EBHF Assignments for Week 24

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Case-Based Written Assignments for Wk 24

There are two questions this week for Week 24 ( Case 39 and Case 40).

The EBHF Program now requires all fellows to upload their assignments to our server using the simple link below. We no longer permit the emailing of ASSIGNMENT ANSWERS. ASSIGNMENTS ARE ONLY ACCEPTED USING THE LINK BELOW.

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DOWNLOAD PDF OF CASE 39/40

Case 39

Dr Pinkerton sends you the following email.

---------- Forwarded message ---------
From: Dr Samantha J. Pinkerton
Date: April 14, 2024 at 3:19 AM
Subject: "What is this all about? Ahhhh.”
To: EBHF FELLOW

Hi EBH Fellow,

I have a patient with androgenetic alopecia and I just don’t know what to do. I’ve never even heard of some of this stuff and thought you would!

My patient is a 44 year old male. He has androgenetic alopecia and is on oral minoxidil, finasteride, and topical latanoprost/minoxidil solution. He was doing okay with his hair until 4 months ago when he saw a new specialist in town and started some new treatments for his general health. Now he is shedding and I’m trying to make sense if the new supplements and treatments are the problem. I really have no idea. Ahhhhh.

He was given the following:

Tribulus Terrestris

Tongkat Ali

Maca

The patient also wants my advice on whether starting Ipamorelin is better than Sermorelin and if these will cause a problem for the hair.

I don’t even know what these are? Ahhh.

So, can you help answer these questions?

1) What is Tribulus Terrestris?

2) What is Tongkat Ali?

3) What is Maca?

4) Do you think Tribulus Terrestris, Tongkat Ali or Maca cause hair loss?

5) What is Ipamorelin and Sermorelin ? I’ve never heard of these!

6) Do you think all these new treatments are a problem?

Thanks for your help and advice here! This one confused me!

Samantha

Case 40

Dr Shirvani sends you the following email.

---------- Forwarded message ---------
From: Dr F. Shirvani
Date: April 11, 2024 at 6:19 AM
Subject: "HCG, Anastrazole, Clomiphene?”
To: EBHF FELLOW

Hi EBH Fellow,

I have a patient with androgenetic alopecia and I just don’t know what to do.

My patient is a 38 year old male who is a body builder. He is currently uses topical minoxidil, and PRP but it’s not doing much to help the hair. He used laser and exosomes in the past. He doesn’t want a hair transplant right now.

My patient uses anabolic steroids as part of his training and also started clomiphene citrate about 3 months ago. He had used HCG about 6 months before that. I think he said he is using Anastrozole because he had developed gynecomastia.

I’ve heard of anastrazole for my breast cancer patients and I prescribe clomiphene to help my female patients with fertility problems but I’ve never even heard of any of this stuff for male patients!

Of note, his past medical history includes:

Depression

Low libido

Hypercholesterolemia

Infertility

So, can you help answer these questions?

1) What is HCG? Why did he use this? Isn’t this a pregnancy hormone?

2) Why is he using clomiphene citrate? Is there a mistake here? I think he said his wife uses it now or used it in the past because they want to have a baby soon.

3) Why is he using anastrazole?

4) Do you think HCG, clomiphene citrate, anabolic steroids or anastrazole are causing (or caused) hair loss?

5) What treatment would you recommend for helping his hair?

Thanks for your help and advice here! This one confused me!

Farzad