Minoxidil's effectiveness varies due to genetic differences in the SULT1A1 enzyme, affecting how well it converts to its active form, minoxidil sulfate. Hyper-responders may experience rapid hair growth and increased side effects, such as pericardial effusion, even at low doses.
The user has been using topical finasteride and minoxidil for five months with little progress and is considering oral dutasteride to lower DHT levels, questioning if minoxidil is more effective with reduced DHT. They also use microneedling and tretinoin in their treatment routine.
Some people have low sulfotransferase enzyme levels, affecting their response to minoxidil. Lifestyle factors, genetics, and diet, like MSM intake, might influence these enzyme levels.
Microneedling and tretinoin may enhance minoxidil absorption for hair loss, but evidence on their effectiveness is limited. Iron supplements and broccoli sprouts are suggested for enzyme activation, but their impact on hair is unclear.
The user experienced worsening hair loss despite using finasteride and topical minoxidil, and is considering switching to dutasteride and oral minoxidil. They also tried microneedling and tretinoin with minoxidil, and are exploring Sulfogenz topical minoxidil.