Starting treatment- looking for thoughtful advice please.

[tbforever]

Hello everyone,

I'm 24 and I noticed my hair loss in April of 2010. It's funny because I began noticing days after a haircut in which I had my hair "shredded" (thinned out) because it was so damn thick that I couldn't really style it. My barber said "if i do this you'll notice some hair coming out for a while." He didn't specify if it were cut hair or telogen hairs that would be falling out. Regardless, I started noticing.

I was pretty certain it was telogen effluvium because I'd lost my job, interviewed and got a new one, had a minor health scare, lost 25 lbs (practically all my body fat), changed my diet, and went through a particularly stressful breakup with my girlfriend of two years.

By the time I realized "Oh crap, if this isn't TE and it's MPB I need to start doing something about it before it's too late" (that was after denial/hoping I was just being paranoid about the hair loss) I got a doctors appointment, got referred to a terrible derm who did one hair pull test and said "it's TE, just wait a month or two and it should go away." Finally I saw a more respectable derm last week who basically said "probably MPB, start some Rogaine, take these vitamins (Biotin, Folic Acid), and come back in two months to see about Propecia etc."

So I used liquid Minox 5% for the first time today and plan to keep using it. I'd love to believe I have TE. I have no receding hairline(yet), thinner spots above and a little set back from my ears, and I can see some thinning on the top of my head. What still keeps my hopes about TE (sucks to not know) is that I have definite diffuse hair loss all the way to my neck hairline. I can pluck 2-4 telogen hairs with a mild squeeze and tug. The thinner spots on my head were naturally thinner when I had a full head of hair, so logically they look thinner now. Still, I don't want to be a fool and let the MPB (potential, but likely) get too far.

My question is, how can I ever know if it is really just TE if I start Minox and even Propecia in the next couple of months? I don't want to be using these meds and spending $$$ for the next 10 years without being sure. I'm hoping that if it is TE, the Minox will get all my hair back on a regular growth cycle... but then what? Stop and hope it doesn't all shed? I had plenty of "triggers" for TE, which are mostly resolved, so there should be an end to it (aka not chronic TE)... but I can't wait to find out that I'm wrong and get more months behind on MPB.

What do you all think? I'm dying for some thoughtful advise.

[Brains Expel Hair]

You are aware that hairloss isn't just either TE or MPB, right? The symptoms you mention sound much more inline with diffuse alopecia areata which can be caused by a number of different problems that also cause stress.

In the case of alopecia areata you have 3 possible methods of treatment.
1) Fix whatever problem is causing your immune system to get in a fit (if you can).
2) Suppress your immune system through cortisol shots or other sorts of medicine.
3) Use Minox/Propecia and hope that your immune system stops eating your body on it's own (statistically possible).

On a side note: Seaback, you are aware that your quotation in itself is a scientifically valid concern right? I can't tell if you're trying to mock it (which might mean you are ignorant of the actual science behind it) or if you're just quoting it because it's "odd" (but then, what about the human body isn't?).

[tbforever]

You are aware that hairloss isn't just either TE or MPB, right? The symptoms you mention sound much more inline with diffuse alopecia areata which can be caused by a number of different problems that also cause stress.

In the case of alopecia areata you have 3 possible methods of treatment.
1) Fix whatever problem is causing your immune system to get in a fit (if you can).
2) Suppress your immune system through cortisol shots or other sorts of medicine.
3) Use Minox/Propecia and hope that your immune system stops eating your body on it's own (statistically possible).

On a side note: Seaback, you are aware that your quotation in itself is a scientifically valid concern right? I can't tell if you're trying to mock it (which might mean you are ignorant of the actual science behind it) or if you're just quoting it because it's "odd" (but then, what about the human body isn't?).

I'm going in for some blood work.

Complete blood count,
ANA (antinuclear antibody)
Thyroid profile

If it is my immune system, ANA should uncover that, correct?

I've also read that iron deficiency can cause hair loss, although I eat plenty of meats & veggies so should be getting my iron.. but it would seem foolish not to have this tested too, just in case. No?

Anyways, are there any other blood tests I should get while I'm at it?

Thanks again

[Brains Expel Hair]

Sorry, some confusion there, I meant the quotation in your signature.

"So I am thinking that eating gluten was causing my hormones to shift into estrogen dominance, which gave me the onion body odor."

^Technically a very possible, scientifically valid concern.

Additionally, you should differ between your opinion "AA is a very rare pathology" and scientifically proven figures (of which there are none for now ). Considering the amount of people who come to this board each week complaining of the rampant itch they have accompanying their hair loss it seems quite foolish to me to make such a statement, but that is my opinion. W/e the case is as far as actual occurrence of AA in the general population, this doesn't matter at all when you're dealing with any specific case, especially a specific case that represents itself as more closely following AA pattern compared to AgA (see OP's post).

[Brains Expel Hair]

On to OP's questions.

ANA doesn't rule out/in all forms of malfunctioning immune systems. C-reactive protein levels would be a good indication of total inflammation (from your immune system) in the body and probably a better place to start than ANA. Thyroid levels are also a good thing for most people to determine as are basic levels of all potentially deficient vitamins/minerals such as iron, vit d and vit b (possibly already tested by the guy recommending folic acid supplementation).

[theShade]

Sorry, some confusion there, I meant the quotation in your signature.

"So I am thinking that eating gluten was causing my hormones to shift into estrogen dominance, which gave me the onion body odor."

^Technically a very possible, scientifically valid concern.

No it's not - unless you genuinely think that there is a link between 'onion body-odours' and 'estrogen-dominance'. Actually sounds like a typical inane statement with absolutely no evidence behind it, if not an outright joke.

[tbforever]

I'm researching on my own, but some questions I can't find answers for.

Can chronic injury of another part of the body cause an autoimmune response against hair follicles?

[Brains Expel Hair]

No it's not - unless you genuinely think that there is a link between 'onion body-odours' and 'estrogen-dominance'. Actually sounds like a typical inane statement with absolutely no evidence behind it, if not an outright joke.

Let's see how hard it is to connect the dots.

Chronic consumption of gluten by someone with a gluten intolerance can cause imbalances in sexual hormones.

Your sexual hormone balances determine what sort of oils you secrete around your armpits (and anus too).

The types of oils you secrete around your armpits determine what sorts of bacteria take up residence around these glands.

The types of bacteria that live around these glands give off different odors which are predominantly described as either oniony (on a female) or cheesy (on a male).

Wow, yeah 4 whole steps, I can see how you smerty experts are having problems with it.

[Brains Expel Hair]

I'm researching on my own, but some questions I can't find answers for.

Can chronic injury of another part of the body cause an autoimmune response against hair follicles?

Not in any likely event. There are slightly possible ways that this can be connected (but it's not the likely situation), as if you do have chronic inflammation that increases the likely hood of chronic injury to other parts of your body.

Be very wary of anyone who automatically describes your hair loss as MPB. MPB should only be a diagnosis of exclusion because currently there are no accurate tests to determine if you have MPB or not, while there are plenty of other tests for alternative causes of hair loss. Admittedly though, there are quite a few symptoms to look for that would definitely point you in the direction of androgenic alopecia (of which you have described the opposite trends). On this message board there is an alarming number of people who only believe in one kind of hair loss, to them if you're a male and you're losing hair then you're in the exact same boat as them. They are incapable of understanding anything outside this realm or even basic concepts of statistics and populations. Take everything you read with a grain of salt and only use it for further exploration on the topics they present to you.

[theShade]

This is almost too ridiculous to reply to. It's like the whole thing about wanking and hair loss. But I'm going to try anyway.

No it's not - unless you genuinely think that there is a link between 'onion body-odours' and 'estrogen-dominance'. Actually sounds like a typical inane statement with absolutely no evidence behind it, if not an outright joke.

Let's see how hard it is to connect the dots.

Chronic consumption of gluten by someone with a gluten intolerance can cause imbalances in sexual hormones.

I honestly don't know enough about gluten intolerance to comment on this, but it is the first I heard for what is essentially a food allergy/intolerance causing a variance in hormone levels. It may be possible, I dunno - but where is the evidence for this?

Your sexual hormone balances determine what sort of oils you secrete around your armpits (and anus too).

Very debatable. Besides which, what are 'different sorts of oils' by your definition? Keroscene, Diesel, Benzene, good ol' crude??

The types of oils you secrete around your armpits determine what sorts of bacteria take up residence around these glands.

Debatable, this may be true but only to a very limited extent. Far more important for bacteria are factors such as temperature, acidity, sunlight exposure, local tissue/material/chemical composition, etc... 'different sorts of oils' are likely to vary little by these sorts of measures.

The types of bacteria that live around these glands give off different odors which are predominantly described as either oniony (on a female) or cheesy (on a male).

This is just one big massive LOL. Every person has a more or less unique body odour, from what I read. The amount of factors that determine body odour, well I don't know them, but if indeed every person has a unique body odour (which animals such as dogs, etc... use to identify individuals by), then that would mean that a far greater set of factors would be involved in determining body odour - than just the levels of sexual hormones (which may admittedly be a factor too). And the range of body odours, would certainly go far beyond just oniony (female) and cheesy (male).

Be honest here dude, how much of this stuff have you just pulled straight out your ass?