Susan's Place Transgender Resources

So, I wrote about this earlier, but I've always had low-T. I'm 26, and my endo (who I have been seeing for insulin issues for years) said that I have the T-Levels of a 50 or 60 year old. Because of that he started me on a low dose of estrogen only with no T-blockers. He wanted to see if my T levels fall without them. Also Spiro can be taxing on the kidneys and so are insulin issues. So he's also being cautious on that front.

Anyway, I have always had very thick hair and a naturally low feminine hairline, which was something I've always loved/been proud of. Since I've started estrogen, my hair has been falling out like crazy. It doesn't look noticeably thinner, but whenever I take a shower a ton falls out. Is this normal? I'm paranoid that since I'm on no T-blocker that my T levels are rising and then potentially making me start  to lose hair because of it. My next round of blood work and next endo appointment aren't for almost two months. I'm considering calling him to see if I can come in sooner...

An old man's T level is still way too high to allow good feminization to occur. A low dose of E will do almost nothing to suppress T production. The only effective way to suppress T by using E alone is through strong injections, which are not recommended for starters. It is therefore possible that your hair loss is being caused by DHT. If you can't get a T blocker, you should at least try to get a 5 alpha reductase inhibitor such as finasteride (or better yet, dutasteride if you can afford it.) If the hair loss is being caused by DHT, such medication will be very useful.

Given the similarity between your symptoms and mine, I would be worried about another problem, one that is much harder to treat. Normally, estradiol reduces loss rates, so it is worrisome when things go the other way. I have had the same problem since starting estradiol. My strands are not thinner (indeed, many are thicker), but 80% of them have fallen out. It is only in the last few weeks that I think I have discovered the complex problem. I have recently been diagnosed with a fungal scalp infection. Foods with active yeast (usually simply "yeast" on the ingredients list) cause it to flare, resulting in itchiness, white buildup on the scalp, and morbid hair loss. Initially, my white buildup was dismissed as dandruff; even one dermatologist said that, but now I think I know the truth. It is clear that the white buildup (and indeed the dandruff itself) were caused by a fungal overgrowth condition, likely a yeast infection. Eliminating active yeast from my diet is already helping after only one week, and I will soon start a course of antifungal medication; the two changes combined will hopefully stop my problem.

You may be wondering what that has to do with estradiol. Unfortunately, estradiol increases the growth and survival of potentially pathogenic Candida albicans yeast. A systemic yeast infection may occur, especially in people with compromised immune systems. I have low immunoglobulin levels. I would strongly recommend 1) seeing a dermatologist to check for possible fungal overgrowth on the scalp, which may produce no symptoms until it is too late to save the hair, and 2) having your blood tested for possible immunodeficiency, even if you have been tested in the past. My immunoglobulin levels were once normal, but not anymore.

Here is an article about the effect of estradiol on yeast:
http://jid.oxfordjournals.org/content/181/4/1441.full.pdf

I agree, see if the doc will prescribe finasteride. Also 5% minoxidil twice a day help with dht.

I haven't had any scalp itchiness, dandruff, or anything like that. And also hair loss has never been a problem for me before. Once again, looking at the mirror it doesn't *look* any thinner. It just seems like way more is falling out in the shower than usual. It's just inflaming my neurotic Jewish psyche haha. Basically, I'm trying to figure out if I should bump up my next endo appointment and see where my hormone levels are at sooner rather than later/get on a T-blocker if my T-levels aren't indeed falling,  or if I'm just being neurotic and that I should just wait the whole month and a half left before my next appointment.

Quote from: Cynthia Michelle on January 07, 2015, 06:14:54 PM
Also 5% minoxidil twice a day help with dht.

Minoxidil stimulates hair growth; it does not block DHT and is typically only used in people with more visible hair loss because it is difficult to apply underneath hair. Indeed, people often lose more hair shortly after starting minoxidil, in part because it enriches the scalp with blood, which contains DHT. It is therefore important to take a DHT blocker when using minoxidil. I plan to try it once my infection is gone, to see if any of my hair will come back.