25 - MPB - advice needed

[RobertF]

Hello all,

I need advice on my current situation. It's a pretty long story, but I believe a detailed background could be important in my case.

I'm 25, first noticed temple recession in 2008, almost exactly six years ago. Didn't do anything about it until last year. Initially, I freaked out and went to a dermatologist, whose reply was basically, "Yeah, you're balding, so what, who cares". A trichologist was more understanding, but also told me to do a ton of blood tests for which I had no money at the time (not to mention, most of them had nothing to do with MPB, as I now see). She also broke it to me that I had to at least get on minoxidil and stay on it forever. I guess, the idea of a life-long commitment to meds was just too much for me, so I decided I'll just shave it off when it gets bad, and also get hella ripped to compensate (idiot, lol). Well, for something that went completely untreated, over the next 5 years my MPB was progressing at a pretty glacial pace, I think I was hanging around NW 1,5. But last year, a couple things happened. First, I was stressing out like never before. Let's just say I was on the brink of losing everything I had financially, so you wouldn't think I just got the blues or something. It was bad. The struggle was real. Then, I don't know if this is a coincidence or not, but for about a week or two last March, I was consuming ridiculous doses of zinc, about 600-700 mg a day. I decided to take zinc to help my hair situation, but didn't research the subject well enough and went with what the indications for use said (those pills were actually intended to treat alopecia areata, but I thought what the hell, any alopecia will do). I didn't have any systemic zinc overdose symptoms, but soon enough, I started losing more hair and at a faster pace. Around the same time, life got even worse, and I think the increase in stress further contributed to my MPB. Believe it or not, until last year, my scalp never itched, and I NEVER saw any hair shedding, and I was always very self-conscious about my hair. So I guess those were the signs that my MPB was kicking into high gear. I started using Nizoral 2%, which at first actually increased shedding and itching (and to this day I can't tell if it's doing any good for me). Still, I wasn't using minoxidil or any sort of anti-androgen. Things kind of stabilized around August, I was feeling pretty good about my hair, even grew it out a little. Then in October, there was another surprise in store for me. My hair started thinning ALL OVER my head, even in the back, at the sides and temple points. I used to do the "pull test", and one day I pulled at my right temple point slightly, and 20-30 hairs simply CAME OUT, without any resistance. That was some David Cronenberg body horror type stuff there. That hair never grew back, but it didn't shed any more either, and my left temple point stayed as it was. Similarly, I pulled pretty large chunks of hair from behind my ears, and started noticing very small hairs on the collar of my shirt, presumably shed from the back of the head. What also sucks is, my hair became fine and lifeless overall. Each individual hair that I shed was almost see-through, and could easily be snapped in two. I don't know if this makes sense, but when I'm outside, my hair fels weightless (like, when the wind blows, I barely feel the hair move). I read the forums, and the takeaway was that I'd end up a NW6, if my hair was thinning like that. The thing is, I'm still not sure, if this was a decrease in hair density, or the individual hairs on my head each becoming fine and lifeless. Also, my hair color changed, it became lighter and kinda reddish. Another thing I noticed is my eyebrows and my body were thinning too. This led me to suspect that there was something else going on with me health-wise besides the MPB. Still, I was too busy trying to get my life back on track to start any serious treatment at the time.


In January, I started using 5% minoxidil liquid. After about two weeks, my hair began to shed, which I took as a good sign, hoping that this meant I was respodning to treatment. I also got side effects: bloated face and wrinkles under the eyes. When I got dizziness, I decided enough's enough, took a 10-day break from minoxidil, ordered Rogaine foam on eBay, then resumed using the liquid, but far more sparingly. There was another break in minoxidil use when I ran out of liquid and was still waiting for the foam to arrive. It lasted about 5-7 days, then in the beginning of February, I started the foam. Needless to say, after the greasiness and the side effects that went along with the liquid it was a joy to use. But no shedding followed for a month or two, and my hair kept on getting worse, the hairline creeping up slowly but surely. I then shed from time and time, but there's no way of knowing, if that was a response to the foam, or just my MPB doing its thing. I had to take two more week-long breaks down the road, when I ran out of the foam.


Fast forward to now, I have been using minoxidil in some form for almost six months. My hair kept getting worse, and I saw no improvement. What's happening?


- Is the foam simply not working for me, and the continued hair loss is MPB going on unimpeded? I use the foam once a day in the morning, should I also start using the liquid at night? Could using the two be beneficial? I'm reluctant to drop the foam altogether, since it makes my hair look better. Yeah, I got to the point where I need it as a styling product. Also, I want to keep using the foam for at least two months more, as I still hope for some results.


- Could the times when I took a break from the foam have interrupted its effect? I'm not sure that a week is long enough for that, but still. Perhaps someone had a similar experience?


- Could it be that the minoxidil foam is making my hair WORSE? This sentiment seems pretty common on hair loss forums. Fact is, my hair line began to decline far more rapidly during the time I've been using the foam. But I guess there's no way of knowing what my hair would be like if I was not using the foam.


Also, the overall thinning of my hair I've experienced last October led me to read up on hypothyroidism and as it turned out, I had virtually all of the symptoms. Right around last October, I suddenly and inexplicably started gaining a lot of weight, despite no change in my lifestyle or diet, and working out regularly. I've already mentioned thinning eyebrows and body hair. There was also mild depression, lack of energy and some other characteristic symptoms. Well, guess what? A blood test confirmed this. So I've been on levothyroxine for two months, and I already feel MUCH better overall. I can only hope that my hair will follow suit to some degree in the coming months.


To sum up, my current regime is: 5% Rogaine foam in the morning (on pretty much the entire scalp), topical spironolactone s5 cream at night (started two weeks ago, so nothing to say yet), Nizoral 2% every three days (Regenepure when not using Nizoral). I'm VERY reluctant to try finasteride, since my DHT, T, and free T are all in the lower normal ranges. But my hair loss is getting bad, so I know I'm taking quite the risk using only topical spiro as the anti-adrogen, which may or may not help. I don't know, I could snap and buy some fin soon, but I would very much prefer not to. I'm taking Saw Palmetto, but not very consistently, as well as Maxi-Hair supplements and 8000 mcg of biotin, which I guess improved my facial hair, but predictably, had no effect on the MPB. I'm also doing Tom Hagerty's scalp exercise.

Here's some pictures - http://imgur.com/a/QjRwk

What Norwood am I? NW3? I have a big forehead, and the view from the top makes the recession seem worse than it actually is for some reason. You can tell by the lines in my forehead that my hairline was originally pretty high.

I'll appreciate any advice on my situation. Thanks in advance!

[TotallyScrewed]

To me it looks like you've still got plenty of hair. Actually it kind of looks like the amount of hair I had at your age (I'm 27 now). My hair is sort of like yours... very straight. You don't even seem to have diffuse thinning though from what I can tell. Mine started at maybe late 25 or 26?

Rogaine didn't seem to do anything for me except make me shed like crazy. I also pull hairs from all over, over the ears included.

You might want to get your thyroid checked since you mentioned eyebrows. My TSH is a bit high but I haven't gone back to get it checked again.

I'm currently on Finasteride (no sides at all), but so far it hasn't done a thing other than possibly speed up my loss, lol. Been on it almost 3 months. Everyone's different though, and for most people it works. I've never had my T or DHT checked, but I'd have to guess they're probably well into the 99th percentile (at least my Testosterone is, DHT I really have no idea, that's almost unknowable I think.))

You really shouldn't be afraid of Finasteride's side effects. If they start, they really will go away once you start from what I understand.

[RobertF]

Yeah, I've done thyroid tests and found out that my TSH is high. As I've said in the post, I've been taking levothyroxine for past 2 months, which helped a lot with my overall well-being. It's too early to say anything about its effect on my hair though. I heard hair takes a long time to improve after you fix your thyroid levels. Need to wait at least 6 months on that.

I don't even really shed much these days. Granted, my individual hairs are very thin, so maybe I don't notice some. But having heard all these accounts of people losing tens of hairs in the shower, I sometimes look for hairs in the bathtub REALLY hard and find 2 or 3 at most.

TotallyScrewed, where do you stand now, hairloss-wise? Is it much worse than what I have at the moment?

[RobertF]

Never mind, found your post. You know what, despite the lack of shedding, my hairline has still been creeping up slowly. I suspect my problem is miniaturization as well. There's also this frightening thought that I try not to indulge much, that ALL of my hair is miniaturizing.

By the way, what's your TSH?