Androgen Resistance Associated With a Qualitative Abnormality of the Androgen Receptor and Responsive to High Dose Androgen Therapy

The conversation is about a person experiencing treatment-resistant androgenic alopecia despite using high doses of dutasteride and minoxidil, along with other treatments like microneedling and purilutamide. Suggestions include considering a hair transplant, checking medication authenticity, and exploring other treatments like RU58841 or topical estradiol.

Androsterone may help with sexual and affective dysfunction from finasteride by replacing disrupted neurosteroids without increasing androgenic side effects. Controlled testing is needed to confirm its effectiveness and safety.

Topical androgen receptor antagonists may not be necessary if 5-AR inhibitors like finasteride or dutasteride effectively reduce DHT levels. Combining a 5-AR inhibitor with a topical androgen antagonist could potentially enhance treatment, but oral use of androgen antagonists is too risky due to severe side effects.

The conversation discusses hair loss treatments, focusing on the use of topical minoxidil, microneedling, finasteride, and dutasteride, while debating the role of testosterone and DHT in hair loss. It also touches on the potential liver health impacts of these treatments and the genetic sensitivity of hair follicles to androgens.

The user is concerned about high DHT levels despite using finasteride and dutasteride for hair loss, suggesting these treatments may not be effective. They plan to consult an endocrinologist and consider other antiandrogens, acknowledging potential side effects.

A 26-year-old male with high testosterone is experiencing diffuse hair thinning despite using a comprehensive treatment regimen including dutasteride, oral minoxidil, RU58841, ketoconazole shampoo, microneedling, and low-level laser therapy. Suggestions include adjusting dutasteride dosage, monitoring iron levels, and consulting a dermatologist for further evaluation.