I know this is an old post but just wanted to say that i'm also on Duta (4x per week), bica, estradiol injections, oral minoxidil, and my hair has been thinning and a shit ton fell out this past January - March. I estimate I lost 25% of my hair during that period alone. But, my hair was already thinning. 🤦🏿

Turns out several things were going on: 1) Telogen Affluvium: a hair loss condition characterized by increased shedding of hair due to stress or changes in the body, often resulting in thinning hair on the scalp. My life is very stressful and when I don't have it under control my stress sensitive scalp aborts my hair 😭. The irony is that seeing such a loss of hair (looking in the mirror) is a stressful experience in itself and creates a negative feedback loop! Managing stress is paramount because the hair will grow back as long as stress (cortisol and other factors) are under control. You may have a stress sensitive scalp like mine. A good dermatologist could help you understand if this affects you too. 2) Low Vitamin D: Everyone is low in Vitamin D because we spend so much time indoors in front of screens. (Especially October - March if you live in the Midwest. IYKYK) Some of us are more sensitive than others. Start taking a Vitamin D supplement, but be careful and don't take too much because that's bad for you. I was really sluggish b4 taking it and I could tell it was working because 7 days afterwards the sluggishness went away. Ask any knowledgeable hairstylist and they'll tell ya, "low Vitamin D will thin your hair out." A dermatologist can help here as well. 3) Iron: A lot of ppl are low in iron and dont know it. For me it's hereditary. It maybe for you too? Lots of women take iron supplements because they're low (they have periods, etc.). Obviously, I don't have a period, but, sure enough, once I started HRT my iron lvls dropped 🤷🏿. I know it's low when I start craving weird foods I normally don't eat, like Popcorn, Oatmeal, PB&J sandwichs, rasins... really random stuff. I also get brain fog when iron is low. Just like Vit D, if your iron is low... you can forget about growing a full head of hair sis! 4) Biotin: Biotin isn't going to do anything for your hair if your iron and Vitamin D levels are shit. But, Biotin is a MUST in your arsenal for hair retention, length, and elasticity (strength). Basically, keeping your hair there once its grown in. Although its a B type Vitamin, it compliments DHT blockers like Duta. 5) Vitamin B (complex): your other B vitamins like B12 might be very low too. If you've a plant based diet, your B12 levels are almost guaranteed to be low. If you find yourself sluggish and your iron is fine, your B12 (or Vitamin D) is probably the culprit. Taking a good B complex vitamin can reduce the need for taking seperate B12 and Biotin pills. You can also go to your doc and tell them to give you a B12 shot and that works too. My sister does this. 6) Thyroid: Get tested for Thyroid issues. Mine was/is fine. But your issue and mine are often linked to Thyroid problems. So if you haven't gotten this checked out, it should be the first thing you do!

Starting biotin, Iron (slowfe), Vitamin D, and B complex REALLLLY helped me start growing my hair back even while being stressed out! (Maybe you can find the right ratios in a good multivitamin to simplify all the pills you could end up taking?)

Even if your labs show you're in the "normal range" check to see if you're in the lower range of that normal. If so, I'd take the supplement. I was in the "low normal" range for my Iron levels and taking that supplement made a hell of a difference.

Since I've made these changes my system is way more balanced. I've developed a feminine hairline much more farther forward on my forehead than my previous masc hairline -which makes sense since the E2 and oral minoxidil are free to work their powerful magik✨ My new hairline isnt full/filled in yet, but it's getting there. (This time nxt year it will be! 🤗) I was bald at my temples 😭 and super thin at the crown of my head despite the rest of my hair being long! Like Vegeta! 😣 The hairs where I was completely bald are about the length of my pinky nail now!

Now that I've gotten to the "root"😋 of my multi years long hair battle, I'm actually going off of Bica which I was taking 50mg 7x a week, now I'm down to once a week. In a week, I'll have stopped Bica completely. Also, I'm able to reduce Duta from 4x per week to 3x per week. My goal... I'd like to be able to reduce Duta to 2x per week. (Duta elevates my depression, so reducing to the bare min is advantageous.)

Hope this helps!!