

Hello , good video’s 👍 I have a question I did a dna test from Fagron and they told me I am a not gene responder for hairloss finasteride and that I only benefit from dutasteride, I only have very mild hairloss in the temples, is their such a thing as genes that not respond to finasteride? And also how much Topical Dutasteride percentage and how often a week I need to use for only mild temple hair loss?

[@gilletthealth]

Thank you for the comment. We will revisit these questions soon.

[@adamlapier4520]

Do you think taking 5g creatine per day would negatively effect my hair if I'm on 1mg fin a day already?

[@gilletthealth]

Thank you for the comment. We will revisit these questions soon.

[@SDMotorsports]

No evidence to support this from what I could find

[@juanp.r4344]

Hello! Great Video! 1- Can eliminating obesity (losing weight) contributy to improve Dutasteride/Finasteride side effects while taking it? Coming from a 30 BMI guy with sides hehe 2- Can sides subside with continued use?

[@gilletthealth]

Thank you for the comment. We will revisit these questions soon.

[@talkatz9647]

I am two years on finasteride, for the recently stopped working, I got dut 0.5 , but I’m wondering how to do the switch?? Any advice ?

[@timpoos4635]

Whenyou stop 5 ar inhibition, is when the side effects will really come to light

[@vess928]

Can finaseride cause painful erections? I noticed a direct correlation

[@gilletthealth]

Thank you for the comment. We will revisit these questions soon.

[@Jim-oc3sp]

For some reason, I can’t stabilize my hair loss and miniaturization even though I’ve been on oral Dut (.5mg/day) and oral Min (5mg/day) for over a year. My Dihydrotestosterone, LC/MS/MS scores last two tests have been between 4-18, which I believe is low (can’t find a proper ref range). My total T is 680 and my free T is 110. All other bloodwork is in range. My hair is still miniaturizing and the hair on top of my head barely grows, only sides and back grows thick. Are there known studies where some people have better results to topical medications than oral (maybe if they have gut issues)? Other than experimenting with a (non-FDA approved) topical anti-androgen such as RU58841 or Pyrilutamide, I’m not sure what else I can do. Thoughts/suggestions? History….From 2013-2020, I was on oral Fin (1mg/day) and topical Min (5% foam once/day), which really helped me stabilize my hair. I had noticeable decrease in libido during that time but I still pushed through. End of 2020, I began to lose ground quickly. I continued same protocol for another year but decided to move to oral Dut (.5mg) in Dec 2022 as I could no longer stabilize my hair loss and I could see things getting progressively worse. I felt my libido come back immediately when I started oral Dut. As mentioned, I’m on .5mg/Dut and 5mg/Min (each daily) but still losing ground. Any input is appreciated.