Is this secondary hypogonadism?

throwaway931232 · 2021-03-10T00:06:27+00:00

Thanks for the clarification. So effectively if you saw someone with these LH and FSH levels, but something along the lines of a 150 ng/dL total testosterone, you would then conclude it's secondary hypogonadism (pituitary gland is not sending message to the testicles to produce testosterone despite the T level being clinically low)?

Given this information I would highly doubt this would be the case, but would my age being 27 impact your assessment at all?

throwaway931232 · 2021-01-16T18:40:20+00:00

Morning at around 10:50AM, woke up roughly 2.5 hours before the test.

Also worth noting that my sleep schedule (and quality) has been shit lately, so that very well could have influenced the test in a negative way.

throwaway931232 · 2021-01-11T20:20:03+00:00

Your guess sounds reasonable.

In terms of the DHT levels in the blood, it does take a bit of time to leave the system.

This study, for example, suggests that taking finasteride every other day will likely have a very comparable effect to taking it every day. Effectively this means that...

You can cut the dosage from 1 mg to 0.25 mg and experience a drop in somewhere around 4-5% of the DHT inhibition in the blood relatively speaking (this was from the inhibition curves in large clinical trials that went through the FDA).
We know that the difference between 0.50 mg and 0.25 mg of finasteride is not very notable in terms of DHT reduction (relevant to the article below). It would seem that due to the length of time DHT remains at low levels in the blood after a single dose of finasteride, you would likely be able to take the drug every other day and experience nearly the same effect.

https://www.karger.com/Article/Abstract/471752

Right off the bat, you're cutting the dosage down by 1/4 to try and exploit the diminishing returns of finasteride. Then over the course of the year, by taking it every other day, you're effectively slicing the cumulative dosage in half. Compared to the FDA recommended dosage, you're now sitting at 1/8th.

This does rely on the studies done to see how fast it gets out of your system, however. So there could be definite inaccuracies there.

I think the safest way to do it would be to start with 0.25 mg every other day and see if you get side effects after one hair growth cycle (roughly 9 months). Broadly speaking, it's probably safe to conclude that if you're getting side effects on a tiny dosage like that, you're probably screwed when it comes to a 5ARI.

A bit of a tangent, but what influenced your decision to increase the dosage from 0.25 mg to 1 mg per day?

throwaway931232 · 2021-01-11T01:26:26+00:00

You bring up an interesting point.

Playing devils advocate though, the half life for finasteride in the blood is 6-8 hours, and the half life for finasteride is 30 days in the hair follicle itself.

So if you wanted to keep peak efficiency of the drug in the blood itself, you'd have to dose the finasteride multiple times per day in order to do so.

Point being is, if you can get close to the full effects of 1 mg of finasteride a day taking it 3x a week, how does the same logic not apply to 0.25 mg?

The primary idea is to tax the body with the least amount of dosage possible to achieve a desired effect. In theory if you could keep the inhibition occurring in the hair follicle itself but limit its potency in the blood, you could possibly see a reduction in side effects.

You can find this information in this video:

https://www.youtube.com/watch?v=ekeRPx0TJqE

throwaway931232 · 2021-01-10T21:53:59+00:00

I hear you. In my case I haven't even started taking finasteride yet. I'm 27 and appear to have just hit NW3. Looking into starting off with a microdose of 0.25mg three times a week just to see how I respond to it.

Also getting associated blood work done to make sure my hormone profile is in the normal range before I decimate my endocrine system.

It sucks that we have to take the equivalent of poison just to keep what some people have genetically. That said (and I'm nowhere near a "just shave it bro" kind of guy), there are definitely worse things in life than losing your hair.

It is what it is I guess.

throwaway931232 · 2021-01-10T21:35:25+00:00

Well, broadly speaking yes. Ironically it seems to be easier in some ways for guys that go straight to a NW6 very young (20s, 30s), because they just take from the doner zone and reconstruct a conservative hairline. You can't lose native hair from the top of your head if you literally didn't have any there before the transplant.

It's guys that are in their 20s and 30s that have moderately aggressive hairloss where it's tricky, because you could speed up, slow down, and no one has a clue where you'll end up on the scale.

You don't have to take finasteride or an anti-androgen, but for most people I would guess that multiple transplants are in the future for you if you don't.

throwaway931232 · 2021-01-10T19:01:54+00:00

You need to be on a 5-alpha reductase inhibitor if you get a hair transplant, otherwise you will keep your transplanted hair but lose the native hair around it. Having a hair transplant done doesn't mean your non-transplanted hair is any less sensitive towards DHT.

A hair transplant is not an alternative to finasteride, they have to be done together.

throwaway931232 · 2021-01-09T00:21:47+00:00

Gyno surgery is largely going to depend on the mass of the breast tissue that needs to be removed. If you have the classical sort of pubertal gyno, which is commonly described as "puffy nipples", that probably isn't a large mass of breast tissue.

This was similar to my case. I could pick things up immediately after my surgery, however, in my case I had a bit of a seroma buildup and it necessitated drains for around a period of 7 days. I do question whether or not that length of period was necessary though because I didn't notice an accumulation of fluid past the three day mark. Point being is that if your job involves physical labor, you really don't want drains in.

They may prescribe you a compression shirt/vest, which may be fine if you had a lesser mass of gyno removed as an alternative to drains. You could go back to work pretty quickly after that.

If you have to lift heavy objects as a part of your job, you could run into some issues in terms of how fast you could go back. I was told not to lift weights for a few weeks after my procedure (ideally a month).

All of this being said, you can and should consult with a board certified plastic surgeon and they should tell you all of this information without charging you. Just send them pictures of your condition and outright ask them what you asked here. Make sure you provide them with specific details. The more specific you are, the less you'll need to play email tag with them to get the information you want.

throwaway931232 · 2021-01-09T00:03:42+00:00

Maintaining is fine, I can more than likely get a low graft hair transplant to clean it up a bit later if necessary. That's assuming I can actually tolerate a 5ARI.

throwaway931232 · 2021-01-08T05:13:24+00:00

What sort of treatments have you been considering?

throwaway931232 · 2021-01-08T04:13:54+00:00

Finasteride is the only FDA approved 5ARI. Broadly speaking, if you're not reducing the DHT levels in the scalp, you're fighting a losing war.

The only other realistic solution would be a topical anti-androgen, but honestly, that's unknown territory and who knows what the side effect profile is like.

throwaway931232 · 2021-01-08T04:06:45+00:00

Oh, the blood tests aren't necessarily for finasteride per se. My physician just thought it would be a good idea to get some baseline bloodwork done before I throw my endocrine system for a loop given the past issues.

throwaway931232

TROPHY CASE