Exploring The Hormonal Route. Hair=life.

[Ticken]

So, for guaranteed regrowth, my E must be at the level of 90-100? Does it give significant feminization? Bica raises E to 30-45pg / ml, according to the charts on the internet. A dose of 150 mg increases E by 1.5-2.5 times.

That's a million dollar question...lol.
No one knows what estradiol blood level will "guarantee regrowth" for you.
I suspect the estradiol level that starts regrowth for you will be dependent on your genetics, estrogen receptor sensitivity in your hair follicles and other variables that we are currently unaware of. Sadly, for some folks, no amount of E2 will bring back their hair.

Do you know your current estradiol level? If it's currently at the low end of the reference range you could try increasing it into the top end of the reference range. There's no guarantees in any of this but an estradiol level at the high end of the male range would be more beneficial to hair growth than e2 at the lower end of the range.

 

[JaneyElizabeth]

Bica is a selective nonsteroidal antiandrogen, while spironolactone is potassium sparing diuretic, and a weak steroidal antiandrogen. Bica is infinitly better and is not harmful for the liver contrary to popular belief.

I defer to you but I have gone through group discussions with folks on transfeminine sciences who see spironolactone as being either equal to or less damaging compared to bica in the long-run. spironolactone is sort of the whipping boy/girl of MtF meds but usually because it makes you feel weird with really stereotypical effects that males fear such as loss of strength, increased fatigue, loss of libido, interference with working out safely due to diuretic/lack of NaCl, brain fog and on and on but some people tout it and people often switch from CPA or Bica and have better feminization on spironolactone. Remember, Bica and spironolactone do unusual things in that they both occupy receptors and increase overall T.

 

[JaneyElizabeth]

That's a million dollar question...lol.
No one knows what estradiol blood level will "guarantee regrowth" for you.
I suspect the estradiol level that starts regrowth for you will be dependent on your genetics, estrogen receptor sensitivity in your hair follicles and other variables that we currently unaware of. Sadly, for some folks, no amount of E2 will bring back their hair.

Do you know your current estradiol level? If it's currently at the low end of the reference range you could try increasing it into the top end of the reference range. There's no guarantees in any of this but an estradiol level at the high end of the male range would be more beneficial than at the lower end of the range.

Obviously, I continue to believe that regrowth can ultimately be achieved by a brute force estrogen attack and @bridgeburn's E2 levels had to be off the charts as well. We have seen folks using massive duta/bica/cpa/spironolactone but except for bridge and me, very few seem to be pushing extreme E2 levels which might be necessary to break down for me, even decades of fibrosis.

 

[Gergely]

Bicalutamide does one thing and that is block androgenic activities, spironolactone on the other hand was not designed to do that.

 

[Gergely]

Bicalutamide does one thing and that is block androgenic activities, spironolactone on the other hand was not designed to do that.

What you and others are probably thinking of is the "predecessor" to bica, flutamide which known to cause liver damage.

 

[JaneyElizabeth]

Bicalutamide does one thing and that is block androgenic activities, spironolactone on the other hand was not designed to do that.

I get that but to my knowledge, it still works primarily by receptor blocking otherwise, how is it working when it often increases T? spironolactone resembles chemically some other natural metabolites:

Spironolactone is a moderate antiandrogen.[113][138][163] That is, it is an antagonist of the androgen receptor (AR), the biological target of androgens like testosterone and dihydrotestosterone (DHT).[113][138][163] By blocking the AR, spironolactone inhibits the effects of androgens in the body.[113][138][163] The antiandrogenic activity of spironolactone is mainly responsible for its therapeutic efficacy in the treatment of androgen-dependent skin and hair conditions like acne, seborrhea, hirsutism, and pattern hair loss and hyperandrogenism in women, precocious puberty in boys with testotoxicosis, and as a component of feminizing hormone therapy for transgender women.[138][165][181] It is also primarily responsible for some of its side effects, like breast tenderness, gynecomastia, feminization, and demasculinization in men.[114][181] Blockade of androgen signaling in the breast disinhibits the actions of estrogens in this tissue.[182] Although useful as an antiandrogen in women, who have low testosterone levels compared to men,[183][184] spironolactone is described as having relatively weak antiandrogenic activity.

 

[JaneyElizabeth]

What you and others are probably thinking of is the "predecessor" to bica, flutamide which known to cause liver damage.

Much more so than bica although there are probably more studies still on flutamide but still, we did a forum/seminar with researchers in the MtF field and none of them gave bica "a free pass" as being safer long-run than spironolactone. The first time I ever heard of regrowth for any males was when a forgotten congressman started regrowing hair in the 80's with flutamide, I believe, before succumbing to cancer but most/many prostate treatments work for XY hair loss for obvious reasons related to reductase.

 

[JaneyElizabeth]

Bicalutamide does one thing and that is block androgenic activities, spironolactone on the other hand was not designed to do that.

It does at least two things: block receptors and increase circulating T in most people. Also remember that blocking receptors is pretty vague. spironolactone and Bica don't occupy exactly the same receptors and unlike CPA, they don't lower T. I think the hit or miss aspect of blocking more or less or unusual receptors in some folks since we vary in terms of how many and which get blocked, that account for especially with spironolactone, the uncomfortable and unpredictable sides. Some use spironolactone quietly without issue but along with breast growth questions, "I want to change AA's" is the number one question on MtF fora and my joke is that the favorite AA of MtF's is the one that she hasn't used yet.

Bridge didn't go into this much but he used all of the big 3 AA's and then took breaks but his E2 levels seemed only to go up overall based upon complete protocol. He seemed to be testing them as well which some might want to try but only with extreme caution. Everything worked for dude and maybe that's why he is semi-famous. He found something that can work especially for people who lack sides and who seem more so immune to shedding for some reason.

 

[Gergely]

It does at least two things: block receptors and increase circulating T in most people.

No it doesn't, T increases because there's no free receptor to bind to. It's a natural mechanism of the body. It's not directly caused by the administration of bica.

 

[DogoDiLaurentiis]

That's a million dollar question...lol.
No one knows what estradiol blood level will "guarantee regrowth" for you.
I suspect the estradiol level that starts regrowth for you will be dependent on your genetics, estrogen receptor sensitivity in your hair follicles and other variables that we are currently unaware of. Sadly, for some folks, no amount of E2 will bring back their hair.

Do you know your current estradiol level? If it's currently at the low end of the reference range you could try increasing it into the top end of the reference range. There's no guarantees in any of this but an estradiol level at the high end of the male range would be more beneficial to hair growth than e2 at the lower end of the range.

If estradiol does not help, then it is likely something else but that does mean it is probably a diagnosable and treatable condition.

All that typically means is that you require more testing to figure out what the problem is.

I think it is thankfully a proportionately rare phenomenon when somebody has a hair loss condition that is not remedied by some treatment.

 

[Gergely]

I venture to guess if one can only produce T from the adrenal glands, no amount of bica will increase T by a significant margin. This is just a guess though

 

[JaneyElizabeth]

No it doesn't, T increases because there's no free receptor to bind to. It's a natural mechanism of the body. It's not directly caused by the administration of bica.

I will rephrase yes to be more precise. Its use is accompanied by an increase in circulating T but I think that's the same phrasing one would use for spironolactone as well. CPA does decrease T and significantly so as does MPA. FWIW, I hear far fewer complaints about Provera than any of the other commonly used synthetic AA's and it works straightforwardly which makes the testing most commonly used which is far from detailed, much easier to interpret. I have felt no sides from Provera.

Remember that for cancer meds, it might be the whole point to shut down certain receptor sites but for feminization and hair growth, such a blunt, full frontal attack might be both unnecessary and unrecommended in terms of continuing treatment.

 

[Depression]

You are very lucky to have recovered so much hair, we are both young I understand why you have made such a big diet to recover your hair, I wrote a post on my hair loss that eats my life

 

[DogoDiLaurentiis]

You are very lucky to have recovered so much hair, we are both young I understand why you have made such a big diet to recover your hair, I wrote a post on my hair loss that eats my life

What treatments have you tried?

 

[Gergely]

MPA and CPA decrease luteinizing hormones, while bicalutamide increases LH and gonadal production of T leading to an increase in e2 levels.

 

[Depression]

I'm on finasteride since 112 days and minoxidil since 152 days..

 

[DogoDiLaurentiis]

I'm on finasteride since 112 days and minoxidil since 152 days..

finasteride takes a but if min you should be seeing -something- by now, even if it is just nascent regrowth.

Do you have any other accompanying skin problems? That's important, if your scalp or skin around your hair is irritated, has pain or itching emanating from it you need to get that addressed.

 

[DogoDiLaurentiis]

IMO people might argue this with me but I feel like unless you have documented high testosterone and specifically high DHT, that finasteride or dutasteride should not be the first line response for hair loss.

 

[Depression]

what more can I do in your opinion? I'm going to take an anti-dandruff shampoo but I have tried everything, all the remedies and nothing works I'm cursed

 

[Norwoody]

IMO people might argue this with me but I feel like unless you have documented high testosterone and specifically high DHT, that finasteride or dutasteride should not be the first line response for hair loss.

I agree. There's definitely people out there with low T, low E, and/or other issues that those drugs don't address. It does irk me that people are still stuck in that mentality of "the big 3 is the first line of defense". Generally it will help but that doesn't make it the optimal first line for every individual.