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Finasteride may cause elevated liver enzymes, potentially leading to liver issues, though this is rare. Users should monitor liver function and consider topical alternatives if liver sensitivity occurs.

Liver problems may reduce the effectiveness of oral minoxidil due to impaired SULT1A1 enzyme activity, which is crucial for converting minoxidil to its active form. This reduction in enzyme function can significantly decrease the drug's effectiveness in promoting hair growth.

Before starting hair loss treatment, it's suggested to undergo various blood and health tests to minimize side effects. The checklist includes tests for kidney function, liver enzymes, blood sugar, vitamins, hormones, and more.

Oral minoxidil can still work without the SULT1A1 enzyme because the liver has enough of it, but its effectiveness on the scalp depends on transporters. Oral minoxidil generally does not affect blood pressure at low doses.

Topical Finasteride doesn't directly reduce 5ar enzyme on scalp and has the same mechanism as oral, needing to go through the liver. Users debate the accuracy of this information and discuss various studies and experiences.