Starting treatment- looking for thoughtful advice please.

[tbforever]

Hello everyone,

I'm 24 and I noticed my hair loss in April of 2010. It's funny because I began noticing days after a haircut in which I had my hair "shredded" (thinned out) because it was so damn thick that I couldn't really style it. My barber said "if i do this you'll notice some hair coming out for a while." He didn't specify if it were cut hair or telogen hairs that would be falling out. Regardless, I started noticing.

I was pretty certain it was telogen effluvium because I'd lost my job, interviewed and got a new one, had a minor health scare, lost 25 lbs (practically all my body fat), changed my diet, and went through a particularly stressful breakup with my girlfriend of two years.

By the time I realized "Oh crap, if this isn't Telogen Effluvium and it's male pattern baldness I need to start doing something about it before it's too late" (that was after denial/hoping I was just being paranoid about the hair loss) I got a doctors appointment, got referred to a terrible derm who did one hair pull test and said "it's Telogen Effluvium, just wait a month or two and it should go away." Finally I saw a more respectable derm last week who basically said "probably male pattern baldness, start some Rogaine, take these vitamins (Biotin, Folic Acid), and come back in two months to see about Propecia etc."

So I used liquid minoxidil 5% for the first time today and plan to keep using it. I'd love to believe I have Telogen Effluvium. I have no receding hairline(yet), thinner spots above and a little set back from my ears, and I can see some thinning on the top of my head. What still keeps my hopes about Telogen Effluvium (sucks to not know) is that I have definite diffuse hair loss all the way to my neck hairline. I can pluck 2-4 telogen hairs with a mild squeeze and tug. The thinner spots on my head were naturally thinner when I had a full head of hair, so logically they look thinner now. Still, I don't want to be a fool and let the male pattern baldness (potential, but likely) get too far.

My question is, how can I ever know if it is really just Telogen Effluvium if I start minoxidil and even Propecia in the next couple of months? I don't want to be using these meds and spending $$$ for the next 10 years without being sure. I'm hoping that if it is Telogen Effluvium, the minoxidil will get all my hair back on a regular growth cycle... but then what? Stop and hope it doesn't all shed? I had plenty of "triggers" for Telogen Effluvium, which are mostly resolved, so there should be an end to it (aka not chronic Telogen Effluvium)... but I can't wait to find out that I'm wrong and get more months behind on male pattern baldness.

What do you all think? I'm dying for some thoughtful advise.

 

[Brains Expel Hair]

You are aware that hairloss isn't just either Telogen Effluvium or male pattern baldness, right? The symptoms you mention sound much more inline with diffuse alopecia areata which can be caused by a number of different problems that also cause stress.

In the case of alopecia areata you have 3 possible methods of treatment.
1) Fix whatever problem is causing your immune system to get in a fit (if you can).
2) Suppress your immune system through cortisol shots or other sorts of medicine.
3) Use minoxidil/Propecia and hope that your immune system stops eating your body on it's own (statistically possible).

On a side note: Seaback, you are aware that your quotation in itself is a scientifically valid concern right? I can't tell if you're trying to mock it (which might mean you are ignorant of the actual science behind it) or if you're just quoting it because it's "odd" (but then, what about the human body isn't?).

 

[tbforever]

You are aware that hairloss isn't just either Telogen Effluvium or male pattern baldness, right? The symptoms you mention sound much more inline with diffuse alopecia areata which can be caused by a number of different problems that also cause stress.

In the case of alopecia areata you have 3 possible methods of treatment.
1) Fix whatever problem is causing your immune system to get in a fit (if you can).
2) Suppress your immune system through cortisol shots or other sorts of medicine.
3) Use minoxidil/Propecia and hope that your immune system stops eating your body on it's own (statistically possible).

On a side note: Seaback, you are aware that your quotation in itself is a scientifically valid concern right? I can't tell if you're trying to mock it (which might mean you are ignorant of the actual science behind it) or if you're just quoting it because it's "odd" (but then, what about the human body isn't?).

I'm going in for some blood work.

Complete blood count,
ANA (antinuclear antibody)
Thyroid profile

If it is my immune system, ANA should uncover that, correct?

I've also read that iron deficiency can cause hair loss, although I eat plenty of meats & veggies so should be getting my iron.. but it would seem foolish not to have this tested too, just in case. No?

Anyways, are there any other blood tests I should get while I'm at it?

Thanks again

 

[Brains Expel Hair]

Sorry, some confusion there, I meant the quotation in your signature.

"So I am thinking that eating gluten was causing my hormones to shift into estrogen dominance, which gave me the onion body odor."

^Technically a very possible, scientifically valid concern.

Additionally, you should differ between your opinion "AA is a very rare pathology" and scientifically proven figures (of which there are none for now ). Considering the amount of people who come to this board each week complaining of the rampant itch they have accompanying their hair loss it seems quite foolish to me to make such a statement, but that is my opinion. W/e the case is as far as actual occurrence of AA in the general population, this doesn't matter at all when you're dealing with any specific case, especially a specific case that represents itself as more closely following AA pattern compared to Androgenetic Alopecia (see OP's post).

 

[Brains Expel Hair]

On to OP's questions.

ANA doesn't rule out/in all forms of malfunctioning immune systems. C-reactive protein levels would be a good indication of total inflammation (from your immune system) in the body and probably a better place to start than ANA. Thyroid levels are also a good thing for most people to determine as are basic levels of all potentially deficient vitamins/minerals such as iron, vit d and vit b (possibly already tested by the guy recommending folic acid supplementation).

 

[theShade]

Sorry, some confusion there, I meant the quotation in your signature.

"So I am thinking that eating gluten was causing my hormones to shift into estrogen dominance, which gave me the onion body odor."

^Technically a very possible, scientifically valid concern.

No it's not - unless you genuinely think that there is a link between 'onion body-odours' and 'estrogen-dominance'. Actually sounds like a typical inane statement with absolutely no evidence behind it, if not an outright joke.

 

[tbforever]

I'm researching on my own, but some questions I can't find answers for.

Can chronic injury of another part of the body cause an autoimmune response against hair follicles?

 

[Brains Expel Hair]

No it's not - unless you genuinely think that there is a link between 'onion body-odours' and 'estrogen-dominance'. Actually sounds like a typical inane statement with absolutely no evidence behind it, if not an outright joke.

Let's see how hard it is to connect the dots.

Chronic consumption of gluten by someone with a gluten intolerance can cause imbalances in sexual hormones.

Your sexual hormone balances determine what sort of oils you secrete around your armpits (and anus too).

The types of oils you secrete around your armpits determine what sorts of bacteria take up residence around these glands.

The types of bacteria that live around these glands give off different odors which are predominantly described as either oniony (on a female) or cheesy (on a male).

Wow, yeah 4 whole steps, I can see how you smerty experts are having problems with it.

 

[Brains Expel Hair]

I'm researching on my own, but some questions I can't find answers for.

Can chronic injury of another part of the body cause an autoimmune response against hair follicles?

Not in any likely event. There are slightly possible ways that this can be connected (but it's not the likely situation), as if you do have chronic inflammation that increases the likely hood of chronic injury to other parts of your body.

Be very wary of anyone who automatically describes your hair loss as male pattern baldness. male pattern baldness should only be a diagnosis of exclusion because currently there are no accurate tests to determine if you have male pattern baldness or not, while there are plenty of other tests for alternative causes of hair loss. Admittedly though, there are quite a few symptoms to look for that would definitely point you in the direction of androgenic alopecia (of which you have described the opposite trends). On this message board there is an alarming number of people who only believe in one kind of hair loss, to them if you're a male and you're losing hair then you're in the exact same boat as them. They are incapable of understanding anything outside this realm or even basic concepts of statistics and populations. Take everything you read with a grain of salt and only use it for further exploration on the topics they present to you.

 

[theShade]

This is almost too ridiculous to reply to. It's like the whole thing about wanking and hair loss. But I'm going to try anyway.

No it's not - unless you genuinely think that there is a link between 'onion body-odours' and 'estrogen-dominance'. Actually sounds like a typical inane statement with absolutely no evidence behind it, if not an outright joke.

Let's see how hard it is to connect the dots.

Chronic consumption of gluten by someone with a gluten intolerance can cause imbalances in sexual hormones.

I honestly don't know enough about gluten intolerance to comment on this, but it is the first I heard for what is essentially a food allergy/intolerance causing a variance in hormone levels. It may be possible, I dunno - but where is the evidence for this?

Your sexual hormone balances determine what sort of oils you secrete around your armpits (and anus too).

Very debatable. Besides which, what are 'different sorts of oils' by your definition? Keroscene, Diesel, Benzene, good ol' crude??

The types of oils you secrete around your armpits determine what sorts of bacteria take up residence around these glands.

Debatable, this may be true but only to a very limited extent. Far more important for bacteria are factors such as temperature, acidity, sunlight exposure, local tissue/material/chemical composition, etc... 'different sorts of oils' are likely to vary little by these sorts of measures.

The types of bacteria that live around these glands give off different odors which are predominantly described as either oniony (on a female) or cheesy (on a male).

This is just one big massive LOL. Every person has a more or less unique body odour, from what I read. The amount of factors that determine body odour, well I don't know them, but if indeed every person has a unique body odour (which animals such as dogs, etc... use to identify individuals by), then that would mean that a far greater set of factors would be involved in determining body odour - than just the levels of sexual hormones (which may admittedly be a factor too). And the range of body odours, would certainly go far beyond just oniony (female) and cheesy (male).

Be honest here dude, how much of this stuff have you just pulled straight out your ***?

 

[Vanzzzz]

One statistic is for sure... 95% of adult male hair loss is due to male pattern baldness. Go figure. Not saying it cant be anything else. If you are worried go see a derm, it is really quite easy to diagnose male pattern baldness, as your hair will be miniaturized, while it shouldnt for Telogen Effluvium and AA.

 

[Brains Expel Hair]

I honestly don't know enough about gluten intolerance to comment on this, but it is the first I heard for what is essentially a food allergy/intolerance causing a variance in hormone levels. It may be possible, I dunno - but where is the evidence for this?

Yet even without knowing about it, you felt convinced enough that your ignorant opinion was important for everyone else to hear...
Gluten intolerance is an autoimmune condition, it can cause a ridiculously long list of abnormalities in the human body, hormonal imbalance is one of the less serious conditions that it can cause.

Very debatable. Besides which, what are 'different sorts of oils' by your definition? Keroscene, Diesel, Benzene, good ol' crude??

Are you not aware that the body contains a number of different oils? If not, why do you think you are qualified to be in any conversation at all about health matters?

Debatable, this may be true but only to a very limited extent. Far more important for bacteria are factors such as temperature, acidity, sunlight exposure, local tissue/material/chemical composition, etc... 'different sorts of oils' are likely to vary little by these sorts of measures.

This is just one big massive LOL. Every person has a more or less unique body odour, from what I read. The amount of factors that determine body odour, well I don't know them, but if indeed every person has a unique body odour (which animals such as dogs, etc... use to identify individuals by), then that would mean that a far greater set of factors would be involved in determining body odour - than just the levels of sexual hormones (which may admittedly be a factor too). And the range of body odours, would certainly go far beyond just oniony (female) and cheesy (male).

I don't save every article I read and since I doubt you'll be capable of understanding the actual article I won't bother tracking it down. A simple google search would have started you in the right direction had you actually wanted to know a little bit about what you were bent on mocking.
Here's a random pull from the first 10 results off google to start, you'll have to dig yourself for the actual full article.
http://www.amazingdata.com/men-smell-like-cheese-women-smell-like-onions/

Be honest here dude, how much of this stuff have you just pulled straight out your ***?

Instead of randomly chiming in on subjects that I "honestly don't know enough about ... to comment on (but somehow do anyways?)", I actually try to use real knowledge. Some people actually do read science for fun you know.

 

[Brains Expel Hair]

One statistic is for sure... 95% of adult male hair loss is due to male pattern baldness. Go figure. Not saying it cant be anything else. If you are worried go see a derm, it is really quite easy to diagnose male pattern baldness, as your hair will be miniaturized, while it shouldnt for Telogen Effluvium and AA.

While I've yet to see the study that actually proves that frequently used statistic I won't argue it here. What I will argue is how foolish it would be to use general population statistics instead of considering the individual situation presented by a specific case. The original poster was reasonably descriptive of his symptoms and what he described more closely points towards immune system based hair loss than androgenic hair loss. The only thing refuting this currently is that the statistic you cited would lead us to believe that it is unlikely for the original poster to exist in his current (claimed) form.

Once again: general population statistics generally don't mean sh*t for individuals. This is one of the most basic rules of statistics.

Also, your statement about how it's easy to diagnose male pattern baldness because you will have miniaturized hairs, while AA and Telogen Effluvium doesn't produce miniaturized hairs is flat out wrong. I have absolutely no clue about whether Telogen Effluvium does or doesn't but AA certainly does produce miniaturized hairs. Simple source:
http://www.ncbi.nlm.nih.gov/pubmed/14676070

As I stated above, male pattern baldness is only accurate when it is a diagnosis of exclusion (although possibly genetic testing would be accurate as well). I have to ask though because now I'm curious; do you know the source for that 95% statistic you mentioned?

 

[tbforever]

I'm researching on my own, but some questions I can't find answers for.

Can chronic injury of another part of the body cause an autoimmune response against hair follicles?

Be very wary of anyone who automatically describes your hair loss as male pattern baldness. male pattern baldness should only be a diagnosis of exclusion because currently there are no accurate tests to determine if you have male pattern baldness or not, while there are plenty of other tests for alternative causes of hair loss. Admittedly though, there are quite a few symptoms to look for that would definitely point you in the direction of androgenic alopecia (of which you have described the opposite trends). On this message board there is an alarming number of people who only believe in one kind of hair loss, to them if you're a male and you're losing hair then you're in the exact same boat as them. They are incapable of understanding anything outside this realm or even basic concepts of statistics and populations. Take everything you read with a grain of salt and only use it for further exploration on the topics they present to you.

Good looks man. I'll be having blood tests this week and hopefully something will turn up. If not, then at least it eliminates some possibilities.. albeit better possibilities than some others. Time will tell.

 

[Vanzzzz]

OP said he can pluck 2-4 hair, which is normal. His thinner area has always been thinner, so no issue. In fact, I am really curious to see whether he really has hair loss or is simply paranoid.

In any case, I wonder what is so unique about the OP that Brain thinks that general population statistics does not apply to him. Does the OP has 6 DNA or double Y chromosomes or something?

In any case, Dr Rassman always recommends miniaturization test for determining whether a patient suffers from male pattern baldness. I know I will feel more comfortable following a qualified doctor's advice than some random advice from the internet.

In any case, I am not here to argue with anyone. I hope the OP can get an answer soon and hopefully successfully treat his hairloss problem.

 

[theShade]

Yet even without knowing about it, you felt convinced enough that your ignorant opinion was important for everyone else to hear...
Gluten intolerance is an autoimmune condition, it can cause a ridiculously long list of abnormalities in the human body, hormonal imbalance is one of the less serious conditions that it can cause.

I can sense that you are getting emotional but I fail to understand why. There is really no need to.

This is an open forum. Anyone can post anything they want, which evidently has its good and bad sides. Clearly you view your own opinion as 'worthy' enough for everyone else to hear. We shall see. I myself am no biologist or doctor (I suspect that neither are you), but I do have a scientific background and I do have a good deal of common sense.

It is evident that your own subjective experiences with gluten and hairloss may have somewhat coloured your perspective, and now you insist on pushing it on anyone who would listen. Not to discount your experience, but if you take yourself seriously than you would do well to take a more cautious approach when it comes to things such as food allergies affecting hormones, hair loss, etc... not just blindly defend whatever pseudo-scientific speculation has even a small relation to what you think happened with your own body.

I'm sure that hormonal imbalance as a result of gluten intolerance is possible - but also quite, quite rare. As it would be with any other food allergy (also autoimmune responses). Therefore, just the initial premise that if you do have a hormonal imbalance than it is because of gluten intollerance - should not be dismissed but at the same time it should be acknowledged that there are a multitude of other causes that are far more likely. This is the first point of ridicule of Hoppi's quote.

Are you not aware that the body contains a number of different oils? If not, why do you think you are qualified to be in any conversation at all about health matters?

Admittedly my previous quote may have been a little ignorant. Yes the human body may well excrete a number of different oils. However, what you're saying is that the body is able to excrete a different oil, from the exact same section of the skin, depending on the body's current hormonal balance. Perhaps there is a mechanism by which this is possible, but it doesn't take a biologist to dismiss the possibility as a little far-fetched.

I don't save every article I read and since I doubt you'll be capable of understanding the actual article I won't bother tracking it down. A simple google search would have started you in the right direction had you actually wanted to know a little bit about what you were bent on mocking.
Here's a random pull from the first 10 results off google to start, you'll have to dig yourself for the actual full article.
http://www.amazingdata.com/men-smell-like-cheese-women-smell-like-onions/

Way to ignore everything I wrote about bacteria :thumbdown2:

I don't know what the article is about which you speak, so I will just focus on the one you gave a link to.

Firstly, I may not have been smelling hard enough - but I really have never noticed that a man's body odour is 'cheesy' and a woman's is 'oniony'. Once again, from what I know, everyone has a unique body odour.

Secoundly, this is just one article (as is presumably the one which I 'won't understand') - so there is no need to base all of your assumptions and knowledge off of it. Until proven otherwise, like everything you read about new findings on the human body - it should be taken with a grain of salt.

Thirdly, let's assume that the article is correct. Out of all the biological differences between a man and a women, for some reason on the basis of such an article, you decide that that the difference between the BO of a man and a women must be related to the levels of sexual hormones? And that if a man achieves women-like levels of sexual hormones that he would begin to smell like a woman too (or vica-versa)? Why?

And finally, again let's assume that the article is correct. The article itself states, that while the body odour is indeed produced as a result of bacteria; the type of bacteria that is present depends not on the type of oil (and thus according to you, sexual hormone levels), but on the chemical composition of their sweat.