T Nation

Hair Loss Side Effects

Hi everyone,

Title pretty much says it all. I’m currently 8 weeks in now into testosterone. And it’s going really well so far! No really complaints and feeling good on my current regime of 200mg a week. I have a phone call tomorrow to go over my follow up blood work

My only objection or concern is an increase in hair shedding, and I’ve also noticed my hairline looks a little less strong. I’m wondering if this is going to be a permanent thing or if the shedding will go down with time. I know finasteride is usually a go to. So far I jumped on minoxodil to see if it can decrease shedding. Im wondering what to do, or if anyone else is on fin

Thanks!

That should, and usually does, subside.

Careful here. You might have a nice head of hair and women that want to be with you, but that won’t last if you cannot do anything with them.

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Suggest you check out Moreplatesmoredates on Youtube, his hairloss content is probably the best on the internet.

Be very careful with Finasteride. Post Finasteride Syndrome is very real and more prevalent than you might think. I’d rather be bald than go through what PFS sufferers have to endure. Finasteride is worse than poison in my opinion.

If its temporary shedding it should grow back. Moreplatesmoredates has done some videos on how to tell if your shedding is temporary or not.

Minoxodil is just a growth agent and does nothing to actually prevent androgen induced miniaturization of the hair follicle. Once you stop applying minoxodil the hair you have grown / preserved will fall out - i.e you have to use it for life.

Ketoconazole shampoo, which is a mild topical anti-androgen, should be your first line of defence, this will actually help to prevent androgen induced miniaturization with the least side effects.

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Do you have any suggestions regarding legitimate safe hair loss solutions?

Most are either anti androgenic (wouldn’t touch with a 10-foot pole) or don’t work IME.

Baldness isn’t the worst, but not everyone unfortunately has the face/head shape for it.

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I think Jordan’s suggestions are good. I’ve seen some of the videos. Minoxodil has been reported to cause ED, though it is not supposed to have that effect, since dosing is nothing close to what you take orally. If you did have that reaction, it would likely resolve quickly after discontinuing.

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I’m personally trying LLLT and dermapinning / dermarolling. From my understanding of the science, these are both just growth agents and do nothing to actually prevent androgen induced miniaturization. So it will likely do nothing to prevent hair loss and more than likely a waste of money, however, everyone is different and I personally want to give it a shot. I would rather drink bleach than touch anything that is anti-androgenic.

The products I’m trying are overmachogrande and the derminator 2.

I’m currently running Minox ketoconazole as well as saw palmetto as there’s evidence it’s anti androgenic. My hair loss isn’t bad at all. I have a full head of hair. Just want to catch it early on and wondering if fin is the way to go

I would strongly advise against anyone using fin unless they want to play with fire.

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What about topical dutasteride? I’ve seen it mentioned before as effective but not going throughout the body. Not sure if that’s true or not but may be worth researching further.

No. However, I’ll qualify that. I think one has to consider the sample. For example, on the internet you’ll find a lot of guys who are having trouble with TRT, or at least not satisfied with their results. Those (95%) on TRT feeling great are too busy doing what they do to bother with getting on the internet with their questions and unique circumstances.

I’ll be biased when it comes to finasteride as well. What do I see? If I see a guy who used or is using finasteride he is in the office with…hormone issues. Some have pretty sad stories too. I’m sure plenty of guys are out there that have done fine with the drug, but I’m not seeing them. I guess it comes down to the risks and benefits. I would not take it. Your call, between you and your doctor.

This sounds interesting, whats the brand?

A study I read indicated about 15% of men using finasteride had some sexual side effects, 7% of the placebo group reported sexual side effects. I would guess about half of the 15% were legitimate sexual side effects. It was known to the men before hand that sexual side effects were what they were looking for.

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I use ketoconazole. It’s called sent from earth find it on amazon

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For the algorithm.

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Hahahahhaa

I’ve lurked quite a bit here, and I repeatedly see cases of sexual dysfunction from previous drug use — especially finasteride, SSRIs (myself), accutane, and SARMs/AAS

As a doc who has probably seen a number of these patients, I’m super curious about your views on these conditions and your success — or lack thereof — treating them.

What percentage (approximately) of PFS cases that you’ve seen have been responsive to TRT? What about post-SSRI/PSSD cases?

I know you tailor your treatment plans to the individual’s needs, but are there any general trends you find with regard to successfully treating these different groups? (E.g., does this population require higher doses than the average person, more frequent dosing, more time to see benefits, etc.)?

I know many in the PFS and PSSD communities have tried TRT. Some have had success; others haven’t. I often wonder whether the differences in success are a function of regimen differences or simply differences in severity / brain and body areas affected.

Really interested in your perspective on these issues. If this becomes too long, perhaps you could even make it a post. I’m sure tons would be interested (and it would provide some hope to those lost souls struggling).

Off the top of my head, most respond well. It is not 90%, but greater than 50%. I will say I hate to see this in the past history, as there is an increased chance TRT will not work. The longer they have been on the drugs, the chance for success decreases.

If currently on these meds, and unable or unwilling to stop, the odds for success are even less. I don’t know, I’ve never read any studies or surveys, but I suppose a nice head of hair is important to women, generally. However, I come from the hippie days when you had to have a crew cut to be on the football team.

Yes, wait for it…supraphysiological dosing and levels. I don’t waste any time “dialing in” and start them with at least 200mg a week.

I wonder as well and I think it is likely both. For some, we just keep titrating up to effect. Others, nothing matters.

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Wow - even 50% is quite high. I’m guessing a large part of TRT “failure” is due to shitty mandatory regimens (I.e., T with AIs and HCG) that can be found at most of these clinics.

Do you have something of an upper threshold (mg/wk), where if they hit this number / amount and still cannot find relief, you conclude TRT probably is not the answer?

I’ve read a few studies on androgen insufficiency, where infants have mutations of the AR that make them unresponsive to their body’s natural level of endogenous hormones (and thus have an ambiguous/undefined genitalia). In some of these cases, supraphys doses of T (500+ mg per week) or much stronger androgens are able to get the receptors signaling and expressing appropriately.

I’m no geneticist, but I always thought that if PFS did, in fact, have gene “silencing” due to the rebound of DHT upon quitting the drug, then they would need to drop their hormones to extremely low levels for a period of time, as as the body would then hopefully recognize the low level of androgens and demethylate the ARs accordingly. Perhaps this is even what the body is attempting to due naturally since we observe low FT in the majority of cases. It’s definitely a mysterious condition that needs to be studied more extensively. PSSD appears even more complex with a mix of hormone, neurotransmitter, and neurosteroid imbalances.

Thanks for the answers!

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Not really, they just give up before we get there. I’ve gone as high as 400mg a week for a few, not many, but it’s what it took for them.

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