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NancyDC's story (45 years old) Androgenetic Alopecia

Discussion in 'Tell Your Story' started by NancyDC, Aug 16, 2016.

  1. NancyDC

    NancyDC New Member

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    In late June, I went to see a dermatologist about hair loss. My hair is still acceptable; it's just reduced in volume and changed texture to be smoother and finer. My part is much more noticeable, and one very visible but tiny part of my scalp right at my front hair line kept driving me crazy. It took me a while to accept that it was really hair thinning, rather than just seeing my gray roots.

    I think this all happened in the last three or four years. Before that, I had pretty thick hair with fairly course strands and a wavy texture that was actually kind of troublesome to keep from frizzing.

    Initially, the PA at the dermatologist's office had blood work done. She didn't measure hormones, but looked at other levels. My vitamin D was really low, but she recommended I see my regular doctor about it and my TSH being a tiny bit high, he didn't see cause for concern. Since my actually thyroid levels were in the middle of normal, he felt that if we ever retested right then, my TSH would be normal. I'm taking over the counter D3 and will have that retested in October.

    The PA at the dermatologist recommended I start minoxidil and told me about spironolactone. Since I was already taking two blood pressure medicines, I talked to my doctor to see about dropping one to take spironolactone instead. My initial dose of spironolactone was only 25 mg, so I don't think I will get any hair loss benefits until I've been on a much higher dose for a while.

    I have been taking 37.5 mg of metoprolol twice a day and I had been taking a calcium channel blocker as well, but the CC blocker has been discontinued to add the spironolactone. I expressed concerns about metoprolol causing hair loss to both the derm PA and my doctor, and both seemed to think it was unlikely to be contributing the hair loss.

    I started minoxidil. I don't know the strength because this is a special compounded product with some other active ingredients, one to help with absorption and one to help with scalp irritation. The PA indicated that the concentration of the minoxidil was high enough that one night time application would be all I needed.

    I would say that my hair loss increased with the use of the minoxidil product and the 25 mg of spironolactone, and that my part looks worse than when I started. I think that the rate at which I was losing hair after starting the drugs has slowed. Since I'm increasing the dose of spironolactone gradually, if it does cause some shedding of its own, I would see some increased loss for a few weeks, I supposes. My plan is to continue both until Christmas and then evaluate my progress.

    On the follow up about a month after my first visit, the PA did a scalp biopsy and it came back "consistent with androgenetic alopecia." I don't have a copy of it to give the specifics of what the follicles were like exactly, but there was description.

    I was super disappointed because I hoped that I would have a cause that could be identified and eliminated, but instead, I got a diagnosis that meant that best case, I'd take two drugs to maintain my hair for the rest of my life and that would be an excellent result if they worked.

    I'm not asking for false hope, but I have some questions that maybe you all could help me with:

    1. Does anyone have experience with taking metoprolol for several years and having it change her hair?

    2. My hair texture has changed to become smoother and finer in addition to thinner over the last three or four years (about the same about of time I've been taking the metoprolol FWIW). It would seem absolutely amazing to me that I could have completely gone that far into the miniaturization process that all of my follicles have changed in such a short period of time, considering the way that hair growth cycles are theoretically supposed to work. Does anyone know if blood pressure medicines can change hair texture or thickness? Can your hair size and texture change in response to gradually decreasing hormones in your 40s without it being related to Androgenetic Alopecia?

    3. As far as I know, no women in either side of my family experienced hair loss until they were considerably older than I am now, like up in her 70s. My dad was pretty bald, though, but his started in his late 20s. Is the genetic component of this just kind of wildly unpredictable?

    4. I like some of the effects of taking a beta blocker. I'm a little high strung and I think that the effect of slowing the heart rate moderates my reaction to stress. If my PA and Dr. are correct, and it's not likely that metoprolol is contributing to hair loss, I'd like to keep taking it. But if it's accelerating the hair loss, I want to quit. Any advice on how I can tell the difference?

    5. How can you tell what dose of spironolactone you need? I'd like to take the smallest effective dose to preserve my hair. I think it's going to be between 100-200. How much do you have to take to get the anti-androgen effects and protect your follicle? Is there a blood test that can done to tell?

    Thank you for reading this. I know it was long, but this is the only place that I can expect people to have any idea what I'm asking and to be interested and concerned about hair loss.
     
  2. Lily

    Lily Senior Member

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    I wish I could help. My hair loss started in perimenopause and nothing really helped it. I did take Spironolactone but it was a much higher dosage than you are taking.
     
  3. NancyDC

    NancyDC New Member

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    Lily, thank you for your reply. Having read some of your posts, I admire the way that you've accepted your hair situation and have figured out ways to make the best of it.

    I'm still trying to figure out if I have some control over what's happening to my hair, but I can totally see that we're all pretty much at the mercy our biology and how we respond to the treatments.

    It's probably most helpful to see your example that life goes on and how much hair you have doesn't really determine the quality of the life you lead.
     
  4. Lily

    Lily Senior Member

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    Thsnks! I have a special needs grandchild whose rocky beginning taught me that sometimes the unthinkable becomes simply the next logical step. That's how I feel about "wearing hair."
     
  5. Barbarina

    Barbarina Established Member

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    +1. Yes, as it seems, hair structure is changing when we get older. I noticed hariloss when I was 43 (46 now). Losing my naturally strong thick hairstrands and what regrowth is way too thin. Taking medications for slight Hypothyrotism, Dudasteride, BCpill and androcur (popular and espetially designed for women with Androgenetic Alopecia) Constant stress is probably is aging my hair strands more than everything.
     
  6. mcat111

    mcat111 Member

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    Hair can change in texture plus you may have had gradual DHT going on for long time and not known. And now your more aware of changes.
    DHT attacks the folicles and slowly over time hair grows more narrow.

    You can get it from either parent.

    You may have had a trigger that started it early. Like low ferritin can make it 'easier' for DHT to advance then if it's at a good level.
    I would suggest work with primary to make sure your ferritin is around 70. This will make your treatments more likely to work.

    I have not done minoxidil BUT if your shedding in first few months this is not bad this means it's working. If you shed longer than few months then you should discuss with Dr.

    Spironolactone to work for hair is 200mg day (100 2x)
    I was on it a short time but it really made my period unregulated if I go back on I have to do birth control pills something not really wanting to do at this time. I think both Spironolactone and minoxidil can take six months to work. Does not work in everyone. I don't think except maybe very few people it can make worse and I would guess this is more likely in people with TE than Androgenetic Alopecia I'm just guessing.

    I have no knowledge of the meds you were on. So I can not answer but I think a lot of medications can effect hair.

    Try to maintain your hair with medication there are a lot of treatments coming out over next few years. It sucks we have hair loss but it's never a better time to have it as far as science goes.

    Also try to keep Vitamin D and Iron at optimal levels for hair growth. I think D is 50 range and ferritin is 70 range. Don't do alone but work with Dr and try and find some journal studies showing the effectiveness to bring with you if they shrug it off.
    Don't do on your own with iron it can be deadly if you take too much blood has to be checked every six weeks.
     
  7. NancyDC

    NancyDC New Member

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    I wanted to post an update although I feel like I may be jinxing myself:

    I mentioned on a different thread here that in April of 2017, I started taking Dutasteride and switched from Metoprolol to Bystolic as a beta blocker for my high blood pressure. I also started using a prescription compounded topical minoxidil product that also has tretinoin for absorption vs a different compounded formula without the tretinion. I've been supplementing vitamin D and it's now in the normal range.

    I had been taking about 200 mg of Spironolactone a day, supplementing vitamin d and using minoxidil for more than seven months with no or tiny changes to my hair before switching beta blockers and starting Dutasteride.

    I have no idea which of these changes were most important, but I'm having great results. My hair seems thicker to me and my hair stylist seems to think there some new growth. If I can keep my hair as it is now, I'd be thrilled. It's doing well to the point that I actually would love to see if another biopsy would detect androgenetic alopecia.

    I'm hesitant to change anything because everything all seems to be working well, but I may try to go to having the dutasteride added the minoxidil compound and reduce or quit taking dustaseride orally. If I do, I will update again.

    My gut instinct is that my problem was triggered by the metoprolol. Part of me wonders if I could stop my other hair treatments and maintain my hair, but I'm unwilling to try it at this time, especially as I get further into perimenopause.
     
  8. NancyDC

    NancyDC New Member

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    I forgot to mention this:

    Last summer, I also got in to see an endocrinologist to follow up about the slight variation with the TSH. She also looked at levels for PCOS, but everything came back normal.
     
  9. NancyDC

    NancyDC New Member

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    In case it wasn't clear and you wanted to know exactly what I'm taking for hair, I discontinued Spironolactone a little while after I started Dutasteride.

    I take .5 Dutasteride daily
    I supplement vitamin D (I alternated taking five and ten thousand UI a day until it was normal and will now take about 2,000 a day, I think)
    and I use the minoxidil, retin-a compound
     
  10. valentinab00

    valentinab00 Established Member

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    That’s great news. Please keep us posted.
     
  11. Paperclips

    Paperclips Member

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    Nancy, thanks for posting all this info and for following up! It's very helpful. Did you by any chance take before/after photos?

    Wondering how old you are? (Sorry if you said, and I missed it.) I'm 41 and have experienced something similar - thick coarse almost-curly hair that has become fine and smooth over the last year or so, in addition to reduced volume and thinning at hairline/crown. I have attributed this to the androgenic birth control pill I was on (Lessina) but who knows!
     
  12. Paperclips

    Paperclips Member

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    Doh - just realized it says your age in the title!
     
  13. Emma

    Emma New Member

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    Hi my name is Emma and I've just joined .

    I've struggled with hair thinning on and off for 12 years (am 43 now). It seemed to start after me second child was born. In the last 2-3 years however it has become awful. I also have seborrahiec dermatitis of me scalp which started about the same time. I've tried topical treatments, alternative therapies such as homeopathy and acupuncture. I've just commenced spironolactone 25mg daily in desperation. I have chronic stress in my life. The whole thing is affecting me very badly. Any help or advice is very welcome. Thanks
     
  14. Mia45

    Mia45 New Member

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    NancyDC....have you tried having the duasteride added to your minoxidil? I want my derm to prescribe a topical, but he’s reluctant to. He wants me to try oral minoxidil with oral Spironolactone. I don’t see many using oral minoxidil with success. Plus I’m so worried about side effects. Have you had many sides from taking oral duasteride?

    I have been using 5% Rogaine foam for 2 years on and off....but recently stopped thinking it wasn’t working. Now I’m in a huge shed and thinking it had to be working at least a little. I haven’t tried anything else besides that. Just vitamins and the usual hair helping supplements. It’s getting to the point where I have to try something stronger. I’ve even been browsing info on toppers and wigs and hair systems....just in case I want to throw in the towel and just start wearing hair. I never thought I’d be looking into that....but I’m just tired of dealing with hair loss and trying to make my hair look decent every day.
     

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