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PROTOCOL FOR MEN
     

     Hair loss in younger men is primary a function of male hormones(androgens).  The role of androgens in hair loss goes well beyond DHT.  Other identified hormonal variables include androstendione, prolactin and estrogen metabolites that when not addressed could readily explain the transient and only partial effectiveness and side effect profile of using either Propecia or Avodart as a sole treatment for MPB.

     Our current focus of treatment emphasizes a topical and systemic neutralizing of dihydrotestosterone (DHT) via 5-alpha-reductase inhibition, prolactin downregulation, and androstendione reduction via 17BHSD inhibition.  It also encompasses reducing androgen binding at receptor sites, and increasing of sex hormone binding globulin (SHBG).

     Additional factors of a non-hormonal nature that are addressed in our treatment protocols include inflammation, free radical activity, decreased microcapillary perfusion(follicle blood supply), and peripheral NOS upregulation.

     Studies have shown that androgen related activity in the scalp of men with hair loss in their 20’s is more than double that of men with hair loss in their 50’s.  It has also been established that nonbalding men have higher levels of SHBG, *higher* testosterone (seems counterintuitive, but it's true), and lower DHT than their balding counterparts.  Because age related factors in hair loss such as inflammation, fibrosis (localized collagen rigidification), and decreased microcapillary perfusion are significant, but generally not as pronounced in younger men, they typically enjoy a much better response to anti-androgenic treatments, compared to men over 45.  For those over 45, senescent (age related) thinning can be juxtaposed on an existing androgen hair loss condition, making matters more challenging from a treatment standpoint.  These age-related non-hormonal variables that contribute so significantly to senescent thinning are addressed in our treatment prtocols as well.


ROGAINE GENERALLY CONTRAINDICATED

 Based on the preponderance of studies and anecdotal reports, we have omitted Rogaine 2 and 5% from our protocol.  It appears that Rogaine, despite its short term effectiveness in some patients almost invariably loses its effectiveness due to tolerance.  The typical timeframe on tolerance to set in is from 12 to 18 months. More importantly, it causes a tremendous amount of shedding in all patients upon stoppage.  Of real concern is that this shedding is typically above and beyond what one would have normally gained through any treatment response.  This phenomena is clinically termed loss of “minoxidil dependent hair”, and implies that stopping minoxidil use may result in loss of hair that may have been otherwise unaffected by androgenetic alopecia (pattern loss).  Stopping other treatments such as Propecia will result in a gradual regression to the pre-treatment state.  With Minoxidil this loss is much more dramatic.  This seems to occur regardless of other treatments being used to offset this process.  A review of the medical literature will confirm its transient and marginal effectiveness at both 2 and 5 percent concentrations.


 If however, you have been using Rogaine for some time you would be well advised to stay on it.  You likely could use a 2% concentration at once a day to avoid shedding, and there are many low cost generics available.  If you are currently using Rogaine and chose to get off it, it wouyld be wise to gradually reduce your dosage and substitute the Pyridine-N-Oxides (Dr. Proctor)to avoid the hair loss that invariably occurs with the cessation of Minoxidil treatment.  Because of the similarity in their core technology, the Pyridine-N-Oxides appear unique in their ability to do this.  The current thinking on Rogaine by some in the research community is that it is best avoided altogether.


PRIMARY PROTOCOL

Nizoral Shampoo- twice weekly, alternated with either Head and Shoulders or Dr. Proctor's Hair Regrowth Shampoo.

Natural Estrogen with Pomegranate Extract- Take two caplets in the morning with or without food, or as recommended by your healthcare practitioner.

Dr. Proctor's Advanced Hair Regrowth Formula- once daily, after shampoo, towel drying.

Ultra Natural Prostate Formula- Take two caplets in the morning with or without food, or as recommended by your healthcare practitioner.

Super Absorbable Soy Isoflavones- 1-2 capsules daily.

Mega Green Tea Extract- One 725 mg capsule, 98% Extract,( 326.25mg EGCG) with heaviest meal of the day.

Emu Oil- Massage a few drops into affected areas in the PM prior to retiring. Dr. Holick used applications 3 times daily to obtain 80% hair regrowth. It can be used as a daytime hair dressing, if desired.

Propecia/Proscar(optional)- 1mg finasteride daily if used alone.
1mg every other day if used in conjunction with any systemic compound from our Primary Treatment recommendations.

L-Taurine- 1000 mg. capsule daily.

Grape Seed/Resveratrol Extract - Take 1 capsule (100 mg Grape Seed Extract, 20mg Resveratrol)daily.

Curcumin- 1 capsule daily.


ADJUNCTIVE RECOMMENDATIONS

Dr. Proctor's Hair Regrowth Shampoo- alternated with Nizoral Shampoo or Head and Shoulders Shampoo- 2-3 times weekly.

Root Food(Durk Pearson and Sandy Shaw) Take 4 capsules a day in divided doses

Ginkgo Biloba Extract- 1 capsule(120 mg.)daily. Use only 24% ginkgo extract (6% terpene lactone), not the whole leaf.

Super Omega3 - EPA/DHA- 2 softgels, twice daily with meals.

L-Lysine- One 500 mg. tablet L-lysine, 3 times daily (divided doses on an empty stomach). The addition of Vitamin C (500mg) and Iron;(18-22mg), will replicate the exact formula used by DH Rushton.

Iron Protein Plus- Take 1-2 Iron Protein Plus daily, with meals.



 NIZORAL SHAMPOO Mildly inhibits the binding of DHT to the hair follicle androgen receptor.  Additionally it likely suppresses the localized autoimmune responses through its effects on specific cytokines that are related to dandruff and perifollicular inflammation (present in 98% of balding men).  

     There have been 2 studies published in the medical literature confirming that 2% Nizoral shampoo grows hair in balding men with continued usage.  It appears to cure scalp inflammation and reduces sebum levels confirming its antiandrogenic effect.  Numerous anecdotal reports and a recent study would seem to indicate that the 1% over the counter version is also helpful for hair loss.

     Directions:  Use 2-3 times weekly.

     Side effects:  Dry scalp and hair, only if used daily.



NATURAL ESTROGEN with POMEGRANATE EXTRACT – Natural Estrogen with Pomegranate is a multi-component phytoestrogen compound that addresses all the currently identified hormonal components of androgen mediated hair loss. It functions as an estrogen receptor antagonist, displacing strong endogenous estrogens with weaker phyto-estrogens,In so doing its effects in men would be more accurately described as "anti-estrogenic."

     It functions to reduce DHT, Androstendione via 17BHSD inhibition/Enterlactone production, Prolactin, and modulates estrogen in such a way to neutralize its role in hair loss and prostate cancer development. It also functions as an androgen receptor antagonist, and provides a potent dose of ellagic acid, an antioxidant that has been shown to stimulate hair growth and provide numerous other health benefits.

     Natural Estrogen with Pomegranate Extract also contains Black Cohosh(which mimics the safe estrogen, "estriol"), recently patented as a stand alone treatment for hair loss in Germany.

     Natural Estrogen is often used to ameliorate the estrogenic side effects of Propecia and Avodart.

     Directions: Take two caplets in the morning with or without food, or as recommended by your healthcare practitioner.