Doc, I am 19 and experiencing signifigant hair loss in my hairline/temple area. I have heard that the earlier one looses hair, the balder they will go, but no one on either side of my family has ever experienced extreme hair loss or anything past a norwood class A type Va (worst case)
Is it true that the earlier one starts balding the more hair they will lose, or do they just reach their pattern quicker?
The two points are not necessarily connected, but those that lose a lot of hair often start early in their 20s with the process. From a transplant perspective, a Norwood class 5A pattern is a good end stage pattern for most people who want full coverage, where a class 6 or 7 is often difficult to treat for full coverage. In someone with a Norwood class 6 or 7, the supply of donor hair will often not be enough to solve the need for a full replacement hair transplant. I have transplanted a sereis of Class 7 patients with upwards of 7000 grafts (as high as 9900 grafts in one patient) to get the coverage they wanted. These individuals were fortunate enough to have high density donor hair and good scalp laxity. It certainly took more than one session to reach this number of grafts. For the sake of convenience, the Norwood chart is shown here:
This patient received 250 grafts just a few years ago (not from me, obviously). He knew things were going wrong when the doctor put wooden toothpicks (which could leave behind splinters) into the recipient sites which were made on his head. He overheard the staff chuckling at how he looked. He told me that before selecting his original doctor, he researched the field over the internet and had a few doctor consultations. He selected the original doctor because he was promised a great result and he believed that promise. As the hair started to grow, he became very self conscious and progressively depressed. Going out into social situations made him uncomfortable, even just going out of his house (something he rarely did once the grafts started to grow). 
Our practice is not a typical hair restoration practice in that a good number of our patients do travel a long way to see us, though more than half of our patients are local to California or surrounding states. For those patients who are not local to one of our offices, you can set up a “virtual consultation” with us to get an initial opinion. Some things can be managed without a face to face meeting, but we often direct those potential patients to at least have a phone call. We encourage the use of photographs to help us understand the problems at hand. Hair is very important to our audience and many of those we do a virtual consultation with over the phone have developed questions from reading this blog. If you’d like to request additional info or setup a consultation, check 
How would you classify Josh Duhamel’s hairline on the norwood scale? It has a receding look to it but could it be just his mature hairline?