Increased dihydrotestosterone while taking finasteride

[GRme11]

UPD:


So, a little more than a month has passed since the end of taking finasteride 5 mg and my testing for dihydrotestosterone. As I already wrote, I switched back to taking 1 milligram per day (a little more, since I divide the pill into 4 parts).
Today I received new test results and they not only do not please me, but also confuse me. Now the result is 1312. I don't understand why this is happening. Does anyone have any thoughts?

I really don't know what to do. I could say finasteride doesn't work for me, but April's test results say otherwise.

Have you ever checked your PSA levels? If so, do a test again. Maybe you can try to check 3a-Diol-G too. Have you considered Dutasteride? Anyways, DHT levels are not always accurate. Hormones fluctuate a lot during the day. There is even a study done for Dutasteride, and the DHT levels, surprisingly, were not reduced as expected:

https://journals.sagepub.com/doi/abs/10.1177/2051415820926301

Results:​

DHT and DHEAS decreased by 38.5% and 20.3%, respectively. On the contrary, T and E2 increased by 34.3% and 9.4%, respectively. PV and prostate-specific antigen decreased by 17.7% and 63.4%, respectively. The rate of decrease of DHT had a negative correlation with PV, and the rate of decrease of DHEAS had positive correlation with PV.

Conclusion:​

DHT did not decrease as expected (previous studies showed a decrease of approximately 90%). However, DHEAS decreased more than a natural decrease. It is possible that the conversion from DHEAS to DHT, via the conversion to T, in the prostate was accelerated by the decrease of DHT, especially in larger prostates. However, this discrepancy cannot be full explained by the conversion from DHEAS to DHT, as mentioned above.

Also, keep in mind that there is a "backdoor" pathway, which can still promote DHT. Finasteride can't help with this pathway due to the limited blockade in 5AR1. On the other hand, Dutasteride, due to the dual inhibition of the SRD5A, can handle "better" this pathway.

The “backdoor pathway” of androgen synthesis in human male sexual development

Mammalian sex determination (male versus female) is largely controlled by genes, whereas sex differentiation (development of reproductive structures) is largely controlled by hormones. Work in the 20th century indicated that female external anatomy was ...

www.ncbi.nlm.nih.gov

 

[AlexCross]

Maybe upregulation idk.

ummm...what does that mean?

 

[AlexCross]

Have you ever checked your PSA levels? If so, do a test again. Maybe you can try to check 3a-Diol-G too. Have you considered Dutasteride? Anyways, DHT levels are not always accurate. Hormones fluctuate a lot during the day. There is even a study done for Dutasteride, and the DHT levels, surprisingly, were not reduced as expected:

https://journals.sagepub.com/doi/abs/10.1177/2051415820926301

Results:​

DHT and DHEAS decreased by 38.5% and 20.3%, respectively. On the contrary, T and E2 increased by 34.3% and 9.4%, respectively. PV and prostate-specific antigen decreased by 17.7% and 63.4%, respectively. The rate of decrease of DHT had a negative correlation with PV, and the rate of decrease of DHEAS had positive correlation with PV.

Conclusion:​

DHT did not decrease as expected (previous studies showed a decrease of approximately 90%). However, DHEAS decreased more than a natural decrease. It is possible that the conversion from DHEAS to DHT, via the conversion to T, in the prostate was accelerated by the decrease of DHT, especially in larger prostates. However, this discrepancy cannot be full explained by the conversion from DHEAS to DHT, as mentioned above.

Also, keep in mind that there is a "backdoor" pathway, which can still promote DHT. Finasteride can't help with this pathway due to the limited blockade in 5AR1. On the other hand, Dutasteride, due to the dual inhibition of the SRD5A, can handle "better" this pathway.

The “backdoor pathway” of androgen synthesis in human male sexual development

Mammalian sex determination (male versus female) is largely controlled by genes, whereas sex differentiation (development of reproductive structures) is largely controlled by hormones. Work in the 20th century indicated that female external anatomy was ...

www.ncbi.nlm.nih.gov

And what should I do in the end?
In the near future I plan to do an ultrasound examination of the prostate gland, since if it is enlarged (and I treated it not so long ago), then it may be worth paying attention to this factor

and I didn't quite get it. Can an enlarged prostate cause finasteride to not work or not work as it should?

As for dutasteride. I don't understand how it can help either. because from your scheme it is clear that 5A type 1 does not affect DHT in any way

 

[Mr. Slap Head]

@losingbattle88 knows all about the “backdoor” pathway @DoctorHouse

 

[losingbattle88]

@losingbattle88 knows all about the “backdoor” pathway @DoctorHouse

Yes I sure do my son

 

[GRme11]

And what should I do in the end?
In the near future I plan to do an ultrasound examination of the prostate gland, since if it is enlarged (and I treated it not so long ago), then it may be worth paying attention to this factor

and I didn't quite get it. Can an enlarged prostate cause finasteride to not work or not work as it should?

As for dutasteride. I don't understand how it can help either. because from your scheme it is clear that 5A type 1 does not affect DHT in any way

Yes, because Finasteride might be not enough for your prostate. Have you not done any PSA test to check if it’s reduced? Dutasteride not affecting DHT is a huge misinformation. Dutasteride outperforms Finasteride in every way. The extra DHT blockage comes from the 5AR1 inhibition. If your prostate it’s not enlarged, and your PSA levels are low, then Finasteride still works. By they way, how is your hair? Are you stable or noticed negative impact?

 

[GRme11]

@losingbattle88 Come on, mate. I am not saying about results! Everyone will respond differently! I am just saying what many studies are saying.

 

[losingbattle88]

Yes, because Finasteride might be not enough for your prostate. Have you not done any PSA test to check if it’s reduced? Dutasteride not affecting DHT is a huge misinformation. Dutasteride outperforms Finasteride in every way. The extra DHT blockage comes from the 5AR1 inhibition. If your prostate it’s not enlarged, and your PSA levels are low, then Finasteride still works. By they way, how is your hair? Are you stable or noticed negative impact?

Definately doesnt outperform when it comes to hair, it spikes too much scalp T and serum compared to

@losingbattle88 Come on, mate. I am not saying about results! Everyone will respond differently! I am just saying what many studies are saying.

Ok good. I removed dislike.

 

[GRme11]

Definately doesnt outperform when it comes to hair, it spikes too much scalp T and serum compared to

Ok good. I removed dislike.

Thank you. Of course, we know that. For others will work wonders while for others not.

 

[AlexCross]

Yes, because Finasteride might be not enough for your prostate. Have you not done any PSA test to check if it’s reduced? Dutasteride not affecting DHT is a huge misinformation. Dutasteride outperforms Finasteride in every way. The extra DHT blockage comes from the 5AR1 inhibition. If your prostate it’s not enlarged, and your PSA levels are low, then Finasteride still works. By they way, how is your hair? Are you stable or noticed negative impact?

No, I have never had a PSA test. In fact, I was always prescribed only an ultrasound. And the last time I came in with acute pain, and I was prescribed treatment after.. let's call it "classic prostate examination")
Well, maybe that makes sense. if you look at my tests, the lowest result (about 900) was exactly when I took a high dose - 5mg. And maybe this dose was enough for me. but for now it doesn't make sense without prostate tests

yes, i know that dutasteride works stronger than finasteride, but i referred to some users who wrote in this thread that due to the work of the "backdoor", neither dutasteride nor finasteride will help me

didn't understand this part: "If your prostate it's not enlarged, and your PSA levels are low, then Finasteride still works."

you yourself wrote above that a situation is possible in which 5A inhibitors do not work



No, I haven't noticed any changes in my hair. but I take minoxidil 5% every day, and therefore maybe it corrects the situation for now, but it’s impossible to sit on it for a long time. And on the advice of @Mr. Slap Head, I want to make a solution of ethanol and bicalutamide. According to him, this is what helped him. but so far I cannot find bicalutamide in my city.

 

[AlexCross]

Definately doesnt outperform when it comes to hair, it spikes too much scalp T and serum compared to

Ok good. I removed dislike.

I don't understand. and what's the difference how much T in the scalp, if the main reason for the loss of DHT.

 

[losingbattle88]

Thank you. Of course, we know that. For other will work wonders while for others not.

I don't understand. and what's the difference how much T in the scalp, if the main reason for the loss of DHT.

Dht is not the only androgen that causes hairloss, T has also a roll in it. Some guys hair is T sensitive too.

 

[AlexCross]

Dht is not the only androgen that causes hairloss, T has also a roll in it. Some guys hair is T sensitive too.

I haven't seen any research on this. Yes, and all drugs that are supposed to stop hair loss are somehow related to DHT. but maybe you're right, just never read about it.

 

[GRme11]

No, I have never had a PSA test. In fact, I was always prescribed only an ultrasound. And the last time I came in with acute pain, and I was prescribed treatment after.. let's call it "classic prostate examination")
Well, maybe that makes sense. if you look at my tests, the lowest result (about 900) was exactly when I took a high dose - 5mg. And maybe this dose was enough for me. but for now it doesn't make sense without prostate tests

yes, i know that dutasteride works stronger than finasteride, but i referred to some users who wrote in this thread that due to the work of the "backdoor", neither dutasteride nor finasteride will help me

didn't understand this part: "If your prostate it's not enlarged, and your PSA levels are low, then Finasteride still works."

you yourself wrote above that a situation is possible in which 5A inhibitors do not work



No, I haven't noticed any changes in my hair. but I take minoxidil 5% every day, and therefore maybe it corrects the situation for now, but it’s impossible to sit on it for a long time. And on the advice of @Mr. Slap Head, I want to make a solution of ethanol and bicalutamide. According to him, this is what helped him. but so far I cannot find bicalutamide in my city.

Well, you can test 3a-Diol-G and your PSA. At least, these are better markers than DHT alone. I wrote a lot about 3a-Diol-G here:https://www.hairlosstalk.com/intera...ation-of-hair-follicles-and-3a-diol-g.134542/

I am in a kinda similar situation. My dht levels rebounded back to baseline after they were constantly inhibited about 44% from Finasteride. Although, even with the 44% reduction, I was still having results. My 3a-Diol-G levels were low too. 3a-Diol-G it’s an indicator of 5AR in tissues. Quick reference: http://immunotech.cz/Media/Default/Page/A-G_analyte_info.pdf

Well, you saw the study that I linked above. The dht might be normal, but if the PSA is crashed, then it’s supposed that is doing something. That’s what I wanted to tell.

Yes, you are correct about Backdoor pathway. Dutasteride might not be enough, as well, but it is the common next step. Also, you can't judge without trying. You might respond, you might not. Furthermore, topical Finasteride could help too, since it’s blocking more scalp DHT according to the studies. You might need more local inhibition. There are lot of causes. Hair loss is multi factorial. @Mr. Slap Head and @losingbattle88 are correct. Some people can be very sensitive to Testosterone, with result to lose ground even with the 5ARis inhibitors. Although, there is a conflict with the study which mentions that those who were lacking 5AR2 enzyme, did not developed baldness. However, there is a tremendous rise on scalp Testosterone from Dutasteride. So, this increment could damage someone’s hair if it’s sensitive to it, as Testosterone is still an Androgen. You can try topical Bicalutamide if you want. You can try topical Finasteride too. I am just trying to help and provide as much information as I can because I read and search a lot. Because it’s bothering me so much and has sucked my soul. Thank you.

 

[losingbattle88]

I haven't seen any research on this. Yes, and all drugs that are supposed to stop hair loss are somehow related to DHT. but maybe you're right, just never read about it.

Well, you can test 3a-Diol-G and your PSA. At least, these are better markers than DHT alone. I wrote a lot about 3a-Diol-G here:https://www.hairlosstalk.com/intera...ation-of-hair-follicles-and-3a-diol-g.134542/

I am in a kinda similar situation. My dht levels rebounded back to baseline after they were constantly inhibited about 44% from Finasteride. Although, even with the 44% reduction, I was still having results. My 3a-Diol-G levels were low too. 3a-Diol-G it’s an indicator of 5AR in tissues. Quick reference: http://immunotech.cz/Media/Default/Page/A-G_analyte_info.pdf

Well, you saw the study that I linked above. The dht might be normal, but if the PSA is crashed, then it’s supposed that is doing something. That’s what I wanted to tell.

Yes, you are correct about Backdoor pathway. Dutasteride might not be enough, as well, but it is the common next step. Also, you can judge without trying. You might respond, you might not. Furthermore, topical Finasteride could help too, since it’s blocking more scalp DHT according to the studies. You might need more local inhibition. There are lot of causes. Hair loss is multi factorial. @Mr. Slap Head and @losingbattle88 are correct. Some people can be very sensitive to Testosterone, with result to lose ground even with the 5ARis inhibitors. Although, there is a conflict with the study which mentions that those who were lacking 5AR2 enzyme, did not developed baldness. However, there is a tremendous rise on scalp Testosterone from Dutasteride. So, this increment could damage someone’s hair if it’s sensitive too it, as Testosterone is still an Androgen. You can try topical Bicalutamide if you want. You can try topical Finasteride too. I am just trying to help and provide as much information as I can because I read and search a lot. Because it’s troubles me so much. Thank you.

Well said.

 

[AlexCross]

Well, you can test 3a-Diol-G and your PSA. At least, these are better markers than DHT alone. I wrote a lot about 3a-Diol-G here:https://www.hairlosstalk.com/intera...ation-of-hair-follicles-and-3a-diol-g.134542/

I am in a kinda similar situation. My dht levels rebounded back to baseline after they were constantly inhibited about 44% from Finasteride. Although, even with the 44% reduction, I was still having results. My 3a-Diol-G levels were low too. 3a-Diol-G it’s an indicator of 5AR in tissues. Quick reference: http://immunotech.cz/Media/Default/Page/A-G_analyte_info.pdf

Well, you saw the study that I linked above. The dht might be normal, but if the PSA is crashed, then it’s supposed that is doing something. That’s what I wanted to tell.

Yes, you are correct about Backdoor pathway. Dutasteride might not be enough, as well, but it is the common next step. Also, you can judge without trying. You might respond, you might not. Furthermore, topical Finasteride could help too, since it’s blocking more scalp DHT according to the studies. You might need more local inhibition. There are lot of causes. Hair loss is multi factorial. @Mr. Slap Head and @losingbattle88 are correct. Some people can be very sensitive to Testosterone, with result to lose ground even with the 5ARis inhibitors. Although, there is a conflict with the study which mentions that those who were lacking 5AR2 enzyme, did not developed baldness. However, there is a tremendous rise on scalp Testosterone from Dutasteride. So, this increment could damage someone’s hair if it’s sensitive too it, as Testosterone is still an Androgen. You can try topical Bicalutamide if you want. You can try topical Finasteride too. I am just trying to help and provide as much information as I can because I read and search a lot. Because it’s bothering me so much and has sucked my soul. Thank you.

Topical finasteride..as an option. Hm. How to make it and how often to take it?

All in all, this really upsets me. So many reasons for hair loss. So many reasons for the lack of positive results from taking inhibitors. And while we are looking for a reason - precious time is running out

 

[AlexCross]

Today I did an ultrasound examination of the prostate gland. Everything is normal. I don't even know whether to be happy or sad.

So far, I will be taking Finasteride 5 mg for another month. I'll see what happens. I also plan to start using topical bacalatumide (I found the tablets, but they are prescription, I managed to buy only 10 tablets of 50 mg each, I don’t know how long it will last). Yes, and there are a lot of questions about how to make a topical solution and how to take it. There is not much information and that what is different, I will create a topic someday, maybe someone will tell

 

[Adri23]

Today I did an ultrasound examination of the prostate gland. Everything is normal. I don't even know whether to be happy or sad.

So far, I will be taking Finasteride 5 mg for another month. I'll see what happens. I also plan to start using topical bacalatumide (I found the tablets, but they are prescription, I managed to buy only 10 tablets of 50 mg each, I don’t know how long it will last). Yes, and there are a lot of questions about how to make a topical solution and how to take it. There is not much information and that what is different, I will create a topic someday, maybe someone will tell

Don't wanna be negative but it might not even stop hair loss. I use bica and E2 and still losing my hair. You can try ofc but it is not the saint grail. Just put your expectations low so that way it won't disappoint you.

 

[AlexCross]

Don't wanna be negative but it might not even stop hair loss. I use bica and E2 and still losing my hair. You can try ofc but it is not the saint grail. Just put your expectations low so that way it won't disappoint you.

As far as I know, there is no aggressive androgenetic alopecia in my family. father has been losing hair for 30 years since he was 20. therefore I will hope that by lowering DHT my alopecia it will at least slow down until something worthwhile appears on the market. besides, I had no illusions about the different ways to deal with baldness. everything that doctors offer and people on forums helps only 50% at best. But I think it's better to do something than sit back.




As far as I know, there is no aggressive androgenetic alopecia in my family. father has been losing hair for 30 years since he was 20. therefore I will hope that by lowering DHT my alopecia it will at least slow down until something worthwhile appears on the market. besides, I had no illusions about the different ways to deal with baldness. everything that doctors offer and people on forums helps only 50% at best. But I think it's better to do something than sit back.

 

[Adri23]

As far as I know, there is no aggressive androgenetic alopecia in my family. father has been losing hair for 30 years since he was 20. therefore I will hope that by lowering DHT my alopecia it will at least slow down until something worthwhile appears on the market. besides, I had no illusions about the different ways to deal with baldness. everything that doctors offer and people on forums helps only 50% at best. But I think it's better to do something than sit back.




As far as I know, there is no aggressive androgenetic alopecia in my family. father has been losing hair for 30 years since he was 20. therefore I will hope that by lowering DHT my alopecia it will at least slow down until something worthwhile appears on the market. besides, I had no illusions about the different ways to deal with baldness. everything that doctors offer and people on forums helps only 50% at best. But I think it's better to do something than sit back.

I don't have aggressive balding on my family either. Is not always about your family. Wish you luck in finding a treatment that work, in my case nothing worked.