Chronic Telogen Effluvium Or Androgenetic Alopecia? Spironolactone Not Helping?

CJ-B

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Hello, I'm CJ, currently 27 and this is going to be long I'm so sorry haha,

I've been experiencing hair loss and thinning for the past two years after I turned 25. Never used birth control pills, consistently underweight my entire life and prone to anxiety, but I never had hair issues before that I noticed. Vit D and iron deficiency in 2016 so I started taking a multivitamin and resolved the issue within a few months and gained some weight (still under though). Over the next few months I had a wisdom tooth removal and found a complex cyst in my right breast (benign), still taking a multivitamin this whole time. Started losing weight again, not as bad as before but I noticed my hair was getting very thin and see through in certain light especially when wet. The pattern is such that I have a bit of a thin/balding spot right at the top of my head and sort of down the back (similar to mens i guess?) but i also have diffuse thinning ._.

First dermatologist: telogen effluvium, also noted acne that I didn't notice but whatever Treatment: minoxidil 5%, viviscal Results: I started with the foam which I had trouble applying, used only once a day, half a cap than a little less over the next four months then I switched to the liquid, was easier to apply, used 1ml once a day at first then decreased to .75 ml because I seem to get sides with minoxidil. Discontinued the viviscal after the first box for financial reasons though it did seem to help with thickening. Not sure though.

Second Dermatologist (6mo or so later): also telogen effluvium, also acne vulgaris (which was noticeable to me by that point, I also had some increased facial hair) Treatment: minoxidil 5%, sodium sulfacetamide for my acne and added spironolactone after follow up 3 months later. Also now taking nutrafol (has been a little over a month)

Results: This is the weird part for me, the addition of spironolactone seemed to make my hair loss progress faster? I was only taking 25mg/day and while it helped my acne quite a bit, my hair actually got thinner and some of the excess facial hair (and some body hair) got longer and darker, I recently was upped to 50mg/day as my derm said it shouldn't make the shedding worse :/ The only reason I was even trying the medicine is because I wanted to quit using minoxidil because of sides (excess hair/ dark circles/ some drowsiness) but spironolactone also gives me sides it seems :( I think I made a mistake in using a full 1ml dose for about 3 months when I hadn't been previously (could that have caused increased shedding too?) the lengthier part of my hair has decent thickness I guess, but not so much on top lol. I'm not sure if the combination of nutrafol and spironolactone is good either.

Sorry I wrote a book here, but my real question is this: Has anyone had these adverse side effects to spironolactone at a low dosage like this? Do you think my hair loss is even androgen related? I wish I could determine whats actually causing my thinning :/ I kind of don't think it's Telogen Effluvium? I never lost huge clumps of hair just bouts of increased shedding with subsequent thinning that would get better in some areas but not all.

Tests done: TSH, LH, FSH, Total T, Free T, %T freely/weekly bound, DHEA-S, Vit D, Iron, Zinc and a bunch of other nutrients all within normal levels (the only nutrient deficiencies ive ever had were vit D and iron)
Family history: No hair loss on dad's side, Men on my mom's side lose hair, mother had some mild thinning with menopause, other than that nothing

Thanks for reading- CJ-B :)
 
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