0 Testosterone and 350 DHT COMPLEX PROBLEM

[marmot]

Hi
I’ve got some complex problem that has to do with extremely high DHT concentrations finasteride and dutasteride not being able to decrease them.

I first notice itching and that my hair is flat and greasy in 2018 when I was 21 yo.
I ignored it till January 2020 when I decided to have an appointment with a trichologist for the diagnose -hair loss so he prescribed minoxidil and Propecia.
So due to my lack of knowledge on this subject, I started minoxidil and Propecia at the same time simultaneously. I discontinued minoxidil after 3 months and keep only with Propecia for 2 more months but I don’t think I got any results whatsoever so
decided to check my DHT levels and there it is 1700 DHT.

Meanwhile also started RU which is the only reason why I still have hair on my scalp to this day.
My testosterone was higher than normal due to Propecia increasing it also got sides - loss of libido and erectile dysfunction.
SO I switched to dutasteride for about 1,5 months to see what gonna happen I checked the DHT levels again and this time it was about 2350.
Again my testosterone was really high and I've got all the sexual sides but my DHT paradoxically increased.
My hair was shedding there was no doubt about it. I went crazy so I took 3 pills of androcur and the same results occurred DHT 2350, testosterone was even higher than before.

I started doing research, I ask my mother to do the examination of her DHT levels she did and she has a DHT of about 500 so it's increased similarly to mine. (of course, based on that that women have a lower range of normal amount of DHT)
I stooped finasteride/dutasteride.

Switched to CPA I was taking dosages even as high as 200mg per day and 4 mg estradiol. the only feminization effect is gino my face looks totally normal. When I was on that I also stooped using RU which was a huge mistake.

After a while, I checked my hormones so testosterone was almost 0 at the castration range but DHT is still around 350. So the question is where does this DHT come from? From adrenals? Because I can’t believe that this small amount of testosterone is converted to DHT, adrenals also produce 10% of androgens, and correct me if I'm wrong but they also produce DHT?

CPA is not a pure antagonist it also posses some agonist activity (the same goes for flutamide which I also used for some time and it didn't work too)so my assumption is because of this small agnostic activity of cpa I was getting worse on higher dosages and at lower I get better. I got worse on 200mg of CPA without RU ( I was losing hair).
Was thinking about NCAH I did a gene test due to 21-hydroxylase deficiency which is responsible for about 90% of all cases of ncah and it showed that I don’t have this one.
I've also used Firmagon(degarelix) it decreases your FSH and LH to almost 0 so I've got 0 testosterone but this time 600 dht which makes no sense at all.

Currently 4mg estradiol per day, CPA 3,25-6mg per day, RU 58841

Is there anyone that has any solution for all of this-what to do?
I was thinking about topical finasteride maybe it will work.
Maybe it's something with the liver?

 

[GRme11]

Hi
I’ve got some complex problem that has to do with extremely high DHT concentrations finasteride and dutasteride not being able to decrease them.

I first notice itching and that my hair is flat and greasy in 2018 when I was 21 yo.
I ignored it till January 2020 when I decided to have an appointment with a trichologist for the diagnose -hair loss so he prescribed minoxidil and Propecia.
So due to my lack of knowledge on this subject, I started minoxidil and Propecia at the same time simultaneously. I discontinued minoxidil after 3 months and keep only with Propecia for 2 more months but I don’t think I got any results whatsoever so
decided to check my DHT levels and there it is 1700 DHT.

Meanwhile also started RU which is the only reason why I still have hair on my scalp to this day.
My testosterone was higher than normal due to Propecia increasing it also got sides - loss of libido and erectile dysfunction.
SO I switched to dutasteride for about 1,5 months to see what gonna happen I checked the DHT levels again and this time it was about 2350.
Again my testosterone was really high and I've got all the sexual sides but my DHT paradoxically increased.
My hair was shedding there was no doubt about it. I went crazy so I took 3 pills of androcur and the same results occurred DHT 2350, testosterone was even higher than before.

I started doing research, I ask my mother to do the examination of her DHT levels she did and she has a DHT of about 500 so it's increased similarly to mine. (of course, based on that that women have a lower range of normal amount of DHT)
I stooped finasteride/dutasteride.

Switched to CPA I was taking dosages even as high as 200mg per day and 4 mg estradiol. the only feminization effect is gino my face looks totally normal. When I was on that I also stooped using RU which was a huge mistake.

After a while, I checked my hormones so testosterone was almost 0 at the castration range but DHT is still around 350. So the question is where does this DHT come from? From adrenals? Because I can’t believe that this small amount of testosterone is converted to DHT, adrenals also produce 10% of androgens, and correct me if I'm wrong but they also produce DHT?

CPA is not a pure antagonist it also posses some agonist activity (the same goes for flutamide which I also used for some time and it didn't work too)so my assumption is because of this small agnostic activity of cpa I was getting worse on higher dosages and at lower I get better. I got worse on 200mg of CPA without RU ( I was losing hair).
Was thinking about NCAH I did a gene test due to 21-hydroxylase deficiency which is responsible for about 90% of all cases of ncah and it showed that I don’t have this one.
I've also used Firmagon(degarelix) it decreases your FSH and LH to almost 0 so I've got 0 testosterone but this time 600 dht which makes no sense at all.

Currently 4mg estradiol per day, CPA 3,25-6mg per day, RU 58841

Is there anyone that has any solution for all of this-what to do?
I was thinking about topical finasteride maybe it will work.
Maybe it's something with the liver?

That's very odd and complex indeed. Hormones are like that, coming with so much complexity.
Firstly, we can claim that you experience the partial agonist activity of CPA with higher doses. CPA is not a full antagonist of AR like Bicalutamide, for example. So, with 200 mg, it started acting in reverse. That's is why you don't need high dosages of CPA and partial agonists in general. Low doses can achieve great results, as you experienced later when lowering your dosage. Here is a very great article which concluding this (low dose=maximal effectiveness): https://transfemscience.org/articles/cpa-dosage/. (Although, we know that non-steroidal/full-silent antagonists like Bicalutamide, are having greater efficacy.)
Secondly, RU probably acted as it should, inhibiting both T and DHT on the scalp effectively.
Now, let's focus on the main problem. WHY my DHT is still high, even if I nuked my Testosterone? This is very complex here, could be many things that we can only assume and goes on, but I will suggest some things. (Just keep in mind the partial agonist effect of CPA.)
1) Try again Finasteride/Dutasteride. You can go topical, as you mentioned. You still need to attack DHT no matter what. Sensitivity matters. Now that you create an anti-androgenic and estrogenic environment, I assume that will work better on the final equation. You have RU already, which is working, so this is good.
2) Please check your 17-OHP, 3a-Diol-G, Δ4-Androstenedione, and DHEA-S! Probably it will help for the adrenal and backdoor pathway of DHT.
a)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464227/
b)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3367713/
c)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4437668/ (extra info)
d)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432488/ (extra info)

*Have you checked your E2 levels?

 

[marmot]

Thank you for your response. I tried using Propecia during my CPA and RU treatment and again I get an itchy scalp and my hair is falling at faster rates.
If I will check those things that you mentioned above is there anything other than Propecia/duta that I can do to lower these things?
I also read about bica cpa and other newer antiandrogens like enzalutamide can act as a full agonists if the genes are mutated but those examples come from prostatic cancer. Don't know if you can have mutated genes even if you don't have cancer??
My estradiol levels 114,3 pg/ml

Also, I've got a question about topical finasteride because you apply it topically the mechanism of action is somehow different from the oral route?

 

[GRme11]

Thank you for your response. I tried using Propecia during my CPA and RU treatment and again I get an itchy scalp and my hair is falling at faster rates.
If I will check those things that you mentioned above is there anything other than Propecia/duta that I can do to lower these things?
I also read about bica cpa and other newer antiandrogens like enzalutamide can act as a full agonists if the genes are mutated but those examples come from prostatic cancer. Don't know if you can have mutated genes even if you don't have cancer??
My estradiol levels 114,3 pg/ml

Also, I've got a question about topical finasteride because you apply it topically the mechanism of action is somehow different from the oral route?

Well, if you tried and you didn't get any positive result, then yes, give it a try to the topical route. Yes, this is where I am stuck as well. These studies mention cancer cells and mutated genes. This is why it's very complex.

(To lower DHT aside from finasteride/dutasteride, I don't know… Maybe you could increase your E2, or maybe you can ditch CPA and go with Bica, etc. *I just assume and I do not recommend*)

The difference when comparing the mechanism of Topical-Oral Finasteride/Dutasteride is: Because DHT is a paracrine hormone as well, it can act on the tissues of the scalp, skin, etc. So, the claim of effectiveness for topical finasteride/dutasteride is that they can act immediately on the scalp and stop the production of scalp DHT to a greater extent than the oral route.

 

[marmot]

the Pill -Propecia has to be somehow unpacked in the body I mean digest so does the liver plays some role in all of this? maybe there is something in the body that blocks its effectiveness. So by putting it directly on the hair I can skip this process. don't know maybe I'm just raving here but anyways I will try topical finasteride what solution do you recommend because there are few with diffrent concentrations?

 

[GRme11]

the Pill -Propecia has to be somehow unpacked in the body I mean digest so does the liver plays some role in all of this? maybe there is something in the body that blocks its effectiveness. So by putting it directly on the hair I can skip this process. don't know maybe I'm just raving here but anyways I will try topical finasteride what solution do you recommend because there are few with diffrent concentrations?

As I said, it is so difficult to tell exactly what's the cause. Yes, it could be your liver's metabolism for the Propecia pill. Who knows. There are many assumptions. Yes, applying on the scalp is supposed to skip the process to a great extent. Maybe you could start with 0.05-0.1% (0.5mg/ml & 1mg/ml, respectively). These are pretty common dosages.

 

[marmot]

Thank you so much. If anyone would like to add something pls do I will be even more than glad to read it.

 

[GRme11]

Thank you so much. If anyone would like to add something pls do I will be even more than glad to read it.

I hope I shed some light. Thank you.

 

[AlexCross]

Thank you so much. If anyone would like to add something pls do I will be even more than glad to read it.

Is there finasteride for topical use? I heard a lot but never met. what is the name of this drug? do you know an online store where i can order it?