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Finasteride may temporarily increase cortisol levels by inhibiting the 5a-reductase enzyme, potentially causing fatigue and insomnia. The body might adjust over time, but some users report prolonged issues with elevated cortisol and sleep disturbances.

The conversation humorously suggests that drug use might be more effective for hair retention than traditional treatments like minoxidil or finasteride. It attributes full heads of hair in homeless individuals to lifestyle factors like reduced stress or hormonal changes.

Finasteride and dutasteride have potential risks, including post-finasteride syndrome, but are commonly used for hair loss. RU58841, minoxidil, and needling are suggested as alternatives, though all treatments carry risks.

The user has been taking oral Finasteride and topical Essengen 6 Plus for hair loss and is experiencing increased depression. They plan to get bloodwork to check hormone levels and are seeking advice on which tests to include.

Clascoterone is suggested as an alternative for those who experience side effects from finasteride and dutasteride. It is not widely available yet, but some users are obtaining it from compounding pharmacies or suppliers like Echemi.