Looking for an alternative to finasteride without side effects?
Dr Kyle Gillett discusses hair loss, the risk of taking finasteride and some effective finasteride alternatives.
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We’ve been talking about fine asteroids A lot on this channel and most experts That we have had on before they all are Against the use of it yeah because of uh Possibilities of post finasteride Syndrome a lot of risks for erectile Dysfunction and libido loss so what’s Your maybe more Nuance take on this Matter Are you a proponent of using a Finasteride I don’t really claim to be for or Against using any medication I call my Clinic service individualized medicine Because it takes into account each Individual’s Um I guess predisposition and also each Individual’s genetics So um the way that I sometimes explain Finasteride is it inhibits two of the Three ISO enzymes of the five Alpha Reductase enzyme so you think of your Bloodstream as Um the pipe or the plumbing that’s where It flows in between and three different Types of cells one of the cells that it Inhibits offroaductase in is on the cell That has the hair follicle One of the cells is the cell that has That is in genetic urinary skin so for Example penile skin or scrotal skin and Then the other one is in the rest of the Skin in your body So um your body has many different
Feedback inhibition mechanisms but when You’re thinking about uh androgenic or Anti-androgenic side effects for example Loss of sensitivity loss of libido Changes in the brain it’s not just the Androgen receptor and the progesterone Receptors that you have to Um like look at how often they’re bound But it’s also how strongly they’re bound So for someone that is that has a very Sensitive Androgen receptor they often Do not need as high of a level of DHT to Get the same amount of Gene Transcription the way I explain that is It’s like a door and some people just Genetically have a very heavy door That’s the Androgen receptor so you need A stronger Androgen to push that door Open And on top of that there’s also a change In Androgen receptor density so that is Likely why we see very frequent side Effects with finasteride because your Body detects that one of the buckets That’s the cell for example Um in non-genital skin it detects that There’s a normal level of DHT in that cell through various Feedback mechanisms so it is not going To change like heat shock protein Signaling from Androgen receptor density And whatnot Whereas if you have the level of all Those three the same
Then it is much less likely that you Will have the symptoms and we see this In studies that compare Doses that have the same serum level so Again that’s not inside the cell it’s Not the intracrinology but the same Serum level of DHT you can compare the Finasteride and dutasteride and dose for Dose dutasteride has less side effects That being said classically when Dutasteride is taken for benign prostate Hyperplasia it’s taken over high doses It’s kind of the same thing with Finasteride although five Meg and one Meg is not really that different of a Dose when it comes to pharmacodynamic Effects So that’s a lot of words and a long Story but um I guess the thousand foot View of that is yes side effects are Relatively common with finasteride it’s Important if you’re a candidate for it And there’s not a better treatment Option and often there is better Treatment options but if you’re a Candidate for it you need to look at Your estrogen to Androgen ratio you need To look at your free androgens across The board not just free DHD but also Free testosterone accurately assay or Estradiol so likely not an eclia Especially if you’re producing your own Endogenous testosterone and then it’s Rheumatizing and then also look at
Finally your progestogens so I call it The progestogen pool it’s your Pregnenolone plus your progesterone get An idea of how how much progesterone is Five Alpha reduced and crossing the Blood-brain barrier it is of course a Very nuanced topic I believe James and I Uh our podcast on hair loss that focuses On this a lot it’ll probably be three Hours long that will be very reference Heavy but I love talking about it and I Love the pharmacology of it so hopefully That kind of helps explain the Nuance Behind without duct taste members sure Thing and while there are maybe better Options are there for prevention of tree Or treatment of male pattern baldness Yeah Um the more it is related to the Hyperandrogenic signaling so the excess Gene transcription at the Androgen Receptor the more you need to consider Other what I would call anti-androgens Now if it’s a mixed picture sometimes Growth agonists can help growth agonists Would be like minoxidil PRP mini Peptides Anti-androgens would be uh final four Adeptase Inhibitors topical as well are Often good choices of node not as much Topical finasteride that significantly Goes systemic depending on the dose of Topical dutasteride A clinically insignificant level
Um Like it does go systemic as well but it Is usually clinically insignificant so Dosing for topical dutasteride is Extremely important and then there’s Other topical anti-androgens that are in Development basically cousins of Ru58841 once it brings you up but that One’s been stuck in phase two or three For a long time so there’s several Promising prescription anti-antergens And then I always like talking about Caffeine and then always like I can wrap Ketoconazole spironolactone also goes Systemic but most of it’s metabolized Before it goes systemic but probably not All of it depend on the dose so there’s A lot of options for topical Anti-andergens neuromodulators another Um uh topical anti-androgen and then There’s definitely a difference between Mesotherapy and topical so topical You’re thinking about a solution Directly on the scalp for some things You want to microneedle for some things You definitely do not sometimes you can Combine these in a device like an aqua Gold where you can develop you know Deliver PRP and like a non-immunogenic Neuromodulator like a botulinum toxin at The same time And then Um depending on where you’re at Basically if a sterile compounding
Pharmacy makes topical detest red you Can do mesotherapy for that but the dose Is definitely not the same for solution Of dutasteride Versus mesotherapy of your test drive [Music]