Very High Dht Blood Levels And Hairloss

[zi01]

Hello,
I'm 31 years old and have been seeing hair loss mainly in my hairline for little over a year and am likely an Norwood 2.5 now. I started using minoxidil 8 months ago and it seems to have slowed things down but of late I can feel my whole crown start to thin also.

I ran a couple of AAS cycles in my early 20's from which my total T levels never fully recovered but other than that I have no lasting physical or psychological side effects and haven't used anything hormonal for 7+ years. A couple of months ago I got a set of hormone blood tests which showed my DHT levels to be very elevated (> 2500 pg/ml vs a normal range of 250-990 - more than 2.5x the max range). Everything else was normal (Total T: ~500 ng/dl, E2: ~30 pg/ml, SHBG: 40 nmol) and unchanged from the last few years. My last test for DHT was 3 years ago when it was at a normal 600 pg/ml. Other than the hair loss I don't really have any major symptoms of high DHT which is surprising because I never lost any hair while on steroids but had other side effects.

After repeating the tests along with many others and having them come out normal except for the elevated DHT, the endocrinologist I saw said that Finasteride is the way to go to save my hair but that the high DHT isn't an issue otherwise. I was also offered Dutasteride by a trichologist.

After getting burnt by messing with hormones in the past I'm very hesitant to go down this road again. Since there seems to be no other way though, I want to try to get the DHT levels to normal using an anti-androgen and then taper the drug off, hoping it sticks at the new levels. Is this a possible or likely outcome? On the face of it Dutasteride seems like the better choice for this as it blocks all 5ar isoforms and has a long half life allowing for a more balanced return to homeostasis once withdrawn but would appreciate any comments by people that have gone off these drugs and anyone with tested high DHT levels. For people with high DHT levels, does the hair loss stop or slow down once the levels are controlled without continued treatment?

 

[arnoldd]

I think you need to find what is raising your dht levels. Did your endo say anything about that ?
I would check your thyroid, but if you have hyperthyroidism your testo levels should be high too.

I run roids in the past too but i was unlucky they destroyed my hairs.

 

[zi01]

I think you need to find what is raising your dht levels. Did your endo say anything about that ?
I would check your thyroid, but if you have hyperthyroidism your testo levels should be high too.

I run roids in the past too but i was unlucky they destroyed my hairs.

The endo initially suspected something with adrenal function causing backdoor conversion to DHT as T levels are normal but everything seems normal there after further tests. Thyroid seems fine - TSH is consistently around 2. Prolactin, Progesterone, DHEA, Androstendione and 17a-OHP are all within range. Cortisol is a bit high and FSH is low (1.5) but that has always been the case over the years - not sure if that's because of past steroid use but is unlikely to be the reason for the recent DHT increase. The only medically relevant thing that happened since the last normal DHT reading 3 years ago was repeated rounds of antibiotics for gastro infections.

Right now the endo doesn't think there is a secondary cause for the high DHT and does not seem too worried about it being so high and wants me to consider Finasteride only if I want to save the hair. I really do want to fix this indirectly if possible without going the anti-androgen route but I don't think my endo will be of much more help here and I don't have access to tests where I am now that give more insight into 5ar activity to confirm if that really is the cause. I feel it is likely though as all upstream levels are normal.

Interesting how AAS have an immediate effect on hair for some - I really though I was safe from pattern hair loss after I lost no hair from my DHT derivative heavy cycle but I guess age and prolonged elevated levels will catch-up eventually.

 

[arnoldd]

Well, with these levels of dht even for finasteride would be difficult save hairs.

Why do you think your past steroid use could be the culprit? From my knowledge post roids side effect is low test.

Is there any chance that your dht levels are wrong from the lab ? Because really ,you should have a very high testo levels..

 

[zi01]

Well, with these levels of dht even for finasteride would be difficult save hairs.

Why do you think your past steroid use could be the culprit? From my knowledge post roids side effect is low test.

Is there any chance that your dht levels are wrong from the lab ? Because really ,you should have a very high testo levels..

I don't think roids are the direct reason for the high DHT since I've tested in the past and they have been normal. My total T levels are definitely because of roids though - down to high 400's and 500's from ~900. The high DHT is only in the past couple of years and I was Norwood 1 pretty much until then. It's certainly possible that the lab tests are incorrect - I'll definitely get them retested from another place before any intervention but this is the same place where I've always got tested and it does coincide with the start of hair loss.

Why do you think finasteride or dutasteride will not be enough? I know that the DHT level is close to 2500 because it came back as 2420 (less than the max lab value) in one test. I guess if finasteride only lowers DHT by 70% then for me it might still not be enough but my interest really is to go off the drug at some point and keep the lowered DHT and new HPA axis balance. Does this happen to people that come off these drugs? I know that for people with high estrogen / gyno after roid use - using letrozole for 1-2 months makes the estrogen remain low once off the drug - like post finasteride syndrome but for AI's and estrogen.

 

[arnoldd]

I meant finas will help for sure but with those high levels probably you will still have some loss. Take in consideration that you need take it for life ( like minoxidil) , after you quit in 3-4months you will come back to your previous baseline.
When you go off finasteride , it takes 2 weeks to your body to recover your normal dht production.
And if the high dht is from adrenal glands it wont have any effect if im not wrong.
I think first you need to restest the dht result because its very strange with normal test levels and no others healthy issues.
Than if the result come back so high again look for some serious endo to find what cause the high dht. It can hurt prostate too not only hairs.

 

[zi01]

I meant finas will help for sure but with those high levels probably you will still have some loss. Take in consideration that you need take it for life ( like minoxidil) , after you quit in 3-4months you will come back to your previous baseline.
When you go off finasteride , it takes 2 weeks to your body to recover your normal dht production.
And if the high dht is from adrenal glands it wont have any effect if im not wrong.
I think first you need to restest the dht result because its very strange with normal test levels and no others healthy issues.
Than if the result come back so high again look for some serious endo to find what cause the high dht. It can hurt prostate too not only hairs.

Thanks for the conservative approach. Hope I don't lose all my hair before I figure this out.