Suffering from Low T/Libido symptoms and Hair Loss (MPB/AGA)?

[dvs17]

Has anyone here suffered from both Low T symptoms (specifically low libido/sexual function issues) + Hair loss (MPB/AGA) and seen an improvement in symptoms going on TRT and using Finasteride or Dutasteride (even low dose topically) to treat hair loss? 

To try and cut a long story short, I have been suffering from Low Libido and Erection issues since 2016 (28 now). The symptoms started relatively suddenly around the time I started using this ‘Testosterone Booster Supplement’: (photo attached) (I'm not sure if this was 100% the cause but it started exactly around the time I started using this and supposedly Saw Palmetto which it contains is a mild 5ari though I'm not sure if it can cause long term side effects). Before this I was also suffering from other Low T symptoms (partly the reason why I decided to try a Testosterone Booster in the first place) although I had no sexual function issues. Have already made a post here with a bit more detail: (reddit link removed)

A few years back (around 2021) I noticed that my hair was starting to thin (diffuse thinning) and recede (although I probably started losing it before this but perhaps didn't notice) and it has progressed since. I looked into Finasteride/Dutasteride but have always been concerned about the potential side effects especially since I already have some of the symptoms that Finasteride/Dutasteride can potentially make worse and the fact that I may be sensitive to even a mild 5ari like Saw Palmetto. 

I have never been on TRT or Hair loss medications yet I am suffering from both Low T symptoms and hair loss, so it seems like I have to either choose between sexual function or my Hair (i.e. TRT may help symptoms but perhaps will accelerate my hair loss and Fin/Dut may help my Hair but might make my Low T/sexual symptoms worse). Obviously my sexual function and overall health is more important so I would try and probably focus on improving that first before even considering hair loss meds although I have seen a few people report improved libido gong on Fin or Dut but perhaps that's only in the short term/initially.

[TakeAction]

TRT is probably the single worst thing you can do to your hair. 400-500 ng/dL is not nearly as bad as some people will have you believe and your libido should be fine at that level.

You're probably better off hairwise natty and not on meds than on TRT and dutasteride.

TRT destroys SHBG and spikes up free testosterone through the roof. That means much higher scalp DHT. Dutasteride only lowers scalp DHT by about 50 percent.

In many cases, TRT + dut is worse than natty and nothing.

There are many factors to libido and TRT clinics and marketing have made people believe that a testosterone level in the 400s means you will have zero sex drive. Couldn't be further from the truth.

Make some basic lifestyle adjustments and see if that helps. 

[shiba1985]

Unless you are some genetic abnormality, most likely your T is more than normal. Check it again exactly at 7 am after a good nights sleep. It will be higher. Chances are you have boy image issues, or anxiety around erection such as size of your penis, lasting longer etc. All that has killed your boner. Unless you have taken some medications or done anything major with your hormone system you need to get over your mental stuff. 

I read somewhere that even castrated eunuchs can have erections. there is no reason that you cant have erections at those level. Also TRT is not a cure to libido and erection issues. Since 99% of this is mental TRT will not solve it. You will just be a little muscular and hornier without being able to get it up. 

[DedLifts]

You don't need to take TRT. At least try raising your T naturally through these:

1. Lifting
2. Eating healthy
3. Getting better sleep
4. Avoid alcohol (and other controlled substances)

Also, Fin actually raises T since it blocks it from converting into DHT.

Edited April 9 by DedLifts

[dvs17]

On 4/9/2024 at 3:32 AM, shiba1985 said:

Unless you are some genetic abnormality, most likely your T is more than normal. Check it again exactly at 7 am after a good nights sleep. It will be higher. Chances are you have boy image issues, or anxiety around erection such as size of your penis, lasting longer etc. All that has killed your boner. Unless you have taken some medications or done anything major with your hormone system you need to get over your mental stuff. 

I read somewhere that even castrated eunuchs can have erections. there is no reason that you cant have erections at those level. Also TRT is not a cure to libido and erection issues. Since 99% of this is mental TRT will not solve it. You will just be a little muscular and hornier without being able to get it up. 

Yeah I think its likely just genetic as my current levels shouldn't really be causing these symptoms although there are many who've gone on TRT at my levels and seen improvement in symptoms (random example attached), its likely genetic as to the reason why some require higher levels. Its nothing psychological unfortunately, I've never had any of the mental issues you've pointed out on. 
I don't have complete ED just very low libido and weak erections, no morning erections. I havent taken any medications that should cause my symptoms, just that supplement above but I don't see how that can cause long term side effects. 
This was my last blood test done at 8.30am, fasted with around 8 hours of sleep but I will get another one soon and do it even earlier this time. 

I did have slight developmental delay when I was younger and a late growth spurt but not sure if any of that is related. 

[dvs17]

On 4/9/2024 at 2:37 AM, TakeAction said:

TRT is probably the single worst thing you can do to your hair. 400-500 ng/dL is not nearly as bad as some people will have you believe and your libido should be fine at that level.

You're probably better off hairwise natty and not on meds than on TRT and dutasteride.

TRT destroys SHBG and spikes up free testosterone through the roof. That means much higher scalp DHT. Dutasteride only lowers scalp DHT by about 50 percent.

In many cases, TRT + dut is worse than natty and nothing.

There are many factors to libido and TRT clinics and marketing have made people believe that a testosterone level in the 400s means you will have zero sex drive. Couldn't be further from the truth.

Make some basic lifestyle adjustments and see if that helps. 

Yeah accelerated hair loss has been one of my main concerns going TRT. I agree that a lot of TRT clinics will just prescribe TRT to anyone, there are people who have levels in the 300s that have no libido/sex drive issues.

Not much more I can do lifestyle wise.  
 

[OfficerWinslow]

@dvs17 I'm a bit late to this convo, but I can relate to what you've been experiencing.  A few big points I'd like to share:

• As other pointed out your T levels are not "terrible".  However, how you feel is a metric that you should not be forgetting.  What is normal for one person, could be low or high for another.  There have been plenty of guys who go on TRT with similar levels as you and report feeling much better.  
• As a first step, I strongly suggest you see a good functional medicine doctor who understands hormones and a Urologist.  Low libido and poor erections could be caused by more than just Low T.  Make sure you see someone who has a good track record for treating these symptoms.  
• Not a doctor but based on my personal experience it seems your prolactin levels are a bit high which can definitely affect libido and erections.  I was taking some supplements that I found out were likely causing higher prolactin levels.  Definitely review with a good hormone doc. 
• If you choose to go on TRT, I would personally wait and see how you feel before introducing Fin.  Yes, you are likely going to shed without being on Fin, but if you want to put your sexual health first, you need to see if TRT is actually helping.  If you're sensitive to Fin, it may offset the TRT treatment.  Once you know how you are responding to TRT, I would then add in Finasteride. 
• If you're not sensitive to Fin and can tolerate, make sure you stay on it as TRT can really accelerate your hair loss.  The benefit for Fin while on TRT is that it will help mitigate not just hair loss, but some cystic acne that can occur. 

Hope some of that helps! 

[dvs17]

On 4/26/2024 at 8:04 PM, OfficerWinslow said:

@dvs17 I'm a bit late to this convo, but I can relate to what you've been experiencing.  A few big points I'd like to share:

• As other pointed out your T levels are not "terrible".  However, how you feel is a metric that you should not be forgetting.  What is normal for one person, could be low or high for another.  There have been plenty of guys who go on TRT with similar levels as you and report feeling much better.  
• As a first step, I strongly suggest you see a good functional medicine doctor who understands hormones and a Urologist.  Low libido and poor erections could be caused by more than just Low T.  Make sure you see someone who has a good track record for treating these symptoms.  
• Not a doctor but based on my personal experience it seems your prolactin levels are a bit high which can definitely affect libido and erections.  I was taking some supplements that I found out were likely causing higher prolactin levels.  Definitely review with a good hormone doc. 
• If you choose to go on TRT, I would personally wait and see how you feel before introducing Fin.  Yes, you are likely going to shed without being on Fin, but if you want to put your sexual health first, you need to see if TRT is actually helping.  If you're sensitive to Fin, it may offset the TRT treatment.  Once you know how you are responding to TRT, I would then add in Finasteride. 
• If you're not sensitive to Fin and can tolerate, make sure you stay on it as TRT can really accelerate your hair loss.  The benefit for Fin while on TRT is that it will help mitigate not just hair loss, but some cystic acne that can occur. 

Hope some of that helps! 

thanks for the advice

• As other pointed out your T levels are not "terrible".  However, how you feel is a metric that you should not be forgetting.  What is normal for one person, could be low or high for another.  There have been plenty of guys who go on TRT with similar levels as you and report feeling much better.  

Correct, I've come across many people who've had similar numbers to mine and seen improvement and it's not like I've been suffering from these symptoms for a few weeks or a few months and then just jumped on Test....it's been years. I think individual genetics and receptor sensitivity play a role as to why people feel normal at different levels. 

• As a first step, I strongly suggest you see a good functional medicine doctor who understands hormones and a Urologist.  Low libido and poor erections could be caused by more than just Low T.  Make sure you see someone who has a good track record for treating these symptoms.  

Yes I'm in the UK and there aren't really that many good functional/integrative medicine docs who have an interest in Men's Health/hormones. There are a few decent TRT clinics here now but I wouldn't call them functional/integrative medicine docs/clinics, they mostly just prescribe TRT and most ‘TRT docs’ are usually against using hair loss meds like Fin and Dut, most of them will just tell you to 'just shave it bro'. Dr Kyle Gillett and James O’Hara at Gillette Heath in the US are the only two that I've come across on YT/online that actually seem kind of pro Finasteride/Dutasteride and they are both on TRT + oral Dutasteride although I would say they are more functional/integrative medicine docs than just 'TRT docs' (they've made a few hair loss videos on their YT channel)

Have already seen a Urologist/Andrologist, had a physical exam (said I had a varicocele but shouldn't effect my levels) and even had Doppler ultrasound which came back normal which I was expecting anyway as my symptoms feel more Hormonal/neurotransmitter related but most Urologists don't seem to be that good at managing hormones (they just prescribed me Cialis)

• Not a doctor but based on my personal experience it seems your prolactin levels are a bit high which can definitely affect libido and erections.  I was taking some supplements that I found out were likely causing higher prolactin levels.  Definitely review with a good hormone doc. 

I've had both normal and slightly elevated levels before with not much noticeable difference but I will be getting updated blood work next week to see if it's still elevated and will discuss them with a TRT/hormone doc. Don't think I'm taking anything that should be elevating it.                                                                                                                               

• If you choose to go on TRT, I would personally wait and see how you feel before introducing Fin.  Yes, you are likely going to shed without being on Fin, but if you want to put your sexual health first, you need to see if TRT is actually helping.  If you're sensitive to Fin, it may offset the TRT treatment.  Once you know how you are responding to TRT, I would then add in Finasteride. 

Yes if I go on TRT I will wait before trying any hair loss meds even though it may accelerate it, I was considering trying Fin or even Dut now to see how I respond since I already feel messed up hormonally but as you said my general/sexual health is more important and I need to see how well I respond to TRT so would do that first, trying a 5ari first probably wouldn't be the best idea even though I have seen some people say they've actually had an improved libido from taking 5ari specifically with Dut.

• If you're not sensitive to Fin and can tolerate, make sure you stay on it as TRT can really accelerate your hair loss.  The benefit for Fin while on TRT is that it will help mitigate not just hair loss, but some cystic acne that can occur. 

This was one of the main reasons why I've delayed going on/trying TRT besides fertility (would freeze some sperm before also). If I go on TRT and see improvements I will be curious to see how adding fin/dut (oral or topical) effects my symptoms.         

I saw someone comment this but not sure how much truth it has. 

‘Side effects from fin come from low testosterone in the first place.... if your body relies heavily on DHT for androgen functioning because of low testosterone, then yeah, inhibiting DHT in that case will make you experience side effect from low androgen level as simple as that....therefore do a free testosterone analysis before taking fin’.

                                                                                                                                                                      

 

Edited May 3 by dvs17