Guide For Those Starting Their Hair Loss Journey... Page 1 Of 3

Hair-pun

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Hey chaps!


I’m sure there have been many of these threads before but I thought it might be worth making a new guide for those just starting out with hair loss medication. There is so much misinformation online about hair loss- and also through medical professionals- that it would be great to cut through that with rational advice from those that are treating it themselves. There is no more reliable resource. If people could add in any mistakes, what didn’t work, bad advice to watch out for and then most importantly WHAT WORKED. I have personally wasted a lot of hair through waiting for snake oil treatments to work when I could have been using a treatment that did work and maintaining a great head of hair. For this reason I want to put down all the information that I have learned through trial and error so that others don’t have to find out the hard way.





When to Start.

START EARLY. This comes up time and time again. Treatments are very limited in their action and nothing is going to bring back your teenage hair line, the best you can really hope for is to keep what you have. All anti-ageing medicine works by slowing the decline- it is best started young from a position of strength. It’s very difficult to turn the clock back. Only a very lucky minority get regrowth, particularly at the front where treatments are rarely very effective. The minute you start noticing hair loss start taking 1mg brand name Propecia (may be more effective than generic) daily. Taking a daily pill is no trouble so don’t get put off by the idea of taking it for life. The benefit of keeping your hair going for years longer than your genes dictate is priceless. If you’re in the UK boots and Superdrug will post it to you cheaply, absolutely worth the money. Think of what you have now as your ‘bank’ of follicles. As you get older it becomes harder and harder to protect this reserve as they become increasingly sensitive to damage by your hormones. They are a precious resource and once they are gone they are gone- you won’t know how much this hurts until you’ve lost them. The change from acceptable to uncomfortable is really profound between NW2 and NW3 (imo)- when balding becomes obvious. It could really start impacting on your quality of life at this point. If you’re NW2 now really do keep a close eye on any change in density so you are ready to act in time to prevent it getting worse.


The game is basically a tug of war between your genes and the drugs you put into your body to counteract your genes expressing themselves. The aim is to counter the pull of your genes with the minimum amount of drugs to achieve stability. For long term results you need to achieve stability on anti-androgens first and then add growth stimulants as a bonus. The goal is to keep going for as long as possible with what we have now in the hope that something else comes along to use in the future. Don’t wait for the cure, it isn’t five years away!



Consistency.Keep your regimen consistent. Don’t change things around unless you’re adding something on top. Don’t get frivolous and stop taking your medication because you read a horror story online, skip days/weeks/months, change brand, lower your dosage or switch to something else just to see what happens. Three months later the consequences could be serious and what’s lost is generally unrecoverable. Just take Propecia every day and forget about it. Be very careful to preserve as much hair as you can for as long as you can.


Order to use Treatments

I feel that it is best to start with weaker treatments (finasteride) and then add to this to give yourself the longest period of stability. Some go straight to dutasteride but I think it’s better to use the weakest treatment you can stabilise on then you have somewhere to go when that stops working. Also, you want to always minimise risk and I have read that dutasteride is harder on the liver over a long period. The one instance where I would say go straight to dutasteride before giving finasteride 6 months is if you’re about to go past a point that you really can’t live with (maybe NW2 to 3). In this instance throw everything you can at it in the hope of stabilising, you can worry about which treatment is doing the heavy lifting later, what you can’t get back later is the lost hair. I have done this and then gradually eliminated drugs one by one, (except dutasteride) and kept a close eye on shedding to find out which was doing the work. Eventually we are all going to lose hair but to give yourself as many years of stability as you can I would recommend using the available treatments in this order, allowing 3-6 months in between steps to gauge if it’s working. If you’re desperate give it 3 months, if you can afford to lose a little then 6 is better. Step up when it becomes clear that the previous isn’t enough to achieve stability



:

1)Finasteride and Nizoral (maybe add minoxidil after a year on finasteride if you feel you need it)

2)1-2Dutasteride per week in addition to normal finasteride/nizoral regimen.

3)dutasteride every other day, finasteride the other days.

4)Daily dutasteride

5)Daily dutasteride and 50mg RU/ CB topically (often required to protect the hair line).

6) All of the previous but adding minoxidil (foam) topically or oral tablet and possibly micro needling as another growth stimulant.

7)There are more experimental treatments after this but I am not experienced in these. It seems like people add oral spironolactone/ cypro/enza/ bica/ daro etc. These all seem to come with sides as they are strong drugs. It would be great if someone that knows about these could comment on their experience.


If you think realistically that you’ll only use the FDA approved treatments then go for finasteride and Nizoral shampoo then add Minoxidil and micro needling when required and ride that as long as it lasts.



Treatments

1. Finasteride

After many conversations with various dermatologists I can tell you that finasteride is a well researched (25ish years of data) and well tolerated medication that prevents hair loss for many years without side effects for most people. There is a biological model- a group of people are born without the 5AR2 enzyme that finasteride blocks. They live normal, healthy lives. They don’t lose their hair and they don’t develop prostate cancer. Of course a (vocal) minority of people do get side effects from finasteride but the (silent, happy) majority don’t. If you do get sides you have the option to keep going and see if the side effects go away (I did this) or dropping the medication. Fear of sides is not a good reason to not try it. I don’t mean to cause any offence to anyone who reacted badly to finasteride, I feel for you if you had this experience. I’m just saying that most have a positive experience and so don’t need to come on forums to say this. Does Finasteride Work for Life? No, you can’t expect to beat your genes indefinitely, you can only slow them down for a period of time. Finasteride won’t hold your hair forever, nor will any other treatment. Results vary but from posts I’ve read many seem to get around 8-10 years maintenance then hair loss begins again- though some very lucky people seem to manage up to 20ish years. I think it is really important for finasteride users to know that when it stops working it can be very rapid, so you need to be prepared for your next step. For me when finasteride stopped holding my hair it was as if I had stopped taking it and I pretty much returned to where my identical twin is within a year- I’m guessing this is where I would have been without finasteride. If I had known what I was doing I would have immediately added Dutasteride and maintained a great head of hair. I didn’t understand what was happening until it was too late- don’t let it happen to you.

Continued on page 2: https://www.hairlosstalk.com/intera...g-their-hair-loss-journey-page-2-of-3.128424/

And on page 3: https://www.hairlosstalk.com/intera...g-their-hair-loss-journey-page-3-of-3.128425/
 
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TomRiddle

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There is a biological model- a group of people are born without the 5AR2 enzyme that finasteride blocks. They live normal, healthy lives. They don’t lose their hair and they don’t develop prostate cancer.

"Some children with a rare genetic condition appear female at birth but later develop a penis and testes around the time puberty begins. But what causes this to happen?

A new article in BBC Magazine tells the story of some children in the Dominican Republic with this condition, who are known in the country as Guevedoces, which roughly translates to "penis at 12." One child named Johnny was raised as a girl, but when he matured and neared puberty, he grew a penis and his testicles descended, according to the BBC.

X and one Y chromosome. However, as they develop in the womb, a genetic mutation prevents their bodies from converting the male hormone testosterone into a hormone called dihydrotestosterone, or DHT. Because DHT is responsible for the development of male sex organs, the lack of DHT means the male organs don't develop properly, according to the National Institutes of Health.

When children with the condition are born, their external genitals look female, or in some cases, appear ambiguous, the NIH says. But during puberty, Guevedoces, like typical males, experience an increase in testosterone. The body appears to respond to these higher levels of testosterone — the penis and scrotum grow larger, and secondary sex characteristics — such as increased muscle mass and a deep voice — can also appear.

Men with this condition, officially called 5-alpha reductase deficiency, are usually infertile, and often do not develop much facial or body hair. Although most children with this condition are raised as girls, about half identify themselves as male after puberty, the NIH says."

https://www.livescience.com/52247-guevedoces-girls-boys.html

https://en.wikipedia.org/wiki/Güevedoce

https://en.wikipedia.org/wiki/5α-Reductase_deficiency

I wouldn't call this exactly normal healthy lives. Better inform yourself better before actually pretending to know something.

JJ-ar7-X0-GXHd-S20kp-Xz-HREAQfs-UJ6s-Ouyb-Re1o-Ax-R0w.jpg


guevedoces.jpg
 
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TomRiddle

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1. Finasteride

After many conversations with various dermatologists I can tell you that finasteride is a well researched (25ish years of data) and well tolerated medication that prevents hair loss for many years without side effects for most people.

As for this statement lol

Adverse Event Reporting in Clinical Trials of Finasteride for Androgenic Alopecia: A Meta-analysis.
Belknap SM1, Aslam I2, Kiguradze T2, Temps WH2, Yarnold PR3, Cashy J4, Brannigan RE5, Micali G6, Nardone B2, West DP2.
Author information

Abstract
IMPORTANCE:
Two meta-analyses conclude that finasteride treatment of androgenic alopecia (Androgenetic Alopecia) is safe but do not assess quality of safety reporting.

OBJECTIVE:
To assess safety reporting for clinical trial reports of finasteride for Androgenetic Alopecia.

DATA SOURCES:
MEDLINE, ClinicalTrials.gov, and a clinical data repository for an academic medical center.

STUDY SELECTION:
Published clinical trial reports for finasteride treatment of Androgenetic Alopecia.

DATA EXTRACTION AND SYNTHESIS:
For each trial, we assessed quality of adverse event reporting, extracted the number and type of adverse events in treatment and placebo groups, and assessed duration of safety evaluation and adequacy of blinding. Two observers independently extracted the data; differences were resolved by consensus. We assessed generalizability in a large cohort of men prescribed finasteride, 1.25 mg/d or less, by assessing for eligibility in the finasteride-Androgenetic Alopecia pivotal trials.

MAIN OUTCOMES AND MEASURES:
Quality was assessed as adequate, partially adequate, inadequate, or no events reported. We used funnel plots of the hazard ratio to assess bias.

RESULTS:
Of 34 clinical trials, none had adequate safety reporting, 19 were partially adequate, 12 were inadequate, and 3 reported no adverse events. Funnel plots were asymmetric with a bias toward lower odds ratio for sexual adverse effects, suggesting systematic underdetection. No reports assessed adequacy of blinding, 18 (53%) disclosed conflicts of interest, and 19 (56%) received funding from the manufacturer. Duration of drug safety evaluation was 1 year or less for 26 of 34 trials (76%). Of 5704 men in the clinical data repository who were treated for Androgenetic Alopecia with finasteride, 1.25 mg/d or less, for Androgenetic Alopecia, only 31% met inclusion criteria for the pivotal trials referenced in the manufacturer's full prescribing information and 33% took finasteride for more than 1 year.

CONCLUSIONS AND RELEVANCE:
Available toxicity information from clinical trials of finasteride in men with Androgenetic Alopecia is very limited, is of poor quality, and seems to be systematically biased. In a cohort of men prescribed finasteride for routine treatment of Androgenetic Alopecia, most would have been excluded from the pivotal studies that supported US Food and Drug Administration approval for Androgenetic Alopecia. Published reports of clinical trials provide insufficient information to establish the safety profile for finasteride in the treatment of Androgenetic Alopecia.

https://www.ncbi.nlm.nih.gov/pubmed/25830296

The Dark Side of 5α-Reductase Inhibitors' Therapy: Sexual Dysfunction, High Gleason Grade Prostate Cancer and Depression

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064044/
 

Hair-pun

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As for this statement lol

Adverse Event Reporting in Clinical Trials of Finasteride for Androgenic Alopecia: A Meta-analysis.
Belknap SM1, Aslam I2, Kiguradze T2, Temps WH2, Yarnold PR3, Cashy J4, Brannigan RE5, Micali G6, Nardone B2, West DP2.
Author information

Abstract
IMPORTANCE:
Two meta-analyses conclude that finasteride treatment of androgenic alopecia (Androgenetic Alopecia) is safe but do not assess quality of safety reporting.

OBJECTIVE:
To assess safety reporting for clinical trial reports of finasteride for Androgenetic Alopecia.

DATA SOURCES:
MEDLINE, ClinicalTrials.gov, and a clinical data repository for an academic medical center.

STUDY SELECTION:
Published clinical trial reports for finasteride treatment of Androgenetic Alopecia.

DATA EXTRACTION AND SYNTHESIS:
For each trial, we assessed quality of adverse event reporting, extracted the number and type of adverse events in treatment and placebo groups, and assessed duration of safety evaluation and adequacy of blinding. Two observers independently extracted the data; differences were resolved by consensus. We assessed generalizability in a large cohort of men prescribed finasteride, 1.25 mg/d or less, by assessing for eligibility in the finasteride-Androgenetic Alopecia pivotal trials.

MAIN OUTCOMES AND MEASURES:
Quality was assessed as adequate, partially adequate, inadequate, or no events reported. We used funnel plots of the hazard ratio to assess bias.

RESULTS:
Of 34 clinical trials, none had adequate safety reporting, 19 were partially adequate, 12 were inadequate, and 3 reported no adverse events. Funnel plots were asymmetric with a bias toward lower odds ratio for sexual adverse effects, suggesting systematic underdetection. No reports assessed adequacy of blinding, 18 (53%) disclosed conflicts of interest, and 19 (56%) received funding from the manufacturer. Duration of drug safety evaluation was 1 year or less for 26 of 34 trials (76%). Of 5704 men in the clinical data repository who were treated for Androgenetic Alopecia with finasteride, 1.25 mg/d or less, for Androgenetic Alopecia, only 31% met inclusion criteria for the pivotal trials referenced in the manufacturer's full prescribing information and 33% took finasteride for more than 1 year.

CONCLUSIONS AND RELEVANCE:
Available toxicity information from clinical trials of finasteride in men with Androgenetic Alopecia is very limited, is of poor quality, and seems to be systematically biased. In a cohort of men prescribed finasteride for routine treatment of Androgenetic Alopecia, most would have been excluded from the pivotal studies that supported US Food and Drug Administration approval for Androgenetic Alopecia. Published reports of clinical trials provide insufficient information to establish the safety profile for finasteride in the treatment of Androgenetic Alopecia.

https://www.ncbi.nlm.nih.gov/pubmed/25830296

The Dark Side of 5α-Reductase Inhibitors' Therapy: Sexual Dysfunction, High Gleason Grade Prostate Cancer and Depression

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064044/
"Some children with a rare genetic condition appear female at birth but later develop a penis and testes around the time puberty begins. But what causes this to happen?

A new article in BBC Magazine tells the story of some children in the Dominican Republic with this condition, who are known in the country as Guevedoces, which roughly translates to "penis at 12." One child named Johnny was raised as a girl, but when he matured and neared puberty, he grew a penis and his testicles descended, according to the BBC.

X and one Y chromosome. However, as they develop in the womb, a genetic mutation prevents their bodies from converting the male hormone testosterone into a hormone called dihydrotestosterone, or DHT. Because DHT is responsible for the development of male sex organs, the lack of DHT means the male organs don't develop properly, according to the National Institutes of Health.

When children with the condition are born, their external genitals look female, or in some cases, appear ambiguous, the NIH says. But during puberty, Guevedoces, like typical males, experience an increase in testosterone. The body appears to respond to these higher levels of testosterone — the penis and scrotum grow larger, and secondary sex characteristics — such as increased muscle mass and a deep voice — can also appear.

Men with this condition, officially called 5-alpha reductase deficiency, are usually infertile, and often do not develop much facial or body hair. Although most children with this condition are raised as girls, about half identify themselves as male after puberty, the NIH says."

https://www.livescience.com/52247-guevedoces-girls-boys.html

https://en.wikipedia.org/wiki/5α-Reductase_deficiency

I wouldn't call this exactly normal healthy lives. Better inform yourself better before actually pretending to know something.

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View attachment 142251
Hi Tom, please can we discuss this off this guide? I have spent a long time putting it together to help people who want to treat their hair loss. As we have spoken about before it's totally fine to not want to treat hair loss and there are plenty of threads dedicated to this- I just don't feel that this is the place to have that conversation
 

TomRiddle

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Hi Tom, please can we discuss this off this guide? I have spent a long time putting it together to help people who want to treat their hair loss. As we have spoken about before it's totally fine to not want to treat hair loss and there are plenty of threads dedicated to this- I just don't feel that this is the place to have that conversation

Lmao so let's get this straight, you want to ignore everything except what suits your mentality and ideologies? Lmao, damn, never thought some of you guys are so sick but whatever i will let you do your thing, whatever that is lol

But i really don't get it why would you want to spread misinformation just because you are so desperate in treating your hairloss, regardless of the dangers this thing could involve, i really don't get it. And it was just conversational, i mean why wouldn't you want to be truthful and informed about this subject rather than just extracting out of context whatever suits your insecure and desperate mentalities.

But i will respect your request and leave your thread alone, if that's how you want to live your lives no worries, as i said many times, in the end your gonna be the only ones who will suffer the consequences of your actions, being they good or bad... Good luck
 
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