Low Local Estrone Ipotrichia Or... Just Inflammation?

Go_faster_Sonic

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Hello everyone, i'm new here.

I was a finasteride user and i quit that drug because of the severe advere effects (still here after discontinuation, after six months) but this is not a post about the pfs, it's about my situation which, i suppose, is very common.

My first dermatologist made a huge mistake telling me that i have an androgenetic alopecia and giving me propecia, indeed i don’t have it. i took finasteride without having male androgenic alopecia but something different: my hair tend to be thin in the frontal area, where my skin is always red and itchy.
My latest dermatologist told me that i have something different, something called “low local estrone ipotrichia”, which means that in the frontal area my hair tend to become thin because of low local estrone. So this is why i’m putting a lotion on it.

i report from his website:
the causal factor is the deficiency, either in the production or in the action, of estrone by the hair bulb; the estrone is a hormone that is erroneously considered to be of the female type, being also produced by the testis; at the level of the hair, the estrone is the antagonist of testosterone, because if the second pushes the hair to the telogen phase, ie shortens its cycle until the fall, the first causes the hair to maintain its anagen phase and therefore the physiological duration of its cycle.
This hormone is one of the chemical messages, along with hydrocortisone and glycogen, that the hair in fall sends to its successor, inside the hair follicle, so that there is a change. It is therefore an important input that the new hair must have to face its entire growth phase. It follows that if the hair is lacking in the production or in the uptake of this mediator, a fundamental fuel for the life of the hair is missing, which then is faced with this deficiency at first thinning, then saving some important structures (eg the sheaths), and then falling earlier or more than usual. The areas affected are different from those of androgenetic alopecia, being a pathology not related to androgenic damage, and therefore the extron - sensitive areas will be affected: the frontal and upper area of the scalp.

He gave me a lotion for that, a lotion which contains 1% progesteorne, 0.02% estrone, 0.04% hydrocortisone butyrate, assuring me that this would only act locally and not systemically.
Now, what if he’s wrong? And that’s not all.
Currently i started thinking something: what if the problem is just… inflammation? In that area my skin is always red, hot, itchy… what if my hair get thin because of inflammation? what if while fighting pfs i can save my hair as well just treating the inflammation at it’s root?

When i thought this, i sent an email to my dermatologist (a very important one in the whole country) and to another very important dermatologist asking them:

  1. if the cause is just inflammation, why don’t we remove the thing that is causing the inflammation? is it an allergy? what it is? let’s remove the cause and we would have solved the puzzle. after the terrible experience with finasteride, i don't want to tax again my sistem.
  2. you claim that there is not systemic absorption: would you please prove it?
my dermatologist did not answer. the second dermatologist, the most important in italy, answered “keep on putting the hydrocortisone, is anti-inflammatory” and “i know for sure that there’s no risk for health but i don’t have those studies who confirm it with me, look in the internet” so he basically didn’t answer.

of course, in this situation, i don’t trust doctor’s so much.
i know this can sound very stupid seeing what’s happened to me but i feel that i can fight pfs and my strange shedding as well.
doctors tend to cure the symptoms, not the causes.

any idea?
 

Trichosan

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Ipotrichia seems to be a diagnosis mainly of Italian origin. Nothing similar seems to come up in English in a search for that condition. I can't read Italian, but if you can, look at the research papers or medical case histories to see what diagnostic tests are done to diagnose it. Did your dermatologist do similar tests? Or, was he just diagnosing based on clinical appearance? Did he give a differential diagnosis or just one based on looking? That is not good medical practice. Here is my suggestion-do more research in Italian and report back here. Meanwhile, use the medication they gave you for three weeks as instructed and report back here. There are cautions about progesterone and estrogen being associated with cancer but don't be alarmed by that at all with this short term topical treatment. Did the doctors make you an appointment for a follow up visit?
 

Go_faster_Sonic

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Hi and thank you for the answer.
here's an article in english with some studies at the bottom - i can't link because i'm new - Now i'm gonna make an extensive research and tomorrow i'll try to talk with my dermatologist.
If the problem is low local estrone, i wonder why my lotion contains progesterone... i'm so scared that i don't think is good to keep on playing with 5 alpha inhibitors (though progesterone seems to be a 5 alpha inhibitor only in huge quantities).
My dermatologists based his diagnosis just on clinical appearance. Indeed, my head has not the typical male pattern baldness shape...
He told me to apply everything for 6 months and i'm at the end of the sixth month... then i'm gonna make a follow up visit.
dunnow, i "feel" that maybe things are easier than this... and i'm so scared that the idea of applying hormones and corticosteroids forever seems insane...
 

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Trichosan

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Remember, this is a topical, so even if you where applying it for three years there is nothing irreversible that is going to happen. At the end of six months (I think even three months) you will see improvement or not. Then you will know if the diagnosis is correct or whether you should see another derm. Just eat a good diet, exercise and don't add other meds or topicals. Oh, and don't worry-causes too much stress.
 

Trichosan

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Yes, but the two hormone equivalents involved here are completely different functional pathways and also work differently in males. Also, there are no reports of permanent impairment with them, unlike finasteride. Personally I would try anything if I needed it as long as any side effects were not permanent. That's the great thing about being a living, self-repairing organism.
 

Go_faster_Sonic

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If nothing permanent, what kind of side effects have been reported from topical estrone, progesterone and hydrocortisone butyrate?
 

ChemHead

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Sonic, if I were you, I would give the estrone a shot. It will not have the side effects that finasteride has and any side effects that you may experience would subside within a week.

I have a lot of experience with finasteride. I don't use it at all, but I know why it works in some people and why it doesn't in others. The only real way to get finasteride to work is to take it in a very high dose (5-10mg daily). This does two things:

- it will very quickly bind 5a-reductase and stop inflammation and improper signalling via DHT
- it will cause a sharp rise in concentration of testosterone

Both are very important and synergistic. Because the 5a-reductase is bound in the skin and hair (and pretty much everywhere else), that still very high concentration of testosterone (and probably androstenedione) has only one path of metabolism: estrogen synthetase (aromatase). Testosterone has a much higher binding affinity for the 5a-reductase enzyme than aromatase, so in the presence of both, the 5a-reductase will always win. The quick antagonism of 5a-reductase causes a spike in estrone and estradiol. Which one is more significant in terms of hair growth? I'm not really sure, but the increase in local metabolism to these estrogens is responsible for MASSIVE thickening, darkening, and growth of hair. Unfortunately, the positive effects are very short-lived. The sharp increase in testosterone as well as estrogens will cause two things to happen: the pituitary gland in the brain will release less luteinizing hormone (LH) and follicle stimulating hormone (FSH) due to the binding of estrogen and androgen receptors in the hypothalamus. The lower levels of LH will cause your overall steroid production to decrease and the lower levels of FSH will down-regulate your aromatase expression in order to protect your body from excessive estrogenism.

For me, I can get finasteride to work really, really, well for about a one week window. It takes about 3 weeks of 5-10mg daily and then, for about 5-7 days, I have really thick, dark hair.. not a single hair falls out. Then the hypothalamus says "stop" and my hair becomes thin, wimpy, and dry... also a little bit of scalp itch returns, but not anything like what it would be without the finasteride. And that's it. If you want to experience it again, you have to stop taking finasteride, let your body replenish its 5a-reductase, and allow your HPTA to re-balance. For me, it takes about 2-3 months to recover. It's honestly no different than an anabolic steroid cycle, but rather than introducing exogenous testosterone, you're blocking the metabolism of testosterone to DHT in the whole body, causing the sharp increase in concentration of testosterone and estrogens.

So, you can see why finasteride wreaks havoc on the body. It essentially has the same effect that anabolic steroids have on the HPTA (the extent being dose dependent of course). With finasteride, some are more or less fortunate. Some people do very well with no side effects and it all comes down to their genetic enzymatic expression. For example, someone with a high expression of 5a-reductase in only the skin and hair would benefit really well with very little or no side effects. Some people don't really have a high level of 5a-reductase expression in the skin or hair, but maybe have very low levels of aromatase expression or estrogen receptors (this is the case for most women that experience hair loss). This ultimately results in weak, thin, wispy hair.. basically the diffuse pattern that women get if they experience hair loss.

Anyway, I just thought it would be important to note that there are two elements to hair loss: there's the DHT and then there's the lack of intrafollicular estrogens... both of which are caused by the presence of 5a-reductase in the hair folicle. I don't know, however, whether estrone or estradiol is more important in terms of hair growth.
 
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Go_faster_Sonic

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i won't ever take finasteride again, you have no idea of what i'm experiencing. as for the estrone... my lotion contains estrone, progesterone and hydrocortisone butyrate. if i really have low local estrone ipotrichia, in my opinion, estrone sulphate would be the best choice, not estrone. i know that estrone sulphate is biologically inactive but that once gets in touch with the hair follicles, gests converted in estrone...
if i really have that thing. can i trust a doctor who says that i have low local estrone just watching at my scalp?

btw what i have is really similiar to femal pattern baldness. i read a study which says that left-handed and gays have a more estrogeni hormonali profile, which might explain my shedding...

but i even read that inflammation can cause dermatitis and then thinning of hair.

now, ho can i find out what really my problem is? androgenetic? low local estrone? inflammation?

btw, for one week i've stopped the lotion, i'll start again next week to see if my pfs improves or get worse...
 

ChemHead

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Trust me, I've had horrible side effects from finasteride.. all of the worst that people complain about.. the brain fog, exhaustion, sexual side effects. It definitely sucks. The only way to resolve the lingering effects of finasteride is to get your body to start replenishing the 5a-reductase that was rendered permanently inactive due to finasteride. The only thing that has ever helped me fully recover from finasteride is adopting a fully raw vegan diet for a couple months.. tons of fresh fruits, vegetables, leafy greens, nuts, etc. It takes all the digestive stress off your body and allows it to clear metabolic waste and inflammation from food and chemicals.. and it works fairly quickly.

If you want to find out if your problem is androgenic, you will likely have to carefully experiment with drugs or chemicals that alter steroid metabolism. Drugs like spironolactone indirectly cause an increase in peripheral aromatization of androgens to estrogen. Unfortunately, spironolactone is also a weak androgen receptor antagonist, so it might not be conclusive in determining if you only have an issue with low estrogens locally in the skin and hair follicle.

When you took finasteride, how long did you take it for and at what dosage? What were the effects you noticed from taking it, both positive and negative? Did it have any effect on your hair at all (increase in shedding, changes in texture)?
 

Go_faster_Sonic

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i took it for 14 years, 1mg and i simply went nuts! mightmarish psychiatric conditions after 12 years. when i stopped it, my face changed and is still that way...
i'm on a 70%raw food diet now but maybe i should fast, in order to heal quickly... my hairs remained full and stable except for the part above the frontal line: red, itchy, oily skin and a little shedding. then, my new dermatologist, told me that i have low local estrone, not androgenic and that finasteride was useless... now, that lotion doesn't seem to help...
 

ChemHead

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Here's the issue with any enzyme antagonist like finasteride: it could be more or less effective in different parts of the body. If, for some reason, finasteride effectively bound 5a-reductase in most areas of your body, but did not effectively antagonize 5a-reductase around your hairline, this would cause an overall increase in testosterone concentration systemically.. and around your hairline, that higher concentration of testosterone would be metabolized to an even higher concentration of DHT. This would definitely cause an increase in redness and irritation as well as thinning of the hairline.

Finasteride isn't really useless... it only does exactly what it's supposed to do. It binds 5a-reductase.. everywhere it can. It would be a miracle drug if it worked only in the skin and hair because it wouldn't disrupt the bodies regulation of steroid production. As far as a long term hair loss solution, finasteride is not really a good choice, though.

If you really want to determine if your hair loss/thinning is an androgenic issue, I would probably try using an androgen receptor antagonist like RU58841, CB-03-01, Spironolactone, etc. They CAN be safer than finasteride since they don't have any effect on 5a-reductase, but they are experimental with the exception of spironolactone.

One thing that I will also say is that it's going to be difficult to determine if your hair loss/thinning is related to low local estrogens until you recover from the finasteride. Unfortunately, your body is probably not producing enough steroids, and therefore not creating the proper amount of estrogens that it should be. This is because your brain has downregulated aromatase expression and lowered steroid production by lowering gonadotropin releasing hormone.

Once your 5a-reductase has been fully replenished, your side effects will subside and your face will also return to normal. As far as the diet is concerned.. make sure you include copious amounts of things like ginger root, raw garlic, raw onions, cabbage, and celery. It's definitely a difficult diet to follow, but it's very effective.
 

Go_faster_Sonic

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there’s something that does not make sense in my mind.
If it is said that progesterone is 5-alpha-rd inhibitor (type 1? type 2?)… but it is also the precursor of dhp (through 5 alpha rd), which is the precursor of allopregnanolone (through 3 alpha hsd)… does progesterone inhibits it’s own transformation in allopregnanolone?

the pathway is the following:

  • Progesterone > 5 alpha rd > Dihydroprogesterone > 3 alpha hsd > Allopregnanolone.
so, applying progesterone on my scalp, i'm inhibiting 5alpha rd or not?
 

ChemHead

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Progesterone can bind 5a-reductase. However, it has a relatively low affinity and is weakly bound. Finasteride is incredibly potent. Doses as little as 0.05 mg daily have been demonstrated to lower systemic DHT nearly as well as 1 mg after ~40 days. Finasteride also permanently binds the 5a-reductase NADP complex, which is part of the reason why it's so potent.

By using high concentrations of progesterone, you're increasing the probability that progesterone will spend more time bound to the 5a-reductase enzyme than other steroids. It may have a lower affinity, but you can push the equilibrium in favor of progesterone simply by overpowering with concentration. It's kind of like this... a very large, strong man may be able to kill another with one huge blow to the face, whereas a child would do relatively little damage. If you stack 100 children against one man, though, it's definitely possible to disable the man.

Like anything else, high concentrations of progesterone come with it's own set of problems, though.
 

Go_faster_Sonic

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but if dihydroprogesterone comes from the alpha reduction of progesterone... does progesterone inhibits its own reduction? this is nonsense
 

ChemHead

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Not really.. any steroid that will bind 5a-reductase is technically inhibiting it from reducing any other steroid while it's bound. It does not stay bound for very long though (it's released as dihydroprogesterone after some time), which is why progesterone is a weak inhibitor. Because it doesn't stay permanently bound to 5a-reductase, you would have to rely on large concentrations of progesterone to keep the 5a-reductase enzyme bound by progesterone more often than testosterone.

So, in essence, progesterone is not really a 5a-reductase inhibitor. You're just keeping the 5a-reductase enzyme busy reducing progesterone instead of testosterone or other steroids... you're pushing the system in favor of producing dihydroprogesterone instead of other 5a-reduced steroids like DHT and dihydrodeoxycorticosterone.
 
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