DHT and Testosterone

[marianco]

Originally Posted by drp90210

May I bother you with a question? The testosterone cream I am using gets my total and free testosterone to middle levels (600-700 total test and 10-20 free test), but my DHT is through the roof at 240 (normal is 17-66). Reducing the skin area of application has not improved the DHT problem. I do not want lose any more hair, which is a big issue for me. Do you know how I could get my DHT down? Would injectible testosterone significanty reduce DHT versus creams? And would there be a problem with using SMALL amounts of Propecia (like a 1/4 tablet a day) to simply get my DHT to the top of the normal range? Any thoughts would be greatly appreciated. If you prefer, you can email me directly or simply post to the group. Many thanks and best regards.

High DHT can occur with transdermal testosterone.
It is a concern in regard to hair loss, possible abdominal fat increases, and other negative effects of DHT when it is at too high a level.

Possible ways to maintain control over DHT include:
1. High potency testosterone gels or creams allowing reduced skin area of application.
2. Alpha-reductase inhibitors like Finasteride or Saw Palmetto - to reduce DHT production. The dose and potency have to be considered since alpha-reductase activity is important for brain function. Saw Palmetto would probably be the safest of the alternatives. It is not as potent as finasteride, and hasn't been shown to grow hair like finasteride. But it can reduce DHT levels. Low dose Finasteride is a viable option - so long as one monitors for side effects.
3. Scalp application of an alpha-reductase inhibitor to avoid systemic alpha-reductase inhibition (which can cause cognitive problems, sexual problems, etc.), while reducing hair loss at the scalp itself. These included compounded lotions and shampoos containing products such as azelaic acid or saw palmetto. ucprx.com (University Compounding Pharmacy) and minoxidil.com are examples of compounding pharmacies that carry products like this.
4. If a man was progesterone deficient, rubbing a compounded progesterone cream into the scalp is an option - progesterone being an alpha-reductase inhibitor.
5. Injection of a testosterone ester - e.g. depo-testosterone, testosterone enanthate, testosterone cypionate, when done twice a week, help reduce DHT production. When injections are done once every two weeks, DHT production can also be high, due to the higher peak levels of testosterone obtained.
6. etc.

[drp90210]

Many thanks. Would once-a-week injections of testosterone cause an unwanted DHT spike? The thought of doing IM shots twice a week is not appealing.

[masterpp]

hey guys

i wanted to run a couple of ideas past you.

firstly, do we believe that most people who are loosing their hair are doing so because of elevated dht levels. i do not believe this can always be the case, as so many young ish guys start loosing their hair, how can they all have elevated, or even mildly elevated dht. my point is that therefor we must assume, as most people would agree, that it is infact a genetic disposition to have hair follicles which are sensitive to dht- therefor i dont see how propecia could work for these guys, as unless it totally decimated their dht levels, there would always be ample dht, and tesoterone to reach the follicle, as propecia only reduces 70 percent of conversion- and indeed dht is an essential hormone and one wouldnt want to go too low on it. therefor we shouldn;t be too surprised that many men do not respond to propecia.

i was also wondering about guys who do have elevated dht, such as myself, but who choose not to do propecia or the equivalent. in these cases, can topical formulas, particular minox and things which do not attach the course of the problem, ie dht, but instead try to regrow hair can work. do we have evidence of guys growing back hair, and halting hairloss, despite not using an anti androgen and only relying on minox.

finally, i was wondering about the nature of dht conversion in itself. do we know if hairloss is due to the presense of circulating blood serum levels of dht, or is it due to the conversion of testosterone in the scalp. there is a subtle difference, as with prostate health for instance, a high dht blood level isnt always the problem, as in fact it is the conversion of high levels of testosterone in the prostate itself, which is the problem. is there any posibility that it is the conversion in the scalp itself, rather than the circulating dht which is the problem. this would have implications for guys who think they have elevated dht levels, as using propecia may in fact make it worse, as the extra testosterone liberated may in fact just reach the scalp and convert in the follicles. however, this may be way off the mark, as propecia may be particularly effective at stopping conversion in the scalp- however i just dont know how propecia works- how readily it targets the follicles itself.

just a few thoughts

[marianco]

Originally Posted by drp90210

Many thanks. Would once-a-week injections of testosterone cause an unwanted DHT spike? The thought of doing IM shots twice a week is not appealing.

Injections twice a week aren't so bad considering that the dose is half the size.

A smaller gauge needle can be used.

At around 25 gauge and smaller - plus the smaller dose - pain is much less or non-existant.

The ventrogluteal site is the least painful site - it has fewer nerves and blood vessels than the dorsogluteal or lateral thigh (vastus lateralis muscle)

Realize that if one was on growth hormone, then one would be doing daily injections. If one was on insulin for diabetes, one would be doing even more frequent injections - plus the needles involved for monitoring blood sugar.

If one wants zero pain, then transdermal testosterone is the best.

Testocream is one version of a compounded PLO, oil-based testosterone cream which may minimize DHT production compared to other creams and gels since it seems to have lower storage in skin fat. Rather, the pharmacokinetics indicate most of the testosterone goes directly into the intracellular space then into the blood stream. It also has an aromatase as a component. One can Google to find it.

[JustOne]

Insulin injections are much easier then t injections though, no need to aspirate or load the liquid into the needle, it would be awesome if a compounding pharmacy made 10mg test prop injections preloaded.

[chip douglas]

Originally Posted by marianco

High DHT can occur with transdermal testosterone.
It is a concern in regard to hair loss, possible abdominal fat increases, and other negative effects of DHT when it is at too high a level.

My last DHT blood test levels was normal high : 1599 [ ref. range (men : 20 - 49) 217 - 1650] pmol/L

Is it correct that stress alone can cause DHT to increase ? I guess it can to *some*extent, as other hormones can increase from reactive states. Also androgens throughout the day, can vary widely, as opposed to say, Hemoglobin which is pretty stable.


My concern here's with retroperitoneal fat.

[The_Skeptic]

Originally Posted by masterpp

hey guys

i wanted to run a couple of ideas past you.

firstly, do we believe that most people who are loosing their hair are doing so because of elevated dht levels. i do not believe this can always be the case, as so many young ish guys start loosing their hair, how can they all have elevated, or even mildly elevated dht. my point is that therefor we must assume, as most people would agree, that it is infact a genetic disposition to have hair follicles which are sensitive to dht- therefor i dont see how propecia could work for these guys, as unless it totally decimated their dht levels, there would always be ample dht, and tesoterone to reach the follicle, as propecia only reduces 70 percent of conversion- and indeed dht is an essential hormone and one wouldnt want to go too low on it. therefor we shouldn;t be too surprised that many men do not respond to propecia.

i was also wondering about guys who do have elevated dht, such as myself, but who choose not to do propecia or the equivalent. in these cases, can topical formulas, particular minox and things which do not attach the course of the problem, ie dht, but instead try to regrow hair can work. do we have evidence of guys growing back hair, and halting hairloss, despite not using an anti androgen and only relying on minox.

finally, i was wondering about the nature of dht conversion in itself. do we know if hairloss is due to the presense of circulating blood serum levels of dht, or is it due to the conversion of testosterone in the scalp. there is a subtle difference, as with prostate health for instance, a high dht blood level isnt always the problem, as in fact it is the conversion of high levels of testosterone in the prostate itself, which is the problem. is there any posibility that it is the conversion in the scalp itself, rather than the circulating dht which is the problem. this would have implications for guys who think they have elevated dht levels, as using propecia may in fact make it worse, as the extra testosterone liberated may in fact just reach the scalp and convert in the follicles. however, this may be way off the mark, as propecia may be particularly effective at stopping conversion in the scalp- however i just dont know how propecia works- how readily it targets the follicles itself.

just a few thoughts

I do not believe DHT is the sole reason men lose their hair because I had a receding hairline at the age of 26 when I first got on TRT because my test levels were so low. I know my DHT levels were also low because I never fully virilized.

Perhaps estrogen also plays a role in hair loss, just like it does with BPH, another condition that is mostly blamed on excessive DHT.

[Kanecore]

I recently found out my DHT is over the top level of the normal range despite taking T injections twice a week and taking Arimidex. My E2 is in check but my total Es are high. I get bph at times. My hair thinned out in a matter of a month after starting TRT 8 years ago but never got worse. The dermatologist said I didn't have male patter baldness but something else was causing it. My adrenals and thyroid are fine though. I just started taking a prostate formula and am trying to get off Arimidex and start with Indole 3-carbinol, Zinc, TMG and Milk Thistle. Can an excessively high DHT level cause hair to thin despite not having male pattern baldness?

[chip douglas]

I have high DHT levels as evidenced by my blood test--unless the blood test is innacurate, and I can tell you that my hair is thinning out quite a bit. I've ordered Dr. Proctor's hair formulas, and Folligen to battle it on the outside. I'll also start taking saw palmetto and beta-sitosterol.

On a different subject, but still relevant since Saw Palmetto is concerned, I've just found this on Pubmed :


Saw palmetto-induced pancreatitis.Jibrin I, Erinle A, Saidi A, Aliyu ZY.
St. Agnes Healthcare, 900 South Caton Avenue, Baltimore, MD 21229, USA. imjibrin@yahoo.com

Saw palmetto is a frequently used botanical agent in benign prostatic enlargement (BPH). Although it has been reported to cause cholestatic hepatitis and many medical conditions, Saw palmetto has not been implicated in acute pancreatitis. We report a case of a probable Saw palmetto induced acute hepatitis and pancreatitis. A 55-year-old reformed alcoholic, sober for greater than 15 years, presented with severe non-radiating epigastric pain associated with nausea and vomiting. His only significant comorbidity is BPH for which he intermittently took Saw palmetto for about four years. Physical examination revealed normal vital signs, tender epigastrium without guarding or rebound tenderness. Cullen and Gray Turner signs were negative. Complete blood count and basic metabolic profile were normal. Additional laboratory values include a serum amylase: 2,152 mmol/L, lipase: 39,346 mmol/L, serum triglyceride: 38 mmol/L, AST: 1265, ALT: 1232 and alkaline phosphatase was 185. Abdominal ultrasound and magnetic resonance cholangiography revealed sludge without stones. A hepatic indole diacetic acid scan was negative. Patient responded clinically and biochemically to withdrawal of Saw palmetto. Two similar episodes of improvements followed by recurrence were noted with discontinuations and reinstitution of Saw Palmetto. Simultaneous and sustained response of hepatitis and pancreatitis to Saw palmetto abstinence with reoccurrence on reinstitution strongly favors drug effect. "Natural" medicinal preparations are therefore not necessarily safe and the importance of detailed medication history (including "supplements") cannot be over emphasized.

PMID: 16800417 [PubMed - indexed for MEDLINE]


I guess Saw Palmetto can still be said a relatively safe alternative, but still, I wouldn't ingest large doses of it long term.

[thebigEZ]

I think it is mostly genetics. My hair has gotten thicker since starting trt. Both my testosterone and dht levels are high.