Thinning or MPB?

[sulla]

Hello,

Could someone help me with this?

Most of what I read with reference to Finasteride and Monoxidil is that it is for "male pattern baldness." Which I take to basically mean thinning from a genetic predisposition usually manifesting itself with the receding hair line, thinning at the top, etc. The question I am having difficulty finding the answer to is this; what if it's not typical mpb? For example, what if it's natural (I don't even know if there is such a thing) thinning because of age? And what age would this normally occur?

Bottom line - my hair is thinning. More so recently. Seems enough so that it's very troubling. But it seems to be thinning evenly - EVERYWHERE. I'm 50 - or will be soon enough. Would I expect "normal" thinning at 50? Also, would Finasteride and, or Monoxidil help. I'm doing both now - Monoxidil for about two months, Finasteride for two weeks. Is there such thing as natural thinning - or is it all prelude to MPB?

Thanks

P.S. I have no health problems and am in good shape. Eat right, exercise every day, etc, etc.

- wonderful website and community by the way

[John P. Cole, MD]

Great question.

It all goes down to what causes hair loss and what slows/reverses it.

I'd say that if you are experiencing new hair loss at age 50, you should have it worked up for metabolic and inflammatory disease. This could include things such as syphilis, thyroid disease, iron deficiency, arthritis, heavy metal (such as arsenic/lead), etc. Have it a biopsy.

Then recognize that Rogaine can help such things as eyebrows. It may be that different meds help different situations.

There are also some genetic tests that help suggest a genetic predisposition to androgenic alopecia or male pattern baldness.

Work it up. Perhaps you can find a treatable cause. Most likely, if you have new onset AGA at age 50, it is not going to be marked in terms of the degree of loss you will experience over the remainder of your life.

Most extreme degrees of loss manifest first in the early 20s or sometimes earlier in life.

[sulla]

drcole,

Thanks so much for your reply. I'm guessing you know exactly what you are talking about as you appear to be a transplant surgeon. Could you clarify a couple of your comments?

The workup for metabolic and inflammatory disease that you refer to – can all of those be done with blood? Can you give me the name of those tests? Will any iron deficiency show up in a B-12 test? I have several workups scheduled:

• High Sensitivity C-Reactive Protein
• Creatinine, Serum
• Calcium, Serum
• Uric Acid, Serum
• Alt, Serum
• AST, Serum
• Testosterone, Total
• Vitamin D, 25-Hydroxy
• Vitamin B-12 (Folate)
• Urinalysis W Reflex to Microscopy and culture
• Reflex to FT4

With the possible exception of Reflex to FT4 (the Thyroid that you mentioned) and B-12, I'm not sure now how relevant these are.

What exactly do you mean when you say, “Have it a biopsy”? Is that different than blood?

And – just one more question if I may – you stated that “… if you have new onset AGA at age 50, it is not going to be marked in terms of the degree of loss you will experience over the remainder of your life.”

I’m not sure I understand exactly what you are saying. But I think I like the way it sounds. Can you clarify?

Gracious of you to take the time - thanks.