Low levels of serum DHT - still take finasteride?

[TinTon]

Hi there,

I'm NOT on finasteride yet, had my blood DHT levels tested recently and they were in the normal range but basically at the bottom of the normal range, so 'low normal'.

My balding is gradual diffuse all over the top, mainly so at the vertex, hairline still intact so not really on the typical Norwood Scale. Also I have a quite a decent amount of 'body' hair (not much on my back though yet, thankfully)

So if I take finasteride and knockout about 68% of this 'low normal' level of DHT, I would be quite a bit below the normal range. Is that a bad idea?

Does this just mean that I have very sensitive scalp AR receptors and so should still go on finasteride?

 

[g.i joey]

it would be interesting to see if you taking .25/day would completely stop your hairloss, it didnt for me. But i assume i have high normal ref ranges of dht.

 

[Admin]

This is actually a really interesting topic, and one that I've thought a lot about lately.

Back before i started Propecia, the concept of a regular person knowing to test their DHT levels was unheard of. Doctors still ruled the world back then. Now health information is available to everyone and testing DHT levels prior to taking Propecia seems like a very interesting concept.

If Bryan were here I bet he would say that serum levels are not the true indicator of DHT "load" however. He would probably say that there is another reservoir of DHT in the scalp which plays a bigger role in causing hair loss. We've always known that Propecia is like using a bomb to kill an ant. It wipes out DHT levels in the serum, which has, as a side benefit - ultimately lowering DHT levels in the scalp.

The real trick would be to reduce DHT levels in the scalp, and leave serum levels unchanged. Or at least not wiping them out completely just to knock down the levels in the scalp.

I personally stopped losing my hair completely. Propecia did something to my system that left me with low DHT levels ongoing. Its great for my hair. But as I've grown older, I've begun supplementing Testosterone. This increases my serum DHT levels and guess what happens? I begin losing hair again for the first time in 10 years.

This is what got me thinking about advising people to see if they were "high in DHT" prior to taking propecia, then monitoring serum levels with micro doses of Propecia, just to bring them down to "normal" levels.

But the OP here has stated a case where he is starting with normal-low levels already, yet still loses hair. This confirms for me that its the levels in the scalp (and/or the level of sensitivity to DHT in those follicles) that is most important. Its not always assumed that guys who lose hair are dealing with high DHT levels after all. Even though the high body hair issue sure seems to point to that.

I would try a topical antiandrogen with your regimen, and microdose the Propecia. Like 1/4 the normal dose. Maybe combine Revivogen or topical spironolactone with it. Unfortunately that can get messy. But might be worth it. Don't evaluate progress until you're well past the 8 month mark, and have been using Nizoral consistently 3x a week the whole time. Recheck your DHT levels at about the 1 month mark and see where you're at.

Sorry there's no easy answer.

Admin

 

[TinTon]

I had to go private (pay full cost as opposed to being free on the public health system) for my blood tests

Yep. Do it routinely myself. Privatemdlabs.com. If you add them on facebook they always have a 15% off coupon code you can use.

I had actually previously mentioned to my doctor about the possibility of having a DHT blood test however he looked at me somewhat perplexed.

Of course he did. Because doctors are generally completely clueless. If it doesn't fit in their tiny worldview, it doesn't exist, and is not valid. And when i say tiny, I mean tiny. It takes very little effort to educate yourself on things to the point that your doctors education is dwarfed these days. I guarantee anyone approaching their doctor asking for a pre-propecia DHT test will either get laughed at, or dismissed. That's what doctors are best at these days. Acting like you're the idiot, while they're actually under-informed.

but I'm still glad I had the DHT test done along with a whole bunch of other blood tests, gives me a good insight into how my body is currently working pre-treatment.

Absolutely. This is what health care is supposed to be about. In a world where doctors are fully informed and actually fully involved in the patients health, this would be done routinely for you, without you even asking. I almost have to keep myself from laughing out loud at the thought that this would ever happen with an actual doctor though. Patients being empowered is the health care of the future. And public health is going to be significantly better as a result.

Do I look at it in the sense that 'well I already have low DHT levels so knocking out 68% of an already small amount isn't going to make too much of a difference for me health wise', or do I adopt the 'theory' that 'DHT is a crucial hormone for an adult male and I'm on the edge of what's considered normal so taking finasteride might tip me over the edge'. Tough one to call really.

I believe that different guys are reliant upon DHT in different capacities. I personally was heavily DHT dependent. I had a lot of problems taking Propecia and I noticed changes in tissues throughout my body. Drastic changes. When it was depleted from my system. But I have several friends who have been on it for over 10 years and haven't noticed a single thing. So for me, DHT was a crucial hormone. They love to call it the puberty hormone, but like most humans - people take it to an extreme and make irrational comments like "Its not used for ANYTHING after puberty and the secondary male characteristics that kick in, in the mid 20's." Anything absolute is almost always wrong.

Genetics are the cause, DHT is merely the fuel that goes into the motor.

Yes - in the sense that its a genetic switch that causes hairs to become suddenly sensitive to DHT levels that have always been there. Since we've got CRISPR and gene editing coming very soon, we may simply be able to start switching these triggers off one day.

You mentioned that you were taking Propecia; How long did you take it for? Did you stop? If so, why?

Took it for 3.5 years then had to stop. Estrogen levels went too high. Constant migraines. Testicle pain. Prostate stabbing sensations. Sensitivity "down there" dropped 75%. Of course every doctor told me I was imagining things. That's what they do best.

-Admin

 

[TinTon]

I didn't realise that you had replied to my post above, as it was a sneaky admin-only type response within my actual response hahaha - that's magic!

Well I started taking finasteride on the 4th of December, was taking 0.5mg ED for almost 3 weeks but got depressed looking at the state of my thinning hair so bumped up to the full 1mg ED a week ago.

No side effects as yet (well not that I'm aware of anyway), just hope it works despite my low-normal baseline DHT levels. Really hope that we are both correct in the theory that AR sensitivity dictates over the serum DHT levels and that myself wiping out my DHT will lead to benefits for my scalp follicles.

Can I ask, within the 3.5 years you took finasteride, did you experience any re-growth or thickening of your hair?


Time will tell, but with my hair looking so thin these days, one can easily become impatient.

 

[parisienne]

I didn't realise that you had replied to my post above, as it was a sneaky admin-only type response within my actual response hahaha - that's magic!

Well I started taking finasteride on the 4th of December, was taking 0.5mg ED for almost 3 weeks but got depressed looking at the state of my thinning hair so bumped up to the full 1mg ED a week ago.

No side effects as yet (well not that I'm aware of anyway), just hope it works despite my low-normal baseline DHT levels. Really hope that we are both correct in the theory that AR sensitivity dictates over the serum DHT levels and that myself wiping out my DHT will lead to benefits for my scalp follicles.

Can I ask, within the 3.5 years you took finasteride, did you experience any re-growth or thickening of your hair?


Time will tell, but with my hair looking so thin these days, one can easily become impatient.

Hi.
My serum DHT levels are also really low.
I'm a woman and I have just been diagnosed with FPHL. I started loosing my hair last November.
I think that it might be beneficial to try a topical AA. I bought some topical Progestogel and applied it all over my scalp the last two days. Ofc I can't tell anything yet regarding my shedding, but I feel like my scalp itch sensation is decreasing. What have you done so far, did you improve your situation ?

 

[buckthorn]

Hi there,

I'm NOT on finasteride yet, had my blood DHT levels tested recently and they were in the normal range but basically at the bottom of the normal range, so 'low normal'.

My balding is gradual diffuse all over the top, mainly so at the vertex, hairline still intact so not really on the typical Norwood Scale. Also I have a quite a decent amount of 'body' hair (not much on my back though yet, thankfully)

So if I take finasteride and knockout about 68% of this 'low normal' level of DHT, I would be quite a bit below the normal range. Is that a bad idea?

Does this just mean that I have very sensitive scalp AR receptors and so should still go on finasteride?

I think that myself, along with several others that I have discussed this topic with, are living proof that serum DHT levels don't really mean sh*t. I had mine tested along with a thorough blood panel. On finasteride, my DHT was at the very bottom of the acceptable spectrum, and my test went up...

Three months into finasteride, my scalp went downhill really quick. for eight months after that I experienced constant, rapid hair loss, horrible dermatitis, along with a slue of other crap, including highly elevated libido and oily skin. It's what is going on in your scalp that matters. Just because your serum DHT is low, does NOT mean your scalp tissue DHT is low. Also, the Androgen receptors play the biggest role. Full heads have DHT too, never lose a hair. So, finasteride in any sense is a gamble. It may solve the problem, it may not. If your DHT is already low, and you've been somewhat maintaining with diffused thinning, I personally think you should consider RU. I love that damn stuff. :youbet:

 

[parisienne]

I think that myself, along with several others that I have discussed this topic with, are living proof that serum DHT levels don't really mean sh*t. I had mine tested along with a thorough blood panel. On finasteride, my DHT was at the very bottom of the acceptable spectrum, and my test went up...

Three months into finasteride, my scalp went downhill really quick. for eight months after that I experienced constant, rapid hair loss, horrible dermatitis, along with a slue of other crap, including highly elevated libido and oily skin. It's what is going on in your scalp that matters. Just because your serum DHT is low, does NOT mean your scalp tissue DHT is low. Also, the Androgen receptors play the biggest role. Full heads have DHT too, never lose a hair. So, finasteride in any sense is a gamble. It may solve the problem, it may not. If your DHT is already low, and you've been somewhat maintaining with diffused thinning, I personally think you should consider RU. I love that damn stuff. :youbet:

Thanks for your answer !
So, how long have you been using RU and what kind of results do you have with it ? Would you mind if I PMed you about the RU, because I have a **** load of questions about it.


I also begin to think it doesn't mean ****, I am on cyproterone acetate atm, one of the strongest anti androgen of the *legal* market and my hair started falling while on it. It would be damn great if I could go topical and ditch the ****ing pill !

 

[buckthorn]

Thanks for your answer !
So, how long have you been using RU and what kind of results do you have with it ? Would you mind if I PMed you about the RU, because I have a **** load of questions about it.


I also begin to think it doesn't mean ****, I am on cyproterone acetate atm, one of the strongest anti androgen of the *legal* market and my hair started falling while on it. It would be damn great if I could go topical and ditch the ****ing pill !

Of course! feel free to ask me anything.

 

[TinTon]

I have been on finasteride now for 12 weeks, not seen any real differences but because I already have low-normal serum DHT I may only see slight improvement i.e. stoppage of loss rather than vast improvement i.e. regrowth, but that's all speculation as 12 weeks is nothing in terms of timescale for taking finasteride. I don't fully understand if it's a case of I have really sensitive follicles therefore if I had of had high DHT to begin with then I would have been totally bald years ago, or not. We are all guinea pigs in a sense but the fact that I did get baseline DHT (amongst other hormones) tested gives the puzzle a lot more clarity in terms of making an evaluation than those who don't get baseline blood tests and jump on finasteride.

If I get some good regrowth after a full year of taking the drug then I will be very pleased and will also happily state this on the forum that despite already having low serum DHT it has very much improved, the conclusion then would be that I just have hair follicles that are very sensitive to DHT and the fact that I seem to have low-normal DHT levels gave me a few extra years with some hair, but that day is yet to come (I hope).

 

[Dench57]

I don't think your baseline serum DHT level would have any bearing on how you respond hair-wise. It might be more relevant in terms of side effects.

 

[TinTon]

That also could be very true.

I can honestly say that touch wood right now I wouldn't even know that I'm taking finasteride other than having to remember to take it, I feel exactly the same as always and have no additional physical or mental effects from it whatsoever. Again "touch wood".

I must add though that my hair is in a crappy state right now, Im gradually balding to an NW7 and not in the typical deciding style but rather all over the top simultaneously (I think it's called diffuse thinning) and so if finasteride does work and it stops this or gives me some regrowth then like most men on here I'm just going to think to myself 'damn I wish I had started this years ago when my hair was better than it is now'.

The debate on taking finasteride or not really does come down to the question of 'if you think you can handle being bald soon or not?', if the answer is no then it's best you get on finasteride and don't debate it with yourself for ages. If the answer is yes and you can handle going bald soon then forget finasteride, forget this forum and continue the natural cycle of male pattern baldness and enjoy life. I really hate the fact that I'm going bald, it weighs me down, and especially so due to the fact that my dad who is 61 has better hair than I do at age 34 - when you are talking to your dad and in your head constantly thinking to yourself 'you lucky git, how has your hair stuck around for so long' you really need to get on a anti-androgen treatment

 

[TinTon]

I've been on it for about 1.5 years now and my hair has stabilised as far as I can tell.

I've not had any regrowth whatsoever, however hopefully I can hang on to what i have.

Zero side effects.

 

[TinTon]

My result = 0.66 nmol/L

The "Normal Range" as per the label that did my tests = 0.34 - 2.06 nmol/L

 

[RocketMan]

Hi TinTon,

The results you provided above are not really at the bottom and I assume it's after finasteride treatment...?. Could you let us know what your DHT result was before finasteride treatment..? I'm asking because my situation is similar to yours at the beginning of this thread. My DHT serum levels are at the rock bottom of the scale - actually even one point below the range to be precise, here are my resluts:

Dihydrotestosteron (DHT) 249 ng/l range: 250 — 1000

So obviously I'm afaid to jump on finasteride or dutasteride with that level of natural DHT, hard to imagine what can happen if I decide to decrease it by ~70% presumably...But anyways, your experience might be very helpful for me.

 

[TinTon]

Hi there

My DHT blood test I gave here was done before I started taking finasteride.

I’ve not had any blood tests since I started taking finasteride.

 

[RocketMan]

Ah ok... Thanks. If you ever decide to take a test while you're on finasteride please post it here

 

[TinTon]

Will do mate!

Although I don’t plan on having another DHT test unless my hair suddenly starts to get really bad or if I were to experience any concerning side effects.

 

[RocketMan]

Sure, I understand. So you haven't had any side effects so far....? This is good news considering your DHT levels are very likely below the range at the moment. Have you noticed any difference while on finasteride?

 

[TinTon]

No sides (touch wood), no extra hair growth, just seem to be maintaining at baseline, but that’s better than it getting worse.