Anything else I can do or look into?

[Jim1973]

Looking for guidance on why my hair loss won’t subside and if there is anything else I should do or look into. I began using Finasteride and topical Minoxidil in 2013, which did well for me. My hair loss subsided, and I maintained what I had through 2020. I noticed hair falling out 2020 so in early 2021, I made some additional changes. I still take FIN but also incorporated Dutasteride. Every 3 days, I replace FIN with DUT (5mg). I also incorporated oral Minoxidil (2.5mg) daily.

I have no side effects from anything that I’m doing. I use 2% Ketokonazole shampoo twice/week and use a Theradome laser helmet twice/week. I’ve recently started microneedling my scalp once/month (depth of .75). Six months ago I had bloodwork done my bloodwork showed that I was low on Iron and Vitamin D so began taking supplements to bring those into normal range. Everything else was in normal range such as hormones, thyroid, etc. I recently had my DHT levels checked (blood/serum), and the test concluded that both DHT and free were very low (below reference range – 9L and .76L), so I no longer have high DHT (although not sure how to measure DHT in scalp specifically).

To summarize, I feel as though I’m doing everything possible to at least maintain the hair I have but my hair is still thinning, miniaturizing and falling out. I'm wondering if I should go back to topical Minoxidil if the oral isn't working for me. I have a scheduled hair transplant in April 2023 but am nervous about proceeding if I can’t stabilize my current hair fall. Is there anything else I can do to stabilize my hair loss or something else that may be causing it?

 

[Bigmac]

Hi Jim. Your regimen is pretty intense as is. You could up the dose of oral minoxidil to see if it makes a difference.
How noticeable is the hair loss? Do you have pictures to compare?
You said you were low on vitamin D. Did the supplements bring you back into range. I recently chatted to a doctor about this deficiency. He said if you’re low it can offset the benefit/effect the meds have. Sometimes supplements aren’t enough, therefor, eating and drinking vitamin D rich foods is required. As well as benefitting from the Sun.

 

[Jim1973]

Hi Jim. Your regimen is pretty intense as is. You could up the dose of oral minoxidil to see if it makes a difference.
How noticeable is the hair loss? Do you have pictures to compare?
You said you were low on vitamin D. Did the supplements bring you back into range. I recently chatted to a doctor about this deficiency. He said if you’re low it can offset the benefit/effect the meds have. Sometimes supplements aren’t enough, therefor, eating and drinking vitamin D rich foods is required. As well as benefitting from the Sun.

Hi Bigmac. The vitamin D and iron supplements did bring me back into normal range (I re-tested 2 months later after beginning the supplements). I do actually eat alot of vitamin D food, which is why I was surprised that I was originally low. I haven't taken pictures of my head hair in the last 6 months. The hair loss is noticeable to me as I see hairs on my pillow every morning and in the sink after a shower every day, as well as see more scalp with dry hair, but not sure if side by side pictures would be noticeable enough just after the last 6 months. I'll take pictures in a few months to compare. I wish they were strong, think hairs falling out but they are all very fine, thin, short hairs, even though my hair has always been thick and course, which tells me that everything is miniaturizing. I thought about upping my dose of oral Minoxidil but thought that was more related to "growth" and that FIN/DUT was more related to holding onto existing hair, which is where I'm having the issues. I will consider upping the dose of oral Minoxidil to 5mg. Thank you.

 

[Bigmac]

That’s good to hear your levels returned to normal. I was thinking of a pro-longed shedding phase but you’re saying the hairs are noticeably thinner/miniaturised. Have you had Covid? Quite a few articles on it and people reporting they suffered hair loss which recovered eventually.
Minoxidil does strengthen the hair so upping the dose could be effective.
Dr Donovan has a lot of information on meds and causes of hair loss. It’s worth having a read of his blog articles if you have time.

Dr. Donovan's Hair Loss Articles (2011-2022) — Donovan Hair Clinic

donovanmedical.com

 

[Jim1973]

@Bigmac I did have Covid but that was in December of 2020 and haven't had it since.

 

[Bigmac]

I’m not sure what might be causing it then. Possibly going back on the topical is your only option to see if it improves.

 

[Coopman]

You are certainly chucking everything into your regimen.
Maybe you are just not responding to Minoxidil anymore or as Bigmac suggests try going back to topical minoxidil.

I have been on FIN for approx 20 years and my loss stabilised. In the 20 years where i have had breaks of between 3-6months, i noticed minimal shedding but did experience hair thinning/miniaturisation. i have also witnessed improvements when i switched from 1mg fin per day to a quarter of a proscar tablet per day (1.25mg). Never tried Dutasteride, was never convinced that it was any better than FIN and never knew the answer to the question (Will i lose my FIN gains if i stop and start using Dutasteride as an alternative).

Hope your situation improves.

 

[Bigmac]

I have added Dut 0.5mg once a week. Only started 2 weeks ago, so nothing to report yet. I substitute Fin for Dut on a Saturday.

 

[spl]

can you try oral and topical minoxidi; at the same time ?

 

[TBH]

I have added Dut 0.5mg once a week. Only started 2 weeks ago, so nothing to report yet. I substitute Fin for Dut on a Saturday.

What made you switch to that Mac? Does DUT have any efficacy with that frequency?

 

[Bigmac]

I switched as I noticed my hair was a little thinner. I am starting on this low dose to see if I get any sides. So far so good. I`ll increase it to twice a week at 3 months. As far as I know, this low dose will start working.
I`ve been on Finasteride 1mg for nearly 18 years.

 

[TBH]

I switched as I noticed my hair was a little thinner. I am starting on this low dose to see if I get any sides. So far so good. I`ll increase it to twice a week at 3 months. As far as I know, this low dose will start working.
I`ve been on Finasteride 1mg for nearly 18 years.

Ah i see,- are we talking more hairs lost than average or you can see a visual difference? I'm saving DUT for the next batch of baldness i'll do doubt experience in the next few years haha!
Going to try oral min after getting a health check up as we discussed!

Are you taking topical or pill?

 

[Bigmac]

My hair fall is normal on a daily average. Some hairs looked finer, doesn’t help they I’m greying too. But, after 18 years of Fin a low dose of Dut could help.
I see you’re mentioning oral minoxidil. That’s a good option if you think you’ll need it at some point.

 

[ninaross]

You should take a holistic approach to manage your hair loss. Look for a functional medicine doctor that will be able to identify the root cause of your problem and will be able to advise solutions for the same.

If you're not getting any results from these treatments, then it's better you look inside. What you eat inside will reflect outside. Ensure you are eating a clean and healthy diet with potassium and magnesium-rich foods. Replace any chemical-based products with more holistic ones. Incorporating these small changes will definitely help you with your condition.

Let me know if this helps! Thanks!