The Synergy of Finasteride and Minoxidil on Testosterone Therapy

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Science & Humans

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Maria Jacob

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The Synergy of Finasteride and Minoxidil on Testosterone Therapy

Testosterone therapy helps replace deficits which is essential for the well being of a male, especially as they get older and testosterone synthesis starts tapering down. Testosterone therapy effectively counters hypogonadism or low – T. ​

Long term external replacement of testosterone might lead to an excess production of DHT(Dihydrotestosterone) which shrinks hair follicles eventually leading to hair loss. A genetic disposition to MPB (Male Pattern Balding) is the leading cause for a thinning crown and a receding hairline. But being proactive and starting early treatment will help reverse this condition. ​

Finasteride, a 5AR blocker blocks the enzyme called Type -II Alpha Reductase that synthesizes DHT from testosterone. More 5AR enzyme, more DHT, leading to MPB hair loss. ​

Minoxidil, which is a scalp treatment, helps increase blood flow to the hair follicles. Together finasteride and Minoxidil help regrowth of hair, and keep a good mane. ​

The quarterly follow ups will help manage side effects if any. Finasteride has been well studied, with long term and short term side effects very well researched and considered safe for treating hair loss.​

Finasteride is Health Canada approved. ​

Why is only Finasteride prescribed and not Dutasteride for people undergoing Testosterone Therapy ?

Finasteride was discovered and patented a few decades earlier to Dutasteride. While dutasteride is as good and has similar side effects it is a recent drug and not enough studies or long term usage data to be approved by FDA.

Currently Dutasteride for hair loss is only an ‘off label’ prescription but is not allowed by Health Canada.



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Finasteride and Dutasteride – what is different?

  • Finasteride blocks type-II 5AR while Dutasteride blocks both Type – I and Type -II 5AR enzymes, this is one reason it is considered potent.
  • Fnasteride effectively blocks 70% of DHT while Dutasteride blocks more than 80%
  • Half life – Finasteride lasts in the system for a day, while Dutasteride lingers for longer time.

It is important to remember that DHT is removed not only from the scalp but from all other tissues as well. In this context is it wise to take dutasteride which is too efficient in removing DHT?

DHT in the scalp might be bad for hair, but it has a role to play in other tissues. Muscle tone for instance. Synthesizing of estradiol is another reason. Can eliminating DHT increase estradiol which can result in more body fat? Being mindful of such cascading side effects is another reason finasteride is favored over dutasteride.

The anabolic and androgenic factors of testosterone therapy are much more potent in DHT. It is DHT which is responsible for the development of male sexual features in the womb, and later in puberty secondary sexual characteristic features like deepening of the voice, pubic hair development etc.

And yes, when we credit testosterone with the good things of mood upliftment, good muscle tone, libido, it is actually DHT that is doing the heavy work. Everyday about 10% of testosterone is converted into DHT.

Hormone optimization does not mean just replacement but carefully monitoring all side effects including the likelihood of hair loss and preventing it as well. It is achieving balance as close to nature intended.

Regular blood work & quarterly check ups while on testosterone therapy is emphasized for this reason.

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