Am I a Norwood 2 or 3? (or 2A or 3A?)

[2020]

There was a famous case about 100 years ago of a set of twins who were genetically susceptible to hair loss. One twin lost his hair as expected but the other twin had been castrated due to mental illness, so this twin still had a full head of hair. The physician injected the castrated twin with testosterone, and the castrated twin quickly lost all of his scalp hair except that on the sides on back.

yes and? T converts to DHT doesn't it?

It could be reflex hyperandrogenicity as you said, but it could also be simple catch-up. I have no doubt that if I stopped taking dutasteride today, within a year I would have lost 30% of the hair on my head, and would probably have a lot more body hair as well. This would not be due to reflex hyperandrogenicity, but rather due to my genes playing catch-up. My genes say I'm supposed to be a lot more bald and have a lot more body hair than I do right now. I've actually lost a bit of body hair from dutasteride, and my facial hair has thinned out by approximately 50% as well.

that is an insanely stupid theory... there is no such thing as a catch up loss. Your genes have no ****ing idea how much hair you should have at July 1, 2012. AR sensitivity is inherited and that's that.

What is a fact is that AR sensitivity DOES GO UP when 5AR inhibitors are introduced to your body.

I don't understand what you're saying.

VAST MAJORITY of your DHT is biologically INACTIVE.

I haven't seen any evidence of what you're describing. I also don't understand your question. If someone isn't already losing hair, why would they get on finasteride or dutasteride? As a purely preventive measure? I doubt there are many people without an AGA diagnosis taking these drugs. Their hair loss might be minor, but the process has started in the vast majority of them. The fact that they continue to lose hair after getting on them is not proof that the drugs have caused the continued hair loss, is it? They were losing hair before getting on the drugs, so it seems odd to blame the drugs for the continued hair loss.

I meant to say that some people who are losing hair and when they start using finasteride, still lose hair despite it being VIRTUALLY IMPOSSIBLE if fin truly blocked 70% of DHT and left your AR at the same sensitivity...

http://www.hairlosshelp.com/hair_loss_research/hyperandrogenicity.cfm

"A: When the effects of androgens in the body are lessened, e.g. through lowering DHT or by systemic hormone receptor blockade, the body seeks equilibrium through a process called upregulation. This can take the form of increased hormone production and/or increased tissue sensitivity to the remaining hormones. The reason side effects usually gradually disappear with finasteride is probably due to such upregulation. In a small percentage of individuals, it may be that this process overshoots the mark, resulting in significant hyperandrogenicity. This is marked by such signs as greatly increased facial oil, increased pimples, and greatly elevated libido.It's possible that in certain cases such hyperandrogenicity overcomes the hair-protective effect of, say, finasteride, though this does not appear to be the case for the vast majority of people."

right, and?

I am unsure why you think it is incredibly unlikely that I will still have most of my hair 10 years from now when I haven't lost any in 6 years. You said that the decline happens a couple years in, well, mine didn't.

yeah 6 years ain't that long in the business.... even the people on fin can get that. The point is that eventually YOU WILL start losing hair even though you shouldn't....

I have seen probably 20-30 cases posted on forums over the years, but you should also consider that people who have maintained their hair and are completely/mostly satisfied with it are a lot less likely to begin posting/continue posting on internet forums dedicated to hair loss.

I've seen studies that are done over 10 years.... half of those people won't make it to 10 years with the same amount of hair

[Tracy C]

Castration before baldness begins will prevent it from ever occurring, from what I understand. Is there any evidence that castration after baldness has started will prevent further baldness? If so, I would certainly like to read the studies.

All you need to do is meat up with a few M2F transsexuals. Most will have a male hair line, depending on how old they were when they had surgery, some will have suffered some degree of hair loss but after they have surgery their hair loss stops dead in it's tracks.

I am in the unique position of having a very dear friend who just happens to be a M2F trans woman. I have met several of her friends and can attest to what I have seen of their hair. Even those who were suffering hair loss before they had their sex change surgeries stopped losing hair. So yeah, castration prevents it and arrest it - but it doesn't reverse it.

[TJ1154]

http://jcem.endojournals.org/content/20/10/1309

I stand corrected on that.

that's not logical at all... finasteride lowers your DHT levels below castration and castrates never lose their hair.
THE ONLY EXPLANATION for this phenomenon is that your body makes all of your androgen receptors more sensitive over time so that's why you start losing hair after some years with finasteride...

There was a famous case about 100 years ago of a set of twins who were genetically susceptible to hair loss. One twin lost his hair as expected but the other twin had been castrated due to mental illness, so this twin still had a full head of hair. The physician injected the castrated twin with testosterone, and the castrated twin quickly lost all of his scalp hair except that on the sides on back.

I don't care about the position you're at after 5 years... I see a trend and it is obvious after reading these forums that finasteride DOES in fact stop "working" after 5 years or so....

read propeciahelp.com forums. A lot of people there report EXCESSIVELY RAPID scalp hair loss and just as bad body hair growth after going off finasteride. Why would that happen unless your androgen receptors have become more sensitive to due 5AR blockers?

It could be reflex hyperandrogenicity as you said, but it could also be simple catch-up. I have no doubt that if I stopped taking dutasteride today, within a year I would have lost 30% of the hair on my head, and would probably have a lot more body hair as well. This would not be due to reflex hyperandrogenicity, but rather due to my genes playing catch-up. My genes say I'm supposed to be a lot more bald and have a lot more body hair than I do right now. I've actually lost a bit of body hair from dutasteride, and my facial hair has thinned out by approximately 50% as well.

sex hormones don't work like that.

http://en.wikipedia.org/wiki/Androgen-binding_protein

I don't understand what you're saying.

sure, because it blocks that much more DHT it takes your body a long time to adjust itself to its "newly normal" androgen receptor sensitivity....

also, how do you explain how some people start LOSING hair after getting on finasteride/dutasteride?

I haven't seen any evidence of what you're describing. I also don't understand your question. If someone isn't already losing hair, why would they get on finasteride or dutasteride? As a purely preventive measure? I doubt there are many people without an AGA diagnosis taking these drugs. Their hair loss might be minor, but the process has started in the vast majority of them. The fact that they continue to lose hair after getting on them is not proof that the drugs have caused the continued hair loss, is it? They were losing hair before getting on the drugs, so it seems odd to blame the drugs for the continued hair loss.

didn't I already prove that androgen sensitivity does in fact go up after taking 5AR blockers?
http://www.ehrs.org/conferenceabstra...s04-sawaya.htm

http://www.hairlosshelp.com/hair_loss_research/hyperandrogenicity.cfm

"A: When the effects of androgens in the body are lessened, e.g. through lowering DHT or by systemic hormone receptor blockade, the body seeks equilibrium through a process called upregulation. This can take the form of increased hormone production and/or increased tissue sensitivity to the remaining hormones. The reason side effects usually gradually disappear with finasteride is probably due to such upregulation. In a small percentage of individuals, it may be that this process overshoots the mark, resulting in significant hyperandrogenicity. This is marked by such signs as greatly increased facial oil, increased pimples, and greatly elevated libido.It's possible that in certain cases such hyperandrogenicity overcomes the hair-protective effect of, say, finasteride, though this does not appear to be the case for the vast majority of people."

I don't care about one particular person's results. His body must be slow at adjusting itself then.

odds are very much against you at maintaining your hair with DUT for 16 years but good luck

I am unsure why you think it is incredibly unlikely that I will still have most of my hair 10 years from now when I haven't lost any in 6 years. You said that the decline happens a couple years in, well, mine didn't.

many? I don't think there are that many at all. 5-7 years is about the average before you start losing hair again

I have seen probably 20-30 cases posted on forums over the years, but you should also consider that people who have maintained their hair and are completely/mostly satisfied with it are a lot less likely to begin posting/continue posting on internet forums dedicated to hair loss.

[Kirby_]

Have to admit, when I started taking fin, I knew it isn't a drug that is effective forever, and I only ever considered it something to 'tide me over' until the big guns are available. (I'm becoming rapidly pessimistic that anything will be, on the mainstream/legit market, but that's another story.)

[2020]

Castration before baldness begins will prevent it from ever occurring, from what I understand. Is there any evidence that castration after baldness has started will prevent further baldness? If so, I would certainly like to read the studies.

http://jcem.endojournals.org/content/20/10/1309

The logical reason for why average hair counts decline on finasteride is that the drug is not preventing hair loss entirely, but is simply slowing it down dramatically.

that's not logical at all... finasteride lowers your DHT levels below castration and castrates never lose their hair.
THE ONLY EXPLANATION for this phenomenon is that your body makes all of your androgen receptors more sensitive over time so that's why you start losing hair after some years with finasteride...

As you can see from the chart, and as Tracy mentioned, the average finasteride responder is still considerably above baseline after five years on the medication. The slope is also much less steep for the finasteride user than it is for the placebo user, indicating that the rate of loss also continues to be slower after the 5 yr period.

I don't care about the position you're at after 5 years... I see a trend and it is obvious after reading these forums that finasteride DOES in fact stop "working" after 5 years or so....

read propeciahelp.com forums. A lot of people there report EXCESSIVELY RAPID scalp hair loss and just as bad body hair growth after going off finasteride. Why would that happen unless your androgen receptors have become more sensitive to due 5AR blockers?

If 1 mg of finasteride blocks less than 90% of the type 2 5alphareductase, then the remaining DHT could still attack the follicles, and this would explain why loss still occurs, albeit slower.

sex hormones don't work like that.

http://en.wikipedia.org/wiki/Androgen-binding_protein

Dutasteride blocks more than 97% of type 2 5alphareductase, from what I understand, and while there has never been a 5 yr study done by Glaxo in a manner similar to Merck's finasteride study, my hunch is that the rate of loss is only a fraction of what the finasteride loss rate is, and certainly way lower than placebo.

sure, because it blocks that much more DHT it takes your body a long time to adjust itself to its "newly normal" androgen receptor sensitivity....

also, how do you explain how some people start LOSING hair after getting on finasteride/dutasteride?

If I am on here 10 years from now and have maintained all of my hair (that would be for a total of 16 years on dutasteride), then I think you will have to eat your words, because there is baldness on both sides of my family.

didn't I already prove that androgen sensitivity does in fact go up after taking 5AR blockers?

http://www.ehrs.org/conferenceabstracts/2000marburg/guestlectures/s04-sawaya.htm

I don't care about one particular person's results. His body must be slow at adjusting itself then.

odds are very much against you at maintaining your hair with DUT for 16 years but good luck

There are many accounts on forums of people maintaining for 15 years on finasteride, how does this square with your hyperandrogenicity theory? On the other hand, if my loss suddenly picks up in the next 3-4 years and I go bald very fast, then I will put some serious stock in what you are saying.

many? I don't think there are that many at all. 5-7 years is about the average before you start losing hair again

[TJ1154]

right but my point was that hair count SHOULD NOT GO DOWN EVER.

That study I posted says that FINASTERIDE is more effective than CASTRATION.
If castrates never go bald, why do finasteride users do?

There is something more to this... as I said, you can't just suppress your 5AR long enough without your body doing something about it.

Castration before baldness begins will prevent it from ever occurring, from what I understand. Is there any evidence that castration after baldness has started will prevent further baldness? If so, I would certainly like to read the studies.

The logical reason for why average hair counts decline on finasteride is that the drug is not preventing hair loss entirely, but is simply slowing it down dramatically. As you can see from the chart, and as Tracy mentioned, the average finasteride responder is still considerably above baseline after five years on the medication. The slope is also much less steep for the finasteride user than it is for the placebo user, indicating that the rate of loss also continues to be slower after the 5 yr period. If 1 mg of finasteride blocks less than 90% of the type 2 5alphareductase, then the remaining DHT could still attack the follicles, and this would explain why loss still occurs, albeit slower. Dutasteride blocks more than 97% of type 2 5alphareductase, from what I understand, and while there has never been a 5 yr study done by Glaxo in a manner similar to Merck's finasteride study, my hunch is that the rate of loss is only a fraction of what the finasteride loss rate is, and certainly way lower than placebo.

If I am on here 10 years from now and have maintained all of my hair (that would be for a total of 16 years on dutasteride), then I think you will have to eat your words, because there is baldness on both sides of my family. There are many accounts on forums of people maintaining for 15 years on finasteride, how does this square with your hyperandrogenicity theory? On the other hand, if my loss suddenly picks up in the next 3-4 years and I go bald very fast, then I will put some serious stock in what you are saying.

[2020]

The most logical conclusion is that the findings of that study you posted are flawed. You cannot fully trust wiki "research".

what this?

http://www.ncbi.nlm.nih.gov/pubmed/21557276

this is an actual study from Taiwan university.
Castration leaves more androgens than finasteride that's why castration sometimes it's not enough to stop prostate cancer:

http://en.wikipedia.org/wiki/Prostate_cancer#Castration-resistant_cancer

finasteride works in a bad way because your body tries to fight its effect and after 5 years or so it starts winning....

[Tracy C]

right but my point was that hair count SHOULD NOT GO DOWN EVER.

That study I posted says that FINASTERIDE is more effective than CASTRATION.
If castrates never go bald, why do finasteride users do?

There is something more to this...

The most logical conclusion is that the findings of that study you posted are flawed. You cannot fully trust wiki "research".

[2020]

At least you are conceding your mistake. So what if it goes down compared to baseline, it is still significantly above not using the med at all. Look at that huge gap between the real medicine and the placebo. Discounting that gap the way you are is unethical.

right but my point was that hair count SHOULD NOT GO DOWN EVER.

That study I posted says that FINASTERIDE is more effective than CASTRATION.
If castrates never go bald, why do finasteride users do?

There is something more to this... as I said, you can't just suppress your 5AR long enough without your body doing something about it.

[25 going on 65]

lol I'm not really castrating myself, at that point hair loss would be the least of my worries

[Tracy C]

I'm sorry if this sounds silly but I can't tell if you are being sarcastic or not.

[25 going on 65]

Either way at least this thread is teaching me new things.
My new regimen:

1.25 mg finasteride: once daily
2% keto shampoo: 1-2 times weekly
Castration: as needed

[Tracy C]

how am I misreading it? Hair count starts to go down after year two and it keeps going down... sure, you're still above the baseline but after some time you won't be....

At least you are conceding your mistake. So what if it goes down compared to baseline, it is still significantly above not using the med at all. Look at that huge gap between the real medicine and the placebo. Discounting that gap the way you are is unethical.

[mpb47]

Ok. So this article does strongly suggest AR count increases with fin use. But that isn't technically hyperandrogenism (which would mean excess secretion of androgens rather than an increasing # of receptor sites) and I'm not convinced it would lead to the same symptoms, or to hair loss, nor am I convinced it is the sole reason why one can lose ground while on fin--if it is a reason. I think jumping to these conclusions isn't doing guys like Kirby any favors. It still requires a lot of guesswork on our part to fill in all these blanks, and guesswork has its place but it doesn't substitute for proper studies.
It still doesn't add up that fin actually does continue working for as long as 17 years (most likely longer, that's just the longest example I know of). Spencer himself admits he uses spray and concealer, but he is still a NW3v. He started balding in his early 20s and is now 47. There's no way he wouldn't be at least a NW5 by now without fin, and that's being highly generous. If he quit the drug tomorrow he'd be a bald man in less than 16 months. And there are users on hair loss forums who report over a decade of keeping their hair on fin or fin/dut.
I'd say this notion of the body compensating/overcompensating for finasteride is worth looking into with more, different and bigger studies, but I'm not ready to embrace it yet--certainly not as a cause of hair loss--any more than I'm ready to embrace the idea of Gho multiplying follicles.
(btw I agree T doesn't cause hair loss, I only brought it up because it's needed for DHT to form and thought that might be another contributing factor to DHT reduction in castrates)

He may just have very gradual mpb like me. I am also 47 and min started at 17. My mom's brother also started in his teens and didn't become a NW5 till around age 60 and that was without any medicine.

[mpb47]

http://www.ncbi.nlm.nih.gov/pubmed/21557276

.. Immunohistochemical study revealed significant upregulation of ARs by finasteride treatment for 30-180 days....


seriously, how else would you explain that even though finasteride brings your DHT to castrate levels, yet you still continue to bald overtime when castrates don't

My guess on what I have read elsewhere:

Well FIN does not block dht 100% .. and as time goes on some other variable comes into play. MPB genetics have a time clock that determine when you start going bald.

For example, why do some older men (60 +) who have mostly full heads of hair start going bald so late in life? They have lower levels of T/DHT compared to when they were younger yet they are only now starting to go bald.

The theory I read was that the time clock part of the genetics does something to make your AR's more sensitive to what remaining DHT you still have. So as long as you have some DHT, you will start going bald .
Probably the same reason as to why % wise, the amount of men balding, keeps increasing with age.