Hair Regrowth After Glucocorticoids - Any Ideas Why?

[miko]

I have very bad hair loss, balding from my 18 (now I'm 30). For some medical reason a few years ago I was put on synthetic glucocorticoids (prednisone). After few months I was shocked that my hair was growing back (dark fine hairs) on forehead and on my receding hairline. Any ideas why? I have one idea, because in my labs I have high DHEA and androstenedione (little above upper limit) glucocorticoids that suppress adrenals could decrease this hormones. Anybody have other ideas? Thanks.

 

[nograde]

Some forms of alopecia that - in the speak of mainstream medicine - are caused by "your immune system attacking hair follicles" (esp. areata) respond well to prednisolone. Some theorize that similar mechanisms are involved in plain old MPB. Topical cortisone for example is known to regrow hair, with the side-effect that it dissolves your skin ;-)

 

[miko]

But typical androgenic alopecia too? In CAH (congenital adrenal hyperplasia) there is balding, hirsutism, acne etc. This is mainly adrenal androgen excess problem, so it's indicates that high adrenal androgens can be a source of that issues. Main treatment for CAH are synthetic glucocorticoids (that's treat some symptoms) - to suppress adrenal androgens (via feedback mechanism). Topical glucocorticoids are known for systemic effects (you can "get" cushing via inhaling or topical glucocorticoids).

"Cushing's syndrome and adrenocortical insufficiency caused by topical steroids: misuse or abuse"
http://www.ncbi.nlm.nih.gov/pubmed/18183788

"Iatrogenic Cushing’s syndrome with inhaled steroid plus antidepressant drugs"
http://www.mrmjournal.com/content/7/1/26

 

[Such_Saturation]

I think a side effect of cortisone is unwanted hair of the "bodily" type.

 

[miko]

I know, I had more hairs on the body after prednisolone, but I think it's complex, because beyond that it's suppress adrenal androgens it's strong glucocorticoid too. In Cushing Syndrome we have more body hair, hirsutism, acne, and hair loss/baldness, so one does not exclude the other.

 

[kineticz]

Cortisols functions are vast, in excess it is an issue, but so is a deficiency. The problem with cortisol excess arises more from the knock-on effects rather than cortisol itself.


For example, cortisol prevents excess DHT and E2. If you are cortisol deficient, it may be making your T3 more effective. It is also anti-inflammatory, and maintains blood sugar. Low blood sugar is heavily taxing on nutrients that make great hair.

Furthermore, via pregnenolone sparing, if basal metabolic rate is high enough, the addition of cortisol may have boosted neurotransmitters that protect against harmful hairloss such as prolactin.

 

[miko]

The problem is I'm not deficient in cortisol, labs show the opposite.

 

[kineticz]

Interesting. It is still possible the cortisol cream spared the adrenals some of their steroid synthesis.

 

[Such_Saturation]

When you mention dark fine hairs I think those are typical Cushing's-like growth, they should also fall off pretty easily.

 

[miko]

kineticz there is cortisol negative feedback to the upper stages of HPA axis (ACTH, CRH?), so if we get some synthetic glucocorticoids (my was oral, not topical) adrenals will be "shut down". There is more about it on the many pages of "adrenal fatigue" - they say that when you are taking exogenous glucocorticoids you should watch for "adrenal shutdown".

Such_Saturation I have many of "fine" dark hair on my body, but head hair loss too. I have high cortisol, so If it's pro-hair, then I should have fine dark hair on my head too, and I'm bald. We should know that adrenal cortex produce cortisol and andrenal androgens, so if the person have HPA axis hyperactivity (ACTH increase production of cortisol and adrenal androgens) it's means that there could be balding and strong hair on the body. One does not exclude the other (like in Cushing, there is acne, hirsutism, but hair loss too).

I think hair regrowth from exogenous glucocorticoids in my case was from suppression of my DHEA and androstenedione (I have both over the limit before prednisolone) or strong anti-inflammatory effects of it. But If I have high activity of HPA axis (high cortisol) this is unlikely (why exogeneous glucocorticoid should work better than endogeneous?).

 

[mujuro]

I was about to say: maybe the oral form suppressed your endogenous adrenal production. Although as you said, this seems like the opposite of what would happen in a subject with high cortisol. High cortisol usually indicates a faulty HPA axis feedback, and therefore a very weak or non-responsive suppression in response to exogenous hormones. Although most suppression tests use dexamethasone in the literature.

 

[Such_Saturation]

This guy had a similar problem viewtopic.php?t=1756

 

[miko]

mujuro exactly, I have bad feedback mechanism or "simply" hyperactivity of HPA axis from stress (I'm stress prone person). Because of it I dropped the caffeine (HPA axis stimulator). I know taking exogenous glucocorticoids for hair loss is stupid and risky so I'm searching for methods/drugs that decrease HPA axis activity (and I don't like cyproheptadine). I'm thinking about mirtazapine or amitriptyline.

Such_Saturation thanks for link.

 

[kineticz]

Cortisol only negative feedbacks if your basal metabolic rate has saturated.