24M seeking help for aggressive androgenetic alopecia - "nuke" stack?

[Renovation]

Read again but slowly and have your magnifier at your disposal, I said in my case f*****

Believe it or not, idc. But what Renovation is saying is true and applicable in my case.

One day I slept furrowing, I woke up with debilitating nerve pain like symptoms.

I've had tensed my eyebrows & frontalis.

That's what have triggered my Androgenetic Alopecia.

That's interesting, I trace my thinning back to 2007, exactly when I had minor neck injury. It took me years to put 2 and 2 together.

For anyone not having neck pain, there's still probably a disconnect occuring between shoulder muscles, sternomastoid muscles and muscles of front side and back of head you mentioned surrounding gelea, and this is likely not always even visable.

Recently I've been to some conferences and shows and sat near the back, I'd estimate 90 percent of balding men have had similar look neck and off centre head posture. And 90 percent with no hair loss have great posture.

It's 100 percent a major factor for most people. I think there's more to it, but all linked.

I have yet to see a single person who has a soft and pliable scalp and is bald. If anyone disagreeing with me can post a video this id love to see it. For anyone who is in doubt, inflammation of the scalp means it's not pliable and underneath is calcified/fibrosis(it doesn't mean it's red and blistering)!

Inflamation^DHT^hairloss. The key is that inflammation comes first NOT DHT!

 

[bulli103]

Hey hairloss community,

Thanks for keeping this subreddit so informative

I’m a 24M with aggressive Androgenetic Alopecia (Dad & maternal grandad went bald in early 20s). I live a healthy lifestyle - lift weights 2-3x/week, eat well, sleep well, rarely drink, and don’t smoke.

My Situation & Questions​

I’ve been on 1mg finasteride daily for about 2-3 weeks with minimal side effects (maybe slightly less semen volume, but nothing major). However, I feel like my hair is already looking thinner and shedding more, though I didn’t take proper before pics to compare (big mistake, I know). I understand shedding can be normal early on, but it’s definitely making me anxious.

I also get that finasteride takes at least a year to show real results, but since I’m still early in the process, I want to make sure I’m on the most effective possible protocol and not wasting time with something that might not work.

I want to be as aggressive as possible with my treatment (without, you know, cutting my balls off). My goal is to find the most effective stack that balances efficacy vs. potential side effects - essentially, what gives me the best shot at regrowth while keeping risks reasonable?

Here’s the stack I’m considering:

1. Combined daily oral: 0.5mg Dutasteride + 2.5mg Minoxidil
2. Ketoconazole shampoo (2%) – twice a week
3. Alpecin caffeine shampoo – as my daily option
4. RU58841

Questions:​

• Is 2.5mg oral Minoxidil safe for long-term use? What side effects should I watch out for?
• Is 0.5mg Dutasteride actually more effective than 1mg Finasteride, or does it not make a major difference?
• Does RU58841 actually work, and is it worth adding to my regimen? Should I be using topical finasteride + Oral dutasteride instead

Main question - Would you tweak anything in my approach?

I’d love to hear about your experiences and recommendations. Appreciate any advice you guys can give!

once in the week duta does wonders, oral minoxidil minimum dosage should be 5 mg, forget about RU and the shampoos....add cb0301 and you will be fine

 

[NathanN23]

It sounds like you're really committed to taking control of your hair loss, and it's great to see that you're researching your options carefully. With androgenetic alopecia, being proactive and open to a well-thought-out treatment plan is key!

To answer your questions:

1. 2.5mg oral Minoxidil: This is a higher dose than the standard 1mg oral Minoxidil. While it's generally well-tolerated, higher doses can increase the risk of systemic side effects, including dizziness, tachycardia (rapid heart rate), or even lower blood pressure. It's best to monitor any new side effects and consult with a healthcare provider if you're considering long-term use.
2. 0.5mg Dutasteride vs. 1mg Finasteride: Dutasteride is a more potent 5-alpha reductase inhibitor than finasteride, blocking both Type 1 and Type 2 enzymes (while finasteride primarily blocks Type 2). Some studies suggest that Dutasteride may have better results in some individuals, but there are also increased risks of side effects. It's worth weighing the potential for better results against the risks. You could start with Finasteride and consider Dutasteride if you feel you're not seeing enough improvement.
3. RU58841: This topical treatment has been shown to block DHT at the scalp, and many people have seen positive results, but its use is still somewhat experimental, as it’s not FDA-approved in most regions. If you decide to use it, make sure to purchase from reputable sources, as product quality can vary.
4. Topical Finasteride vs. Oral Dutasteride: Combining topical Finasteride with oral Dutasteride is an option some people prefer to minimize systemic side effects while still benefiting from the oral medication. However, some studies suggest that topical Finasteride can be just as effective as oral in many cases. It depends on your response and comfort with the treatments.

Recommendation: While your stack is quite comprehensive, it’s always a good idea to approach treatments in a way that balances both effectiveness and potential side effects. If you’re unsure about any part of the regimen, I recommend consulting a professional who specializes in hair restoration to make sure you're tailoring your plan for the best results.

Additionally, if you're looking for more personalized advice or just want to get a second opinion, feel free to check out the link in my signature to get more information and schedule a free consultation.

Best of luck!

Nathan