My Visit With Dr. Vera Price, UCSF

[totaldispHAIR]

So, I thought I'd post a quick summary of my visit with Dr. Vera Price, one of the leading researchers in women's hair loss at UCSF.

First, it took about 2.5 months from the time I made my appointment to the time I could actually see her. At first I was really bummed, but it was a blessing in disguise. Because, by the time I finally had my appointment with her, I had done all the research in the world (I'm talking hours and hours on google), and I had run all the possible lab work necessary and sought out all other avenues. This really maximized my visit with her because we didn't need to go through remedial stuff, we could jump to the chase.

Get all your labs done first! There's a complete list of all the things you need to get done on this site. And if your doctors won't do it, keep insisting that they do. One of the things that's not on this site is thyroid antibodies testing--and indicator of Hashimoto's or Graves, you can have antibodies without having a positive TSH/T3,etc., panel, and any thyorid issue can cause hair loss.

We first reviewed the timeframe and type of shedding I was having, and then she asked me detailed questions about balding history in the family--both maternal and paternal all the way back to great grandparents. She asked the standard questions about potential triggers--pregnancy, surgery, etc.

Next, she looked at all my lab results and said everything was "normal". We talked about my former BCP that I had been on (LoEstrin) and she said that was one that she did not like at all because the Progesterone in it can be an androgenetic trigger. (I stopped BCP as soon as I found out my estrogen/progesterone levels were too low)

She did a pull test and then turned on a bright light, pulled out a card with measurements and started examining the short, alfalfa-like hairs that were sticking straight up. She said she could tell these were regrowth because the ends were tapered instead of blunt from being cut. She measured the width of growth and said that a lot of the hairs are growing back thick, with some of the hairs growing in thinner. This means that there is some miniaturization going on, but nothing too severe.

I told her I thought I had Telogen Effluvium but wasn't sure. My hairloss is all over, but heavier on the top--my part has widened and I see more scalp on the top and sides when I pull my hair back. She said that when she compare the nape of my neck to the top of my head, the hair loss is heavier on the top and she thinks that it's Androgenetic Alopecia. But, I didn't freak out because she examined my regrowth and said that I don't have excessive miniaturization going on.

In summary, she said that she thinks that the worse may be over as she asked me how my shed was now compared to when it first started, and I told her it's slowed down. She said that typically hair loss has a cycle, and it just runs its course. She told me that I would not be going bald from what she saw (and this is big considering how thin I've gotten!).

Next steps: I'm supposed to collect my shed once every two weeks on a non-shampoo day and go back in 8 weeks for another eval.

So, I felt pretty good after my visit...my husband (who went to the appointment with me) and I went to Benefits for a treat and I got my eyebrows done, and now, I'm just doing the best I can to take care of myself, be good to myself, and keep the negativity out of my life.

 

[totaldispHAIR]

Treatments -- Tricomin and minoxidil

I forgot to add, I asked her about Tricomin and she said, "oh, those people are so nice but their test results did not show any statistical significance for regrowth. They went ahead and marketed it anyway as a regrowth product because they needed to recoup their losses." Nutshell, she told me not to waste my money on it because she's seen the research and it isn't proven to work.

She said minoxidil is really good, with lots of statistical evidence to support it. I asked her about 2% vs 5% and she said go with 2% as 5% can be really irritating to the scalp, esp. for those of us with seb derm.

 

[jvantin1]

I think it really, really important to add that minoxidil is not the answer for everyone--that it can cause EXTREME shedding that sometimes does not grow back.

I must point out that this has not happened to me personally, because I heeded the anguished warnings of dozens of women who've tried it. In my view, the risk is not worth it.

Of course, there are lots of women who benefit from minoxidil. (I've read THEIR posts as well.) All I'm saying is, if you're going to use minoxidil, go in knowing that you might be lucky--or not. After my Depo experience, I'm a big believer in knowing what MIGHT happen, so you can make an informed choice.

End of sermon.

 

[mariejoe]

So, I thought I'd post a quick summary of my visit with Dr. Vera Price, one of the leading researchers in women's hair loss at UCSF.

Dear total,
I just know you feel better having someone telling you WHAT IS WRONG, wht is really happening. How lucky for you!!!! :rockon:
For those of us who are new, or those of us who don't want to look up all your posts, could you please do a brief history (or a cut and paste) of your hair loss?
Kinda put the whole story in one place? Thanks!

I've also been thinking about Dr. Price's comments on Tricomin. I have some thoughts on that, vis a vis my Folligen use. I'm gonna post that later, with a link to this thread. :roll:

Thanks for sharing your wonderful experience with us, .

 

[totaldispHAIR]

Hi MarieJoe,

Here's my history:

Hairloss started in Feb/Mar. timeframe...I was losing lots of hair in the shower, to the point where I had to clear the drain twice. I freaked out when I noticed one day that I could see my scalp when my hair was wet, and set off on a long-assed journey to figure out what was going on.

Landscape at that time in my life: on LoEstrin BCP, went off all allergy meds and started homeopathic supplements which included a lot of things like N-acetyl-cysteine and other powerful antioxidants to reduce the inflammation triggered by my allergies, was miserable and very stressed at work.

Went to primary care doctor who did TSH tests, went two dermas, one who told me it was Telogen Effluvium and the other who told me it looked like Androgenetic Alopecia with some Telogen Effluvium but had no answer as to why, sent lab results to gyno who immediately flagged that my estrogen/progesterone levels were almost non-existent, went to two endocrinologists (one of them was a total jackass male who told me I just needed antidepressants), and did hours and hours of research on google.

What I think are my triggers: the bcp for sure...it was suppressing my hormonal system so badly that I wasn't producing any and only getting the synthetic ones from the pill. Loestrin has one of the worst types of progesterone in it...can trigger androgenetic activity. And w/o a good balance of *good* progesterone to offset androgenetic hormones, it can trigger Androgenetic Alopecia. I also think that my biochemistry just went out of whack when I stopped all my allergy meds cold-turkey and introduced all the antioxidants into my system. I think my system was just so overloaded that it shut down the first things that it didn't need to support--like my hair. Finally, I think that severe stress also was an issue...your body pumps out cortisol whenever you go into fight-or-flight, which taxes your adrenal glands. Your adrenal glands can't keep up, and it affects your thyroid and other hormones in your system, and research has shown that under severe stress, rats will lose all their fur because the body shuts down what it doesn't need to support so it can save what little energy it has left for the vital organs.

So, that's where I've been, and I'm just looking ahead to the future. I'm off the pill and will never take synthetic hormones again <read "What your doctor may not tell you about premenopause" by Dr. John Lee>, my progesterone levels are coming back up and I just started supplementing with progsterone cream because I noticed that the shed seems to be slowing down <read same book by Dr. John Lee which goes into a lot of detail about why certain "natural progesterones" like those derived from yam extract aren't really natural or beneficial>; I'm managing my stress levels with regular exercise and meditation;

and overall, I've just really learned that most things aren't worth getting angry/upset/stressed out over. The "major" dramas I used to have about office politics, stupid things people did to anger me, my own negativity about my self-image, all the hurtful gossip that happens...they're all just activities that fill my body and soul with negative energy. There are enough people out there who are willing to do that for me if I let them...I don't need to also be doing it to myself. Because I'm the only one who can control what I let affect me, and I'm the only one who can remove the negativity and negative people from my life. And that is how I finally found peace with my hairloss. And the hope and faith that it will end someday. It was a long journey for me (8 months) and I never thought I'd be here in this position, but I've finally arrived.

Blessings to all of you who are going through this as well.

 

[mariejoe]

Next, she looked at all my lab results and said everything was "normal". We talked about my former BCP that I had been on (LoEstrin) and she said that was one that she did not like at all because the Progesterone in it can be an androgenetic trigger. (I stopped BCP as soon as I found out my estrogen/progesterone levels were too low)

I looked up your BCP, LoEstrin and the form of progesterone used is NORETHINDRONE , which I think is pretty commonly used. I know it is my former HRT, femHRT.
That confirms the HRT triggered my hairloss. Hug Vera Price for me and ask her if we can clone her!! :laugh:
Hopefully, my Prometrium will counteract my androgenic activity.

So, that's where I've been, and I'm just looking ahead to the future. I'm off the pill and will never take synthetic hormones again <read "What your doctor may not tell you about premenopause" by Dr. John Lee>, my progesterone levels are coming back up and I just started supplementing with progsterone cream because I noticed that the shed seems to be slowing down <read same book by Dr. John Lee which goes into a lot of detail about why certain "natural progesterones" like those derived from yam extract aren't really natural or beneficial>; I'm managing my stress levels with regular exercise and meditation;
and overall, I've just really learned that most things aren't worth getting angry/upset/stressed out over. The "major" dramas I used to have about office politics, stupid things people did to anger me, my own negativity about my self-image, all the hurtful gossip that happens...they're all just activities that fill my body and soul with negative energy. There are enough people out there who are willing to do that for me if I let them...I don't need to also be doing it to myself. Because I'm the only one who can control what I let affect me, and I'm the only one who can remove the negativity and negative people from my life. And that is how I finally found peace with my hairloss. And the hope and faith that it will end someday. It was a long journey for me (8 months) and I never thought I'd be here in this position, but I've finally arrived.

You are so right about ALL of this. The only thing I would add is to also read Dr. John Lee's book on menopause, if you are nearing that part of your life.

Thanks, totaldispHAIR, I am getting some mileage out of your visit to Dr. Price. :love:

 

[totaldispHAIR]

Anytime! Might as well share the wealth, especially for those who can't get to her.

 

[Cada]

I am so grateful to read all of the stories and advice. It has given me some comfort to know that I am not the only one suffering from Alopecia. I have been viewing everyone's discussions as a guest for the past few weeks but would like to join in to ask about Tricomin. I recently ordered the Tricomin Pak with the expectation that it may help stop the shedding and return some of the hair that I have lost in the past 10 months. It is disheartening to find out that the clinical trials with this product were not impressive. Has anyone had any success with this product?

 

[vanessa]

There were two people in the Women's Treatment Forum on Tricomin that had results. As for me, I have been using the Tricomin trio since end of June. I wasnt all that impressed with it. The shampoo tends to dry out my hair pretty badly. I noticed an increase in shedding the first month while I was on it. Then I added Rogaine to the mix in July. Truthfully, since starting the ROgaine I have stopped using the Follicle treatment regularly. I do think the Rogaine has helped me a heck of a lot more than the Tricomin (if you can endure the traumatic shedding) I think I am not going to re-order once I run out of it. This is just my personal experiece., though and I am sure there are others out there who might have been sucessful with it......I must say that I feel a lot more comfortable stopping it if Dr. Price said it isnt a valid treatment. :lol:

 

[Cada]

Thanks,

I will also try Rogaine the 2% formula instead of the 5% because I have a very sensitive scalp. What sort of results have you experienced with Rogaine? I just want to regrow enough hair so I do not have to wear wigs any longer.

CADA

 

[vanessa]

I cant tell you much about regrowth as I have only been on it for about seven weeks. In the past week the shedding has decreased. I am still shedding a lot more than I used to before I statred thinning, but it has decreased enough that I am not so obsessed and anxious about it all the time (even my fiancee has noticed this). From reading other posts and doing research growth seems variable. So my goal right now is simply maintenance. Once I hit the four month mark I'll see about growth.

 

[ll]

hi totaldisphair... i live in the bay area too... i was considering going to see her (dr. price)... but my medical does not cover her. can i ask you what she suggested as your remedy for hair loss? i have been experiencing hairloss for the last 5 months due to some emotional and physical stress earlier this year and have been diagnosed with Telogen Effluvium by a doctor and derm. both said this will ride out. but i am still overly concerned. situation does not seem to be getting better. blood results are normal. i am asking since i was wondering if seeing her as well would be worth the money. thanks.

 

[totaldispHAIR]

Hi Il,

I can tell you out-of-pocket costs are $495 for a visit. She didn't really tell me anything earth-shattering that made me think "things would be worse if I didn't visit her." She did give me a diagnosis (Androgenetic Alopecia) where most of my other doctors said possibly Telogen Effluvium, possibly Androgenetic Alopecia, possibly both. She did reassure me that she could see re-growth and that there was some miniaturization going on but there was also a lot of thick hairs growing back so my Androgenetic Alopecia isn't too severe. She flagged my BCP (LoEstrin) due to the progesterone in it; I had figured out the BCP was messing up my estrogen/progesterone ratios but didn't learned from her that the type of progesterone causes Androgenetic Alopecia in people who may have a pre-disposition to it.

So, if you're pretty certain you've got Telogen Effluvium, I'm not sure if she's going to offer anything else that you don't already know. My derm told me she has patients with Telogen Effluvium who use minoxidil for a few months to get the hair to start growing and then they've been able to discontinue it.

I've increased my omega-3 intake *a lot* based on guidance from a nutritionist and shedding seems to be slowing down a bit but I don't know if it's from that, or from stopping the pill or whatnot. I'm just waiting for re-growth and hoping the shedding stops completely.

Good luck to you.