DHT in men without male pattern baldness?

[masterbilt84]

I had a few questions for the more knowledgeable members of the forum with regards to finasteride.

Do men without male pattern baldness have low levels of DHT or no DHT whatsoever being produced in their system (or is it a combination)?

I wonder this, because I was on a dosage of 1.25mg finasteride a day. It stopped me losing my hair, however I suffered from sides. From what I gather, such a dosage essentially eliminates DHT from the system (or reduces it significantly).

Now, after losing a fair bit of hair since stopping, I have decided to return to finasteride and take a smaller dosage (0.5mg / day). My opinion is, I'd rather have DHT at a manageable level than to eliminate it completely. I hope this reduces sides, while stopping any further hair loss (or at least slowing the process significantly).

Thanks for your views.

 

[Avery]

Removed my post, it was full of lies! =)

 

[Ian Curtis]

finasteride doesnt stop DHT from binding to the follicles, it stops testosterone from being converted into DHT( 5mg decrease DHT blood levels about 70% i think).
As there is less DHT in your system, the follicles will grow happily.
Now, for those people who keep lowering the dosage in hopes of reducing sides and maintaining hair, they are deluded. If you lower the dosage, there will be more DHT in your body (providing you have lowered it enough) and consequently hair maintenance will decrease and side effects will decrease but only as much as you lower the dosage. You would still be inhibiting DHT so you would still suffer sides.

 

[Fundi]

Now, for those people who keep lowering the dosage in hopes of reducing sides and maintaining hair, they are deluded

Multiple success stories of people using 0.5mg or lower suggests otherwise.

Obviously, the better the dose the more DHT suppressed (Until it flat lines anyway), but if your hairloss isn't super aggressive it should keep DHT at a level which allows hair to maintain.

Back to the original point, I don't think male pattern baldness is caused by high levels of DHT. It's your hairs susceptibility to DHT, which is inherited. So in theory male X can have twice as much DHT in his system as Y, and X be a Norwood 1 and y a Norwood 7.

 

[Boondock]

^ I agree with that basically, with the caveat that if your hair is genetically sensitive to DHT, then having more of it will make things worse. It could be that the males worst affected with have the highest follicle sensitivity and the highest upregulation of DHT.

 

[Bryan]

Do men without male pattern baldness have low levels of DHT or no DHT whatsoever being produced in their system (or is it a combination)?

The studies I've seen on that have been rather conflicting. I think it's probably safe to say that in general, balding men probably _do_ have a little higher levels of DHT on average, but I doubt that it's a very big difference. I think what the other poster said is correct: it's much more important how sensitive your hair follicles are, to androgens in general (including DHT). That's determined genetically.

I wonder this, because I was on a dosage of 1.25mg finasteride a day. It stopped me losing my hair, however I suffered from sides. From what I gather, such a dosage essentially eliminates DHT from the system (or reduces it significantly).

The finasteride doses that are typically used (like 1-5 mg/day) reduce serum DHT levels by about 60% to 70% or so. However, there are two different enzymes which manufacture DHT from testosterone: the type 1 enzyme, and the type 2 enzyme. Finasteride has a negligible effect on the type 1 enzyme, but it reduces the activity of the type 2 enzyme by around 85% to 90% or so, at the usual doses.

 

[masterbilt84]

Thanks for the comments guys.

However, there are two different enzymes which manufacture DHT from testosterone: the type 1 enzyme, and the type 2 enzyme. Finasteride has a negligible effect on the type 1 enzyme, but it reduces the activity of the type 2 enzyme by around 85% to 90% or so, at the usual doses.

Bryan, what reduces Type 1 enzyme? I think I heard adovart reduces both types, but I am not sure I want to try it given its not FDA approved. Is this type 1 enzyme an important factor in hair loss too?

 

[Bryan]

Bryan, what reduces Type 1 enzyme? I think I heard adovart reduces both types, but I am not sure I want to try it given its not FDA approved.

Dutasteride (Avodart) is a dual 5a-reductase inhibitor. It's approved by the FDA, just not for hair loss.

Is this type 1 enzyme an important factor in hair loss too?

Not nearly as much as the type 2 enzyme.

 

[somone uk]

Is this type 1 enzyme an important factor in hair loss too?

Not nearly as much as the type 2 enzyme.

don't the both produce DHT anyway so it doesn't matter if you use finasteride or a pill that inhibits type 1 (if there is one)
or does your body produce more 5AR2 than 1?

 

[Bryan]

don't the both produce DHT anyway so it doesn't matter if you use finasteride or a pill that inhibits type 1 (if there is one) or does your body produce more 5AR2 than 1?

YES to that last question of yours: the authoritative Gisleskog et al studies of dutasteride and finasteride say that slightly over 80% of the DHT in our bodies is produced by the type 2 enzyme, with the rest of it produced by type 1.

However, that really isn't the main point here. The main point is that DHT isn't much of an endocrine hormone. It's mainly an autocrine or paracrine hormone. It mainly affects the cells and tissues where it's actually produced, and has much less of an effect on other remote tissues by getting into the blood and traveling to them via the bloodstream. And since one study found the 5a-reductase in the dermal papillae of human hair follicles to be apparently almost exclusively the type 2 version (Happle & Hoffmann, 1999), that neatly explains why specific 5a-reductase type 1 inhibitors have no significant beneficial effect on hair: there isn't any in hair follicles to be inhibited (at least not in the "control center" of the hair follicle). Finasteride is much more effective, because it goes after the type 2 enzyme in the follicle.

 

[monitoradiation]

Bryan, since you said that finasteride goes after the 5-AR2 enzyme at the location of DHT production, and thus, theoretically, topical finasteride SHOULD work? Then is the reason that topical finasteride applications have not been giving consistent results to most users due to that finasteride isn't getting to the enzymes somehow?

 

[Bryan]

Yes, it certainly seems plausible that topical finasteride ought to work, but there must be reasons why it doesn't work consistently in the Real World. Maybe it's not absorbed properly into local tissues, or maybe it's absorbed too easily into the bloodstream so it doesn't have much of a local effect, or maybe it's both of those reasons put together, or maybe it's something else entirely. Who knows?

 

[chromedomefear]

What I gather from everything said here is that finasteride, since it goes after the type 2 enzyme, is more effective than dutasteride?

I'm going into my 2nd year on dutasteride, and don't see any better results from when I used propecia.

 

[Bryan]

What I gather from everything said here is that finasteride, since it goes after the type 2 enzyme, is more effective than dutasteride?

They BOTH go after the type 2 enzyme. But dutasteride does it more effectively than finasteride at typically-used doses, which is one of the reasons why dutasteride is also a little better than finasteride at fighting male pattern baldness. On average, of course. Individual results may vary.