Anyone Recover From Reflex Hyperandrogenicity??

[trialAcc]

Have you done a hormone panel? You may need to do one. Either way, you need treatment to halt the hair loss. If finasteride wasn’t the solution and somehow bumped up your AR sensitivity or test levels, then maybe you need an AR blocker like RU.

But yeah I understand the fear of finasteride. I’m afraid that even if I have sure signs of thinning in my hair that starting finasteride would make it worse and I’d regret it. That’s why if you experience increased sebum, acne, facial or body hair, scalp hair shedding for longer than say two or three weeks, you should stop finasteride. But I’m not sure what else you can do proactively stop finasteride from making your hair worse

How would a hormone panel determine if it bumped your AR sensitivity?

Furthermore, telling people to quit finasteride if you shed for more then 2-3 weeks is crazy. When I started I shed like mad for 6+ months before fully stabilizing for 5-6 years. The oily scalp has also come on and off during that time. Only reason it's different for me this time is because it hasn't stopped after I was forced to stop it orally for 2-3 months and had to swap to topical. Now I have the crazy scalp itch and my shedding hasn't stopped since I started retaking it in October. Still just going to ride it out, the alternative is probably losing 6~ years of maintenance in a shorter period.

 

[Matt Rogers]

I'm not telling you that it didn't make it worse, because I believe that it did. I think restarting finasteride after a small break has given me similar symptoms as HA, but what I am saying is that the increase in shedding for you could be otherwise. You both started finasteride and quit it, all before you waiting it out to see the final results. You're likely going through the finasteride induced shed that many people did at the start but you also stopped right after and it didn't end.

I dont think there was any "gain" phase that was in my future with finasteride. I started finasteride with very good hair. Over the 6 months on it I dropped a Norwood easily and my hair became all diffused with a balding crown

 

[trialAcc]

I dont think there was any "gain" phase that was in my future with finasteride. I started finasteride with very good hair. Over the 6 months on it I dropped a Norwood easily and my hair became all diffused with a balding crown

I shed like nothing I'd ever seen before when I started finasteride for 6+ months. I thought the exact same as you. 90% of it grew back and then was cemented in for 5+ years. Whether or not you had a gain coming is impossible to know now, but I also think it's unfair of you to blame finasteride for destroying your hair when you didn't ride out the minimum period to know for sure.

I am sorry that happened to you though, we're all going through the same stressful process.

 

[Matt Rogers]

I shed like nothing I'd ever seen before when I started finasteride for 6+ months. I thought the exact same as you. 90% of it grew back and then was cemented in for 5+ years. Whether or not you had a gain coming is impossible to know now, but I also think it's unfair of you to blame finasteride for destroying your hair when you didn't ride out the minimum period to know for sure.

I am sorry that happened to you though, we're all going through the same stressful process.

My hair is so bad right now that I'm contemplating just trying finasteride again I have nothing to lose at this point. I'll have to shave my head probably in a year judging by how I look now. Sucks because I never thought I would be at this point so early in life my hair was so good just 2-3 years ago

 

[Selb]

How would a hormone panel determine if it bumped your AR sensitivity?

Furthermore, telling people to quit finasteride if you shed for more then 2-3 weeks is crazy. When I started I shed like mad for 6+ months before fully stabilizing for 5-6 years. The oily scalp has also come on and off during that time. Only reason it's different for me this time is because it hasn't stopped after I was forced to stop it orally for 2-3 months and had to swap to topical. Now I have the crazy scalp itch and my shedding hasn't stopped since I started retaking it in October. Still just going to ride it out, the alternative is probably losing 6~ years of maintenance in a shorter period.

A blood panel can help determine your dht and test levels. This helps I think because you can determine if you’re low dht, and a lot of your balding actually comes from AR genetic sensitivity. Which would explain why it’s susceptible to hormonal changes through finasteride.


Typically the upregulation of the AR levels off or gets to a normal point which is why sides go away and your hair maintains. I’m saying if it continues to be really bad for a few weeks androgen sensitivity-wise. I’m not referring to just shedding, I’m talking about all the other things in addition to shedding.

But I agree, sometimes it’s better to ride it out. I think finasteride is the type of thing you should commit to since 90% of the time it’s > than the alternative. I was trying to justify reasons for why someone could spot hyperandrogenicity and stop

 

[trialAcc]

A blood panel can help determine your dht and test levels. This helps I think because you can determine if you’re low dht, and a lot of your balding actually comes from AR genetic sensitivity. Which would explain why it’s susceptible to hormonal changes through finasteride.


Typically the upregulation of the AR levels off or gets to a normal point which is why sides go away and your hair maintains. I’m saying if it continues to be really bad for a few weeks androgen sensitivity-wise. I’m not referring to just shedding, I’m talking about all the other things in addition to shedding.

But I agree, sometimes it’s better to ride it out. I think finasteride is the type of thing you should commit to since 90% of the time it’s > than the alternative. I was trying to justify reasons for why someone could spot hyperandrogenicity and stop

Ah fair enough, I'm pretty concerned to be honest. Like I said, I had great success with finasteride but covid lockdowns basically forced me into splitting 6 pills over 4~ months and then running out completely for a few weeks. Got topical finasteride and started September 1st~ and got a script again October 15th~. I also started minoxidil in march which caused me some shedding with 0 noticeable benefit (yet I continue).

Mildly higher body hair, scalps on fire and constant shedding/verified temple recession and a newly diffuse crown. Can't tell if it's catch up loss or the reaction to restarting the finasteride but I hope it can at least stabilize. If I quit now, I'll be buzzing it anyways within a year so I might as well see what comes. dutasteride seems like a reasonable step up but now I'm thinking if I do have this upregulation that would just make it worse...

Also thinking of RU but I'm not sure I can mentally go down that rabbit hole. I'm almost just as scared it works wonders, because then I've committed to something that could be killing me down the line.

 

[Selb]

I have RU in my freezer but im also scared to take that as well lol. Basically finasteride has caused me to fear any hair loss treatment even though my hair continues to get worse by the day.
Never have gotten a hormone panel. I've asked doctors but they see me as a healthy young male and they just refuse. Of course I could buy a hormone panel out of pocket if I wanted

That’s fair enough. Sometimes you have to weigh the risks and decide to go for it or don’t. I think what can help your case is really understanding why it happened. That’s why I think attacking hair loss using a different mechanism is worthwhile. You had a bad reaction to lower dht, so maybe don’t lower dht at all, but block androgens from reaching the receptor at all.

RU is dose dependent too, so the more you use the more it blocks. The good thing about this in your case is it your hyperandrogenicity acts up, you can increase the RU dose to counteract it. I’m not entirely sure, but I’d imagine there’s a natural limit to how much your body can upregulate sensitivity and it falls short of exogenous AR blocking.

Ah fair enough, I'm pretty concerned to be honest. Like I said, I had great success with finasteride but covid lockdowns basically forced me into splitting 6 pills over 4~ months and then running out completely for a few weeks. Got topical finasteride and started September 1st~ and got a script again October 15th~. I also started minoxidil in march which caused me some shedding with 0 noticeable benefit (yet I continue).

Mildly higher body hair, scalps on fire and constant shedding/verified temple recession and a newly diffuse crown. Can't tell if it's catch up loss or the reaction to restarting the finasteride but I hope it can at least stabilize. If I quit now, I'll be buzzing it anyways within a year so I might as well see what comes. dutasteride seems like a reasonable step up but now I'm thinking if I do have this upregulation that would just make it worse...

Also thinking of RU but I'm not sure I can mentally go down that rabbit hole. I'm almost just as scared it works wonders, because then I've committed to something that could be killing me down the line.

I think in your case it’s your scalp undergoing shedding because of the inconsistent use of finasteride. Once your body hormones stabilize, your shedding should go down and the oiliness would go away too. Topical probably goes into the system slower too. September 1st is around 3 months ago so I’d imagine your shedding and hair should stabilize soon. Topical dutasteride is apparently really good for a once in a week type deal. It has a long half life in tissue so it doesn’t need to be as frequent

 

[trialAcc]

That’s fair enough. Sometimes you have to weigh the risks and decide to go for it or don’t. I think what can help your case is really understanding why it happened. That’s why I think attacking hair loss using a different mechanism is worthwhile. You had a bad reaction to lower dht, so maybe don’t lower dht at all, but block androgens from reaching the receptor at all.

RU is dose dependent too, so the more you use the more it blocks. The good thing about this in your case is it your hyperandrogenicity acts up, you can increase the RU dose to counteract it. I’m not entirely sure, but I’d imagine there’s a natural limit to how much your body can upregulate sensitivity and it falls short of exogenous AR blocking.



I think in your case it’s your scalp undergoing shedding because of the inconsistent use of finasteride. Once your body hormones stabilize, your shedding should go down and the oiliness would go away too. Topical probably goes into the system slower too. September 1st is around 3 months ago so I’d imagine your shedding and hair should stabilize soon. Topical dutasteride is apparently really good for a once in a week type deal. It has a long half life in tissue so it doesn’t need to be as frequent

I hope so! Unfortunately it seems like the damage has been done, lost a lot of hairline and added some diffuse/crown thinning in there for the first time ever. Really using all my personal restraint here to not add RU.

 

[Selb]

I hope so! Unfortunately it seems like the damage has been done, lost a lot of hairline and added some diffuse/crown thinning in there for the first time ever. Really using all my personal restraint here to not add RU.

Might be able to get the hair you lost back with microneedling. With finasteride it’s proven to be a good growth agonist. I’ve always thought of it as if you’ve lost the hair within the last year/two years, finasteride should be able to restore it. But that could be bro science. Maybe the hair will come back in your case if you stay steady on finasteride

 

[trialAcc]

I actually just bought a pen. I'm also hesitant to start that though because my scalp is so inflamed. I can't imagine wounding ontop of heavily inflammation would be beneficial, and might speed it up. Been looking for topicals to reduce the redness/inflation. If my scalp settles and I have a week of less shedding I'll do my first session.

Any suggestions?

 

[Matt Rogers]

I actually just bought a pen. I'm also hesitant to start that though because my scalp is so inflamed. I can't imagine wounding ontop of heavily inflammation would be beneficial, and might speed it up. Been looking for topicals to reduce the redness/inflation. If my scalp settles and I have a week of less shedding I'll do my first session.

An

I actually just bought a pen. I'm also hesitant to start that though because my scalp is so inflamed. I can't imagine wounding ontop of heavily inflammation would be beneficial, and might speed it up. Been looking for topicals to reduce the redness/inflation. If my scalp settles and I have a week of less shedding I'll do my first session.

Any suggestions?

I wouldn't do it if you already have a lot of inflammation. I've done plenty of microneedling with no benefit. I think microneedling only has the possibility of working if its used with minoxidil and a dht inhibitor. For me microneedling has just caused a sore, itchy, flaking scalp

 

[Selb]

I actually just bought a pen. I'm also hesitant to start that though because my scalp is so inflamed. I can't imagine wounding ontop of heavily inflammation would be beneficial, and might speed it up. Been looking for topicals to reduce the redness/inflation. If my scalp settles and I have a week of less shedding I'll do my first session.

Any suggestions?

Unfortunately there’s many reasons for an inflamed scalp. If you can find a good derm I’d go to them. If not, in the meantime maybe use T Gel/SAL and aloe Vera. If it’s really that bad, you may need topical steroids.

I’m wondering if that inflammation is also part of the temporary hyperandrogenicity you have, since more oil can sometimes mean more inflammation.

 

[trialAcc]

I've tried T/gel and nizoral, no luck. I used to have the inflammation/itch years ago before I started finasteride, so I'm assuming it's just a resumption of the Androgenetic Alopecia process. I'm open to topical steriods, I was going to actually call my GP to see if I could get a prescription while I let my hormones and regimen take hold again. I'm very surprised that treating inflammatory symptoms has not picked up more steam in the treatment communities. Seems like while DHT is the culprit of Androgenetic Alopecia, if you could eliminate or reduce inflammation you'd severely slow down loss.

The quick onset of it has brought me to threads like these, because I'm wondering if my symptoms are hyperandrogencity, and lets pray that it's temporary. Have you experienced at all?

Unfortunately there’s many reasons for an inflamed scalp. If you can find a good derm I’d go to them. If not, in the meantime maybe use T Gel/SAL and aloe Vera. If it’s really that bad, you may need topical steroids.

I’m wondering if that inflammation is also part of the temporary hyperandrogenicity you have, since more oil can sometimes mean more inflammation.

 

[Selb]

I've tried T/gel and nizoral, no luck. I used to have the inflammation/itch years ago before I started finasteride, so I'm assuming it's just a resumption of the Androgenetic Alopecia process. I'm open to topical steriods, I was going to actually call my GP to see if I could get a prescription while I let my hormones and regimen take hold again. I'm very surprised that treating inflammatory symptoms has not picked up more steam in the treatment communities. Seems like while DHT is the culprit of Androgenetic Alopecia, if you could eliminate or reduce inflammation you'd severely slow down loss.

The quick onset of it has brought me to threads like these, because I'm wondering if my symptoms are hyperandrogencity, and lets pray that it's temporary. Have you experienced at all?

No, I haven’t experienced hyperandrogenicity, at least I don’t think, I haven’t even been on finasteride. I’m waiting on a scalp biopsy before I start any treatment. But I’m a bit obsessed with the science of hair loss at this point. My hair loss was triggered by Accutane, and my hair is diffusely thin, with the sides and behind my ears also somewhat effected.

One thing I’ve noticed in hyperandrogenicity threads is that hair loss also occurs in the sides/back of the head.

The connection here is that Accutane actually suppresses dht. So it may be that I’ve experienced AR upregulation as a result and I’ve lost hair because of it. But that’s a bit of a far fetched theory...

 

[trialAcc]

No, I haven’t experienced hyperandrogenicity, at least I don’t think, I haven’t even been on finasteride. I’m waiting on a scalp biopsy before I start any treatment. But I’m a bit obsessed with the science of hair loss at this point. My hair loss was triggered by Accutane, and my hair is diffusely thin, with the sides and behind my ears also somewhat effected.

One thing I’ve noticed in hyperandrogenicity threads is that hair loss also occurs in the sides/back of the head.

The connection here is that Accutane actually suppresses dht. So it may be that I’ve experienced AR upregulation as a result and I’ve lost hair because of it. But that’s a bit of a far fetched theory...

Ah small world. My hairloss started when I was 17 immediately (or noticeably in the temple area 6 months or so) after my first and only course of Accutane. Although it may have ruined my hair earlier then I was destined to, I havn't had cystic acne since then and I'm 27 now. Honestly probably a trade I'd make again.

 

[Selb]

Ah small world. My hairloss started when I was 17 immediately (or noticeably in the temple area 6 months or so) after my first and only course of Accutane. Although it may have ruined my hair earlier then I was destined to, I havn't had cystic acne since then and I'm 27 now. Honestly probably a trade I'd make again.

It’s an awful drug IMO, and I’m hearing more and more how it causes diffuse hair loss or accelerates male pattern baldness. My problem is that I don’t even know if it’s a contributing factor anymore. It would be easy without Accutane, since at the first sign of hair loss I would have jumped on finasteride

 

[trialAcc]

It’s an awful drug IMO, and I’m hearing more and more how it causes diffuse hair loss or accelerates male pattern baldness. My problem is that I don’t even know if it’s a contributing factor anymore. It would be easy without Accutane, since at the first sign of hair loss I would have jumped on finasteride

I agree it is awful, but to be honest I had tried everything and my cystic acne was as severe as it gets. Talking about chest/back/neckline, multiple cm (if not an inch sometimes) legions. Still have tons of scars. Accutune cured it completely in 1 go.

Like I said, if that had continued into my 20s I'd probably be a lot more miserable then I am now with thin hair at 27 lol. At least the hair is normal, I know a lot of bald guys my age and I can shave it and be a regular guy when needed. With that type of acne you can't be taken serious by girls, professionally or even strangers.

I always thought it had something to do with it, but it didn't seem worth investing the time into seeing if it was because the damage was done.

 

[Selb]

I agree it is awful, but to be honest I had tried everything and my cystic acne was as severe as it gets. Talking about chest/back/neckline, multiple cm (if not an inch sometimes) legions. Still have tons of scars. Accutune cured it completely in 1 go.

Like I said, if that had continued into my 20s I'd probably be a lot more miserable then I am now with thin hair at 27 lol. At least the hair is normal, I know a lot of bald guys my age and I can shave it and be a regular guy when needed. With that type of acne you can't be taken serious by girls, professionally or even strangers.

I always thought it had something to do with it, but it didn't seem worth investing the time into seeing if it was because the damage was done.

I wouldn’t worry too much about it at this point, it’ll just muddy the waters. My acne wasn’t so bad I needed it, and it was my second course. I didn’t need it and shouldn’t have done it but oh well. I’ve already regretted enough. I’m glad your acne was taken care of in one shot though.

And definitely man, a lot of 27 year olds are balding, so having hair is already a huge advantage.

Btw, estrogen apparently downregulates ARs, so if you come back in a few months with no improvements maybe give topical bi-estro a try. It doesn’t go systemic enough to cause problems, at least in the one thread I followed about it

 

[trialAcc]

I've had the exact same experience as you and the OP. The sudden extreme hair loss and other side-effects plus knowing that you would still have a perfectly fine head of hair if you never started finasteride is increasingly hard to deal with. Also because there's no way out. It has destroyed the quality of my life.

Did you document with any pictures?

 

[Selb]

Might be of interest:

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onlinelibrary.wiley.com

Topical green tea extract (EGCG) reduces AR expression through downregulation, and helps protect hair in the presence of direct testosterone injections. So it protects from the direct effect of testosterone plus it seems to have a benefit of downregulating androgenic sensitivity for T and DHT without affecting serum levels for either in the tissue. In other words, it’s not inducing downregulation through deprivation like finasteride, it’s doing it by affecting AR transcription through Sp1 regulation. More evidence of this:

Tea polyphenols down-regulate the expression of the androgen receptor in LNCaP prostate cancer cells - Oncogene

Androgens via their cognate receptor may be involved in the development and progression of prostate cancer. The aim of this study was to determine whether tea polyphenols have inhibitory effects on androgen action in an androgen-responsive, prostate cancer cell line, LNCaP. The tea polyphenol...

www.nature.com

I think this means it’s less likely for your body to have a bounce back effect like hyperandrogenicity, as I believe it does that through AR expression which you’re directly countering with topical EGCG.
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