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!
Take oral dutasteride + minoxidil ASAP your hairloss is crazy big, you need to use the big weapons
How do I choose between dutasteride vs finasteride? Also I’ve started topical minoxidil and bought a micro needle dermastamp. How much do you recommend the stamp. It’s the one where you can adjust the depth
Dutasteride is stronger than fin and has similar side effects. Your hair loss is crazy big so you need dutasteride if you want to recover your hair. I don’t like microneedling in general because it can cause scarring long term.
If you want to do more things for your hair you can do:
-Be at a healthy weight
-Don’t take alcohol/smoking
-Wash you hair daily with anti dandruff shampoo, if you have itchy scalp (seborreic dermatitis) it’s gonna speed up the balding
-Eat a mediterranean diet, the more vegetables in your diet the better, specially things rich in isoflavones like soy that are antiinflammatory and have a protective effect
-Red light cap, though if you have long hair it’s not gonna be as effective
-Sleep well, have a good hygiene of sleep, sleeping and waking up at the same time etc
-Reducing stress
-Do exercise and be active
Source for soy. and AGA : https://pubmed.ncbi.nlm.nih.gov/24386074/
Source for mediterranean diet and AGA: https://pubmed.ncbi.nlm.nih.gov/29181579/
Source for sleep and AGA: https://pubmed.ncbi.nlm.nih.gov/35469370/
Source for dermatitis and AGA: https://pmc.ncbi.nlm.nih.gov/articles/PMC12270407/
All the “drop social media, hit the gym” tips I need but whoody-whoop it’s a struggle. For buying dutasteride, Amazon for example, I need a prescription ya? Whats the cheapest way to do this? Like is in person vs online cheaper. Even for ketoconazole 2% shampoo. They’re keeping it locked up like the laundry detergent at the Target in my area, wtf. Gatekeeping that extra 1% is crazy. Also if I see the MD and forgot to mention a prescription for somthing else, I gotta see him again and pay just to get that missed prescription? Sorry I havent seen a doctor or dealt with insurance in forever.
Cheapest way is to go to the doctor and get prescription and then buy at the pharmacy. Details change between countries so I can’t advise you on that, sorry! I live in spain so I only know about spain