What is the dose of Finasteride? Is Microdosing or customised dosing the better way forward. Or should we adhere to the FDA recommended regulation dose of Finasteride?
So when we speak of microdosing, can we get away with 0.2 mg a day and get a good result as far as maintenance of hair is concerned, without so much as even an inkling of a side effect -even in those vulnerable?
So coming back to microdosing, it has been shown by a particular study that the effect of taking 0.2 mg Finasteride daily or 0.5 mg Finasteride 3 days a week is not much different from taking 1 mg dose. You may support these findings by endless studies and theoretically this may even be true; but the body does not respond in all cases like we intend it to. In my practice, I have been using similar dosing - 0.5 mg on alternate days and found that not much benefit accrued in the vast majority of clients. However in those fit for the medication but otherwise fearful are advised 0.5 mg and then gradually I build up on it more to allay the patient’s fears and have him as an ally in his own interest so he develops confidence in the medication and the doctor and gradually overcomes his phobias. I do not exhibit this dose routinely since I am not convinced about its benefits as alluded by some studies. To me my clinical judgement and instinct borne out of years of practice and prescribing Finasteride in various doses is more important than one sided research.
So I do not think 0.2 mg taken daily or 0.5 mg taken 3 times a week and omitted on weekends is a plausible option in the face of aggressive baldness which is so common these days. This approach merely wastes precious time especially since patients agree to taking Finasteride very late in their hair loss timeline. It is gross injustice to advise them a miniscule dosage and waste another few months when we fully know that when the hair shaft diameter decreases to less than 50%, Finasteride fails to have any effect. It just reminds me of Nero and how he watched Rome burn as he played his fiddle.
So this is the rationale of customized dosing. A belief out of clinical experience that there is no one dose best suited for all. Every person is different, his metabolism and mind are different. We have to seek out the lowest dose best suited for him to maintain his hair and at the same time save him from side effects.
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21 мар 2021
