Pre-op Finesteride window...

[Lockdown-Locks!]

Hi All,

Just wondering if it is essential to be on Finesteride for a significant period before having a HT?

Or perhaps many folks have never had it, start as soon as they have their HT and successfully recover to good 12 month results?

 

[Bigmac]

It's better to try it before a HT to see if you get side effects. If you can't use any hair loss prevention meds you could continue to lose more native have and possibly transplanted hair.

 

[Lockdown-Locks!]

HI Bigmac,

That is a great point, I didn’t think of that. Is that to say that HT are only viable to those who can tolerate Finesteride?

Secondly, surely the transplanted hair is DHT resistant, since it is harvested from a DHT-proof part of your head?


P.S. I’ve found this forum earlier this week and have been reading through so many posts - you’re knowledge and response have been so helpful - thanks so much for sharing your expertise with us all.

Regards

 

[Bigmac]

In my opinion and that of numerous doctors, a hair transplant has a better chance of success if you can prevent your remaining hair from becoming susceptible to DHT.
There are other options to try if you can`t tolerate Finasteride or simply don`t want to try it. I`ve been on Proscar, then Finasteride since 2005. Without it, I`m in no doubt my hair loss would have progressed aggressively.

Hairs/grafts taken from the safer donor zone are not guaranteed to be DHT resistant. However, they have a much higher chance of being so. People's donor areas thin out over time as we age, some people progress to a high Norwood or you may be affected by a condition such as retrograde alopecia which thins out the hair mainly on the side of your head.

Quite a few clinics harvest grafts outside what many doctors have stated as the safer donor. Without any hair loss preventative measures in place, these grafts could be the first to miniaturise and vanish. As long as patients know this risk, then it`s their choice to go ahead.

Hair loss can be unpredictable, you may progress to whatever Norwood and then the loss stops but you never know. Doctors will look at all the factors such as when did your hair loss begin, how far you have progressed, check for miniaturised hairs, family history of hair loss etc to try and determine to the best of their knowledge what they think is the best approach for you.

I always like people to read this thread which shows how hair loss can progress, especially if you don't use any preventative measures or stop using them.

Accelerated hair loss after stopping Finasteride.

ps, nice to hear the forum helps you.

 

[Lockdown-Locks!]

In my opinion and that of numerous doctors, a hair transplant has a better chance of success if you can prevent your remaining hair from becoming susceptible to DHT.
There are other options to try if you can`t tolerate Finasteride or simply don`t want to try it. I`ve been on Proscar, then Finasteride since 2005. Without it, I`m in no doubt my hair loss would have progressed aggressively.

Hairs/grafts taken from the safer donor zone are not guaranteed to be DHT resistant. However, they have a much higher chance of being so. People's donor areas thin out over time as we age, some people progress to a high Norwood or you may be affected by a condition such as retrograde alopecia which thins out the hair mainly on the side of your head.

Quite a few clinics harvest grafts outside what many doctors have stated as the safer donor. Without any hair loss preventative measures in place, these grafts could be the first to miniaturise and vanish. As long as patients know this risk, then it`s their choice to go ahead.

Hair loss can be unpredictable, you may progress to whatever Norwood and then the loss stops but you never know. Doctors will look at all the factors such as when did your hair loss begin, how far you have progressed, check for miniaturised hairs, family history of hair loss etc to try and determine to the best of their knowledge what they think is the best approach for you.

I always like people to read this thread which shows how hair loss can progress, especially if you don't use any preventative measures or stop using them.

Accelerated hair loss after stopping Finasteride.

ps, nice to hear the forum helps you.

Hi Bigmac,

In regard to your first point that a HT success-rate increases the more you can prevent your remaining hair from becoming susceptible to DHT, I guess this brings my original question more into context; how long should one ideally be on Finasteride before undergoing a HT i.e. how long does it take for Finasteride to build up adequate DHT protection for the native hairs; and can this process be done at the same time of implanting new hairs?

Thanks for the thread link, really brings home the importance of getting on the meds. I’ve already had a consultation at The Private Clinic, whereby the advice was to get on Finasteride to 1) protect the native hairs and 2) reach any regrowth potential of the miniaturised hairs. They said this would reduce the total grafts required and, in the meantime, they could operate on my temples since there no hairs there at all i.e. Finasteride won’t regrow this area at all (I’m a circa Norwood late 3/early 4 right now).

I’ve decided to take action – I want a HT and am (reluctantly) willing to initiate Finasteride.

Interesting to see you initially started on Proscar; that is simply the branded version of Finasteride (which I believe is at 5mg only).

I am thinking of taking some pre-Finasteride blood tests privately so I have baseline measurements of key bio-markers, since essentially, I will be playing with my body’s hormonal homeostasis and I don’t like the idea of that at all!

For anyone interested in my research around this (I’m not a scientist/medical expert): Biomarkers to record in a pre-finasteride blood test

Essential

• Total testosterone determined via liquid chromatography with tandem mass spectrometry i.e. not with ECLIA; Electro-chemo-luminescence Amino-asset (if possible)
• Free testosterone determined via equilibrium dialysis or equilibrium ultra-filtration; try not to use direct analogue amino asset (this is the standard common test)
• Dihydrotestosterone levels via high pressured liquid chromatography with tandem mass spectrometry
• Free DHT Levels via equilibrium dialysis
• Oestradiol
• Sex Hormone Binding Globulin
• Prolactin
• DHEAS (Dihydroepiandrosterone Sulphate)
  
  

Recommended, if you still have budget after the above

• Prostate Specific Antigen
• Progesterone
• Follicle stimulating hormone
• Luteinising Hormone
• Thyroid Hormones – to check if thyroid is causing hair loss (i.e. not androgenic cause)
  • TSH
  • Free T4
  • Free T3
  • Reverse T3
  • Thyroid Globulin Antibodies
  • Thyroid Peroxidase Antibodies

 

[Bigmac]

Most studies suggest a minimum of 6 months on finasteride to see if it works. Therefore, using it 6 months prior would be ideal but this isn’t always possible for whatever reasons. Some start it less than 6 months and others after they’ve had their surgery. I used Proscar initially because it was accessible at the time, then switched to finasteride with it being easier to source and cheaper.
The advice from the Private clinic makes sense.
If you go for the blood tests it will be interesting to see if there are any changes and what effects they could have.

 

[Lockdown-Locks!]

Most studies suggest a minimum of 6 months on finasteride to see if it works. Therefore, using it 6 months prior would be ideal but this isn’t always possible for whatever reasons. Some start it less than 6 months and others after they’ve had their surgery. I used Proscar initially because it was accessible at the time, then switched to finasteride with it being easier to source and cheaper.
The advice from the Private clinic makes sense.
If you go for the blood tests it will be interesting to see if there are any changes and what effects they could have.

For me time is of the essence; I want to make use of the lockdown as recovery time (though at the same time, will not rush this if it is not clinically advisable).

Regarding the drugs, that makes sense - it suggests you started it when Finasteride was still patented i.e. not available as a generic.

As for the blood tests, I’ve spent some time researching into this and in summary;
1.There are many ‘at home’ blood tests available here in the UK - you order a kit in the post, draw your blood and send off the sample to which you received your results online
2. Using a combination of these tests, I can get about 90% of the above tests done for around £230
3. It is better to use venous blood sample (as opposed to a finger-prick test that often comes with these postal services). This will incur additional costs as you will need to get a phlebotomist to draw your blood sample (unless you know someone)



I feel like I am edging closer to a better head of hair!

 

[bullitnut]

Interesting thread, I have had numerous private blood tests over the years as I have an unrelated hair loss illness and before I was diagnosed I had pretty much every blood test going. What I did find was all my male hormone related tests were all within so called normal ranges according to my GP despite being on Finasteride for 10 plus yrs.....I do wish I had had the same tests done when I first started the Finasteride though to get a base line to see the changes if any, so thats a good idea of yours.

If your reluctant to start the Finasteride before the surgery why not try something more along the lines of a supplement with Saw Palmetto etc in to see how you go.

Personally though my view is if you aren't on any type of preventative medication or even a supplement that reduces DHT then I wouldn't have a HT unless your planning on going very conservative with the design or you have extensive knowledge about your families hair loss patterns/Gene's so you know where your likely to end up.

Many people would probably say to me what's the point of supplements they arent as good as Meds and for lots of supplements that's likely true but I came off Finasteride whilst trying to get my partner pregnant with our 3rd child six yrs back and just took a supplement called Folligain stimulating hair regrowth supplements containing saw Palmetto and Biotin, MSM and others and I swear I didn't loose any hair.

I did go back on Fin mind...probably due to paranoia worrying incase the supplements stopped working.

Just another option that could possibly help some people?

 

[Bigmac]

For me time is of the essence; I want to make use of the lockdown as recovery time (though at the same time, will not rush this if it is not clinically advisable).

Regarding the drugs, that makes sense - it suggests you started it when Finasteride was still patented i.e. not available as a generic.

As for the blood tests, I’ve spent some time researching into this and in summary;
1.There are many ‘at home’ blood tests available here in the UK - you order a kit in the post, draw your blood and send off the sample to which you received your results online
2. Using a combination of these tests, I can get about 90% of the above tests done for around £230
3. It is better to use venous blood sample (as opposed to a finger-prick test that often comes with these postal services). This will incur additional costs as you will need to get a phlebotomist to draw your blood sample (unless you know someone)



I feel like I am edging closer to a better head of hair!

As bullitnut mentions, something like Folligain may help rather than Finasteride.
Having a transplant during lockdown is convenient allowing time to recover.
The patent on Finasteride may have been another reason but with it being so long ago I don’t remember.

The blood tests will incur the extra charges for the reasons you list.
I don’t know if you’ve read this topic by Prohair on DNA testing for genetic hair loss.
DNA testing for hair loss

 

[SheddinStevens]

Most studies suggest a minimum of 6 months on finasteride to see if it works. Therefore, using it 6 months prior would be ideal but this isn’t always possible for whatever reasons. Some start it less than 6 months and others after they’ve had their surgery. I used Proscar initially because it was accessible at the time, then switched to finasteride with it being easier to source and cheaper.
The advice from the Private clinic makes sense.
If you go for the blood tests it will be interesting to see if there are any changes and what effects they could have.

Most clinics I've been in touch with much prefer you to be on it for 6 months prior to your HT. For most it isn't essential and some have insisted on it.

I've been on it for only 2 months in addition to minoxidil and a couple of other things. I've seen some small results of some new tiny, tiny new hairs after shedding quite a lot from it and now I'm getting my HT next week. My hope is that some more hairs may come in from it, but in my experience of using it for 2 years previously it isn't going to work wonders for me but just helps keep hair to some extent.

 

[Bigmac]

The main benefit is to prevent or slow right down future loss.
If you get an improvement in your hair, then that’s a bonus.
I have seen a lot of people who improved enough that they decided a HT was not required.

 

[Lockdown-Locks!]

Hi All,



Sorry for the delay in my response, I was flooded with work and a few other things.

Some great points raised here. @bullitnut thanks for the supplement suggestions. My opinion of supplements is this; whether you instigate biological changes to your body through synthetic means (aka medications), or through natural supplements is irrelevant – they are both exogenous stimulants administered to achieve a particular outcome/result – a change in your internal chemistry/biology. Hence, I think supplements are an equally suitable and viable option for many. I’ll certain be looking into these supplements you mention.


@Bigmac this DNA testing thread is such a great read. Some very interesting points raised- thanks for sharing.



Since starting this thread, I have now started my Finasteride 1mg daily dose. I’m 7 days in and carefully looking out for any undesirable side effects.



Have any of you guys experienced any side effects on Fin?