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

[clandestine]

or worse:
reflex hyperandrogenicity

How common is this?

[2020]

How common is this?

more common than you think. For example, those 10% of people or whatever who don't respond to fin, I'm thinking that > 90% of them have hyper androgenicity.... a real 70% reduction in DHT is almost castration. No reason you would ever lose hair but you do because that 30% is wreaking havoc on those AR who become very sensitive for some... Also, how else would you explain that fin stops working after 5 years? Hyper androgenicity is the reason.

it's been documented in prostate studies so it's definitely real.

[lalala]

Dude, get a grip. You won't leave you house because of your hair? First of all, man up and stop acting like a 2 year old. Secondly, your hair loss is totally minor right now and if you used a little concealer it would look perfect. Just wait until your hair loss gets really bad and you can't even cover it up with concealer......

[Tracy C]

I am getting panic attacks every day unless I take the Lorazepam I was prescribed. I have to be very careful every single day to make sure I don't shave my head and throw away the tablets, it all seems hopeless.

It hasn't been long enough yet. Treating hair loss takes a long time. Time that is measured in months AND years. It takes 12 full months before you will know if Propecia is working for you. You still have six months to go before you will actually know if it is. It takes more than 12 months to know how well Propecia is working for you. Remember, months AND years.

[Kirby_]

Why do I look much worse than in October? Why do I look worse at 6 months compared to 3 months when I didn't have an actual solar panel bald patch? I'm convinced fin sped up my hair loss by half a decade. I should look at least as good as baseline by now. I can't even trust my girlfriend's opinion, she talks utter shit and denies I am balding, I'd be NW6 before she admitted I was balding. 2020's explanation about DHT makes sense, I haven't had any sexual side effects from fin after all...

[Kirby_]

Sorry guys and Tracy C total nervous wreck at the moment

[Tracy C]

Why do I look worse at 6 months compared to 3 months when I didn't have an actual solar panel bald patch?

You don't - and yes you did have that thin area back then. It isn't much worse now than it was back then. You are freaking out right now.

I'm convinced fin sped up my hair loss by half a decade...

No it hasn't. You are freaking out right now.

I should look at least as good as baseline by now.

You do not look worse than base line. You are freaking out right now.

2020's explanation about DHT makes sense...

Don't trust 2020's explanations. Doing so would be a big mistake. He is not a qualified physician and he does not know what he is talking about. 2020 is just here to cause trouble and make himself feel better by making others feel terrible.

[25 going on 65]

Reflex hyperandrogenism induced by finasteride is a hypothesis that very few doctors and (mostly) laymen on forums have come up with. It's not known or documented to exist at this time.

Second, it unfortunately can take 12 months or longer on fin for men to return to/get beyond baseline cosmetically. (Some show improvement earlier but the "3-6 months" product literature is basically nonsense in many or most cases.) This is the "hurry up and wait" part that drives people crazy.
However, your photos don't look that bad. Actually your crown looks mighty solid, where I see thinning is more on top of the scalp towards the back. Maybe the pictures are misleading. But your diffuse pattern normally responds quite well to medication, so in 6-8 months you'll probably be in good shape.

I know it's easy to read into your own symptoms and start worrying yourself to death. There have been times, particularly during sheds, that I thought fin was not helping me or perhaps making things worse. But I keep riding it out, and almost 2 years after starting, here I am still a NW2--with better thickness than I had when I started.
The last thing I'll leave you with is to remember: any hair you lose on fin, you would also lose off of fin. The difference is that off of fin, you have a 0% chance of stopping or reversing the process, while on fin your chances go up to 75-80 or more.

[2020]

Reflex hyperandrogenism induced by finasteride is a hypothesis that very few doctors and (mostly) laymen on forums have come up with. It's not known or documented to exist at this time.

then explain how fin doesn't work for 10% of people even though fin makes your DHT levels go to castration levels? And then explain why it stops working after 5 years

[Tracy C]

And then explain why it stops working after 5 years

It doesn't stop working after five years.

[25 going on 65]

then explain how fin doesn't work for 10% of people even though fin makes your DHT levels go to castration levels? And then explain why it stops working after 5 years

Well with MPB the problem isn't your DHT levels, it's that your follicles are sensitive to the hormone (or whatever cascading process is triggered by DHT).

That's why some guys have above-average DHT levels but die at 80 a NW2, while guys with low levels (whether naturally or from drugs) can hit NW6 by their mid 20s. For some, fin just doesn't reduce DHT enough to stop the miniaturization process. (Even at 30% DHT baseline, your follicles are still being attacked over time.) I imagine that's also why some guys who lose ground on fin can sometimes switch to dutasteride and stop their MPB that way.

It doesn't necessarily stop working in 5 years, that's just the typical length of time it takes to get below your baseline hair count. In fact you can tell the drug is still working because guys who stop after 5-15 years, because they think fin has quit on them, tend to lose insane amounts of hair over the following year.
Take Spencer as an example--he started losing hair over 20 years ago as a young adult, has been on fin for 17, and is now a NW3v. Without meds he would most likely be a NW5-7 by now

btw I'm not saying reflex hyperandrogenism can't be caused by fin, just that there isn't enough evidence to say it can. Keep in mind also, almost any drug has non-responders, not necessarily due to reflex hormonal changes

[2020]

It doesn't stop working after five years.

^ you're pretty much back at the baseline after 5 years... some people get more sure but fin won't work forever for reasons I mentioned above

[2020]

For some, fin just doesn't reduce DHT enough to stop the miniaturization process. (Even at 30% DHT baseline, your follicles are still being attacked over time.) I imagine that's also why some guys who lose ground on fin can sometimes switch to dutasteride and stop their MPB that way.

completely false. Most of that 30% would have been neutralized by your natural androgen binding proteins so whatever tiny amount was left over wouldn't cause you to lose any more hair...

btw I'm not saying reflex hyperandrogenism can't be caused by fin, just that there isn't enough evidence to say it can. Keep in mind also, almost any drug has non-responders, not necessarily due to reflex hormonal changes

you can't just suppress one of your most important hormones and expect your body not to do anything. Your body will try to reach homeostasis at any cost whether you like it or not.

5AR inhibitors over time WILL CAUSE HYPERANDROGENISM. THAT'S A FACT. AND HERE'S THE PROOF:

Studies in 10 men with AGA where scalp biopsies are obtained before and after 6 months treatment with finasteride (a specific type II 5a-reductase inhibitor) reveal interesting results with regard to the effects of suppressing DHT and how it affects these androgen associated factors. Differences in expression were found for some of the enzymes as well as transcription proteins, AR, ER-alpha and beta.
All scalp biopsies from patients obtained 6 months after finasteride treatment revealed intense upregulation of AR expression in comparison to pre-treatment biopsies of the same patient, whereas ERs were not affected, indicating that AR is very sensitive to the affects of 5a-R type II suppression of DHT.

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

what now? Still a theory? I can dig up a bunch of studies on prostate issues where they found that 5AR inhibitors stop working after some time with definite AR upregulation

[25 going on 65]

Am I misreading this abstract or are they basically saying the number of Androgen receptors will increase as a response to DHT suppression?

Also is there a way I can read the whole study without paying money?

[2020]

Am I misreading this abstract or are they basically saying the number of Androgen receptors will increase as a response to DHT suppression?

if you're suppressing DHT by blocking 5AR then yes, number of AR will go up and they will probably be more sensitive.

Also is there a way I can read the whole study without paying money?

it's free?