Hair Transplant & Low Testosterone (Dr JIM)

[Jonny Craig]

Hi!

Age 28, white male. NW3 on norwood balding scale, and I am scheduled for a FUT hair transplant procedure to restore hairline in September 2016 (I only have balding in front).

This has sped up like crazy starting in Dec-2015/Jan-2016, coincidentally I've been feeling like that crap since then as well, and it appears I know the cause, my T levels are super low. (Keep in mind I was using a topical anti-androgen on my scalp from OCT-2015 TO JAN-2016 to try and combat hair loss, basically it made it much worse)

Please view my results below. I used to be on clomid from 2010-2012 and felt great and had very thick hair. I am considering getting back on it at a low dose to boost my T.

I would really like to know if it would be advisable to do this? I've previously been trying to LOWER my testosterone (using inositol 10g+ day,etc) because the simpletons say, HIGH T = HIGH DHT = increased baldness. But.. all the research indicates men with pattern baldness all have LOW T, LOW FSH, LOW SHBG, etc. A switch went off in my head. I am just scared to do anymore damage to my hair, especially since I am getting a transplant so soon.

Should I just get on clomid at say 12.5/mg EOD/ED and see how it goes? I am seeing a urologist on Aug 20th for the low T. I don't want to go on TRT or anything, clomid seems like the most attractive option, and I have a bunch of pills in my fridge so I could begin immediately.

As far as sides from Low T... reduced libido, reduced zest for life, although I am depressed directly due to the hair loss so that's probably related.

Also can someone please answer if High T = High DHT = increased hair loss? I saw a study on elderly men that were injected with test and their DHT REDUCED. Does T have an antagonist affect on DHT? This information is very hard to find a clear answer on.

Dr JIM I know you've had a transplant and have a lot of info on this subject.

FYI, I would never touch finasteride or dutasteride. Won't even use rogaine.

Blood results below:

SPECIAL TESTOSTERONE: 12.8 nmol/L
men ref range age 18-50 = 10-30
age 50+ = 9-25

FREE TESTOSTERONE: 220.0 B pmol/L
ref range = 223-915

BIOAVAILABLE TESTOSTERONE: 4.5 B nmol/L
men ref range age 18-39 = 4.6-18.8
age 40-49 = 4.0-15.6
age 50-59 = 3.9-15.6
age 60+ = 3.7-13.8

SHBG = 46.0 nmol/L
men ref range 18-50 = 12.0-46.0
men other = 12.0-52.0
women ref range = 22.0-104.0

TSH is 4.6

BTW there's a supposed very popular endo who wrote a book and states in it that Low T is a cause of MPB and not high T. (can't remember the guy's name though)

 

[Jonny Craig]

Welp. I just took 25mg.

Anyone know when Androxal will be available???

 

[Jonny Craig]

Here we go!

LowTestosterone.com - Testosterone and Hair Loss

thoughts???

 

[Andrew Androgen]

Which doc is doing your HT? I'm considering have a HT with Dr Konior.

 

[Jonny Craig]

Which doc is doing your HT? I'm considering have a HT with Dr Konior.

Fantastic choice, you've obviously done your research.

Rahal.

 

[Dr JIM]

So in one sentence or less what is your question?

 

[Dr JIM]

But.. all the research indicates men with pattern baldness all have LOW T, LOW FSH, LOW SHBG, etc.

Apparently I missed ALL OF THAT LITERATURE, lol!

Cite ONE evidence base article supporting this comment bc the antithesis is more likely to be TRUE! Why else do you think those who are using AAS lose their hair at a faster pace!

 

[Jonny Craig]

Apparently I missed ALL OF THAT LITERATURE, lol!

Cite ONE evidence base article supporting this comment bc the antithesis is more likely to be TRUE! Why else do you think those who are using AAS lose their hair at a faster pace!

I think the relation between balding and AAS can largely be attributed to supraphysiological levels of testosterone that are usually reached, but I could be wrong. My levels as you can see are very low, worried about this being a negative factor for hair..

Hormonal profile of men with premature balding. - PubMed - NCBI

RESULTS:
The frequency of subnormal values in SHBG, FSH, testosterone and epitestosterone (but not in free androgen index) was significant in the balding men. A borderline significant trend was recorded with respect to increased levels in 17OH-P and prolactin.

CONCLUSIONS:
The hormonal pattern of a substantial number of men with premature balding resembles in some respects the hormonal pattern of women with polycystic ovary syndrome.

But then there's this that states increased T, but everything else kind of the same. Low SHBG, etc.

A Comparison of the Hormonal Profile of Early Androgenetic Alopecia in Men With the Phenotypic Equivalent of Polycystic Ovarian Syndrome in Women. - PubMed - NCBI

This is on women but it's kind of interesting..

Improvement in scalp hair growth in androgen-deficient women treated with testosterone: a questionnaire study

Conclusions
Subcutaneous testosterone therapy was found to have a beneficial effect on scalp hair growth in female patients treated for symptoms of androgen deficiency. We propose this is due to an anabolic effect of testosterone on hair growth. The fact that no subject complained of hair loss as a result of treatment casts doubt on the presumed role of testosterone in driving female scalp hair loss. These results need to be confirmed by formal measurements of hair growth.

Here's another interesting study..

Decline of plasma 5alpha-dihydrotestosterone (DHT) levels upon testosterone administration to elderly men with subnormal plasma testosterone and high DHT levels.

Gooren LJ, Saad F, Haide A, Yassin A.
Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Abstract

The study was performed to measure the impact of testosterone (T) administration on circulating levels of 5alpha-dihydrotestosterone (DHT). Group 1 (32 men; mean age 61 years; mean T 6.9 +/- 1.9 nmol l(-1)) were treated for 15 months with long-acting T undecanoate. Group 2 (23 men, mean age 60 years, mean T 7.6 +/- 2.0 nmol l(-1)) were treated for 9 months with T gel. Plasma T and DHT were measured before and after 9 months T administration. In the men treated with T undecanoate plasma T and DHT were also measured after 12 and 15 months. Before T administration, plasma DHT ranged from 0.39 to 1.76 nmol l(-1) (0.30-1.90 nmol l(-1)). Mean DHT declined upon T administration from 0.95 +/- 0.50 to 0.55 +/- 0.30 nmol l(-1) (P < 0.05). With an arbitrary cut-off at 0.60 nmol l(-1), all 21 values of DHT > 0.60 nmol l(-1) had fallen from 1.29 +/- 0.50 to 0.70 +/- 0.60 nmol l(-1) (P < 0.01). Below this cut-off point 13 values rose and 21 fell upon T administration. Below this cut-off point values on average declined from 0.39 +/- 0.12 to 0.30 +/- 0.14 nmol l(-1) (P < 0.05). The study revealed that in a cohort of elderly men with subnormal plasma T levels plasma DHT levels declined upon T administration when they were in the higher range of normal (>0.6 nmol l(-1)), with a profound shift of DHT/T ratios presumed to be an indicator of a reduced 5alpha-reductase activity. Below plasma DHT levels of 0.6 nmol

There are some studies which indicate increased testosterone levels in men with AGA as well, too. Which is why this is all so confusing.

Dr. JIM, would you know the ideal levels of ferritin for men (for optimal hair growth)? Mine is 63. I've read 80+ is good, also read 100+ is good and 110-120 level ideal for hair growth. Hard to get a straight answer on this one. Is it possible the answer is 100+? I am trying to boost it via iron supplementation with ferrochel chelated iron. Aside from receding hairline the hair on the sides of my head is thin and patchy, looking much like hairloss in women from low iron/thyroid issues. As I said my TSH is 4.6 so likely hypothyroid. I am also taking an OTC desiccated bovine thyroid supplement for now until I can see a doctor and get something else.

Also, I am strongly considering obtaining Topical liposomal finasteride formula. Thoughts? I am deathly afraid of finasteride, but it may be worth a shot, I can request dosage of like 0.005% - take a look: Topical Finasteride Solution - What Is It? - Hasson & Wong

We have produced a liposomal gel containing silicone particles which “anchor” the liposomes at the skin level. This prevents most of the drug from moving further into the tissue.

Our current preparation ,which we have been supplying to a group of test patients in Italy is soon to be available worldwide. The effectiveness appears to be equal to oral Finasteride but serum levels are 1/18th that of the oral route. We have had no reports of any sexual side effects in any of the test group (+/- 100 patients). Many of these patients have been on the oral form and had to quit on account of side effects.

Thanks for your time, Dr JIM. Also may I ask, who has done your HT work?

 

[Andrew Androgen]

Fantastic choice, you've obviously done your research.

Rahal.

Do you think Rahal has the edge over Konior for hairlines, or would you rank them the same?
I only want to lower my hairline by about 1 inch or so.

 

[Jonny Craig]

Do you think Rahal has the edge over Konior for hairlines, or would you rank them the same?
I only want to lower my hairline by about 1 inch or so.

Artistically.. I would rank Rahal higher, yes. Hairline work is also his bread and butter.

That said, I would rank Konior above Rahal at the moment, overall.

Konior is a unique breed of HT surgeon who does almost all the work himself. Has almost zero negative reviews too, like literally none, it's crazy. His work always looks so super super clean, which makes sense since he is doing almost all of the implanting, most of the time.

Konior is more expensive, and his waiting list is like ~1year.

All that said, both are excellent surgeons and if you to lower your hairline, both would be amazing options.

What NW are you currently?

 

[Schredder]

So in one sentence or less what is your question?

So in one sentence or less what is your question?

Dude its ok to admit you dont know the answer or arent able to lead him in the right direction. When patients come to you in real life is that the first thing you say to them? 'Hi, in one sentence or less what is your question'. Of course not because no one comes to you in real life. Quit beating around the bush with BS.

OP I cant help you unfortunately but I just wanted to point out that who your asking for help from is not who you want help from. He cant offer you help as made obvious by the one and only himself.

Talk with your doctor and i wish you all the best. Some matters are not able to be solved over forums as some people just dont have the knowledge to help. Thats ok though.

Good luck.

 

[Jonny Craig]

Dude its ok to admit you dont know the answer or arent able to lead him in the right direction. When patients come to you in real life is that the first thing you say to them? 'Hi, in one sentence or less what is your question'. Of course not because no one comes to you in real life. Quit beating around the bush with BS.

OP I cant help you unfortunately but I just wanted to point out that who your asking for help from is not who you want help from. He cant offer you help as made obvious by the one and only himself.

Talk with your doctor and i wish you all the best. Some matters are not able to be solved over forums as some people just dont have the knowledge to help. Thats ok though.

Good luck.

I am seeing a urologist soon, doubt he will be of much help though. I am hoping to eventually see a hopefully very knowledgeable endo soon.

Thanks for your post Schredder.

Hey, would you happen to know the optimal ideal ferritin range for men? Some sites state 70-80 (then some state 70-80 for women) and men should be over 100, then some say 110-120 for men is optimal (especially for hair growth). Not sure why this information is so sacred/hard to find. I know most doctors will say if you're within the ref range (which is like 20-335 or something) more or less you're OK, but I'm talking optimal levels here.

Thank you sir!

 

[Dr JIM]

Hey @Schredder NOT, FUCK OFF, if you "can't help" but what else is new.

Bc if the OP can't pose a question without first writing a novel that's HIS PROBLEM, not mine.

Oh look @shredded NOT, there's a more simplified ferritin question some bros with half a brain COULD answer, give it a try numb nuts, lol!

 

[Dr JIM]

Yea I know such Ferritin question seem unfair to those who don't know how to read right @Schredder NOT

 

[Jonny Craig]

I figured if I asked a question without giving the backstory then it would seem somewhat pointless and harder to answer.

Dr Jim, are you able to answer?

1. Who is your HT doc?
2. Ideal ferritin levels in men?

 

[Dr JIM]

Here we go!

LowTestosterone.com - Testosterone and Hair Loss

thoughts???

My thought, goodness GTF off these know nothing blogs now,
and begin to read EVIDENCE BASED RESEARCH, that is readily located on MEDLINE or thru Google Scholar!

Your friend @Schredder will find comfort knowing he's not the only one who believes the crap cited on such blogs is GTG

 

[Dr JIM]

Show me the scientific basis for a "low ferritin" being associated with MPB!

What's that? Why sure you can PM @Schredder for those studies, lol!

 

[Jonny Craig]

Show me the scientific basis for a "low ferritin" being associated with MPB!

What's that? Why sure you can PM @Schredder for those studies, lol!

Huh?

You don't know that low ferritin is associated with hair loss, especially in women, but also in men?

Are you an actual M.D or just use the username Dr. JIM?

 

[Dr JIM]

Huh?

You don't know that low ferritin is associated with hair loss, especially in women, but also in men?

Are you an actual M.D or just use the username Dr. JIM?

I've already asked you to cease quoting BLOGS bc that's where you're acquiring such info.

To that end just long ontoGoogle Scholar and search "low ferritin and male pattern baldness".

At best you may locate a questionable relationship to a specific FEMALE balding pattern referred to as Alopecia Aerata , but NO CAUSE and EFFECT relationship has been identified bt MPB and "low Ferritin" levels!

I'd suggest you ask your own physicians, unless they are responsible for feeding you this line of crap, which I DOUBT.

Otherwise believe what you like!

 

[Jonny Craig]

I've already asked you to cease quoting BLOGS bc that's where you're acquiring such info.

To that end just long ontoGoogle Scholar and search "low ferritin and male pattern baldness".

At best you may locate a questionable relationship to a specific FEMALE balding pattern referred to as Alopecia Aerata , but NO CAUSE and EFFECT relationship has been identified by MPB and "low Ferritin" levels!

1. PubMed is classified as a blog to you?
2. Did I say I only had MPB? I have patchy hair loss all over head, including sides, that commenced after using high dose vitamin B5 for a few weeks and has not ceased. This has happened to many others... but there is no study on google scholar so it must not be true I guess.
3. Are you an actual M.D?