Thanks so much for the guidance! After further research I have to agree with you 100%. Lipogaine Big 3 does containe ketoconazole, which would eliminate the need for Nizoral, however the shampoo only contains a few hair loss/thinning related ingredients. The Big 5 contains 17 and just seems like a better overall product. That plus Nizoral twice weekly seems pretty solid to me.
The pull test may be used to diagnose hair loss conditions.1 The examiner grasps approximately 40 to 60 hairs at their base using the thumb, index, and middle fingers and applies gentle traction away from the scalp. A positive result is when more than 10% of hairs (four to six) are pulled from the scalp; this implies active hair shedding and suggests a diagnosis of telogen effluvium, anagen effluvium, or alopecia areata. However, a negative test result does not necessarily exclude those conditions. The pull test is difficult to standardize because the pulling force is not distributed uniformly and because it is difficult to approximate the number of hairs grasped, thereby leading to false interpretations.
The trick about all of these hair-loss products and treatments is that they’ll stop working as soon as you stop using them. “They have to be ready for a lifetime commitment,” says Rieder. But, just like brushing your teeth, as long you keep on keeping on with the scientifically proven preventative treatments, those hairs on your head should be just fine.
Hair transplants will likely lead to better results in the long run (you are introducing new hairs to the balding areas), but you’ll still need to use minoxidil or finasteride after surgery to maintain the results. Like all hair loss treatments, hair transplants are best when combined with other methods, and you’ll want to speak with your doctor to see what combination is best for you.