Yes, this blog is about customised dosing of Finasteride. What should be the right dose? Does it even matter?

But before we answer these questions, let’s go back to the basics briefly.

Relation between DHT and Hair Loss

DHT is the main hormone causing Male Pattern Baldness. DHT (Dihydrotestosterone) is an androgen (male sex hormone) that emerges as a by-product of testosterone in the prostate, testes, and other tissues. Post puberty, a male, if genetically inclined, can start to lose hair. This means you cannot prevent it from occurring, but only accelerate it with your lifestyle choices. Once the body determines you have reached a certain biological age (which can be different to the chronological age), your hair cells release an Androgen receptor from the nucleus, allowing for the very first time, Testosterone to enter the nucleus of the cell. This Testosterone binds with an enzyme called 5 Alpha Reductase, and thereby produces DHT.

DHT shortens the anagen (growth) phase of the hair cycle, from a normal duration of 3–6 years to just weeks/ months. DHT causes the follicles to miniaturize (think of it as shrinking) and, eventually, stops new growth altogether.

Can we give high dose of Finasteride?

The dose of Finasteride must be kept lower to a specific threshold. By keeping it very high, there is a possibility that DHT becomes close to zero. This will not be good outcome as DHT does a lot of good things for the body as well.

So what is the right dose of Finasteride against hair loss?

We can confidently say nobody really knows! Each person is different and it is about finding the lowest dose that works for you. Think of how a cardiologist regulates your blood pressure medicine by keeping it to a minimal dose. It works something like that.

For this, you need to understand how the Finasteride medication works in the body, how does it get metabolised and so on, which we somewhat explained in the first section above. You perhaps don’t need Finasteride on a daily basis. A higher dose may drop the DHT and may even result in some side effects.

At Evolved Clinics in Perth, Australia we generally start with Finasteride 1mg for three times a week. We have seen this to be in the sweet spot. Will it work for everyone? Short answer is No. But by giving this dose as a starting point, we will decide how we progress thereon and finally arrive at the dose which can be kept sustainable on a long term basis.

In our view, if someone follows a Finasteride regime for 6 months and the Hair loss is stabilised with side effects, this becomes the de facto dose. On the other hand, if there is continued hair loss, you may have to increase the dose or its frequency. Or perhaps even add another hair loss treatment. The other possibility is someone gets side effects but the hair loss condition is stabilised. In this case, there is no choice but to pull back the dose and do a reassessment.

In summary, the right dose of Finasteride goes down to every individual and his genetics. And therefore, it is super important that you get your hair loss condition assessed by a hair loss expert who can help you with the process.