Everything you need to know about hair loss, including what prescription drugs may be able to help.
Sure, T NATION is about building muscle. That's a given. But there's more to living a good life than just muscle. There's another category that we specialize in and it's the exploitation or manipulation of human physiology. We can pretty much make your body react in almost any way you want it to. The answer is often there...if you've got the guts to try the solution.
That's the focus of this new series from TC. If you want to know how to use supplements or drugs in orthodox and sometimes unorthodox methods to increase your sexual vitality, your energy, your athletic and muscular capabilities, your looks, or your joy of life in general, TC's got it covered.
Each article will cover some aspect of feeling better, performing better, looking cosmetically better, or just plain kick-ass being better.
Give me a head with hair, long beautiful hair
Shining, gleaming, streaming, flaxen, waxen
Give me down to there, hair, shoulder length or longer
Here baby, there, momma, everywhere, daddy, daddy...hair
— The musical, Hair
I started using the 5-alpha-reductase inhibitor finasteride after reading studies on how it had prevented hair loss in macaque monkeys.
Who knew those monkeys were so vain?
Anyhow, this was years before finasteride was marketed as the hair loss drug, Propecia.
Keep in mind, though, that prior to that, finasteride had been the drug of choice for treating BPH (benign prostatic hypertrophy). Both hair loss and prostate growth are linked to higher levels of DHT (dihydrotestosterone) and finasteride prevents Testosterone from converting into DHT.
Limit the conversion rate and generally speaking, your prostate stays normal-sized and hair loss is prevented.
As I alluded to above, the drug finasteride took two pharmaceutical paths, first as the prostate drug Proscar, and years later as the hair-loss drug Propecia.
Predictably–when you take pharmaceutical company greed into consideration–the 5 mg. prostate version of the drug sold for considerably less than the 1 mg. hair-loss version of the drug, even though it was the exact same drug. Thus is the price of vanity.
Most cost-conscious people who used finasteride for hair loss, rather than purchase the much more expensive Propecia, would just buy the cheaper Proscar version and cut it into quarters and take one crumbly fragment a day. That's exactly what I did for years.
Did it work? I don't know. I started using it as a preemptive measure and while I can say that I still have a crown of blond, Bieber-ish hair, it's impossible to say what would have happened had I not been using 5-alpha-reductase inhibitors.
But I've no regrets. It wasn't a gamble as far as I'm concerned, at least not any more of a gamble that flossing and brushing your teeth will keep you from looking like a recent transplant from the dentally-challenged British Isles.
Hair Trek, The Next Generation
Despite the apparent success of my protocol, I continue to pursue alternative strategies to keep my hair. In fact, some years after I read about those experiments on macaque monkeys, I read about a "second-generation" version of finasteride.
While finasteride is a competitive inhibitor of what's known as the type-2 isoenzyme of DHT (the compound largely responsible for hair loss and prostate enlargement), a new drug called dutasteride was a competitive inhibitor of the type-2 isoenzyme and the type-1 isoenzyme.
That meant that, theoretically, dutasteride would be much more effective than finasteride as a hair loss preventative (and as a prostate enlargement preventative).
As before, the drug was released as a prostate drug with the trade name Avodart while simultaneously undergoing trials to test its effectiveness as a hair loss cure.
True to my druggy trend-setting nature, I chose not to wait for the results of the hair-loss trials. I obtained some Avodart and set about trying to figure out how to dose it. The problem was that it comes in gel cap, with each capsule containing .05 mg. of the liquid drug.
I determined that I'd get best hair-protective results from using .01 mg a day, but obviously I couldn't just cut a liquid-containing capsule into quarters or fifths.
The solution required a bit of kitchen chemistry. I poured one shot of vodka into an empty plastic Coke bottle. I then peppered one gel cap with thumbtack holes and threw it into the vodka. (I know, I know, it's not exactly standard lab practice.)
I waited a couple of hours for the drug to diffuse into the alcohol and then added four shots of Crystal Light orange drink, shook the mixture vigorously, and poured myself one shot, which gave me exactly .01 mg. of dutasteride.
I've been following that same protocol for a few years now.
The results of the phase II testing of Avodart seemed to confirm my ideas, if not my methods. A daily dose of 2.5 mg. of dutasteride increased target hair counts in subjects (men ages 21 to 45) to 109.6 hairs, while a 5 mg. dose of sibling finasteride resulted in a target hair increase of 75.6 hairs.
A smaller, 0.5 mg. dose of dutasteride also showed impressive results, with hair in the target area increasing to 94.6 hairs.
Potential Side Effects
Clearly, the 2.5 mg dosage was superior in promoting hair growth (and in lowering both serum and scalp DHT), but such a large dose would be more expensive and possibly leave the user exposed to more potential side effects such as a possible decrease in libido or diminished sexual function.
I've not noted either of these side effects with my comparatively small .01 mg. per day dosing. Keep in mind, though, that I'm not trying to re-grow hair, only keep what I have. Those who are trying to regain the flowing hair of their youth might do best taking 0.5 mg. of dutasteride a day, which is likely still too small a dosage to elicit any of the possible reported side effects mentioned above.
Interesting aside – is that the use of these 5-alpha-reductase inhibitors actually increases Testosterone levels. Why then, does a loss of libido or diminished sexual function sometimes occur? It's because you need some DHT to maintain sexual function, among other things, and if you block the conversion too efficiently, you may experience side effects.)
Regardless of the promising phase II test results, GlaxoSmithKline pulled the plug on the drug as a hair-loss remedy. I've heard anecdotally that they worried about being able to convince the buying public that it was that much different from finasteride, and that the results, while promising, weren't significantly better than those afforded by the earlier drug. In short, they didn't think they could market it effectively.
Regardless, I've continued to use dutasteride and believe in its efficacy.
Even so, I continue to keep an eye out for more promising hair regrowth formulas because there's a suggestion that 5-alpha-reductase inhibitors ultimately fail. The thinking is that 5-alpha-reductase inhibition merely delays the inevitable, which is hair loss.
Hair goes through a cycle, beginning with a growing phase (anagen), progressing to a resting phase (telogen), and culminating in an shrinking or regressive stage (catagen). It may be that 5-alpha-reductase inhibitors merely lengthen the anagen, or growing phase.
Perhaps what's needed is a more stimulative solution.
Anti-Inflammatories and the Mysterious "Substance P"
For months, I've been hearing from co-workers that their barbers, particularly, but also their girlfriends or wives, were noticing hair growth on their scalps where before there was little or none.
As a hair-growth aficionado, I was naturally curious to see if there was some sort of connection between these folliculalry reborn men, but it didn't take any serious detective work. All of them told me that it had happened since they started using resveratrol, the famed polyphenol found in red wine that's been linked to a whole host of healthful benefits.
At first, it didn't make much sense to me. I know that inflammation of hair follicles plays a part in balding and that resveratrol is an anti-inflammatory, but why haven't other anti-inflams been linked with restoring hair?
A Google search paid off immediately. An Italian company has filed a use patent on a combination of resveratrol and curcumin to combat hair loss and even hair graying. The proposed method of action is a synergistic anti-inflammatory effect from combining the two substances.
In addition, resveratrol and curcumin apparently stimulate nerve cells in the roots of hair follicles, therby promoting a release of neuropeptides known as Substance P, Neurokinin A, and calcitonin gene related peptide, all of which have been linked to hair regrowth.
Substance P, in particular, is interesting in that induces the transition of hair from the telogen phase to the anagen phase. That means that Substance P kick starts hair out of its resting stage into its growth stage, which is a good thing.
There's additional research (Pubmed study 18549505) that links curcumin and resveratrol with the reduction of inflammation through NF-kappaB signaling, which regulates cytokine production which in turn, regulates inflammation.
It's an alphabet soup, I'll grant you, but it makes sense. Furthermore, when I went back to ask those same co-workers about their new hair, almost all of them admitted to also using Biotest's Curcumin 500 product. So while most of us assumed that the hair regrowth was because of resveratrol, it might well be the result of a synergistic effect from resveratrol and curcumin.
The Chemical Hair Club For Men
I've been using 5-alpha-reductase inhibitors for years and I've been taking Biotest's REZ-V and Curcumin 500 ever since we released both products, but I've always had a full head of hair. As such, my example doesn't carry as much weight as it would if I were a reformed baldy.
Regardless, the research, as incomplete as it is, seems to make sense. If you're balding or worried about losing your hair, I'd recommend doing as exactly as I'm doing, which is as follows:
|Option A||Daily Dose||Option B||Daily Dose|
|Dutasteride||.01 - .05 mg||REZ-V||200 - 400 mg|
You can do either one or do both options daily.
Growing hair is a slow process as anyone who's ever had a bad haircut can attest. Growing hair from a bald or balding head is obviously even slower, so if you choose to adopt all or part of this protocol, give it a little time–a few months–and enlist the aid of a second pair of eyes to help judge the success or failure of the process. Better yet, take some pics and compare the before and afters.
You might be one of those rare guys who can pull off the bald look, but do you really want to find out? Like birds, girls rarely make nests in a bare tree, especially if it's a lumpy and misshapen one.