I had been suffering from hair loss due to DHT poisoning. I expected it to stop when I transitioned, and indeed the 5AR inhibitors slowed the loss rate dramatically. Then, I started HRT, and my remaining strands thickened nicely, so it is obvious that I suffered from DHT poisoning and that did stop.

Unfortunately, most of my hair has fallen out anyway, and I lose more every day. In November, I was diagnosed with fungal overgrowth on the scalp. The dermatologist could not tell me what fungus it was, and another dermatologist even dismissed it as dandruff. (I know what dandruff feels like and this is very different, although the fungal infection did sometimes increase skin die-off, leading to a mix of fungus and dandruff.)

I tried ketoconazole shampoo, which is supposed to be antifungal and anti-androgenic. It made my hair thin and stiff/dry and fall out so fast that I literally thought I would be totally bald in a week. I am now on antifungal pills and should start using a gel, but it seems like a lost cause. My scalp itches, I lose hair. I may consider a restrictive diet or a probiotic.

My dermatologist could not tell me what type of fungus it was. After much thought, I realized that moldy rooms and yeast-based food both worsen it dramatically. I also have most of the symptoms of systemic candidiasis.

I have three risk factors for yeast problems: a weak immune system (low immunoglobulin levels), disturbed gut bacteria (due to IBS), and use of estradiol (albeit not at a high dose). This is really taking a toll on me, and it makes me question whether I can go on with life.

I need to eliminate the fungus to get my life (and my hair) back, but I do not want to lose my femininity. Although the fungus is killing all of my hair, quitting E also causes hair loss and increases T poisoning. I also fear the spironolactone, added in December, could be making it worse by suppressing the immune system further. I will see the endocrinologist on Wednesday, but he can't help my scalp problem. I may request progesterone, since some people swear by it for breast growth and emotionality, and it is apparently safer for someone with a systemic yeast infection, but it is no substitute for the broad-spectrum feminizing agent estradiol. This is a big stumbling block in my transition. Is there anything I can do?!?!?

Trial and error. I know my hair got thicker since being on injectable E and oral P but it took at least 6 months before noticing a change. 

I know the hormonal changes associated with transition are *supposed* to be good for hair. Higher levels may be better due to a stronger suppressive effect on androgens or for other reasons not fully understood. Unfortunately, things do not always go as expected. Although my hormonal hair loss slowed dramatically, I am still in danger of going totally bald in the very near future due to my fungal infection, which seems to be triggered by yeast and mold. Worst of all, my hair cannot regrow in a fungal environment and I can't use topical regrowth products. Nothing I do from a hormonal standpoint can possibly save my hair as long as my scalp is infected. This infection is very stubborn; I am using both oral and topical antifungals and they do not seem to be working much.  My thought is that estradiol is contributing to the fungus. Although my infection did pre-date HRT, it has gotten worse with each successive increase in my E dosage, although I am still on a fairly modest dose. I therefore think I may need to put my transition on hold to kill the fungus. It is widely recognized that E makes fungal yeast more aggressive, yet if I skip my E, my hair falls out all over due to hormonal imbalance. I am also very concerned about Testosterone poisoning still affecting my hair, and removing E would make that worse. It is a lose-lose situation and it is really taking away my hope for a feminine future, and with it, my will to live.

More Estradiol = Yeast overgrowth = Hair loss
Low/No Estradiol = Hormonal imbalance = Hair loss
Topical products = Clogged scalp = Hair loss

I may try P if the doctor lets me, but my hair loss is more fungal than hormonal. "Good" bacteria may help, and while I am disgusted by the thought of ingesting bacteria, I think I have to try. What else am I to do? Any suggestions would be greatly appreciated.

I've used castor oil to treat minor fungal infections, just make sure to put it on at night and wash it out the next morning.  One other thing you can look into is to see if any other medications you take have hair loss as a side effect.  Also, sometimes medications may not individually cause hair loss, but when combined they can.  I've noticed that doctors will often prescribe medications that have hair loss as a side effect, but when it happens and they are confronted about it, will simply attribute the hair loss to male pattern baldness.

Fungal infection + weak immune system pretty much go hand in hand. The fact that yeast-based foods worsens it says a lot. I think what you're spot on with candidiasis.

I know someone else who had a horrible problem with this but fixed it:

Ingredients:
- 1 cup of water
- 2\3 teaspoon of baking soda
- 1\3 teaspoon of potassium
- a little bit of something sweet, like lemon drips or maple syrup, something to make it bearable (it HAS to be unprocessed, so not refined sugar)

Drink this once a day, twice a day. As you get more comfortable with it, slowly increase it until it's two teaspoons each cup three times a day.

Other stuff you can (and should) do is cut refined sugar out of your life, if you haven't already. Processed foods will lower your pH and promote fungal growth, so cut those out too. Natural food will raise your pH and kill fungus. If this is candidiasis, then this is also a precursor to cancer, so it's good to kill.

If you do the baking soda and water thing, then your whole immune system will improve because it gives your body the pH it needs. pH paper will help you see your pH level, and a level between 7.3 and 7.5 is good. Any higher is bad, and any lower will promote infection growth. If you try it for two weeks (your pH being 7.3), then your fungus growth will probably disappear.

It's worth mentioning that bread is yeast based and bad for infections. Milk, despite being high pH, will actually lower your pH once ingested.

I really hope that helps you and I don't seem to imposing on you.