Would raising T levels in older guys cure their hair loss?

[Bryan]

Not me. I think it's a pretty silly way to argue in support of the idea that estrogen is bad for hair.

I didn't say that. I said estrogen-triggered prostate production of DHT is bad for hair.

That's my point.

I already _know_ what your point is. You think that estrogen is bad for hair indirectly by enlarging the prostate, causing it to make more DHT. And I'm saying that that's a silly argument to make, because serum DHT (from the prostate) has no significant effect on hair follicles.

And then there's the separate issue that reducing (or increasing, for that matter) estrogen may not even affect the size of the prostate in the first place, according to that study I mentioned.

Now that really is interesting about inhibiting estrogen not helping... it's quite confusing as apparently estrogen inhibits T production. This suggests that if you LOWER estrogen, you will lift testosterone a little...

Yes. Exactly. It's not "confusing" at all, it's basic physiology.

It is also known that the prostate grows as men get older. It would therefore probably be releasing more DHT into the blood.

I don't think that's relevant to anything.

There are simply so many factors here. SOMETHING is triggering the prostate to enlarge and produce more DHT. That is the part that matters. We can dance around the specifics all night but the point is that when that happens, it causes hair loss.

Nope. It does NOT cause hair loss.

Male pattern hair loss is usually NOT an isolated incident. Unless your hormones make you particularly susceptible, it usually goes hand in hand with other hormone-triggered phenomena in the body, and only by isolating the root cause are we ever going to treat it in a healthy way, or stand a chance of actually curing someone

I think balding IS an isolated incident, at least for the most part. I think it has to do (mostly, like maybe 95% or so) with characteristics inside the hair follicle itself, dealing with its sensitivity to androgens. But if you want to experiment endlessly with other things (like various dietary issues) that have some modest effect on that remaining 5%, be my guest!

 

[Hoppi]

Oh Bryan come on this is ridiculous ._. It flies in the face of all logic ._.

How on earth can DHT levels in the blood not affect the follicles? Please explain that to me, how all this nice, fresh new DHT doesn't just make it's way up there and attach to the androgen receptors? You may have moxsom to argue with on this one lol

And you really think that lowering SHBG will not encourage balding? Why do you think that people get some male pattern hair loss when they get stressed, or eat bad food, or drink too much? Their SHBG drops, and their T levels rise. I was chatting to a guy just yesterday who said his shedding was bad when he drunk lots of beer then when he stopped it stopped (or at least slowed considerably).

So you think NO other factors affect balding? Not serum DHT, not serum testosterone, not SHBG, nothing?

So why do flax seeds work? Why do lignans work? Why has reducing sebum been known to affect balding? Why do people with metabolic syndrome bald more? Now that's not age is it? THAT'S not follicle sensitivity with age. That is diet and hormones.


EDIT -- and why did the ImmortalHair regimen work? Finasteride is not the only cure for hair loss. I would not recommend it except in severe cases, or possibly unless the person was VERY stubborn about their diet and lifestyle choices! heh

 

[Hoppi]

As an extension, I would even imagine that short term increases in estrogen would affect the prostate.

SO.

Let's say some dude is drinking a whole ton of beer and lowering his SHBG, lifting his estrogen without even realizing it. OH NOES his prostate would be getting bigger and releasing more DHT. So he loses hair. So he goes on finasteride! Better stop that hair loss! Good old finasteride!

And then, he thinks after a few years, "ok, let's try coming off of finasteride now and see what happens..."

But of course. If his prostate is still enlarged, or his SHBG is still too low, or possibly his insulin resistance is too high, then all these things will mean he will still lose hair. So OMFG it must be the male pattern baldness gene! Damn I knew I activated it when I drank all that beer!!

My point is, yes we are genetically disposed. But the body is a complex thing and many things are affecting the amount of T and DHT that flood our follicles every day. We need to look at the root causes, not just kill our 5ar!!

 

[moxsom]

Oh Bryan come on this is ridiculous ._. It flies in the face of all logic ._.

How on earth can DHT levels in the blood not affect the follicles? Please explain that to me, how all this nice, fresh new DHT doesn't just make it's way up there and attach to the androgen receptors? You may have moxsom to argue with on this one lol

While I agree with Bryan that locally produced DHT has an effect, I agree that serum DHT can too.

However, all of your theories Hoppi are based on anecdotal evidence, correlations with little relevance, wikipedia science, and other people with little knowledge of hair biology.

I do however applaud your effort for a healthy lifestyle and your quest for knowledge. Perhaps if you go to school, (you are 24ish), perhaps you can take some classes on cellular biology to learn a little bit more.

 

[Hoppi]

Oh Bryan come on this is ridiculous ._. It flies in the face of all logic ._.

How on earth can DHT levels in the blood not affect the follicles? Please explain that to me, how all this nice, fresh new DHT doesn't just make it's way up there and attach to the androgen receptors? You may have moxsom to argue with on this one lol

While I agree with Bryan that locally produced DHT has an effect, I agree that serum DHT can too.

However, all of your theories Hoppi are based on anecdotal evidence, correlations with little relevance, wikipedia science, and other people with little knowledge of hair biology.

I do however applaud your effort for a healthy lifestyle and your quest for knowledge. Perhaps if you go to school, (you are 24ish), perhaps you can take some classes on cellular biology to learn a little bit more.

At least I'm suggesting holistic, viable alternatives to finasteride instead of just killing systemic 5ar without a thought ._.

 

[Bryan]

Oh Bryan come on this is ridiculous ._. It flies in the face of all logic ._.

How on earth can DHT levels in the blood not affect the follicles? Please explain that to me, how all this nice, fresh new DHT doesn't just make it's way up there and attach to the androgen receptors?

I'm going to single-out this one point from your post to address, because it's always interested me for years; I may reply to the rest of your post separately.

For years back on alt.baldspot, Dr. Proctor always used to tell us that the consensus among endocrinologists is that DHT only has an effect (a significant effect?) in the tissues where it's actually produced. I never really understood _why_ that would be the case, I just made a mental note of it whenever he would say that.

Nowadays I've come to fully believe that claim, and it makes perfect sense to me. It's based not only on LOGIC, but also on actual physical experiments. For example, topical 5a-reductase inhibitors have been shown to have a "local" effect where they're applied, and that's in both humans and animals. Topical gamma-linolenic acid (GLA) in that hamster study of topical fatty acids was shown to have an effect that was starting to approach what you get with castration on the flank-organ to which it was applied, but not on the opposite flank-organ. A similar effect on a human volunteer was found by the same researchers who did the hamster study: topical GLA on his forehead significantly reduced sebum production where it was applied. The point of all this is screamingly obvious: if serum DHT were much of a factor, why didn't it keep the topical GLA from having an obvious DHT-suppressing effect in the human and in the hamsters where it was applied?

If you do a little reading, it really shouldn't be that surprising that DHT only seems to have a significant effect where it's actually produced. I was reading an interesting article in a medical journal a long time ago (sorry, I didn't even bother to write it down for later citation) that said that the great majority of DHT molecules that are manufactured inside cells (by 5a-reductase, of course) go on to bind to androgen receptors in those same cells, and produce their usual androgenic effects RIGHT THERE WHERE THEY WERE PRODUCED. Only a relatively small number of the DHT molecules "leak out" of the cell and into the bloodstream (according to the article).

Furthermore, DHT in the bloodstream is eliminated rather rapidly, with a "half-life" of a couple of hours. From a study that I've quoted many times over the years ("A Model for the Turnover of Dihydrotestosterone in the Presence of the Irreversible 5a-Reductase Inhibitors GI198745 and Finasteride", Gisleskog et al, Clin Pharmacol Ther 1998;64:636-47): (page 641) "...The elimination rate of DHT, k(OUT), was relatively high, corresponding to an elimination half-life of 2 hours."

So let's sum it all up this way:

1) Only a (small?) minority of DHT molecules make it into the bloodstream in the first place, compared to all the ones that stay inside the cells and do their dirty work right away;

2) The ones that DO make it into the bloodstream are eliminated rather rapidly, before they have a chance to do much mischief;

3) Actual physical experiments with humans and animals verify that serum DHT seems to have no significant effect as an androgenic stimulus. In other words, DHT isn't much of an endocrine hormone, it's mainly an autocrine hormone.

Questions? Comments? Flames?

 

[DoctorHouse]

Bryan, what about age related thinning in OLDER guys. What is happening in the follicle? Since age related thinning is not EXACTLY the same thing as male pattern baldness, where do they differ? If someone wants to reverse the follicle from thinning due to age which I assume means less collagen production, what can you do? How can you revive those follicles that are producing thinner hair and in most cases gray hair? Any studies on reversing age related thinning hair??

 

[wesleyBelgium]

seems to me that the best way to avoid hairloss at all ages is : do something about the androgen receptors at the hairfollikels....

i agree that hairfollikels get more sensitive to androgens in later life , there are also specials cases like : a boy of age 19 thats almost bald , that would also be the case of to sensitive receptors on the hair to androgens....

is androgens good for the hair , why does anti-androgens work against hairloss ? it clearly that i does work against hairloss , but the sides are not funny...

if you inject womans with testosteron they will become more a men and also get hairloss , so the relation with more testo + more hair is not correct...
its the first time that i see something about estrogen turning into dht , are there not correct studies that show what converts to dht ? is it testo or estrogen, or both ?

 

[Hoppi]

Some great posts, and thank you for the longer and interesting post Bryan

I am sorry, I don't mean to fight, it's just I guess there are so many different ideas flying around sometimes and the body is such a complex thing!

I mean, you may be right about systemic DHT not having a huge impact. You would imagine however that it depends just how much of it there is! I mean if there is simply TONS of it, then I would imagine it would have a similar or maybe more potent effect as if there were tons of free testosterone flying around - it would attach to the androgen receptors.

For this reason I would imagine it is simply down to pure quantity! ... I wonder how much an enlarged prostate DOES produce O.O

And wesley, the idea here is that estrogen seems to trigger the prostate to enlarge, and in theory this then results in it producing more DHT than usual. This is what we're currently trying to establish and stuff Opinion seems quite divided on it from forum to forum and person to person!

 

[Bryan]

its the first time that i see something about estrogen turning into dht , are there not correct studies that show what converts to dht ? is it testo or estrogen, or both ?

ESTROGEN DOES NOT TURN INTO DHT. The wacky "Dr. Wong" doesn't know what the hell he's talking about! The guy is completely Looney Tunes!

Testosterone is converted into estrogen by the aromatase enzyme.

 

[Bryan]

I mean, you may be right about systemic DHT not having a huge impact. You would imagine however that it depends just how much of it there is! I mean if there is simply TONS of it, then I would imagine it would have a similar or maybe more potent effect as if there were tons of free testosterone flying around - it would attach to the androgen receptors.

Sure, if you take supra-physiological amounts of DHT from external sources (like if you shoot-up large amounts of the stuff, or use large amounts of those DHT creams all over your body), you're definitely going to start having androgenic effects from it, despite the general guidelines I posted before. So I think the bottom-line is simply this: don't shoot-up DHT, or apply large amounts of DHT cream to your body!

For this reason I would imagine it is simply down to pure quantity! ... I wonder how much an enlarged prostate DOES produce O.O

According to a study I have which measured serum DHT levels in men before-and-after radical prostatectomy, the prostate contributes about 20% of the DHT found in the blood, and that was presumably in men with prostate cancer. I wouldn't lose even a SECOND of sleep worrying about a slight amount of extra DHT in my blood from an enlarged prostate.

 

[Bryan]

Bryan, what about age related thinning in OLDER guys. What is happening in the follicle? Since age related thinning is not EXACTLY the same thing as male pattern baldness, where do they differ? If someone wants to reverse the follicle from thinning due to age which I assume means less collagen production, what can you do? How can you revive those follicles that are producing thinner hair and in most cases gray hair? Any studies on reversing age related thinning hair??

I'm afraid to say too much about all that, other than to mention that terrific study done by Kligman several years ago: he did an exhaustive analysis and comparison (under a microscope, no less) of thinning hair follicles from age, and thinning hair follicles from male pattern baldness; he found striking similarities between the two. (If you have access to a medical library and want to read it, I can dig it out of my Study Stack and give you the full citation.)

It really does make me wonder if even "age-related" thinning scalp hair is still partly (or mostly?) an androgen-related phenomenon, even if it's drawn-out over a more extended period of time.

 

[DoctorHouse]

I think I asked that same question to Dr P on another forum. I think he said they were similar and that his Proxiphen would definitely help with age related thinning as well. He said Proxiphen helps with all types of hair loss. I would consider age related thinning similar to or the same as DPA. I have finally come to the conclusion I must have DPA with some age related thinning because I have very little temple recession. I guess between using the Proxiphen, minoxidil, and Propecia, I am able to slow things down some. Bryan, would you agree that DPA and age related thinning are basically the same thing? I don't have access to a medical library but if you can some how post the study I would be very grateful. I think copper peptides probably are more beneficial to help thicken up age related thinning as well.

 

[Bryan]

Bryan, would you agree that DPA and age related thinning are basically the same thing?

I think that's a distinct possibility.

I don't have access to a medical library but if you can some how post the study I would be very grateful.

I haven't read the thing in years, but I recall that it's several pages long, far too many pages to scan and post in its entirety. Private Message me your mailing address, and I'll be happy to snail-mail a paper copy of it out to you!

 

[Hoppi]

So, Bryan, in your opinion what is the very best regimen? Do you think it's possible to combat hair loss without Minoxidil?

 

[moxsom]

Bryan, would you agree that DPA and age related thinning are basically the same thing?

I think that's a distinct possibility.

I don't have access to a medical library but if you can some how post the study I would be very grateful.

I haven't read the thing in years, but I recall that it's several pages long, far too many pages to scan and post in its entirety. Private Message me your mailing address, and I'll be happy to snail-mail a paper copy of it out to you!

If you have the citation I can more than likely get an online copy

 

[moxsom]

So, Bryan, in your opinion what is the very best regimen? Do you think it's possible to combat hair loss without Minoxidil?

Minoxidil doesn't even combat hairloss per se, so I'd say yes, quite possible.

Minoxidil is mostly for a cosmetic appearance, it can help the hair follicle grow larger, but androgen damage can still accumulate during this time.

 

[Bryan]

If you have the citation I can more than likely get an online copy

"The Comparative Histopathology of Male-Pattern Baldness and Senescent Baldness", Albert M. Kligman, MD, PhD. Clinics in Dermatology. October-December 1988, Volume 6, Number 4. Pages 108-118.

 

[Bryan]

I just found a post I had made on alt.baldspot back in 2001 about that same Kligman study. Here it is (I was replying to my friend "maneless", the guy who was always so crazy-nuts about RU58841):

I just picked up a study which I think you and your dermatologist friend would find very interesting. This would be: "The Comparative Histopathology of Male-Pattern Baldness and Senescent Baldness", written by the famous and authoritative Albert M. Kligman, MD, PhD. This is chapter 16 in "Clinics in Dermatology", October-December 1988, Volume 6, Number 4.

Dr. Kligman did a microscopic analysis just like you suggest of normal scalp, early male pattern baldness scalp, late male pattern baldness scalp, and senescent balding scalp, and studied the differences. I don't want to type out this entire study, but let me tease you with a couple of passages! In the section "Late Male-Pattern Baldness", he starts out: "All of the early male pattern baldness features are present. More of the shortened follicles are in telogen. The streamers still show considerable inflammation, but fibrosis is in greater evidence, with many parallel bundles of dense collagen. Occasional streamers eventually end up as fibrotic tracts. These are subfollicular scars. These fibrous bands have few cells, sparse vessels, and show hyalinized collagen. End-stage fibrosis of this degree is not common; surprisingly, some seem to undergo partial resorption, suggesting that they might disappear altogether...."

Later in the "Discussion" section, he says: "male pattern baldness is a genetically determined inflammatory disorder that should not be considered as premature aging. The etiology of the inflammation is unknown. Follicular miniaturization in male pattern baldness is a consequence of pathologic fibrosis of the connective tissue sheath. The central pathology relates to abnormalities of the perifollicular connective tissue sheath, evident as inflamed streamers subtending involuting follicles. Those streamers show fibroplasia and hypertrophy, along with proliferation of capillaries and a mixed infiltrate of lymphocytes, histocytes, and mast cells. Chronic inflammation of the streamers prevents anagen follicles from being fully reconstructed during the new cycle. After many years, this can lead to scarring and preclude regeneration. Even in advanced male pattern baldness, most follicles were not fully scarred, offering the theoretical possibility of regrowth. Fibrotic streamers are increased in proportion to the duration of baldness and chronologic age".

This is just a small part of the study, of course. But it does look like something you'd find interesting.

Bryan

 

[moxsom]

If you have the citation I can more than likely get an online copy

"The Comparative Histopathology of Male-Pattern Baldness and Senescent Baldness", Albert M. Kligman, MD, PhD. Clinics in Dermatology. October-December 1988, Volume 6, Number 4. Pages 108-118.

Hmm, unfortunately only have articles dating back to 1993 online for this Journal.