TRT and Hair Loss Question

[ChristianRead]

Hi guys, I have a quick question regarding TRT and telogen effluvium. I’ve been on TRT for 3 years at a dosage of 180mg. Everything was great. This past summer, I made the mistake of using Testosterone recreationally at 500mg a week for only a month and then I stopped. Since then my hair has been thinning and falling out. There have been no other changes to my diet, medications etc. I am only on TRT.

I am 100% certain the cause is the increase in testosterone resulting in TE. I am sure hormonally it shocked my system and the hair began to fall out. I have zero history of Male Pattern Baldness. I am on TRT through a great doctor but I want to make sure I am looking for the correct things to dial in and stop the hair loss. I am currently taking 2 shots per week of Test cyp for 50mg each shot (total of 100mg). What things should I have him look for if I get my levels tested?

Thank you for your help! Chris

 

[MarkM]

Hi Chris, welcome to the forum!

If me, I would have my thyroid checked because a poorly performing thyroid can lead to hair loss in some men. I would run the following test:
TSH
Free T4
Free T3
Reverse T3
Both thyroid antibodies (TgAB and TPOab)

I would also have the ferritin and iron levels checked. There two are very important for our thyroid to function at its best. Low ferritin can create hair loss and I understand that it won't start growing back until your ferritin levels get back up over 80. Many men on TRT have low iron and ferritin levels especially if they are donating blood.

Since you are going to be having labs done I would have the basic TRT labs run:
Total Testosterone
Free Testosterone
Estradiol Sensitive, LC/MS/MS assay (Not the Roche ECLIA)
SHBG

When you spiked your testosterone with those huge doses you also spiked your DHT. That was an excess of about 2,000 mg of testosterone your body was not used to. If DHT played a role, and it probably did not, it would have a delayed effect when the hair started falling out. So that is a possibility and since you are having labs run I would test for DHT just to rule it out if nothing else.

Hope this helps a little bit.

 

[ChristianRead]

Hi Chris, welcome to the forum!

If me, I would have my thyroid checked because a poorly performing thyroid can lead to hair loss in some men. I would run the following test:
TSH
Free T4
Free T3
Reverse T3
Both thyroid antibodies (TgAB and TPOab)

I would also have the ferritin and iron levels checked. There two are very important for our thyroid to function at its best. Low ferritin can create hair loss and I understand that it won't start growing back until your ferritin levels get back up over 80. Many men on TRT have low iron and ferritin levels especially if they are donating blood.

Since you are going to be having labs done I would have the basic TRT labs run:
Total Testosterone
Free Testosterone
Estradiol Sensitive, LC/MS/MS assay (Not the Roche ECLIA)
SHBG

When you spiked your testosterone with those huge doses you also spiked your DHT. That was an excess of about 2,000 mg of testosterone your body was not used to. If DHT played a role, and it probably did not, it would have a delayed effect when the hair started falling out. So that is a possibility and since you are having labs run I would test for DHT just to rule it out if nothing else.

Hope this helps a little bit.

Hi Chris, welcome to the forum!

If me, I would have my thyroid checked because a poorly performing thyroid can lead to hair loss in some men. I would run the following test:
TSH
Free T4
Free T3
Reverse T3
Both thyroid antibodies (TgAB and TPOab)

I would also have the ferritin and iron levels checked. There two are very important for our thyroid to function at its best. Low ferritin can create hair loss and I understand that it won't start growing back until your ferritin levels get back up over 80. Many men on TRT have low iron and ferritin levels especially if they are donating blood.

Since you are going to be having labs done I would have the basic TRT labs run:
Total Testosterone
Free Testosterone
Estradiol Sensitive, LC/MS/MS assay (Not the Roche ECLIA)
SHBG

When you spiked your testosterone with those huge doses you also spiked your DHT. That was an excess of about 2,000 mg of testosterone your body was not used to. If DHT played a role, and it probably did not, it would have a delayed effect when the hair started falling out. So that is a possibility and since you are having labs run I would test for DHT just to rule it out if nothing else.

Hope this helps a little bit.

Mark,

Thanks for the quick reply. You may be correct about the DHT and that’s something I’ve wondered too. I was using 500mg for 1 month and the hair began to fall out shortly after. I then stopped taking Testosterone altogether. I have played around with things this past year and when I stop taking any Testosterone, my hair grows back. I love the benefits of TRT I have stayed on..and even yesterday, I had my shot of 50mg and I can see/feel the hairs thinning and falling out. It’s that fast of a response! If it is DHT related, what can I do? I have even considered going off TRT go this a few months to let everything grow back and return to normal.

Thanks again, Chris

 

[MarkM]

Whatever you do, don;t take oral finasteride. It can cause all sorts of issues. Google PFS, Post Finasteride Syndrome..............

I have read that topical finasteride does not have the same effects that the oral finarstide does because topically it can not bind to the receptors. But I am not the expert on finasteride, have just read a lot about it. Others on here might offer direction on topical finasteride.

However, before you even consider than, make sure that DHT is the culprit. I was reading that very high levels of DHEA-s can cause hair loss but can't speak to that.

 

[fifty]

25mg/day of dhea gave me more hair fallout than 160mg test and 1000hcg a week.

Most hair loss guys say anything over 250mg/wk of test and you’re just asking for hairloss if you’re prone to it.

I would include dhea and dht in your bloodwork if possible.

Edit: there is a guy with an old site called something like hairloss from steroids. Guy is a major bro but his info is actually better than most anything I’ve seen and I’ve been in the hairloss battle game for about 20 years.

 

[bruin]

I have some genetic predisposition to hair loss, nothing crazy or unexpected, but recently my hair has been falling out in droves. I am almost dreading using a comb or brush due to the amount of hair that I seem to be losing.

Im on 150mg of Test a week, never had an issue of estrogen and never been on a blocker. My T counts are on the high end of the spectrum and my Dr opinion is that that is what works for me. All other test results are in normal range.

Any comments?

 

[fifty]

You on T only?

I would consider a topical minox and azelaic acid like lipogaine or dualgen. Keep in mind that minoxidil is a long term solution and azelaic acid is only a mild anti androgen. Old xandrox (from dr lee...not the current xandrox fake imitation) was the gold standard but of course the fda shut him down...cause it worked. You can check it for ingredient ideas. Old site was minoxidil.com. Just white background and old school text. You can probably find it on wayback machine.

Easier option is a 2% or 1% ketoconazole shampoo like regenepure dr or big3 shampoo. There are also some good results with ketoconazole 2% lotion from japan but i have never tried that personally.

There is also topical finasteride but it also has systemic absorbtion as i was on a low dose .05% solution once per day and my dht tested low at like 24 which isn’t desirable.