Hair Loss, Labs Run, Advice Requested

I registered specifically to seek advice.

Cliff notes:
I'm starting to bald on the crown and have no history of MPB on either side of my family ever. My 90 year old grandpa has hair as thick as mine. Mom's side the same, all uncles etc.

Injecting 100mg/ml test cyp EW for the past 5 years
175mg Synthroid ED (removed thyroid several years ago)
42 years old

Latest labs:
Testosterone Total 671 ng/dl
Estradial 39 pg/ml
Thyroxine Free .92 ng/dl
TT4 Thyroxine Total 5.80 ug/dl
DHT 995 pg/ml (a bit high as the labs say 106-719 is normal)

I've been on TRT at 100mg/ml test cyp EW, so a relatively low dose. I started "thinking" I was seeing some hair loss about 3 years ago and began taking pictures each month to track (I'm an engineer so my nature to deal in absolutes). I started noticing a pattern where I'd have some burning of the crown of my scalp, accompanied with shedding. This would come and go as would seem the hair loss.

Recently I had one of these hot head episodes, and noticed the shedding, and now a very obvious thinning of the crown. Comparing the pictures it's now very obvious as well.

I had labs run and had them pull DHT. Never had this test before and it seems a bit high.

So with Thyroid coming back normal and DHT being high, I have to believe that is the culprit.

I'd rather not stop TRT, so what options do I have? If MPB ran in my family I'd just go with it, but that's not the case at all, so something else is wrong and should be corrected IMO.

Advice?

Prescribing Urologist hasn't responded to what should be done as of yet, but did mention 1mg ED of Finasteride when we were talking during the blood draw and I mentioned the hair loss and possible DHT issue. I know that stuff is bad, so don't think that's the way to go.

Starting to feel like I know more about this than the doc!

I'm considering a second opinion with a full blown endocrinologist.

You have never used any of the prescribed, topical treatments? I'm not simply speaking of minoxidil; there are multiple, compounded solutions that have an excellent track record.

eatliftsleep said:

I started noticing a pattern where I'd have some burning of the crown of my scalp, accompanied with shedding. This would come and go as would seem the hair loss.

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My shedding was also preceded/accompanied by a burning sensation in my scalp.

CoastWatcher said:

You have never used any of the prescribed, topical treatments? I'm not simply speaking of minoxidil; there are multiple, compounded solutions that have an excellent track record.

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Correct, it's just now to the point where it's really becoming obvious. I don't think it's past the point of no return, but if I don't correct it soon it will be I'm afraid.

I'd love to know what some options are from those with experience. I've done a fair share of googling, research, reading reviews, etc, but this isn't like a pre-workout where I can just move on to the next thing. Once the hair is gone...it's gone.

I've heard Minoxidil works, but once you start you have to continue it indefinitely or the hair loss increases rapidly and you'll end up back to where you would have been had you never used it. Seems odd but that's what I've read.

With me honing in on the cause being DHT, I'd think a DHT blocking shampoo might be in order? But no idea if the OTC products are worth it or I need a Rx version.

Found what I believe to be a local Endo that specializes in TRT so I'm planning to make an appt with him to get some advice as well.

Propecia would be a last resort outside of stopping TRT. My thought was that a very small does (.25 mg EOD) might be a protocol that would avoid the unwanted side effects, but that's a wild guess on my part.

eatliftsleep said:

I've heard Minoxidil works, but once you start you have to continue it indefinitely or the hair loss increases rapidly and you'll end up back to where you would have been had you never used it. Seems odd but that's what I've read.

.

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Have to disagree there, I use "Regaine" or I did 3 years ago, used it for a year and worked very well, I then stopped and hair stayed same, just recently I have noticed a small amount of thinning on top again around centre parting, I started using again over the last couple of weeks and it really thickens the hair

Perhaps it works for some (myself included) and does not work for others

Your thyroid labs are incomplete. You left out the ranges and there is no FT3. My FT3 was low and I was losing hair and it stopped growing and when they put me on T3 (cytomel) my hair grew back and was perfect. Without FT3, FT4, TSH, RT3 and antibodies you don't know if your thyroid is normal, it's only an assumption.

ratbag said:

Your thyroid labs are incomplete. You left out the ranges and there is no FT3. My FT3 was low and I was losing hair and it stopped growing and when they put me on T3 (cytomel) my hair grew back and was perfect. Without FT3, FT4, TSH, RT3 and antibodies you don't know if your thyroid is normal, it's only an assumption.

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Very astute observation ^

If you need an OTC topical with a fair rep I would recommend Nizoral 1%, you can buy this @ WalMart

Vince Carter said:

Very astute observation ^

If you need an OTC topical with a fair rep I would recommend Nizoral 1%, you can buy this @ WalMart

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I'll add that to things for consideration, thanks. I'm more of a KISS kinda guy, and would rather start off with the minimum required to resolve.

FOX1 said:

Have to disagree there, I use "Regaine" or I did 3 years ago, used it for a year and worked very well, I then stopped and hair stayed same, just recently I have noticed a small amount of thinning on top again around centre parting, I started using again over the last couple of weeks and it really thickens the hair

Perhaps it works for some (myself included) and does not work for others

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Thanks for that info. Will also consider.

ratbag said:

Your thyroid labs are incomplete. You left out the ranges and there is no FT3. My FT3 was low and I was losing hair and it stopped growing and when they put me on T3 (cytomel) my hair grew back and was perfect. Without FT3, FT4, TSH, RT3 and antibodies you don't know if your thyroid is normal, it's only an assumption.

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Well, my thryoid definitely ain't normal, I don't have one LOL it got removed, but I get your point. I asked the Urologist to run a Thyroid panel and those were the only two values that came back on the report.

Thyroxine Free .92 ng/dL range .58 - 1.64 ng/dL
Thyroxine Total (TT4) 5.80 ug/dL range 4.90 - 12.23 ug/dL

I have an endo I see for my thyroid and he's against TRT. Tried to make an appt with another local well known endo and the nurse said I have to have the Urologist transfer all my records before he'll make an appt. Geeze.

Urologist left me a message today that they called in a Rx for 1mg ED Propecia to the pharmacy, but I'm afraid to mess with that. He was kinda nonchalant about it and said 1mg was a very small dose, but this site indicates otherwise by many.

I may try to make an appt with my thyroid endo and just flat tell him I intend to be on TRT and ask for his help.

I would take a look at this

Drug used to grow eyelashes also helps scalp hair growth


There are also some other formulas. Andro Block F does not expose your body to finasteride in a systemic fashion.

https://www.empowerpharmacy.com/drugs/andro-block-f-topical-solution.html