Anecdotally, many men taking finasteride report improvements to side effects by simply lowering their daily dosage from 1mg to 0.2mg.

The rationale? Finasteride has a logarithmic, dose-dependent response curve for DHT reduction. In other words, a tiny amount of the drug can reduce DHT by nearly the same amount as a mega-dose of the drug.

Knowing this, many men will cut their 1mg tablets into quarters. The goal: to reduce their overall drug exposure (to lower side effect risk)... but still get the same DHT reduction (to not sacrifice the drug's efficacy).

Personally, I've always been puzzled by this. After all, if a little bit of finasteride reduces nearly the same amount of DHT as a larger dose of finasteride, then why would micro-dosing finasteride confer a better (anecdotal) side effect profile? Technically, both doses reduces (roughly) the same amount of DHT.

If we take these anecdotes to be true, then I believe we might be able to partly explain them through psychosomatic phenomena – and particularly, the nocebo effect.

In one study of finasteride users, researchers split patients into two groups. In group one, physicians warned their patients about the risk of side effects from finasteride. In group two, physicians said nothing.

During the study, patients warned about the side effects of finasteride were nearly 500% more likely to report side effects than those who weren't told anything! What does that tell us? That finasteride's side effect profile might be partially influenced by our expectation of side effects.

In my eyes, people might be using this phenomena to their advantage through drug titration.

By believing you're reducing your risk of side effects by going from 1mg to 0.25mg, this mindset may very well make you feel a lot better about taking the medication... and thereby improve your tolerability to finasteride (and your hair loss outcomes)!

It goes without saying that when it comes to treating androgenic alopecia, finasteride is the best-studied (and most effective) drug on the planet. Randomized, double-blinded, placebo-controlled studies on thousands of men demonstrate an 80-90% response and a 10-20% increase in hair counts / density over two years.

So, for those seeking treatment, it's paramount to find ways to improve the tolerability of this drug.

At the same time, finasteride side effects do happen. Not everyone can tolerate this drug, and not everyone can avoid side effects through titration.

But if you're apprehensive about starting finasteride, one strategy might be to start with a lower dose and see how you feel!

Study links:
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About Rob English:
-Editorial board member of Dermatology and Therapy
-Medical editor specializing in hair loss disorders
-Peer-reviewed publications: [ Ссылка ]

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