Hello. I’ve been taking creatine on and off about 2 years now and I’ve noticed a strange pattern. Everytime I get off creatine, the hairs on my body(including scalp) grows thiner all over and some falls out. When I go back on creatine, new hair grows back much thicker and longer than it naturally would be. Most people seem to think there’s a connection between creatine and hair loss but for me it’s hair growth. Am I some sort of a freakish exception or do other people experience this?

I do not know you well enough to confirm that you are “freakish”. Kidding aside, I do not know of any good research that correlates hair growth with creatine. Most are all anecdotal evidence like your story. In other words, I unfortunately do not have an answer to your question.

Dr.

I have been using Proscar 2.5 mg since around 1993. I am 45 and do not have any balding at the vertex, just a little thinning when out of the shower and some recession at the temples. Could dutasteride perhaps be a better alternative and possible thicken hair at the vertex and maybe get back some of the recession?

There is no magic cure for hair loss. You can’t just rub a magic lamp and make a wish. I don’t mean to make light of your situation, but really what I’m just trying to say is that even dutasteride has its limits. I realize some patients may want to maximize their treatment and increase hair growth, and extensive scientific research show that finasteride 1mg is just as effective as finasteride 2.5mg or finasteride 5mg for the treatment of hair loss. Dutasteride is not yet FDA approved for the treatment of hair loss, but it is presently being tested in an FDA approved study. The side effects of dutasteride (sexual) are more than on finasteride. As this medication must be prescribed by a doctor, I would suggest you take this question to the doctor you choose.

Do DHT Blockers, in general, reduce the level of DHT in the body as measured by a blood test, or is the intent to reduce/block DHT in the scalp? Could you have high levels in blood test results and still benefit by Avodart/Finasteride?

DHT blockers reduce the level of DHT in the blood stream/body and anywhere it has appropriate receptors. The prostate is a good example and sometimes people who are having a hard time urinating (usually over 50 years old) will find that Propecia makes the urinary symptoms better.

Hairs that are sensitive to DHT will fall out according to their genetic fate. You can have very high levels of DHT, but as long as your hair is not sensitive to DHT, Propecia will have little effect on the normal hairs.

Is there any reason to take Propecia versus the generic version. I have been on the generic for a 7 months and the balding has gotten worse (I am 23). Also, do you have recommendations for where to get generic Propecia?

There is no generic Propecia available legally in the US. I realize other countries may manufacture finasteride in 1mg strength, but Propecia is still under patent protection in much of the western world.

There is a generic finasteride available in 5mg strength — any pharmacy should have it, provided that your doctor prescribes you 5mg finasteride. Some patients cut the 5mg tablet into 1/4ths to save money. There may be problems in cutting down the pill into smaller pieces and the partial tablets will have the problem of hydrating with humidity so do not cut more than one at a time (every 4 days) and keep it in a sealed container. Be sure that the company that makes it is legit and you are getting what you are buying!