May 6 2009, 3:33 pm PT | Posted in: Drugs + Drugs (Cause Hair Loss)
In all of the studies trying to determine whether natural supplements like saw palmetto or green tea block DHT, they never refer to Type I DHT or Type II DHT — just DHT. Why is this? Good question, huh?
Good question. Propecia (finasteride 1mg) blocks mainly DHT type II, and Avodart (dutasteride) blocks both DHT type I & II. You would think if you block ALL the DHT it would be better against androgenic alopecia. Dutasteride is three times more potent than finasteride inhibiting the type II enzyme and 100 times more potent than finasteride inhibiting the type I form of the DHT producing enzyme. There are clinical observations that suggest that dutasteride is better than finasteride, but it is not approved for hair loss by the FDA and the long term safety on human reproduction for dutasteride (reports of sterility is a complication) have been suggested in some rare patients. We have received many reports by varying doctors who switch people from finasteride to dutasteride and get a better response. The next logical question should be: If we increase the finasteride dose to 5 mg or so, will it be better to treat hair loss? I don’t know if anyone really knows that answer for sure. Some of the original studies on finasteride suggested that the 1mg dose is the most universal dose, but it may be that a high dose in those who are refractory to finasteride may help. Some doctors are using a higher dose of finasteride on long term users. It’s a prescription drug, so I’m not suggesting you should take a higher dosage. The problems for either finasteride and dutasteride is that side effects rise when increasing dosages.
To get back to your question though — it’s been proven that type II is linked to male pattern baldness, but type I hasn’t been linked yet (though it’s possibly just not been proven yet). I couldn’t tell you why the studies out there don’t provide a breakdown by type, but I have not found scientific evidence that saw palmetto or even green tea actually block DHT anyway. And even if it did block some DHT, there is nothing in the literature that shows saw palmetto or green tea being effective for treating androgenic alopecia. I don’t mean to be a pessimist, but even Propecia does not completely stop androgenic alopecia.
The real quest should be finding other (non- DHT related) mechanism for androgenic alopecia. DHT is not the only solution out there… we just haven’t discovered the other yet.
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Balding Forum




I took Proscar, the entire 5mg dose for about 14 yrs before I switched to Avodart I guess going on 4 yrs now give or take. Way back then, the first year or so I was on it, I was popping it like candy, sometimes taking up to 20mg a day! At that time my insurance company was flipping the bill. They finally caught on that I was using it for hair loss and stopped paying for it so i cut my dose back down to 5mg per day.
With a higher dose of 20mg (20times the Propecia dose) I Didn’t notice any improvement over just taking a 5mg dose once a day.
who cares? we want stem cells!
Dr.,
You stated that “type I hasn’t been linked yet [to male pattern baldness](though it’s possibly just not been proven yet).”
Wouldn’t it have to be linked if Propecia only deals with type I and there are success stories related to the madication?
The difference is quite simple,
Type 2 enzymes are found pretty much only in hair follicles,
Type 1 enzymes are found in almost any skin cell.
So obviously inhibiting the type 2, that makes DHT right in your hair follicle, is going to have more of an effect.
However, type 1 still produces DHT, a hormone which can circulate and penetrate cells so it can’t hurt to inhibit that too!
Ya want stem cells eh?? Hope you can wait at least 20yrs! LOL!
There was a small typo here i think.
The Doctor wrote: “Propecia (finasteride 1mg) blocks mainly DHT type I”
But actually Propecia blocks DHT type II
Very fascinating blog though - and helpful also…
Here is where it says that Propecia blocks type II DHT
http://www.propecia.com/finasteride/propecia/hcp/mphl_patients/dht-hair-loss.jsp
Steve,
Yes, that was a mistake in editing. Thanks for catching it. Updated the post.