LT3D

I mean, this is really getting into the weeds of things and I'm not really qualified to say one way or another. There is a really great FB group - TRT and hormone optimization. Worth exploring that to learn more about your condition and how to navigate it.

This is purely speculative on my part, but I think the reason why some men get bad side effects on finasteride is because their test levels are low or lower than normal, but not so low that they are fully symptomatic. And a big part of their androgen load is comprised of their DHT. The moment they nuke their DHT, they are left with low-ish test and low DHT. Their free test will go up some, but not enough to make up for the androgenicity that DHT provided. So the low test/androgen symptoms begin. On TRT, assuming you're dialed in and you feel great, the androgen load should be optimal. I can tell you from my experience, when I started finasteride, and later dutasteride, my libido went much higher and I even have blood work showing the increase in my free test. It tapered off back to normal after a while. But I think when you're exogenously injecting test, it's a different equation with DHT-reducing drugs. Just my two cents.

Systemic DHT levels aren't very useful for hair loss as DHT is a paracrine/intracrine hormone. My question is, have you tried fin while on TRT?

I hear that, but ultimately, most people (myself included) will use budget as one of the main deciding factors. Otherwise, we'd all go to Pittella or Zarev or Sethi, etc. At the end of the day, there is a limit on how much I'm willing to spend on this procedure. It's a nice to have, but not more than that. My family, house, retirement, etc. are much higher on the priority list than hair. And I think with today's options, I can reach a balance between a budget-friendly doctor and good results. Afterall, that's the reason why some of these doctors are on this forum. In terms of FUT, I've considered it in the past, but with the advancements today and the doctors' proficiencies with FUE, I no longer would consider it.

So maybe wait another year or so, for a total of 3 years of dut and min?

Thanks for the input. Ultimately, I'm not sure if I'll need a second surgery. But I'm trying to thread the needle with a budget-friendly doctor who can also move a decent amount of grafts. At the same time, I do wonder if I should wait longer to see if I can squeeze out more results from the meds.

Thanks for the recommendation, I'll definitely check out Dr Laorwong. It's too bad about Yaman. I remember he had pretty decent results a few years back.

Hi all, I've been following this forum for some time now, doing research into hair restoration and reputable doctors. A little bit of a background from me. I started losing my hair around 21 years old. It became noticeable around 23-25, and by 27 or so, I started shaving my head. At 35 I decided to go all in with meds (oral dutasteride and topical monoxidil) and see how much of my hair I could regain. This was 2 years ago, and at 37 now, I've regained a decent amount of hair back. (I've added one before picture and also my current pictures). My thoughts are, ideally, I'd like to get one procedure (not keen on multiple trips) from a budget clinic (Gur, Yaman, etc.). For me, having hair is great, but with that said, it's not that high on the priority list (financially speaking). It's something that I'd get done and move on with my life. Having said that, do you guys think it's wise for me to get a transplant? What NW would you classify me as? How many grafts would I need total (I've added a pic without a haircut to show my donor)? Any input on which doctors would be best for me? Should I wait another year or longer to see what else I can get out of the meds? I appreciate any input!