14 months on Fin, Total T 899, serum DHT 276 — high total T may still drive scalp DHT even when blood levels look controlled
23M. 14 months finasteride 1mg + topical minoxidil. Slight improvement then plateau.
Past 3 months progressive shedding mostly lengthy hairs, diffused pretty hard at crown and throughout the front part.
Switched to Minokem N (5% minoxidil + 1.5% azelaic acid + 0.01% tretinoin) one month ago thinking that I’m not responding to minoxidil. Saw no change in shedding
March 2026 bloodwork:
• Total T: 899 ng/dL (ref 240–870)
• DHT: 276 pg/dL (ref 143–842) — on finasteride
• Vitamin D: 19.6 ng/mL — deficient
• B12: 305 pg/mL
Serum DHT looks mid-range on fin. But scalp tissue DHT and serum DHT aren’t the same. High total T means more substrate available for local 5-alpha reductase activity at the follicle level, independent of what the blood test shows.
Considering whether topical RU58841 or dutasteride would better address scalp-level DHT when serum is already mid-range on finasteride.