I may be wrong about this, but I think A&G may be dealing with the problem by introducing other hormones / substances that are either missing or deficient in a balding scalp. Someone please correct me or refine this statement if I am wrong. Anyway, this makes sense to me. It's obvious that DHT isn't the only factor here. Otherwise we should all have full heads of hair. I'm convinced the immune system plays as big of a role... There are probably other factors as well.
This is an old post, but it's relevant. Pay particular attention to the bolded text:
And check out the following old research abstract I had found several years back:Research shows why Propecia is more effective for some
Postby Morphollica on Wed Nov 30, 2005 5:28 pm
Here is a very interesting abstract I came across of a study that shows why Finasteride (i.e. Propecia and Proscar) is more effective for some than for others.
Apparently it has to do with a repeating sequence of DNA in the Androgen Receptor gene. The more a particular sequence repeats, the less effective Finasteride will be for you!
I wonder whether this can be applied to the medical practice, whereby a doctor can let you know in advance whether Finasteride will be effective for you based on some kind of DNA test.
Here is the original forum post on the topic:
http://www.hairlossfight.com/forums/viewtopic.php?t=634
Abstract:
Journal of Investigative Dermatology Symposium Proceedings
Effectiveness of Finasteride on Patients With Male Pattern Baldness Who Have Different Androgen Receptor Gene Polymorphism
Kazuhiro Kobayashi, Nagaoki Wakisaka, Yuh-ichi Taira, Masahiro Ishikawa, Yoshio Nakamizo,
Masashi Uwabu, Yasutaka Fukuda, Yasuyuki Taguchi, Takanori Hama, and Masaya Kawakami
NPO Future Medical Laboratory, Tokyo, Japan
Objectives: Most of male pattern baldness (MPB) patients have androgen-dependent trait although it is under the control of multiple genes, such as genes for androgen receptor (AR), IGF-1 and dihydrotestosterone regulations. A 5 alpha-reductase inhibitor, finasteride, is effective on MPB although there is a variation in the efficacy of this drug among the MPB patients. From the functional mechanism of this drug, it is thought to be effective on MBP caused by hyper-function of AR. Association of polymorphism in the first exon of AR gene with MPB has been demonstrated by some authors (Sawaya and Salita, 1998; Ellis et al,
2001).We have found that there is a correlation between the symptom level of MPB and the CAG and GGC repeat length in AR gene. To investigate relationship between the effectiveness of finasteride and the AR gene polymorphism, we determined the number of triplet repeats in AR gene of patients.
Methods: Blood cell DNA was extracted from 740 MPB patients (1962 y) and 54 non-bald men (4472 y). After PCR of the first exon of AR gene, the number of CAG and GGC triplets was determined by conventional sequencing or transcriptional sequencing method. AGGCCT sequence was determined using two different Stu I restriction enzymes.
Results and Conclusions: Effectiveness of finasteride in each patient was expressed as the improvent point of symptom derived from Hamilton-Norwood typing. Number of the triplet repeats (CAGGGC) was plotted against the symptom points. There was a broad correlation between these variables. Finasteride was more effective for the improvement of MPB in patients with shorter triplet regions of AR gene. These cases may be caused by hyperfunction of AR. On the other hand, this drug was less effective in certain cases with longer triplet repeats. They are thought to result from non-androgenic mechanism. This sort of analysis may help the drug choice for MPB patients.
Here is the original link in the news section of the site:
http://www.hairlossfight.com/?newsid=10
This is very significant! What this seems to say (and again, someone please correct me if you think I'm interpreting this incorrectly) is that finasteride caused IGF-1 to be upregulated (or increased?) in 4 of 9 patients in the experiment. Of those 4, 3 showed improved response to finasteride (i.e. their hair condition improved), while the 4th was unchanged. So IGF-1 is obviously important!This is interesting because of the correlation being made between insulin-like growth factor 1, and the efficacy of finasteride. This may explain why there is a broad range of responses to the drug:
J Am Acad Dermatol. 2003 Aug;49(2):229-33.
The expression of insulin-like growth factor 1 in follicular dermal papillae correlates with therapeutic efficacy of finasteride in androgenetic alopecia.
Tang L, Bernardo O, Bolduc C, Lui H, Madani S, Shapiro J.
Division of Dermatology, The University of British Columbia, Vancouver Hospital, Canada.
BACKGROUND: It is generally believed that dihydrotestosterone is one of the pivotal mediators of hair loss in androgenetic alopecia (AGA). Finasteride, which blocks the conversion of testosterone to dihydrotestosterone, has now become an integral part of the current treatment approaches for male AGA. Several lines of evidence support the notion that dermal papilla (DP) cells represent the androgen target within the hair follicle. The specific molecular regulators modulated by androgens within hair follicles in the balding scalp are unknown. OBJECTIVE: The purpose of this study was to identify and quantify changes in expression of specific molecular hair growth regulators in DP of men with AGA treated with finasteride and correlate these findings to clinical efficacy. METHODS: Biopsy specimens were collected from 9 male patients from both the balding area and nonbalding occipital area before and after 4 months of finasteride therapy. DP were microdissected and total RNA was extracted from an equal number of DP from each biopsy specimen. The expression of various cytokines, including insulin-like growth factor (IGF)-1, was determined by reverse transcription polymerase chain reaction. The signals were detected by autoradiography. All 9 patients were given finasteride for 1 year and evaluated for efficacy at month 12. Efficacy was graded on a 7-point scale on the basis of comparison with initial baseline photography. RESULTS: IGF-1 was up-regulated by finasteride treatment in 4 of 9 patients. Among the patients with increased IGF-1 expression, 3 of them showed moderate clinical improvement after 12 months of treatment and another patient remained unchanged. In contrast, 3 patients with decreased IGF-1 expression in the balding scalp showed clinical worsening after 12 months. The other 2 patients without noticeable change in IGF-1 expression showed either slight improvement or no change in their hair condition. CONCLUSION: In a small uncontrolled study of 9 patients with AGA, an increased expression of IGF-1 messenger RNA levels in the DP was associated with patient response to finasteride.
I think I remembered reading that A&G formula contains IGF-1?? If I'm wrong, again please correct this.
This has a lot of implications! Obviously IGF-1 will help if androgens are also controlled, at least from what this study suggests. So perhaps taking finasteride or dutasteride, or using a topical DHT inhibitor in conjunction with A&G will give better results than just using one of these. Combining this with laser therapy will probably have an even better effect. All of this is assuming that A&G really works, which has yet to be really proven. But it is exciting nonetheless.
Thoughts?
