Category Archives: Finasteride

Finasteride and Dutasteride AMA

Finasteride and Dutasteride Dosage and DHT Reduction
A comparison of DHT reduction via Finasteride and Dutasteride.

I first heard about Dr. Kyle Gillett of Gillett Health (Kansas) when watching the Huberman Lab Podcast on hair loss that he helped create earlier in 2023.

At the time, I had forgotten that Dr. Gillett gave me a detailed and somewhat complicated response to one of my past questions on Twitter in 2022:

Finasteride and Dutasteride AMA

This week, Dr. Kyle Gillett and his clinic’s nurse practitioner James O’Hara conducted a very interesting ask me anything (AMA) session on YouTube. They answered numerous questions in relation to both dutasteride (Avodart) and finasteride (Propecia).

Among the numerous subjects they discuss include: side effects; post-finasteride syndrome (PFS); systemic absorption; dosage iterations; topical finasteride; and topical dutasteride. They did not cover the finasteride and low-dose dutasteride combination treatment (that has become popular on Reddit) in detail.

However, Mr. O’Hara does state that he takes both drugs, and might have gotten some OCD exacerbating mental issues when being on finasteride alone. I have my doubts about such connections, but I am no medical expert.

I was pleasantly surprised to hear that both of these guys take oral dutasteride for their own hair loss and seem to prefer it to finasteride. Both have seen significant benefits to their scalp hair growth while on the drug. Make sure to read my past very important post on dutasteride hair loss reviews and the numerous subsequent reader comments and testimonials.

The reason I was surprised is because enlarged prostate (BPH) drug dutasteride was never approved to treat hair loss in the US by the FDA. In fact it is still only approved for the latter purpose in Japan and South Korea. So most US medical professionals tend to stick with the usually weaker finasteride. Moreover, almost no male US celebrity has ever admitted to taking dutasteride for his androgenetic alopecia. With a notable exception being Ashton Kutcher.

In contrast, quite a few have admitted to taking finasteride to treat their hair loss, including Donald Trump. Do note that finasteride seems to work over the long-term in most patients. However, dutasteride is often an even better option if you get no side effects. In the below video, the doctor and nurse discuss starting patients out on a low dose of dutasteride so as to slowly reduce dihydrotestosterone (DHT).

Interestingly, Dr. Gillett recently stopped taking dutasteride for some kind of fertility related reason. Maybe he is trying to have children? Right away, he saw a reduction in his scalp hair and an increase in his body hair. It is refreshing to see such a video based dutasteride and hair growth related testimonial from a medical expert. Mr. O’Hara said that he saw a reduction in his acne and sebum after starting dutasteride.

Finasteride and Minoxidil Shedding is Normal

Hair Shedding Minoxidil Finasteride
Hair Shedding from Minoxidil and Finasteride.

Finasteride and minoxidil are the only two medications that are FDA approved for the treatment of hair loss.

Both work through different mechanisms of actions, and both can also cause unexpected temporary hair shedding episodes.

Finasteride and Minoxidil Hair Shedding

  1. Finasteride:
    • Mechanism of Action: Finasteride (Propecia brand name) is an oral medication that belongs to the class of drugs known as 5-alpha-reductase inhibitors. It works by inhibiting the action of the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT). DHT is implicated in the miniaturization of hair follicles in individuals who are genetically predisposed to androgenetic alopecia (AGA — aka male pattern baldness). Note that topical finasteride is also becoming very popular.
    • Hair Shedding: Some users may experience an initial increase in hair shedding during the first few months of finasteride treatment. This phenomenon (almost like telogen effluvium) is thought to occur as the drug affects the hair growth cycle.  In particular, the anagen growth phase is increased. Shedding is usually temporary, and most individuals observe regrowth and stabilization of hair loss after this initial phase.
  2. Minoxidil:
    • Mechanism of Action: Minoxidil (Rogaine brand name) is a topical medication that is applied directly to the scalp. While its exact mechanism of action is not fully understood, it is believed to promote blood flow to the hair follicles. This in turn prolongs the anagen (growth) phase of the hair cycle, increasing follicle length and thickness. Higher strength doses of minoxidil 10% and 15% are also available with prescription. Note that oral minoxidil is also becoming very popular.
    • Hair Shedding: Similar to finasteride, some users may experience an initial increase in hair shedding when starting minoxidil treatment. This shed phase is temporary and is often considered a sign that the medication is beginning to take effect. It is followed by a period of regrowth and stabilization of hair loss.


  • Shedding with both finasteride and minoxidil is usually transient and is not an indication that the treatment is ineffective.
  • These medications require consistent and long-term use to realize their benefits. Do not get scared with the temporary increase in hair fall.
  • It is crucial to consult with a healthcare professional before starting any hair loss treatment to determine the most suitable approach. And to address any potential side effects or contraindications.