Clarifying Finasteride Dosage — Taking More than 1mg to Treat Hair Loss

Hello Dr. Rasman,

First I would like to thank you for such a wonderful site. I have been an avid reader of this blog for some time now and find your dedication to this field quite remarkable. I have a question that I would like clarification on regarding finasteride dosage. It seems you that you frequently state dosages higher then 1mg have no increased effectiveness in treating MPB. Most recently quoted here: What If I Take 5mg of Finasteride to Treat Hair Loss?

“Taking finasteride 5mg (Proscar) daily will not have any benefit over the finasteride 1mg (Propecia) in the treatment of androgenic alopecia (AGA).”

But I have come across some blogs in the past were you seem to state that there “may” be an increased effectiveness in higher doses. I have quickly searched your site and here are two examples:

1: Propecia and Dosage
The dosage of Propecia was arrived at because when Merck went through the FDA the 1mg dose was found to be lowest effective dose to get the desired result based on the clinical trial program that was done.

“That may suggest that a higher than 1 mg dose may be more effective, but that was not studied for treating hair loss.”

We do know that higher doses of finasteride will increase the known side effects. A decreased ejaculate is one of those side effects. With regard to brain fog, there is nothing that I know of that will support this as a known side effect of finasteride. Be careful that you are not setting yourself up for this and obsessing too much.

“If you want to play around with the dosage, wait a few weeks between changes as it takes that long to change the tissue levels of the drug.”

2: 1mg vs 5mg Finasteride for Hair Growth
I am not familiar with any study that directly compares the 5mg dose to the 1mg dose, but I would suspect that like any bell curve, the 1mg recommendation applies to those individuals in the center of the bell curve and that “some people most certainly would be better with a higher dose,” possibly worth trying if the 1mg dose is not adequate to meet the needs of the patient’s problem.

Even your colleague Dr. Bernstein makes refrence to this on his own site, which is linked here: BernsteinMedical.com

So then is their truth to the statement, that though unproven, a higher dose of finasteride may be more effective in treating MPB?

I thank you again for your time and this wonderful site.

Best Regards

When I discuss finasteride dosing, I’m referring to the dose that the studies show is effective and safe. There is never one dose for every person, because we all have different body weights, different metabolisms, different hair loss (possibly from sensitivity to DHT that may vary by time, where you are on your hair loss cycle, your genetics, etc.). You can pick and choose and interpret all that has been said about the dosages of finasteride, but in the end 1mg finasteride works and in a large population it is the dose that worked most effectively.

Looking at the big picture, a higher dose is probably not going to make a huge difference. All drugs have limitations and a higher dose is not going to give you dramatic gains. Case in point: think of all the bald men who are taking 5mg finasteride for their prostate issues. I believe that the men on 5mg finasteride are not much better off than men taking 1mg finasteride when it comes to their hair loss.

I am afraid we are beating this issue to death, but I appreciate the time you took to find out about my consistency and respect you for it.