Is Testosterone More Harmful Than Dht On The Frontal Scalp And Hairline?

[DogoDiLaurentiis]

It doesn't matter. You're balding due to excessively high androgens, not due to lack of estrogen.

I'm now of the mind that this statement is utterly the opposite of how things actually work, you have a guy who is on dutasteride for two years and losing hair and you're telling me that testosterone itself is just magically causing hairloss as bad as DHT but they keep taking the 5AR inhibitor.

Estrogen grows hair, period. Epitestosterone is a locked door, that's a feature of preadolescence.

 

[whatevr]

Interesting. I wonder why this hasn’t been used to diagnose balding early... according to this if you try HRT with epitest would that solve this imbalance?

It's not available in significant enough quantities anywhere to actually do this. Even if you did, you would have the same side effects as if you used most other anti-androgens, remember that the ratio is fine in serum. It's only broken in the hair follicle. So you still have the same problem of wanting to limit the action only to your hair follicles just as with all other medication, and don't want systemic absorption.

Do you know why balding people have such a bad T/epiT ratio in their follicles or have any leads on how to counteract it?

It's not entirely sure how epitestosterone is synthesized yet, although a single study claims the proposed pathway is this:

4-dione is androstenedione which is normally converted by 17b-HSD into testosterone. It would make sense that 17a-HSD would convert it into epitestosterone. It is reasonable to presume that there is an imbalance between these two enzymes in the balding follicles which greatly favors 17beta-HSD metabolism. As to why, perhaps that is the 'genetic' part. Maybe there is a better reason but research on this angle is limited and has been dead for about 15 years, unfortunately. The current research is focused on prostaglandins, WNT and other downstream effects which pale in comparison to having proper hormone balance in the first place. We could have known everything about the Androgenetic Alopecia follicle steroid balance by now - perhaps a selective 17b-HSD inhibitor could've been synthesized, or a way to induce 17a-HSD activity back to normal in the follicle.

 

[Selb]

It's not available in significant enough quantities anywhere to actually do this. Even if you did, you would have the same side effects as if you used most other anti-androgens, remember that the ratio is fine in serum. It's only broken in the hair follicle. So you still have the same problem of wanting to limit the action only to your hair follicles just as with all other medication, and don't want systemic absorption.




It's not entirely sure how epitestosterone is synthesized yet, although a single study claims the proposed pathway is this:

View attachment 149477

4-dione is androstenedione which is normally converted by 17b-HSD into testosterone. It would make sense that 17a-HSD would convert it into epitestosterone. It is reasonable to presume that there is an imbalance between these two enzymes in the balding follicles which greatly favors 17beta-HSD metabolism. As to why, perhaps that is the 'genetic' part. Maybe there is a better reason but research on this angle is limited and has been dead for about 15 years, unfortunately. The current research is focused on prostaglandins, WNT and other downstream effects which pale in comparison to having proper hormone balance in the first place. We could have known everything about the Androgenetic Alopecia follicle steroid balance by now - perhaps a selective 17b-HSD inhibitor could've been synthesized, or a way to induce 17a-HSD activity back to normal in the follicle.

Wow that makes me feel like absolute sh*t. Like the hair loss research community backed the wrong horse.

I did look it up and apparently it was used by dopers to make sure their T/E ratio wasn't suspicious. Why not experiment with it using different vehicles to limit it to the scalp?

 

[whatevr]

Estrogen grows hair, period. Epitestosterone is a locked door, that's a feature of preadolescence.

You're ignoring the fact that balding people have on average a 5 times higher ratio of T / Epi-T in their balding follicles compared to non-balding people, their entire life - this has nothing to do with preadolescence or serum levels. This is a localized hormonal imbalance.

Epitestosterone is an endogenous AR antagonist and 5-AR inhibitor, in some studies proven to be stronger than cyproterone acetate (which some people here take systemically for hair loss).

The problem with your approach is twofold:
1) Estrogen can not serve those two purposes in anywhere near the capacity
2) Effective doses for hair growth are impossible to contain locally and will go systemic

By all means prove it wrong - many here have tried, myself included.

 

[DogoDiLaurentiis]

You're ignoring the fact that balding people have on average a 5 times higher ratio of T / Epi-T in their balding follicles compared to non-balding people, their entire life - this has nothing to do with preadolescence or serum levels. This is a localized hormonal imbalance.

It doesn't matter, if epitestosterone levels are higher when you're preadolescent, then it is in effect a locked door and I guarantee you any research or treatment pathway that focuses on that will be so ungodly expensive that it won't be viable for common consumers.

My hypothesis is that in the case of most men you simply don't need to force your body to emulate the functioning of a prepubescent boy to regrow hair. I have said before in other threads, I was 26 and incurred a lot of patterned hairloss in a short time, it was so bad I had to cut my hair down to nothing because my hair at any considerable length looked terrible. It was localized to the top of my head.

By the time I was 30 I had full regrowth, my hair was about as thick as it was when I was in my teens. There's no way even with my somewhat predisposition for genetic vulnerability to hairloss that somehow magically the testosterone I was exposed to all through my 20s either started or stopped working based on my hair loss or regrowth.

What I can say though is that I believe my estrogen levels were significantly higher, I think that's a far safer assumption than saying a 30 year old man was still retaining high epitestosterone expression in his follicles.

I plan on going the topically applied low dose estrogen route, I will report back my findings, but I have a very strong suspicion that the again relapse hairloss of the last two years I've experienced is due to an imbalance where the ratio of my estrogen to testosterone has faltered and no amount of nuking my DHT levels seems to have helped this.

 

[Canuto]

I know I'm starting to sound like an annoying broken record but that doesn't sound like test was the issue at all. Was he at all by chance taking aggressive aromatase inhibitors as well?

If you've kept your hair mostly barring some gradual attrition through out your late teenage years into your twenties, it should not be merely that hormone which has been circulating in your body for all that time which suddenly and completely decimates your hair regardless of where it is. Something else is clearly at play.

No, he didn't. He's been around for a while and always been against AIs, unless you're running a high aromatizable anabolics cycle.

Hair thinning is progressive. You won't start noticing it until you have lost 20/30 % of your hairs.

 

[Canuto]

What I can say though is that I believe my estrogen levels were significantly higher, I think that's a far safer assumption than saying a 30 year old man was still retaining high epitestosterone expression in his follicles.

It doesn't work like that. E2 is proportional with T. The higher the T, the higher the E2, until you'll find a plateau and T will start increasing and E2 will stay the same. But it doesn't happen in naturals.
The only exception to this are high BMI (bm>20%) and people with increased aromatization due to genetic polymorphisms. This is endocrinology 101.

I'm on TRT and my estrogens are way higher than yours. Both estradiol and estrone off the chart. Yet that didn't protect me from the damages done by androgens on the hair follicles. If you introduce exogenous estrogens, you will ignite the negative feedback loop on the hypothalamus and decrease your androgens load while increasing your estrogens load. You're not increasing only the estrogens.

Good luck with your experiment, but I'm afraid to tell you this is not how Androgenetic Alopecia works, unless your hairloss is a combo of androgens and local estrogens deprivation like in FPHL.

 

[whatevr]

It doesn't matter, if epitestosterone levels are higher when you're preadolescent, then it is in effect a locked door and I guarantee you any research or treatment pathway that focuses on that will be so ungodly expensive that it won't be viable for common consumers.

This is not really an argument, and is akin to saying that because DHT levels decrease as a man gets older, yet his hair loss worsens, that proves that DHT isn't implicated in hair loss. As a research target, control of hormonal synthesis is no less viable than altering prostaglandin pathways or WNT. All of these treatments will be intially expensive, if they even deliver significant results.

What happens with epitestosterone levels in serum as we age is largely irrelevant to what happens in balding hair follicles.

I have quoted you a study where both the children and their respective fathers who suffer from androgenic alopecia have a vastly higher ratio of testosterone/epitestosterone in HF compared to controls, showing that the age of the person in question plays very little role and this ratio stays consistent (or gets worse) throughout the lifetime of a patient.

Secondly, here is a study comparing balding vs non-balding follicles of the same person, showing a vast difference in the testosterone/epitestosterone ratio:

Comparative studies on level of androgens in hair and plasma with premature male-pattern baldness - PubMed

We verified that the distribution of androgenic steroids is unlike in various regions of individual subjects. Moreover, the increased DHT/T ratio in balding plasma indirectly confirms the high activity of 5alpha-reductase type II.

pubmed.ncbi.nlm.nih.gov

The conventional explanation is that occipital (non-balding) follicles simply aren't „sensitive“ to androgens, yet here we see that their hormonal balance is in fact completely different, exhibiting a much lower ratio of androgenic testosterone to its antiandrogenic counterpart epitestosterone, which shows a dramatic difference in local hormone synthesis. This is far more likely to be the explanation for why they aren't 'balding', rather than some mythical lack of androgen sensitivity which has no reasonable means of being quantified.

My hypothesis is that in the case of most men you simply don't need to force your body to emulate the functioning of a prepubescent boy to regrow hair.

Of course not, that is a ridiculous approach, nonetheless employed by some people here. What you need to do is to force your hair follicles to emulate the functioning of non-balding hair follicles.

By the time I was 30 I had full regrowth, my hair was about as thick as it was when I was in my teens. There's no way even with my somewhat predisposition for genetic vulnerability to hairloss that somehow magically the testosterone I was exposed to all through my 20s either started or stopped working based on my hair loss or regrowth.

What I can say though is that I believe my estrogen levels were significantly higher, I think that's a far safer assumption than saying a 30 year old man was still retaining high epitestosterone expression in his follicles.

Obviously this is largely anecdotal, but spontaneous regrowth of any kind is rare unless you: had telogen effluvium, some other kind of hormonal imbalance which has resolved (or you have perhaps incurred a 'favorable' one such as increasing your estrogen levels). Without measurements of hormones it is impossible to say anything.

I plan on going the topically applied low dose estrogen route, I will report back my findings, but I have a very strong suspicion that the again relapse hairloss of the last two years I've experienced is due to an imbalance where the ratio of my estrogen to testosterone has faltered and no amount of nuking my DHT levels seems to have helped this.

I have personally used topical estradiolbenzoate for a good while (my results are documented somewhere in the success stories here). Ultimately I had to stop due to side effects, although the results in my case were rather good. As to why nobody else managed to reproduce them, I'm not sure (and a lot of people bought Alpicort F following my experience). Possibly due to the fact that I had gotten off of finasteride a month prior at which point I became hypogonadal or gotten PFS, which would have amplified the results.

My point is that your approach is not exactly ground-breaking, and low dose E2 (esp. In the absence of anti-androgens) will hardly do anything miraculous. Many people have tried that already.

 

[Ganked By DHT]

If front hair loss is caused by T mainly, then why do people with 5α-Reductase deficiency lose no hair at all?

5α-Reductase 2 deficiency - Wikipedia

en.wikipedia.org

 

[JaneyElizabeth]

If front hair loss is caused by T mainly, then why do people with 5α-Reductase deficiency lose no hair at all?

5α-Reductase 2 deficiency - Wikipedia

en.wikipedia.org

What's the status of inter-sex people and hair loss in general? Seems like a good path for research as are the T and DHT levels of say, the Inuit and Native American people who seem to have little or no differences in the hair patterns between males and females.

 

[Norwoody]

I've read plenty of stories of people having worse hairlines on duta. But at the same time, some have improved hair everywhere including the hairline on duta. So what gives?

 

[JaneyElizabeth]

I've read plenty of stories of people having worse hairlines on duta. But at the same time, some have improved hair everywhere including the hairline on duta. So what gives?

This is all much more complicated in terms of endocrine activity than we want to acknowledge and changes to one aspect, say to beards, might throw off other aspects. Some have alleged a link between minoxidil usage for beards and hair loss on top subsequently.

I continue to note that virtually no one in the field anywhere deals with the issue of hair quality as opposed to mere hair count and coverage.

Why do we have meds that are said to "improve" hair loss but none touted to improve "hair appearance?" Look at the recountings by guys on tressless just starting finasteride/min and none of them mention that "my hair looks much nicer and is much more manageable". It's only dealt with in terms of the appearance or not of new terminal hair.

I see many guys with ugly comb-overs who have overall pretty decent coverage but terrible looking hair that has very little to do with juvenile hair in terms of looks and appearance. Transplants might indeed move permanently viable, ugly, crappy hair from the sides to the front but to what effect?

To me, this quest has to ultimately be about improving both looks and health, otherwise, it is likely to be dispiriting and defeating. Balding folks need to comfort themselves more by noticing how many ugly men out there there are with "full" heads of hair that look like absolute crap.

What's the deal with this guy:

 

[Norwoody]

Hahahaha good points. That guy always creeps me out.

 

[JaneyElizabeth]

Hahahaha good points. That guy always creeps me out.

What did he do though? Has he just fluffed his hair and colored it? Or did he have a transplant imposed on what he already had? I note that he, Biden and Trump all have serious hair issues apparently related to the psychological effects of hair loss as did Caesar and several Emperors so maybe the rest of us ordinary mortals need not feel guilty for mourning our locks!

He had a nice matured 60-year old hairline and decided to opt for the Bozo the Clown look. Then again, why did I use to let my hair grow long in the back like a hobo when it didn't favor me? There's something about the ability or purported ability to grow one's hair long that seems to be just as essential as mere coverage for many of us. Crew cuts don't alter coverage but they have rarely been a popular hair style for boys making their own choices.

 

[Norwoody]

Hahahah. I love how that guy, Trump, and Biden all have done things to try and compensate for their hair. Meanwhile Putin has the IDGAF attitude going on xD. And then there's Kim and the chinese guy with the perfect hair lol

 

[JaneyElizabeth]

Hahahah. I love how that guy, Trump, and Biden all have done things to try and compensate for their hair. Meanwhile Putin has the IDGAF attitude going on xD. And then there's Kim and the chinese guy with the perfect hair lol

I have become cognizant of looking at all historic persons in terms of hair and beard growth. Beard grooming and extensive beards were a huge deal in the 19th century and that probably does help the male ego some in terms of having something to groom and compete with others with. Many of the beard patterns back then were ornate and "dandy-like" in my opinion. It continues to be striking just how bald many of the well-known Western European males have been throughout history and in general. That's why, I think, that people like Brad Pitt and Oscar Wilde are so striking to many of us in terms of how they present when virtually no one else past 18 years of age is able to do so in a comparable way. Wilde was 6 feet three inches tall and it is not hard to see why he might have been esteemed for his appearance:

You choose. Would you rather look like Oscar or Abe? They were about the same height and born less than 50 years apart. Abe wasn't exactly a style maven but he had a robust "maturing" hair line. It would be interesting to go through and digitally alter Abe's face and hair line as to what it might look like after HRT. Just to feel good about myself, I note that Abe and I are roughly the same ages in our pics.

 

[Ganked By DHT]

What's the status of inter-sex people and hair loss in general? Seems like a good path for research as are the T and DHT levels of say, the Inuit and Native American people who seem to have little or no differences in the hair patterns between males and females.

Native American are just not susceptible to hair loss, don't have hair loss genes, probably doesn't matter what their androgen tissue levels are.

 

[Ganked By DHT]

Maybe I found the answer to my own question, why 5ar deficient people have prepubescent hairline:
Current concepts of testosterone metabolism in the human skin: temporary, increased dihydrotestosterone formation at specific skin target sites at different ages causes the normal development of certain sexual characteristics, as well as the androgen dependent skin disorders.

 

[JaneyElizabeth]

Native American are just not susceptible to hair loss, don't have hair loss genes, probably doesn't matter what their androgen tissue levels are.

It would be interesting to see what the hair loss effects of T supplementation on Native American hair might be. Perhaps it's a threshold issue and at some levels effects would be noticed. I assume they don't suffer from acne among N.I.'s either.

 

[Ganked By DHT]

It would be interesting to see what the hair loss effects of T supplementation on Native American hair might be. Perhaps it's a threshold issue and at some levels effects would be noticed. I assume they don't suffer from acne among N.I.'s either.

If you mean TRT, then I dont think it would affect them visibly, a lot of people doing TRT dont lose more hair on it afaik. Depends how much you give them. I dont think they suffer acne really.