Anyone familiar w Trichotest by Fagron (Genetic Treatment Protocol)

Ticken

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Anyone familiar with the Trichotest by Fagron?
The Trichotest examines a number of our individual gene variants and gives recommendations as to which treatments (Minoxidil, finasteride, Duta, Latanoprost, etc) we are most likely to respond positively to. This could, in theory, save months or years of futile treatments as many of us our non-responders to certain treatments. The test looks at the following gene variants and your likely response to drugs & supplements in the following catagories:
  • Prostaglandin Inhibitors/Metabolism: GPR44-1; GPR44-2; PTGFR-1; PTGFR-2; PTGFR-3; PTGES2; SULT1A1.
  • Anti-Inflammatories: GR-alpha
  • Anti-Androgenics: CYP19; SR5DA1; SR5DA2.
  • Vasodilation and blood circulation ACE.
  • Collagen synthesis: COL1A1.
  • Vitamins and minerals metabolism: CRABP2; BTD.
  • IGF-1 metabolism: IGFR-1.
One hitch is that it's only available through a prescriber (Doctor, Trichologist, ND etc) at least for now.

If anyone has screen shots from their Trichotest results or cares to share their experience it would be much appreciated!
 
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Ticken

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A more complete summary of the genes analysed and their corresponding treatments in Trichotest:
 

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Selb

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This seems interesting but I don’t know if it’s any accurate. I checked the website and it’s not simple contacting them about it
 

Ticken

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This seems interesting but I don’t know if it’s any accurate. I checked the website and it’s not simple contacting them about it
I agree, there is no way to confirm the accuracy when it comes to genetically based treatments.

As there is currently no "one size fits all" treatment protocol for Androgenetic Alopecia hair loss, I'm really hoping that individualized targeted treatments based on one's genetics will be possible at some point in the future.

I'll hunt around and see if I can locate a US based link for ordering just in case anyone is interested. I'm getting the feeling this test is currently more common in Europe than it is in North America.

EDIT: It looks like the company is based in the Netherlands but has locations in both US and Canada for those interested.

For anyone wanting to read up on the Scientific Validity of their testing:
https://be.fagron.com/sites/default...tion_new_template_-_external_v_21_02_2019.pdf
 
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Rolandas

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One of my subscribers on YouTube told me about it. Interestingly he been told to stop Finasteride and start topical Alfatradiol as it will be best for him personally.

There's really no much information about it, but I've contacted the company and currently waiting for their reply. Perhaps I'll do it myself and document it all.
 

Gert

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Hi,
Actually my doctor proposed this to me and I accepted.
She took a DNA swab last Monday and has send it to Fagron Spain.
It should take about 4 to 6 weeks to have results.
I can share if you like.

FYI, currently on trichosol minoxidil 5% and not seeing too much of a result after 8 months so decided to consider finasteride.
According to my doctor these results should say something about my (lack) of response to minoxidil and potential response to finasteride or other medication.
 

Ticken

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Hi,
Actually my doctor proposed this to me and I accepted.
She took a DNA swab last Monday and has send it to Fagron Spain.
It should take about 4 to 6 weeks to have results.
I can share if you like.

Oh yes, please do share when you can!!

May I ask, what country you are in?
So far, I've had no luck getting a hold of a trichotest in usa so am trying canada now...lol.
 

Gert

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Sure you may ask. I live in Belgium.
Sorry to hear you can't get a trichotest in USA.
Yeah, in Belgium I visited 4 derms during 3y of hair loss to finally find 1 of the 2 only hair specialists in Belgium.
Finasteride isn't even approved here for hair loss so derms stay away from it and kinda fear it.
Just saying every country has it's limitations in access. Hope you get help in Canada.

My hair loss specialist does prescribe finasteride but I'm kinda scared of potential sides (like everybody) so at least this test might show the better treatment for me before I just hop on it.
 

Ticken

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My hair loss specialist does prescribe finasteride but I'm kinda scared of potential sides (like everybody) so at least this test might show the better treatment for me before I just hop on it.
Indeed! and they do check if you have the gene variants associated with positive treatment outcomes for both finasteride & duta and let you know which might be more efficacious. If there are other AAs that are commonly prescribed in your country they may be able to give you insight on those too.
According to my doctor these results should say something about my (lack) of response to minoxidil and potential response to finasteride or other medication.
For min treatment, they examine the gene variants PTEGS2 & SULT1A1. So you find out your PGE2 enzyme activity status and if min will be normally sulfated and effective for you. I would pay a bunch just to know the bit about minoxidil!
 

Rolandas

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Indeed! and they do check if you have the gene variants associated with positive treatment outcomes for both finasteride & duta and let you know which might be more efficacious. If there are other AAs that are commonly prescribed in your country they may be able to give you insight on those too.

For min treatment, they examine the gene variants PTEGS2 & SULT1A1. So you find out your PGE2 enzyme activity status and if min will be normally sulfated and effective for you. I would pay a bunch just to know the bit about minoxidil!
Or just take oral minoxidil :D
 

Gert

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Hi,
I just received my results (by email).
I got a summarized version of my doctor :
My sulfotransferase is not really active meaning I don't metabolize minoxidil well to its active form. I need a higher dose to have it do anything.
5 alfa reductase 1 no remarks
5 alfa reductase 2 'sped up'

Proposed treatment :

TOPICAL
Ketoconazol 2 %
Tretinoïne 0.01 %
Finasteride 0.25 %
TrichoSol 100ml
Once a day before bed.

PILL
Minoxidil

I haven't been able to dicuss this over the phone but the finasteride % sounds very high. So might ask to start with 0,1%...
I probably won't take a minoxidil pill until I've seen what the result of the topical will be.

Cheers
 

Ticken

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Hi,
I just received my results (by email).
I got a summarized version of my doctor :
My sulfotransferase is not really active meaning I don't metabolize minoxidil well to its active form. I need a higher dose to have it do anything.
5 alfa reductase 1 no remarks
5 alfa reductase 2 'sped up'

Proposed treatment :

TOPICAL
Ketoconazol 2 %
Tretinoïne 0.01 %
Finasteride 0.25 %
TrichoSol 100ml
Once a day before bed.

PILL
Minoxidil

I haven't been able to dicuss this over the phone but the finasteride % sounds very high. So might ask to start with 0,1%...
I probably won't take a minoxidil pill until I've seen what the result of the topical will be.

Cheers

Thanks for sharing your result summary and treatment details, Gert!

Starting with a low percentage finasteride and waiting a bit before adding oral min sounds like a smart approach.
Nice that your TrichoSol base is PG and alcohol free so scalp irritation (at least due to the base) shouldn't be an issue.

Perhaps when you have your full report, you'll consider sharing a screen shot or two that shows how your various treatments were chosen based on your specific gene variants. Hoping your new treatment plan brings regrowth over the next few months!!
 
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-Synergy-

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I wish this was available in the United States. A personalized approach to treating hair loss would be perfect.
 

GRme11

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Hi,
I just received my results (by email).
I got a summarized version of my doctor :
My sulfotransferase is not really active meaning I don't metabolize minoxidil well to its active form. I need a higher dose to have it do anything.
5 alfa reductase 1 no remarks
5 alfa reductase 2 'sped up'

Proposed treatment :

TOPICAL
Ketoconazol 2 %
Tretinoïne 0.01 %
Finasteride 0.25 %
TrichoSol 100ml
Once a day before bed.

PILL
Minoxidil

I haven't been able to dicuss this over the phone but the finasteride % sounds very high. So might ask to start with 0,1%...
I probably won't take a minoxidil pill until I've seen what the result of the topical will be.

Cheers
Thank you for posting your results. What about the other factors like Prostaglandins(PGE2,PGD2,PGF2A), IGF-1, Biotin and especially the Aromatase Activity? Not ready yet? Thank you very much.
 

Gert

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Hi GRme11,
I only got a quick email on the results. I'll get more details later.
The email did mention that the aromatase activity was lower than normal. But what does that mean? Can you enlighten me?
Thanks!
 

GRme11

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Hi GRme11,
I only got a quick email on the results. I'll get more details later.
The email did mention that the aromatase activity was lower than normal. But what does that mean? Can you enlighten me?
Thanks!
Thanks for responding back. Aromatase is the enzyme that leads to the biosynthesis of Estrogens, and Estrogens are usually very important for hair and for hair regrowth (many stories posted here). Now, the test is checking this activity and since was lower like you mentioned, if you apply 17a-Estradiol for example, like the TrichoTest suggests, probably you will see positive effects for hair (e.g https://pubmed.ncbi.nlm.nih.gov/12190948/---https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412238/ --- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412238/ ->"The solution 0.025% Ell-Cranell® alpha (17α-estradiol, Galderma Korea, Co., Seoul, Korea) is a stereoisomer of the female hormone 17β-estradiol and has been used for the past 30 years in Europe, as well as in South America. The drug inhibits the conversion of testosterone to the metabolite dihydrotestosterone (DHT) by suppressing 5α-reductase activity. In addition, by inhibiting 17β-dehydrogenase, it impedes the conversion process of androstenedione to testosterone, resulting in a reduction in the syntheses of testosterone and DHT. It also accelerates the conversion of testosterone to estradiol by stimulating aromatase, decreasing the level of testosterone and leading to a reduction in DHT. In addition, the drug has been reported to stimulate the generation of hair follicular matrix cells"). So, in general it's important to have good aromatase activity (thus estrogenic) on scalp for example, that's why there are plenty stories of members using topical Estradiol/Estrogel/Bi-Estro or Estriol, in order to get the positive effects for hair/hair regrowth. (17a-Estradiol is targeting more the ERα receptor and maybe it's a problem but maybe not, can't clearly tell. When you read the thread below you will understand what I mean. Although, something to check as well https://www.hairlosstalk.com/intera...rotects-the-hair-follicle.109106/post-1563166 plus->https://www.jidsponline.org/action/showPdf?pii=S0022-202X(15)52598-0 (related). In general though, ERβ is the receptor we want to target the most, as long as I read and searched that's the main conclusion. (Check the thread below and you will get the point)

Great study for estrogens and hair:
Also, check this thread when you have time: (Last page has a brief but very well organized summary-check it first if you want)

I hope I gave you some help and an insight. It would be very helpful to post the full report when it's ready. Thank you.
 
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Gert

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Thanks for responding back. Aromatase is the enzyme that leads to the biosynthesis of Estrogens, and Estrogens are usually very important for hair and for hair regrowth (many stories posted here). Now, the test is checking this activity and since was lower like you mentioned, if you apply 17a-Estradiol for example, like the TrichoTest suggests, probably you will see positive effects for hair (e.g https://pubmed.ncbi.nlm.nih.gov/12190948/---https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412238/ --- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412238/ ->"The solution 0.025% Ell-Cranell® alpha (17α-estradiol, Galderma Korea, Co., Seoul, Korea) is a stereoisomer of the female hormone 17β-estradiol and has been used for the past 30 years in Europe, as well as in South America. The drug inhibits the conversion of testosterone to the metabolite dihydrotestosterone (DHT) by suppressing 5α-reductase activity. In addition, by inhibiting 17β-dehydrogenase, it impedes the conversion process of androstenedione to testosterone, resulting in a reduction in the syntheses of testosterone and DHT. It also accelerates the conversion of testosterone to estradiol by stimulating aromatase, decreasing the level of testosterone and leading to a reduction in DHT. In addition, the drug has been reported to stimulate the generation of hair follicular matrix cells"). So, in general it's important to have good aromatase activity (thus estrogenic) on scalp for example, that's why there are plenty stories of members using topical Estradiol/Estrogel/Bi-Estro or Estriol, in order to get the positive effects for hair/hair regrowth. (17a-Estradiol is targeting more the ERα receptor and maybe it's a problem but maybe not, can't clearly tell. When you read the thread below you will understand what I mean. Although, something to check as well https://www.hairlosstalk.com/intera...rotects-the-hair-follicle.109106/post-1563166 plus->https://www.jidsponline.org/action/showPdf?pii=S0022-202X(15)52598-0 (related). In general though, ERβ is the receptor we want to target the most, as long as I read and searched that's the main conclusion. (Check the thread below and you will get the point)

Great study for estrogens and hair:
Also, check this thread when you have time: (Last page has a brief but very well organized summary-check it first if you want)

I hope I gave you some help and an insight. It would be very helpful to post the full report when it's ready. Thank you.
Thanks for all the info. I really appreciate it.
My hair specialist directed me to a urologist to have my sperm checked prior to starting finasteride (topical).
I just received my results and although there are enough sperm cells they aren't the ideal shape so he advises against using finasteride.
I'm so upset from this and adds to the overall depression I am experiencing.
I live alone and my dad has cancer so I minimize contact with people as much as possible. I see a psychologist and try to solve my issues one by one. And I am not allowed to...
 
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MrPortugal

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Hi,
I just received my results (by email).
I got a summarized version of my doctor :
My sulfotransferase is not really active meaning I don't metabolize minoxidil well to its active form. I need a higher dose to have it do anything.
5 alfa reductase 1 no remarks
5 alfa reductase 2 'sped up'

Proposed treatment :

TOPICAL
Ketoconazol 2 %
Tretinoïne 0.01 %
Finasteride 0.25 %
TrichoSol 100ml
Once a day before bed.

PILL
Minoxidil

I haven't been able to dicuss this over the phone but the finasteride % sounds very high. So might ask to start with 0,1%...
I probably won't take a minoxidil pill until I've seen what the result of the topical will be.

Cheers
Don't forget you have two DHT inhibitors in your topical ketoconazol 2% and finasteride
 

Ticken

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Thanks for all the info. I really appreciate it.
My hair specialist directed me to a urologist to have my sperm checked prior to starting finasteride (topical).
I just received my results and although there are enough sperm cells they aren't the ideal shape so he advises against using finasteride.
I'm so upset from this and adds to the overall depression I am experiencing.
I live alone and my dad has cancer so I minimize contact with people as much as possible. I see a psychologist and try to solve my issues one by one. And I am not allowed to...
That's a lot to deal with.

Would it be possible to use a .075% or lower concentration topical finasteride?

Hopefully someone who is more familiar with the differences between oral and topical finasteride in terms of negative sperm cell effects will have suggestions. Ideally, there would be a sweet spot where you could still use topical finasteride at a very low percent concentration to get some hair follicle protection without negatively effecting sperm cells.
 
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Gert

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Quite a big task but translated the whole thing.
Please see below.

So basically Finasteride is not possible due to a negative urologist advice and I will likely be put on oral minoxidil. Further treatments have not been proposed but now that I have read my whole report it seems biotin supplements are a no brainer (couldn't hurt).
AND any advice from you guys would be awesome.

Thanks.

Efficacy of treatment with prostaglandins

GPR44-1 RESULT : LOWERED PGD2 RECEIVED ACTIVITY.
Treatment with Prostaguinon is not necessary as the PGD2-route works correctly. Lower activation of biologic cascased that enhance alopecia. Without the necessaty to decrease PGC2-synthesis.
GPR44-2 RESULT : SLIGHLTY LOWERED ACTIVITY OF PGD2 RECEPTOR.
Treatment with Prostaquinon in normal doses is highly advised. Light biological cascade that enhances alopecia. Take Prostaquinon in normal doses.
PTGFR-1 RESULT : GREATLY LOWERED PGF2a RECEIVER ACTIVITY.
Treatment with Latanoprost is not necessary as the PGF2a receptor works with less efficiency.
PTGFR-2 RESULT: SLIGHTLY DECREASED PGF2a RECEPTOR ACTIVITY.
Treatment with Lanatoprost in normal doses is recommended as the PGF2a receptor works correctly.
PTGFR-3 RESULT: SLIGHTLY DECREASED PGF2a RECEPTOR ACTIVITY.
Treatment with Lanatoprost in normal doses is recommended as the PGF2a receptor works correctly.

Efficacy of treatment with minoxidil

PTGES2 RESULT: NORMAL PGE2 – ENZYME ACTIVITY.
Treatment with minoxidil is not recommended as the metabolism is working correctly.
SULT1A1 RESULT: SLIGHTLY DECREASED ENZYMATIC ACTIVITY OF SULFOTRANSFERASE
Treatment with minoxidil is possible but only in high doses.
Efficacy of treatment with glucocorticosteroids
GR-alpha RESULT: HIGH RESISTANCE ON GLUCOCORTICOSTEROIDS
Treatment not advised

Efficacy of treatment with anti androgens

CYP19 RESULT: SLIGHTLY DECREASE AROMATASE ENZYMATIC ACTIVITY.
The aromatase activity should be modulated with hormonal treatments in high doses
SR5DA-1 RESULT: STEROID-REDUCTASE ACTIVITY TYPE I NORMAL.
Treatment with Dutasteride not necessary
SRD5A-2 RESULT: AVERAGE SPED UP STEROID-REDUCTASE TYPE II ACTIVITY (HIGHER DHT)
Treatment with finasteride with normal dose is strongly advised.

Visodilation and blood circulation

ACE RESULT: SLIGHLTY INCREASED ACTIVITY IN METABOLIZING ANGIOTENSINE
Treatment with circulation stimulants is advised like carnitine or arginine.

Collagen synthesis

COL1A1 RESULT: Normal.

Vitamin a metabolism

CRABP2 RESULT: Normal

Biotin metabolism

BTD RESULT : STRONGLY REDUCED BIOTINIDASE ENZYME ACTIVITY.
High doses biotine supplements are highly recommended.

Reduction of IGF-1 values

IGF-1 RESULT: POSSIBILITY OF SLIGHLY LOWERED IGF-1 VALUES.
Advised to use IGF increasing medication
 
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