A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of Botanically Derived Inhibitors of 5-Alpha-Reductase in the Treatment of Androgenetic Alopecia

L. reuteri, a probiotic, is being explored for its potential benefits in treating androgenic alopecia, possibly enhancing finasteride's effects and reducing inflammation. The user combines this with finasteride, oral minoxidil, and other supplements, noting some improvement in hair loss.

Finasteride and dutasteride are discussed for hair loss, with concerns about their effects on neurosteroids and potential side effects like depression. Alternatives like topical estrogen and lifestyle changes are considered, with varying opinions on mental health and hair regrowth.

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

Saw palmetto, a 5-alpha reductase inhibitor, caused unexpected side effects like breast changes and altered semen consistency, which resolved after stopping its use. Concerns about similar side effects with finasteride or dutasteride were expressed, and another user reported low libido and depression from saw palmetto.

Beta-sitosterol may inhibit 5-alpha reductase type 2 enzyme, potentially reducing DHT levels and promoting hair growth, similar to finasteride but possibly with fewer side effects. Its effectiveness and side effects compared to other treatments like saw palmetto and finasteride remain uncertain due to limited research.

The conversation is about managing allopregnanolone deficiency caused by 5-alpha-reductase inhibitors like finasteride or dutasteride. Specific treatments discussed for hair loss include Minoxidil, finasteride, and RU58841.