Im 37M looking for treatment advice. Once I hit 30 my already thinning hair vanished like the last airbender. Currently not on minoxidl or finasteride
It seems salvageble to me even if you had thinned severely and in a very unfortunate situation atm. Not without consulting a doctor I would advise you to consider finasteride 1mg + LDOM 2.5mg-5mg or Topical minoxidil 5% with tretinoin 0.01 to 0.1%, maybe even both topical minoxidil with tretinoin and oral minoxidil. Keep in mind to get a blood pressure monitor and conduct blood pressure checks for at least 3-4 days consecutively once every hour. 3-4 hours, a measurement once every hour, for 3-4 days. This will yield you a baseline of your BP and HB, blood pressure and heartbeat that is, record them on a piece of paper and re-measure 1hr after taking oral minoxidil, if you want to go down that path. Oral minoxidil gave me horrible changes in blood pressure even if it was asymptomatic and it may happen to you too, around 30-40mmhg of drops and rises for systolic I had recorded meanwhile heartbeat went to 107 from 75-80 at rest.
My SBP is around 120s/130s resting. No idea Minoxidil impacted BP that harshly. I used topical Minoxidil in the past but was not really commited. Like applied once a week. Much appreciated on the med regimen advice 
Also how wpuld you fit microneedling in all this? And do you rec hair transplant?
Microneedling is not proven to work though anecdotal experiences vary, might give it a look but maintain hygiene above all else and don’t go beyond 1.5mm. Also some or maybe even most doctors may object it, rightfully so. Tretinoin is the go-to for enhancing minoxidil not microneedling though it may help with its absorption too. When used alone, it is less effective and scientific evidence is scarce but anecdotally it is said to work, so I don’t know and cannot recommend anything. I have yeast on my scalp and if I were to use it, I would get infection/inflammation so rather would not use it, thus I have no experince on that regard.
It is not recommending, but it is likely you will need a hair transplant at that stage of balding as I don’t think most medicines can salvage you. Pick good surgeons above all else if you wanna do down that path and also while I would not say straight out avoid, be extra wary of those who have their nurses/technicians perform the surgery and if possible choose doctors who have both practical experience and the background (theory) knowledge unlike nurses who have pratical skills mostly. Practical Experience+Theoretical Knowledge+Reputable/Trustable, keep these 3 in mind. FUE is better than FUT, if you wanna keep your hair short, your donor is good nor it is bad. It seems to me just average or below average maybe, so you would need medicines to do a good chunk of the work and you may need beard hair or might need verteporfin for extra grafts that you lack, though it is a quite expensive drug. It is salvagable but to me your situation is not going to be very easy. Good luck!