need for finasteride for hair loss with other antiandrogens?

[Lillet]

You shouldn't need Finasteride or Dutasteride if you're on a correct spironolactone dose.

Fun fact, spiro is already given to natal females for hair loss, so to say is does nothing is misleading.

Another fun fact, DHT comes from T, a type of enzyme called 5-alpha reductase (spelling from memory, don't kill me if it's wrong) is responsible for the conversion of T to DHT (along with several other conversions that the aforementioned 5AR inhibitors will also inhibit. Some of which have some sketchy indications of causing side effects like brain fog.

Regardless of its safety, if you have a natal female level of T, I've yet to hear an explanation why your DHT level would be so much higher than a natal female either, resulting in a natal female or lower risk... more or less.

Oh and another thing, spironolactone already blocks the DHT receptors. The reason the 5ar inhibitors are prescribed to men and spironolactone isn't, is because spiro will target all androgends and the 5ar inhibitors only target their conversion to DHT, making them more suitable because unlike women, men are supposed to have high (higher than women anyway) levels of androgens in their system.

This is exactly what I assumed when asking this question.  However, the reason I asked it was because I'm much more interested in practice than theory, especially in the absence of controlled studies.  As an aside, my understanding is that that big marketing push of Finasteride as Propecia is really only because they were provided with a readymade controlled study in the form of those boys born with a natural 5ar defficiency, I think it was in New Guinea. 

[Annah]

when it comes to studies, the best advice is to try it yourself. Stop taking finasteride and take Spiro only and see what happens.

For me, I couldn't afford that luxury as I wanted my hair back as soon as possible and I knew Spiro only would not regrow lost hair back.

Now, I am not specifically familiar with finasteride but from what other transgender people have been saying is Avadort/dutas works much more effectively than finasteride will ever do. Some compare Finasteride is to Avadort as Premarin is to Estrodiol.

But the best thing is to monitor for yourself. I can only tell you how I reacted to the medications and how others reacted to it.

[regan]

Now, I am not specifically familiar with finasteride but from what other transgender people have been saying is Avadort/dutas works much more effectively than finasteride will ever do. Some compare Finasteride is to Avadort as Premarin is to Estrodiol.

They're the same class of medications, they just differ in the manufacturer.  That being said, there shouldn't be a difference in the two.

[Lillet]

They're the same class of medications, they just differ in the manufacturer.  That being said, there shouldn't be a difference in the two.

No, Dutasteride blocks both types of 5ar enzymes, while Finasteride only blocks type 2.  That's why Finasteride can lower DHT by around 70% at max dosage, while Dutasteride can get to 90%. 

[Annah]

They're the same class of medications, they just differ in the manufacturer.  That being said, there shouldn't be a difference in the two.

same "type" of medications but different chemicals and makeup.

Many websites that deals with hairloss states that Avadort grows hair 50% faster than finasteride

In clinical trials, chronic dutasteride thereapy reduces serum DHT by 93 to 94% while finasteride reduces serum DHT by approximately 70%

A brief 3-month prospective and consecutive study was conducted to evaluate the onset of symptom relief with Avodart versus Proscar (finasteride, Merck & Co.) One hundred twenty men with symptomatic benign prostate hyperplasia (BPH) were treated with Avodart, followed by an additional 120 men treated consecutively with Proscar for 3 months in each trial. Among patients who recieved Avodart, there were significantly greater reductions in AUA-SO scores compared with Proscar in the first 3 months ( P <0.0016).

In the study, 416 men with male pattern hair loss (MPHL) ages 21 to 45 years old, were randomized to receive dutasteride 0.05, 0.1, 0.5 or 2.5 mg, finasteride 5 mg, or placebo daily for 24 weeks. The results of the study showed that dutasteride increased hair counts in a dose-dependent fashion and dutasteride 2.5 mg was superior to finasteride 5mg at 12 and 24 weeks.

Dutasteride (Avodart) inhibits both type 1 and type 2 5?-reductase and is approved at the 0.5-mg dose for treatment of symptomatic benign prostatic hyperplasia (BPH). It is about 3 times as potent as finasteride at inhibiting type 2 5?-reductase and more than 100 times as potent at inhibiting the type 1 5?-reductase enzyme.

Dutasteride caused scalp and serum dihydrotestosterone levels to decrease and testosterone levels to increase in a dose-dependent fashion. Whereas 5-mg finasteride decreases serum DHT by about 70%, dutasteride can decrease serum DHT by more than 90%.

Results: Finasteride 5mg    75.6 hairs
Dutasteride 0.1 mg    78.5 hairs
Dutasteride 0.5 mg    94.6 hairs
Dutasteride 2.5 mg    109.6 hairs

These quotes were taken from the ABHRS American Board of Hair Restoration Surgery and the ABD American Board of Dermatology.

In every medical study conducted, Avadort outperformed Finasteride even when Avadort was taken in the most smallest of doeses (Finasteride at 5 mg vs Avadort at 0.1mg)

So while they are the same class of drugs, Avadort has been proven clinically to be much more superior than just Finasteride. And when taken with an Anti-Androgen such as Spiro, the results are even greater without any added unhealthy side effects other than what is typically taken.

[regan]

My doc uses Finasteride + Spiro for his AAs.

I'm not worried about undoing hairloss, more about hair "preservation" as far as MPB.  As far as I understand from our conversation today, his goal is to get T down to a female range, his first line is Finasteride, I would bet Avodart would be his second line - though he even mentioned using Androcur in a worst case scenario.  I don't know how he goes about getting the Androcur, but if he's willing to go that far he sounds pretty aggressive.

I don't know if I'm asking a question, but I feel like I am. 

[Annah]

My doctor said the same thing about 5 years ago. Back then Avadort was really pushed as a prostate remedy and not for hairloss so my doctor was hesitant in trying it on his patients. When I first started doing this last year, I really had to sell him the results of Avadort.

Today, he uses it as his standard treatment alongside Spiro for hair regrowth.

But I can see why your doc is hesitant. Finasteride has been out much longer than Avadort.

[regan]

My doctor said the same thing about 5 years ago. Back then Avadort was really pushed as a prostate remedy and not for hairloss so my doctor was hesitant in trying it on his patients. When I first started doing this last year, I really had to sell him the results of Avadort.

Today, he uses it as his standard treatment alongside Spiro for hair regrowth.

But I can see why your doc is hesitant. Finasteride has been out much longer than Avadort.

As long as my levels end up where they're supposed to be, I'm not going to worry about it.  Though he also says you can't follow the normal male/female endocrinology if you plan on "overpowering what the male body is programmed to do".

[Annah]

As long as my levels end up where they're supposed to be, I'm not going to worry about it.  Though he also says you can't follow the normal male/female endocrinology if you plan on "overpowering what the male body is programmed to do".

sounds like a wise dr

[regan]

sounds like a wise dr

For the record (for the benefit of those following this thread)...

Always be aware of your insurance coverages and what prescription programs are out there.  For example, my insurance requires "pre-authorization" in order to cover either Finasteride or Avodart.  I researched this a little further and what I learned is that an automatic approval is granted to patients over 45.  Under 45 (I'm 37), they require the prescribing doctor to certify that those medications are for the treatment of BPH or an enlarged prostate.  My doctor is willing to diagnose these conditions for the sake of insurance approval.

Walmart (and others) offer Finasteride for $9 for a 30 day supply.  No so for Avodart.  My insurance aside, Avodart may be better, but Finasteride is better then nothing and insurance or not, $9 is pretty cheap and the money you would spend on  Avodart could be spent better elsewhere.  Where it gets interesting, with respect to not discussing dosages, I can get the prescription for Spiro filled for $5, no questions asked (since its used for controlling blood pressure), while going the walmart route and having to buy a larger amount of a smaller dose would cost me much more.

The moral is, know how the system works and work it to your advantage.  HRT isn't always cheap, but there's no need to spend more then you have to to get what you want, even if it means chosing one medication over another.

[Annah]

I get my 30 dollar supply of Avadort for 6 dollars for 30 days at Target under Dutas

[regan]

I get my 30 dollar supply of Avadort for 6 dollars for 30 days at Target under Dutas

Good to know... 

Without disclosing dosages, I don't know how we could establish a thread to share that kind of information though...

[Annah]

Good to know... 

Without disclosing dosages, I don't know how we could establish a thread to share that kind of information though...

yeah that would be nice to have a way to confirm dosage for prescribers as to avoid the forums having self medicators to look into it but that would be a very daunting task!