Testosterone Induced Alopecia & Hairloss Progression

[Pentanol]

Greetings,

After initial fascination with hair loss in my late teens, I began to prioritize other factors in life after creating an active protocol that fortunately worked to make my recession unnoticeable. The other day, I noticed significant hair thinning in one of my colleagues, and revisited the online hair loss spaces to see what developments have taken place and what treatments are currently being administered. To my surprise, many of the treatments that are being discussed are specific to testosterone deliberation— not to prevent its interaction with 5α-reductases which ensues dihydrotestosterone, rather prevent testosterone from expressing androgenic venture on the hair follicle itself. Hair loss is not my expertise, but I have been fortunate to study the subject in great detail when it was of interest to me several years ago at my university. After looking through my notes and countless literature publications on this topic, I have found no tangible demonstration of this speculation in literature. In fact, without getting too technical on the androgenic expressional profile of testosterone, it seems strictly impeding the expression of testosterone in the scalp of non-transitional males that are subsequently producing normal ranges of estradiol might harm hair wellbeing, if nothing at all. Nonetheless, testosterone-induced alopecia seems to have become well understood in the hair loss niche.

Is there something I am missing? Please pardon if this foolish as it has been years since I have delved into androgenic alopecia, but why is it accepted that the testosterone should be mitigated using an inepter of the androgen in addition to a 5α-Reductase inhibitor?

I would be very interested in reading more of dihydrotestosterone-independent hair loss progression; if anyone could guide me to any literature or data supporting this understanding, I would be very grateful. If the study is blocked or subscription-based, please send anyway as I likely have access. Thanks!

 

[Jodhhd]

Hey, not really sure about the studies to back it up, but there are a few youtubers that have said test also causes hairloss. I think MPMD made a vid doing a study on it. Also just curious, what's your profession?

 

[Pentanol]

Hey, not really sure about the studies to back it up, but there are a few youtubers that have said test also causes hairloss. I think MPMD made a vid doing a study on it. Also just curious, what's your profession?

I'm not too familiar with "MPMD," that's a youtube channel, yes? I'll definitely check it after hours to see their reasoning. As for my profession, I'm a chemist in the pharmaceutical field. Most of my duties require testing the integrity of known compounds; their active ingredients content (assay), impurities, bioavailable/ dissociation, as well as the theoretical pharmacodynamic implications of the drug once it is ingested. Infrequently, my lab will receive personal requests (the usual is large manufactures doing quality checks). Usually, it is derived from paranoia, such as comparing brand names against generics or even specific generics against generics. Interestingly, last week, a request was put in comparing GSK Avodart against Epic Pharma generic, and the requestor demanded four trials be run and an interpreter to dissect the results.

 

[Norwoody]

Well people use bicalutamide to combat androgenic expression. Flutamide and a few other drugs work in a similar way. But if you take these drugs for long enough it will likely mess you up permanently in some way shape or form. It would be great to have these drugs only induce their AA effects on the scalp, but almost everywhere else in the body there will be negative effects, aside from maybe the prostate. "Smart" drugs (as I'm sure you are well aware of) which can target specific tissues are likely the future of solving the issue of the side effects from HRT/AA medications. But it would seem we are a few decades away from that.

 

[TanDoc]

You are correct, and not missing anything. The role of DHT is well-established, and there is scientific consensus that DHT damages scalp hair specifically, leading to progressive long-term miniaturization and eventual death/loss of the individual scalp hair follicle. Testosterone at normal physiological levels does not do so to anywhere near the same degree. Not to say testosterone does absolutely nothing for scalp hair specifically compared to DHT, but the effect of DHT is orders of magnitude more significant on hair than any damage a normal physiological level of testosterone could cause.

The evidence is there in men afflicted with 5α-reductase deficiency (who their whole lives have normal levels of testosterone and absent DHT), who possess juvenile hairlines, and no male pattern baldness.

I wouldn't bother with MPMD and the other youtubers. All they do is watch forums like these, summarize some recent posts, reference a few random pubmed abstracts (if you're lucky to even get that), then fuel speculation for the purpose of making clickbait/driving traffic to their various money-making enterprises.

If you have a graduate science background of your own (which it seems you do), you can do better yourself.

 

[Norwoody]

You are correct, and not missing anything. The role of DHT is well-established, and there is scientific consensus that DHT damages scalp hair specifically, leading to progressive long-term miniaturization and eventual death/loss of the individual scalp hair follicle. Testosterone at normal physiological levels does not do so to anywhere near the same degree. Not to say testosterone does absolutely nothing for scalp hair specifically compared to DHT, but the effect of DHT is orders of magnitude more significant on hair than any damage a normal physiological level of testosterone could cause.

The evidence is there in men afflicted with 5α-reductase deficiency (who their whole lives have normal levels of testosterone and absent DHT), who possess juvenile hairlines, and no male pattern baldness.

I wouldn't bother with MPMD and the other youtubers. All they do is watch forums like these, summarize some recent posts, reference a few random pubmed abstracts (if you're lucky to even get that), then fuel speculation for the purpose of making clickbait/driving traffic to their various money-making enterprises.

If you have a graduate science background of your own (which it seems you do), you can do better yourself.

It makes sense, but here is a question: how come some dutasteride users report a worsening of the hairline? Some speculate that the hairline is extra-sensitive to the extra T that dutasteride causes. However, I think it is also possible that some users simply do not give the drug enough time to get through the shed, and the shed could potentially last much longer than finasteride's due to dutasteride's substantially longer half life. Thoughts?

 

[TanDoc]

It makes sense, but here is a question: how come some dutasteride users report a worsening of the hairline? Some speculate that the hairline is extra-sensitive to the extra T that dutasteride causes. However, I think it is also possible that some users simply do not give the drug enough time to get through the shed, and the shed could potentially last much longer than finasteride's due to dutasteride's substantially longer half life. Thoughts?

I think you have the key right there, Norwoody^. Dutasteride is a more powerful and more effective drug than finasteride. The shedding period (eventually followed by regrowth) is something that takes a toll on individuals, and many people aren't willing to ride it out, stopping early because they see it as simple evidence of "drug failure".

To add though - these claims also happen to be really few and anecdotal. I think there are maybe 1-2 users on this forum who believe that, both who did not go long-term. There is one popular youtuber who claims that as well, but his "experiment" involved injecting himself with supraphysiological doses of testosterone, running a steroid cycle while he took the drug.

Actual clinical research on dutasteride (actually keeping subjects on the drug for long periods of time, such as half a year, and running things objectively, like a clinical study) for hair supports it being more effective at stopping and reversing hair loss than finasteride. Take a look at this systematic review/meta-analysis that summarizes studies conducted by different centers, much longer term (6-months-long), over hundreds of individuals https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388756/

There's also no significant difference in dutasteride and finasteride's raising of testosterone (see Traish et al's systematic review in 2018, covering 11 studies comprising 1,784 individuals over years, published in the journal Sexual Medicine Reviews).