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.
Minoxidil's effectiveness is limited by the need for sulfation and proper transport to hair follicles, with tretinoin potentially enhancing its effects by promoting enzyme activity and keratinocyte differentiation. Tretinoin may improve minoxidil's response by boosting the expression of necessary enzymes and transporters.
The user started taking 2.5mg minoxidil tablets daily and reduced their finasteride dose to 0.5mg due to side effects. They are considering a hair transplant but are unsure if they should proceed now or wait after seeing the effects of the reduced finasteride dosage.