PubMed.com & some of my own questions.

[JJacobs152]

As a current medical student, our university makes us use PubMed for a lot of research articles. I just started playing around with it again today and started to see what would come up when typing in "androgenic alopecia". I'm turning 27 this year, and have began to notice quite a bit of hair loss. It's pretty crazy, because my sides and back are EXTREMELY thick, whereas the top is the complete opposite.

Doing some research, there were some interesting articles.

http://www.ncbi.nlm.nih.gov/pubmed/17202653

Current article talks about how using retinol (Vitamin A) in conjunction with Minoxidil, has showed some improvements for individuals with alopecia. For us individuals in medicine, science, the article is interesting as it mentions "elevated Bcl2/Bax ratio" showing reduced cell death.

I did have some questions that I would like to ask the community and I'm hoping that I could get some answers. According to Wikipedia's article on androgenic alo, it mentions the following:

Men with androgenic alopecia typically have higher levels of 5-alpha-reductase, lower levels of total testosterone, higher levels of unbound/free testosterone, and higher levels of total free androgens including DHT.[10][11]

5-alpha-reductase is responsible for converting free testosterone into DHT. The genes for 5-alpha-reductase are known.[12] The enzymes are present predominantly in the scalp and prostate. Levels of 5-alpha-reductase are one factor in determining levels of DHT in the scalp. Drugs which interfere with 5-alpha-reductase (such as finasteride, which inhibits the predominant type 2 isoform) have been approved by the FDA as treatments for hair loss.

Sex hormone binding globulin (SHBG), which is responsible for binding testosterone and preventing its bioavailability and conversion to DHT, is typically lower in individuals with high DHT. SHBG is downregulated by insulin.

Increased levels of Insulin Growth Factor-1 (IGF-1) have been correlated to vertex balding.[13]

High insulin levels seem the likely link between metabolic syndrome and baldness. Low levels of SHBG in men and non-pregnant women are also correlated with glucose intolerance and diabetes risk, though this correlation disappears during pregnancy.[14]

I know there are people here recommending ketoconazole - but isn't this bad for us. We're basically blocking the whole pathway to make aldosterone & glucocorticoids. Sure it'll block 5alpha-reductase, but at the expense of the mineralcorticoids and glucocorticoids?

A few posters were also suggesting taking spironolactone. Can somebody clear up this mechanism as to how this would help with hair loss, considering this is "aldosterone nuclear blocker"?

I'm hoping when I go home this August to pick up Minoxidil and use it along with Biotin (Vitamin B7), Centrum (for Vitamin A supplementation), and possibly some type of 5a-reductase shampoo blocker.

[Winston]

Why wouldn't you just take Propecia? As a medical student you surely understand that the side effects are being way overblown on the message forums and it works well for most people?

[BackwardsBalding]

Propecia has not been out long enough to know long term side affects and if the short term side affects are, erectile disfunction, inability to abtain erection, or in general loss of libido, I wouldn't touch that stuff with a ten foot pole. Literally, actually they advise women who plan on getting pregnet not to even touch it because of birth defects.

[PropeciaVictim]

Why wouldn't you just take Propecia? As a medical student you surely understand that the side effects are being way overblown on the message forums and it works well for most people?

Nobody disputes that the drug works well for most people. Most medications don't cause permanent severely damaging effects in very rare circumstances. The side effects are not overblown, but many people feel it is not worth the small but very significant risk just to maintain hair when hair loss is pretty much the norm in men.

[Samiam]

but many people feel it is not worth the small but very significant risk just to maintain hair when hair loss is pretty much the norm in men.

It's not the norm if you're below 30, what would you tell those people??

[PropeciaVictim]

Wait another ten years and you won't be anything special. Look, if you want to take Propecia that is your right. I'm just letting you know about the risks I wish I had known about so that your life won't be cheated. If you know of the risks and still decide to take Propecia, then you can't blame anybody but yourself if something goes wrong.

[JJacobs152]

Why wouldn't you just take Propecia? As a medical student you surely understand that the side effects are being way overblown on the message forums and it works well for most people?

Thanks again professor. I always thought this class was stupid and a waste of time, but I can see it does come in handy.

Winston, I very highly doubt these side effects are "overblown". Here are a couple of cited articles which state the risks of taking a 5a-reductase blocker. In summary, blocking it does have positive effects on hair growth. However at the same time, you need DHT for growth in other areas of the body.

http://www.nejm.org/doi/full/10.1056/NEJMp1106783

http://www.ncbi.nlm.nih.gov/pubmed/16476520

[VictimOfDHT]

I'd love to feel those "side effects". Been on Fin since it came out and I have yet to experience any. Theraflu however was really bad for me.

[tonypizza]

'As a medical student' the op knows that the final phase of drug testing is on the public in general! When the FDA clears it for use on humans, the drug has been approved for the final stage of testing - human testing.

Drugs that spectacularly failed this final stage of testing include Fen Phen, Vioxx, and Thalidomide.

[JJacobs152]

'As a medical student' the op knows that the final phase of drug testing is on the public in general! When the FDA clears it for use on humans, the drug has been approved for the final stage of testing - human testing.

Drugs that spectacularly failed this final stage of testing include Fen Phen, Vioxx, and Thalidomide.

An incredibly unfortunate mishap in science. Thanks to modern break through on preventing further unfortunate incidences. Are you a med student, science major, or just happened through live through the era of Thalidomide.