The conversation discusses how different factors can stimulate type 1 and type 2 isoforms of 5-alpha reductase, which are enzymes linked to hair loss. Specific treatments mentioned include oral Dutasteride and topical Finasteride.
Topical dutasteride is suggested as a low side-effect treatment for hair loss, with a proposed dose of 0.025% 1ml/day. It is considered better than finasteride due to its even inhibition of DHT isoforms and lower systemic absorption.
The user has been on 1mg finasteride for a year, experiencing low libido and moderate erectile issues. They are considering using Cialis daily with finasteride long term to address these side effects.
The conversation discusses whether finasteride's reduction of DHT and increase in scalp testosterone contribute to hair follicle miniaturization. Some participants argue testosterone does not cause miniaturization, while others suggest that even with reduced DHT, other androgens like testosterone may still contribute to hair loss.
Elevated bile acids can inhibit the enzyme AKR1C2, leading to increased DHT levels, which may accelerate hair loss in those predisposed to androgenetic alopecia. Treatments mentioned include topical minoxidil and finasteride.