A More Comprehensive Approach To Combatting male pattern baldness

[paul2222]

Good morning guys. I I'm a mid 40s male and started receding in my late 20s. I started on Propecia almost 20 years ago. About 5 years ago, I had a 1400 FUE transplant with Bernstein in NY While very happy with the results, I realized that I *may* be having some side effects from Finasteride (it was upped to about 2.5mg / day for quite some time). I went off it for a few months and felt a lot better, however I also noticed what looked like I was losing some volume in the area the transplant was done (not the transplanted hair, but the remaining hair there). That led me on a mission to look into what types of alternative treatments and regimens people are getting good results with. Also coming from a medical background, I decided to go at this a little more scientifically.

Specifically, I have researched many things including

1. Diet - Keeping a healthy diet is key -- Keep sugar and carbs to a minimum as body-wide inflammation affects all parts of the body negatively. I don't smoke or do drugs, but I do drink a bit.

2. Exercise - Again, helps overall body

3. Supplements - I've been taking a potent version of Curcumin for years now (life-extension super bio-curcumin) - This helps reduce overall body-wide inflammation and acts as a powerful anti-oxidant. Also, Vitamin D3 (at least 5000 iu a day is CRITICAL). Also, high quality Omega 3 (3g/day) that's high in EPAs and DHAs

4. The difference in topical vs oral Finasteride - I've spent a tremendous amount of time with this one. I've patiently been waiting for Polichem P-3074 topical Finasteride study with the novel vehicle. I have read this study in depth and one of the most interesting findings in the last study (not the final study) was that the lowest dose, once a day (not twice) decreased scalp DHT as good if not better than oral Finasteride, yet only caused about a 25-30% reduction in serum DHT. It also dramatically lowered the system Finasteride serum levels to about 5% as opposed to taking it orally. I've also read about quite a few other formulations to include the Hasson & Wong formula that also has a unique liposomal vehicle to encapsulate the Finasteride to prevent a complete system absorption. More on this in a bit

5. I've looked into other DHT inhibitors (Nizoral, Tea Tree, Peppermint, progesterone, latanoprost, cetrizine, spironolactone, azelaic acid, castor oil, caffeine, RU, and the list goes one)

6. I've also looked into derm-rolling and just started doing it. I had PRP and Prolotherapy done on two shoulders and I can tell you that IT DEFINITELY WORKS. The body's respond to wound healing is amazing.

So, where does this lead us?

From an infectious disease perspective, when someone has an unknown pathogen in his or her body, a thorough doctor will culture the fluid / cells of suspected infection to find out what the organism is (bacteria / mycoplasm, etc). So, they put this culture in a petri dish and wait for something to grown. If there is growth in a period of time, they do sensitivity testing to see which anti-biotic is effective against the strain grown. Since there are many strains, some of which are anti-biotic resistant, then can then choose of a course of antibiotics, either oral, intramuscular, or IV to treat the pathogen in the human.

Where is all this leading to? The SCALP! We are not, in my opinion, treating the scalp as we would any other part of the body. Some people react well to certain treatments and others don't. I see that some people are actually getting scalp biopsies to measure

1. The DHT in the scalp - From what I understand they are normal levels and high levels. If the levels are high, then we know that it is a DHT issue

2. The inflammation in the scalp - The source of the hair loss can be chronic inflammation which can likely be treated by systemically and via topical products

3. Other conditions affecting the scalp, perhaps hormonal

We spends thousands of dollars on products, but wouldn't it be in our best interest to make sure we are understanding the whole picture as opposed to blindly throwing the kitchen sink at this? There are doctors out there who will take this approach, but they are few and far between.

Also, if you are considering topical propecia, please understand the formulation you are using. I am thinking of swtiching over to it, but I'll be dam*ed if I don't get baseline serum and scalp DHT levels and then start with a formulation and measure results with a biopsy and blood work to see how effective the formulation is and make changes as we measure both the system and scalp DHT levels ** IF ** the problem I am having is indeed a DHT issue in my scalp.

There's also another factor that studies are now linking to hair loss; insulin resistance. Studies have been coming out that are showing a link between male pattern baldness and cardiac issues. Insulin resistance causes body-wide inflammation which can wreak havoc on the scalp.

My point is, if we take a more systematic approach to understanding
1) Why we have male pattern baldness (blood work, scalp biopsy)
2) What treatments are necessary - Is it high DHT in scalp, inflammation, insulin resistance)
3) Monitor the dosage of medication / treatments with followup to see if you are receiving a therapeutic dose
4) Make sure your diet is GOOD! Don't expect a healthy head of hair if you are indulging in food that causes body-wide inflammation. I believe that some people are successful and others are not because they ignore their bodies in other ways by putting very poor quality food in their diet, drinking lots of alcohol, and eating a lot of processed food / sugar / empty calories

Also, stress levels / cortisol levels should be part of the blood work to see how your body is doing overall..

These are my thoughts on a potentially more comprehensive approach to treating male pattern baldness.

-- Paul

 

[countjulian]

Good morning guys. I I'm a mid 40s male and started receding in my late 20s. I started on Propecia almost 20 years ago. About 5 years ago, I had a 1400 FUE transplant with Bernstein in NY While very happy with the results, I realized that I *may* be having some side effects from Finasteride (it was upped to about 2.5mg / day for quite some time). I went off it for a few months and felt a lot better, however I also noticed what looked like I was losing some volume in the area the transplant was done (not the transplanted hair, but the remaining hair there). That led me on a mission to look into what types of alternative treatments and regimens people are getting good results with. Also coming from a medical background, I decided to go at this a little more scientifically.

Specifically, I have researched many things including

1. Diet - Keeping a healthy diet is key -- Keep sugar and carbs to a minimum as body-wide inflammation affects all parts of the body negatively. I don't smoke or do drugs, but I do drink a bit.

2. Exercise - Again, helps overall body

3. Supplements - I've been taking a potent version of Curcumin for years now (life-extension super bio-curcumin) - This helps reduce overall body-wide inflammation and acts as a powerful anti-oxidant. Also, Vitamin D3 (at least 5000 iu a day is CRITICAL). Also, high quality Omega 3 (3g/day) that's high in EPAs and DHAs

4. The difference in topical vs oral Finasteride - I've spent a tremendous amount of time with this one. I've patiently been waiting for Polichem P-3074 topical Finasteride study with the novel vehicle. I have read this study in depth and one of the most interesting findings in the last study (not the final study) was that the lowest dose, once a day (not twice) decreased scalp DHT as good if not better than oral Finasteride, yet only caused about a 25-30% reduction in serum DHT. It also dramatically lowered the system Finasteride serum levels to about 5% as opposed to taking it orally. I've also read about quite a few other formulations to include the Hasson & Wong formula that also has a unique liposomal vehicle to encapsulate the Finasteride to prevent a complete system absorption. More on this in a bit

5. I've looked into other DHT inhibitors (Nizoral, Tea Tree, Peppermint, progesterone, latanoprost, cetrizine, spironolactone, azelaic acid, castor oil, caffeine, RU, and the list goes one)

6. I've also looked into derm-rolling and just started doing it. I had PRP and Prolotherapy done on two shoulders and I can tell you that IT DEFINITELY WORKS. The body's respond to wound healing is amazing.

So, where does this lead us?

From an infectious disease perspective, when someone has an unknown pathogen in his or her body, a thorough doctor will culture the fluid / cells of suspected infection to find out what the organism is (bacteria / mycoplasm, etc). So, they put this culture in a petri dish and wait for something to grown. If there is growth in a period of time, they do sensitivity testing to see which anti-biotic is effective against the strain grown. Since there are many strains, some of which are anti-biotic resistant, then can then choose of a course of antibiotics, either oral, intramuscular, or IV to treat the pathogen in the human.

Where is all this leading to? The SCALP! We are not, in my opinion, treating the scalp as we would any other part of the body. Some people react well to certain treatments and others don't. I see that some people are actually getting scalp biopsies to measure

1. The DHT in the scalp - From what I understand they are normal levels and high levels. If the levels are high, then we know that it is a DHT issue

2. The inflammation in the scalp - The source of the hair loss can be chronic inflammation which can likely be treated by systemically and via topical products

3. Other conditions affecting the scalp, perhaps hormonal

We spends thousands of dollars on products, but wouldn't it be in our best interest to make sure we are understanding the whole picture as opposed to blindly throwing the kitchen sink at this? There are doctors out there who will take this approach, but they are few and far between.

Also, if you are considering topical propecia, please understand the formulation you are using. I am thinking of swtiching over to it, but I'll be dam*ed if I don't get baseline serum and scalp DHT levels and then start with a formulation and measure results with a biopsy and blood work to see how effective the formulation is and make changes as we measure both the system and scalp DHT levels ** IF ** the problem I am having is indeed a DHT issue in my scalp.

There's also another factor that studies are now linking to hair loss; insulin resistance. Studies have been coming out that are showing a link between male pattern baldness and cardiac issues. Insulin resistance causes body-wide inflammation which can wreak havoc on the scalp.

My point is, if we take a more systematic approach to understanding
1) Why we have male pattern baldness (blood work, scalp biopsy)
2) What treatments are necessary - Is it high DHT in scalp, inflammation, insulin resistance)
3) Monitor the dosage of medication / treatments with followup to see if you are receiving a therapeutic dose
4) Make sure your diet is GOOD! Don't expect a healthy head of hair if you are indulging in food that causes body-wide inflammation. I believe that some people are successful and others are not because they ignore their bodies in other ways by putting very poor quality food in their diet, drinking lots of alcohol, and eating a lot of processed food / sugar / empty calories

Also, stress levels / cortisol levels should be part of the blood work to see how your body is doing overall..

These are my thoughts on a potentially more comprehensive approach to treating male pattern baldness.

-- Paul

Problem is Androgenetic Alopecia has been decisively shown to be hormonal in nature. The "inflammation" theory has never produced a treatment which can pass the test of a large-scale double-blind clinical trial. There's no good evidence that Androgenetic Alopecia is caused by diet and the vast, vast majority of men who lose their hair have Androgenetic Alopecia. @Georgie could weigh in more I believe.

 

[paul2222]

Insulin resistance causes a decrease in SHBH and and follicular stimulating hormone. It also increases 5-AR activity. By lowering your SHBH you are allowing more free testosterone. Also, but increasing the 5-AR activity, you are converting more of the free testosterone into DHT. Couple that with the decrease in Follicular stimulating hormone and a certain set of genetics, then yes, you have male pattern baldness. Of course, 5-AR inhibitors will help to lower that conversion to DHT, but you are treating the result of the insulin resistance and not the cause.

"In fact, emerging science suggests that diet plays a significant role and that insulinis a primary driver behind hair loss."

Here's a good article ... https://www.nutritionadvance.com/receding-hairline-insulin/

And to my point, if someone is going to go on a topical form of Finasteride, I think there may be a benefit in doing a scalp biopsy to see if the concentration of DHT in the scalp has been lowered sufficiently by the dose of finasteride in the topical solution. Why give yourself 10x more than you need?

 

[Retinoid]

Insulin resistance causes a decrease in SHBH and and follicular stimulating hormone. It also increases 5-AR activity. By lowering your SHBH you are allowing more free testosterone. Also, but increasing the 5-AR activity, you are converting more of the free testosterone into DHT. Couple that with the decrease in Follicular stimulating hormone and a certain set of genetics, then yes, you have male pattern baldness. Of course, 5-AR inhibitors will help to lower that conversion to DHT, but you are treating the result of the insulin resistance and not the cause.

"In fact, emerging science suggests that diet plays a significant role and that insulinis a primary driver behind hair loss."

Here's a good article ... https://www.nutritionadvance.com/receding-hairline-insulin/

And to my point, if someone is going to go on a topical form of Finasteride, I think there may be a benefit in doing a scalp biopsy to see if the concentration of DHT in the scalp has been lowered sufficiently by the dose of finasteride in the topical solution. Why give yourself 10x more than you need?

I am unsure how much insulin resistance plays a role. I do not want to say it does not at all, but I think it is probably not heavily associated with lifestyle (male pattern baldness) and more of a reaction to something changing/occuring in the scalp area. While insulin resistance surely leads to a lot of hormonal issues, skin issues and hair issues---male pattern baldness seems to afflict the healthy and unhealthy similarly. While certain lifestyle components (smoking, drinking, not sleeping well, eating a lot of bread) and hormonal profiles (low shbg, high insulin, low TOTOAL testosterone) may not be helpful towards preventing progression, I do not think they CAUSED it to happen.

I agree it would be helpful to test dht or inflammatory chemicals in the scalp prior to treatment. Why were you taking 2.5mg/day?

 

[paul2222]

I agree that it's difficult to gauge how much of a role diet plays, but what I can say is that I firmly believe diet is more crucial that people give credit to for many of the disease processes in the body.

https://www.thealternativedaily.com/eating-this-could-prevent-male-baldness/

Good article that goes into detail about Omega 3's, zinc, etc. I believe that the expression of certain genes is tied more to diet than we may imagine. I also believe that some people will be more affected from diet than others. If you think about it, some people also have a more extreme reaction to Finasteride. My point is it's in the best interest of people, especially on a topical F, to invest the money into a skin biopsy to see how effective their Topical F regiment is in reducing scalp DHT.

Minimum Finasteride for maximum results, if people choose to go that way.

On another note, looking for opinions. I have been on oral finasteride for almost 20 years now. I heard that it loses its effectivenss after 10. Does that mean that there is no benefit to continuing to take it or just that it will not grow any more hair? I went from 1 to 2.5 about 5 years ago because it seemed like it was starting to lose its effectiveness.