Naturally Low DHT - What would you do, if you were me?

[Curious25]

Hi Everyone, 

So I got results back from blood work recently, however only today got my DHT result. 

For those familiar with reading bloods, I am only just within reference range by a scrape of a toothpick at 0.44 ng/ml (ref range 0.33 - 1.2), or 1.51 nmol.l (ref range 1.14 - 4.13). 

Simple maths would show that if I was to inhibit this by even 30%, which is what Dr Hassons new topical formula of Finasteride claims, it will take me out of range, which is not what I particularly fancy doing - on top of this, many blood work results I have seen from finasteride or dutasteride users, actually show their DHT levels higher than my own despite the suppression, which, whilst I appreciate these things are always on a case by case basis, suggests to me, that I may just have particularly sensitive follicles, as opposed to an obliteration of free DHT roaming around inside. 

So . . the obvious option to me, when considering how to tackle this from the hormonal side of things, would be to look into topical AA's, again, hardly ideal, considering the lack of safety data and sourcing of the products, however the mechanism of how they work is probably just what I need, given that we can see I have comparable levels of DHT to patients using 5AR inhibitor medication - the 'community' gold standard, suggests bringing your DHT down, and then mopping away the elevation of testosterone with a topical AA. 

I am just over 2 months in on oral minoxidil, first 6 weeks at 2.5mg daily, then upped it to 5mg daily, via 2x 2.5mg administrations. 

Nizoral 2x per week, 

Diffusing in a NW5 pattern, hairline transplant in 2016. 

What do I do? 

[hairman22]

do you have any family memebers who you think you resemble in terms of hairloss?

 

May give you a plan to move forward.

 

I would take any DHT substance in your case.

It is likley as you get older your hairloss will slow down as well. 

[Curious25]

I should also add - topical dutasteride could be a consideration, if claims it reduces serum DHT on average by only 10% are true, however, lack of available data, places it effectively on the same league as the topical AA’s such as RU, from an efficacy standpoint. Obviously from a safety standpoint, you could argue the drug itself is a proven safe alternative. 
 

 

[Curious25]

4 minutes ago, hairman22 said:

do you have any family memebers who you think you resemble in terms of hairloss?

 

May give you a plan to move forward.

 

I would take any DHT substance in your case.

It is likley as you get older your hairloss will slow down as well. 

My father is NW 5 diffuse , however with long hair, so it looks ok for his age. 
 

My mums father NW 6, to probably a NW 7 now at the age of 80+

[JDEE0]

Hi mate,

I don't really believe that the concentration of DHT or any other androgen is the main, driving factor behind MPB. It certainly plays a role, but as you allude to, it's almost certainly down to a follicular sensitivity to said androgens due to genetic factors in our DNA. 

It plays a role because if you do have some level of sensitivity, then of course more of the active hormone itself in your body is going to worsen the issue. But at the same time, you can have huge amounts of DHT and very little sensitivity to the point you basically never lose hair.

Think of a bodybuilder who never really had any hair loss, but started blasting massive amounts and lost decades of hair in a 5 year span or something due to the massive increase in androgens. My point is, most people with MPB fall within the reference range for serum DHT levels and have similar measurements to yourself as opposed to sitting somewhere at the top or slightly out of it. Here is a study which shows the average levels of DHT of around 400 men before treatment to be roughly 390/400 ng/ml (+/- standard deviation, so some a bit higher and some a bit lower in reality, of course) https://academic.oup.com/jcem/article/89/5/2179/2844345

I'm just trying to say that most people who take fin are going to be pushing themselves way out of the reference range, and this should be taken as a given for most people rather than the assumption being that you would take fin to only push you to the low end of the range.

[Curious25]

37 minutes ago, JDEE0 said:

Hi mate,

I don't really believe that the concentration of DHT or any other androgen is the main, driving factor behind MPB. It certainly plays a role, but as you allude to, it's almost certainly down to a follicular sensitivity to said androgens due to genetic factors in our DNA. 

It plays a role because if you do have some level of sensitivity, then of course more of the active hormone itself in your body is going to worsen the issue. But at the same time, you can have huge amounts of DHT and very little sensitivity to the point you basically never lose hair.

Think of a bodybuilder who never really had any hair loss, but started blasting massive amounts and lost decades of hair in a 5 year span or something due to the massive increase in androgens. My point is, most people with MPB fall within the reference range for serum DHT levels and have similar measurements to yourself as opposed to sitting somewhere at the top or slightly out of it. Here is a study which shows the average levels of DHT of around 400 men before treatment to be roughly 390/400 ng/ml (+/- standard deviation, so some a bit higher and some a bit lower in reality, of course) https://academic.oup.com/jcem/article/89/5/2179/2844345

I'm just trying to say that most people who take fin are going to be pushing themselves way out of the reference range, and this should be taken as a given for most people rather than the assumption being that you would take fin to only push you to the low end of the range.

Hi mate, 

 

Yea totally agree with you, it most certainly boils down to follicular sensitivity, hence the reason I annoyingly have a plethora of NW 1 mates, who regularly run quite a lot of gear. 
 

I guess what I was looking for, were consensus’s of what approach most people would take in my shoes. There’s obviously nothing concrete to say by dropping my levels further, it will negatively impact me side effect wise, however, sitting already at the lower end of the generic reference range, I am understandably a little more cautious than perhaps someone who had more room to reduce, for lack of a better phrase. 
 

The mechanisms of topical AA’s really appeal to me, as they probably do to most. Whether or not, alone, they are strong enough to contend with the hormone side of the battle, again, likely to be on a case by case basis - however with low end serum DHT, I would fancy my chances of fending off enough DHT with some of the stronger binding affinity topicals available - hence my great interest in Kintor right now. 

 

 

[Melvin- Admin]

Three things contribute to hair loss, one is scalp inflammation. The other is shorter anagen (growth) phases. The last one is androgens (DHT). You have to treat all three. DHT is only part of the equation, which is why the big (3) works so well. Nizoral treats scalp inflammation. Minoxidil lengthens the anagen (growth) phase, and finasteride inhibits DHT. 

Androgen sensitivity is dependent on your hair loss. If you’re a Norwood 6/7 you are highly sensitive to DHT. If you are a Norwood 2-3 you probably aren’t that sensitive to DHT, as long as you’re above 30. I believe combining therapies with a natural anti-androgen can work. Although, to be transparent, Dr. Hasson said he had the highest quality saw palmetto, and he saw no benefit. 

But how do you measure success? If you measure success by seeing a visual improvement by natural anti-androgens alone, you’re in for a rude awakening. I would measure success by slowing hair loss without any hormonal disruption. The reason why many don’t invest in this kind of stuff is because who’s gonna buy a product that says “this won’t regrow hair, but you might not look worse.” Unfortunately, that’s the reality with natural treatments. That said, staying the same for a prolonged period of time is a success to me. 

[JDEE0]

1 hour ago, Curious25 said:

Hi mate, 

 

Yea totally agree with you, it most certainly boils down to follicular sensitivity, hence the reason I annoyingly have a plethora of NW 1 mates, who regularly run quite a lot of gear. 
 

I guess what I was looking for, were consensus’s of what approach most people would take in my shoes. There’s obviously nothing concrete to say by dropping my levels further, it will negatively impact me side effect wise, however, sitting already at the lower end of the generic reference range, I am understandably a little more cautious than perhaps someone who had more room to reduce, for lack of a better phrase. 
 

The mechanisms of topical AA’s really appeal to me, as they probably do to most. Whether or not, alone, they are strong enough to contend with the hormone side of the battle, again, likely to be on a case by case basis - however with low end serum DHT, I would fancy my chances of fending off enough DHT with some of the stronger binding affinity topicals available - hence my great interest in Kintor right now. 

 

 

Yeah, I understand, but there will be no real consensus amongst people here unless we're just talking scientific in which case it would be use a 5AR inhibitor, but I know you're trying to avoid doing so which I can understand.

I would probably suggest using topical dutasteride and getting your bloods checked periodically for a 6 months to a year or so to see what drop you get in serum DHT. You'll most likely be fine, have no sides and not notice much reduction, beyond that, you can always quit if you feel the need to. 

Topical AA's are interesting, just very problematic in that we have no real data on any and no official sources apart from black market Chinese labs. You can still get good quality stuff relatively easy so that's less of an issue, but again, no real data on efficacy or safety. Either way, I think all available and future topical AA's in the pipeline will help, but are ultimately unlikely to be as effective as finasteride or dutasteride and will be much better suited stacked alongside. 

[Gokuhairline]

not an expert on this by any means but doesn't low DHT mean a good thing ? so wouldn't finas supress DHT even lower which is good for hair loss? 

[Curious25]

52 minutes ago, Gokuhairline said:

not an expert on this by any means but doesn't low DHT mean a good thing ? so wouldn't finas supress DHT even lower which is good for hair loss? 

Low dht relative to high dht is a good thing in terms of hair loss, however as J previously pointed out, the larger factor at play is one’s follicular sensitivity to DHT. 
 

With regards to even lower DHT, yes for hair loss, a good thing - for my body, potentially not , potentially not a problem . . However ideally, I’d like to try and at least keep within ‘range’. 

[Curious25]

2 hours ago, JDEE0 said:

Yeah, I understand, but there will be no real consensus amongst people here unless we're just talking scientific in which case it would be use a 5AR inhibitor, but I know you're trying to avoid doing so which I can understand.

I would probably suggest using topical dutasteride and getting your bloods checked periodically for a 6 months to a year or so to see what drop you get in serum DHT. You'll most likely be fine, have no sides and not notice much reduction, beyond that, you can always quit if you feel the need to. 

Topical AA's are interesting, just very problematic in that we have no real data on any and no official sources apart from black market Chinese labs. You can still get good quality stuff relatively easy so that's less of an issue, but again, no real data on efficacy or safety. Either way, I think all available and future topical AA's in the pipeline will help, but are ultimately unlikely to be as effective as finasteride or dutasteride and will be much better suited stacked alongside. 

The daily application is also a somewhat unappealing prospect for topical AA’s - however with topical dutasteride , I would plan to apply it once every 12-15 days, and leave it on for only 4 hours. That is somewhat manageable, IMO, in terms of adding in a topical. 
 

Your plan is most likely what I will go for . . And then down the line, look at adding in something new if needs be, and we have days to assess. 
 

Would part of you question, if topical DUT doesn’t have an impact systemically, whether or not it is doing anything at all up top? 

[JDEE0]

2 hours ago, Curious25 said:

The daily application is also a somewhat unappealing prospect for topical AA’s - however with topical dutasteride , I would plan to apply it once every 12-15 days, and leave it on for only 4 hours. That is somewhat manageable, IMO, in terms of adding in a topical. 
 

Your plan is most likely what I will go for . . And then down the line, look at adding in something new if needs be, and we have days to assess. 
 

Would part of you question, if topical DUT doesn’t have an impact systemically, whether or not it is doing anything at all up top? 

Yeah, I'm with you there too, however when stacked with some sort of 5AR inhibitor, I would feel comfortable even just doing it 3 times a week/every other day/just when I can remember or be arsed. Since you're not really relying on it at that point and it's just supplemental, it would still be a good protocol overall imo. Obviously wouldn't be as effective as the intended daily application, but certainly still beneficial and dosing schedules could always be ramped up if it became clear loss was progressing (although 3 times a week is still a bit of a pain, it's a small sacrifice for the greater good). Topical dut once a week or every 10 days would be completely fine, wouldn't really be a nuisance at all to me at that frequency. 

Yeah, I think that's probably the best bang for your buck strategy or plan in terms of halting hair loss vs risk-reward ratio for someone like you who is a bit hesitant to hop on but obviously still realises the benefits for stopping loss.

I have indeed actually questioned that before and posted so on here when all the threads initially started popping up around topical dut last year. There was quite a lot of anecdotal evidence from users on here and other sources online that it only reduced their serum DHT by a small amount, 10 percent or so, so I felt fairly convinced that it doesn't go too systemic for the most part. And people can just do their own bloodwork to confirm this aspect of things, so it's all good there. But like you say, I wasn't sold on whether it actually worked and questioned if the lack of systemic activity suggested that it really didn't do much. However, at the time, there wasn't much in the way of evidence, which is still true, but if Hasson's data is good (as he suggests it will be) then it will be clear that it does actually also work to stop loss and this has given me a lot more hope that it will be effective.