Hair loss

[Luke717]

From what I have read, it is possible to keep your hair. That as long as your not predisposed to hair loss, then you won't lose it. How true is this? I look weird with a shaved head , where a lot of yall can pull it off. So I am a little worried.

I ordered red light therapy light for at home use. Many benefits they claim, hair loss being one of them.

Do I need to proactively start hair loss methods if I am not predisposed? Because I am 36 and have a great head of hair with no signs of hair loss at the moment. Only been on TRT for about a month.

 

[fifty]

TRT in moderation won’t hurt hair. If you’re hair is fine now don’t worry about it. Really

 

[Jason Sypolt]

Excess DHT can lead to thinning hair, but to become bald (androgenic alopecia), you do need the genetics for it to happen. DHT from the testisterone in TRT will accelerate the process, but it was going to happen anyway if you have the genes. There are products that can slow or reverse hair loss.

 

[Sly]

I was worried that TRT would cause premature balding, but 2 years later and no acceleration. My dad and brothers and as well as the men on my mom’s side lost most of their hair in their early twenties. I’m pushing 50 and only now can you tell my hair line is receding. I got lucky I guess.

 

[Gman86]

I’ve heard that if you have no hair issues by the time you’re 30, there’s a good chance that you’re fairly immune to TRT effecting you’re hair negatively. I’m 33, been on HRT for 5-6 years, and never had any issues. And I just used the cream for 2 months recently, which sky rocketed my DHT to 311. Still no hair issues. So if you don’t currently have any hair issues at your age, I’d say the chances are pretty good that you’ll be fine

 

[Vince]

From what I have read, it is possible to keep your hair. That as long as your not predisposed to hair loss, then you won't lose it. How true is this? I look weird with a shaved head , where a lot of yall can pull it off. So I am a little worried.

I ordered red light therapy light for at home use. Many benefits they claim, hair loss being one of them.

Do I need to proactively start hair loss methods if I am not predisposed? Because I am 36 and have a great head of hair with no signs of hair loss at the moment. Only been on TRT for about a month.

What are your DHT levels at now?

 

[Appassionato]

Excess DHT can lead to thinning hair, but to become bald (androgenic alopecia), you do need the genetics for it to happen. DHT from the testisterone in TRT will accelerate the process, but it was going to happen anyway if you have the genes. There are products that can slow or reverse hair loss.

I'm waiting for the day these claims will disappear from the Internet.

Young men with higher DHT levels were shown to be immune to MPB, while their counterpart with higher E2 and an impaired T:E2 ratio were the ones suffering from it.
Serum DHT and scalp tissue DHT are completely unrelated.

I've been losing hairs on a serum DHT of 240.

 

[Jason Sypolt]

I'm waiting for the day these claims will disappear from the Internet.

Young men with higher DHT levels were shown to be immune to MPB, while their counterpart with higher E2 and an impaired T:E2 ratio were the ones suffering from it.
Serum DHT and scalp tissue DHT are completely unrelated.

I've been losing hairs on a serum DHT of 240.

Hm, if you search research databases such as Pubmed and the National Institutes of Health, and the research from this site, I think that you will find that they are not claims. Age seems to be a factor in how androgens affect hair follicles. It is called androgenic alopecia. I’m not an expert on the subject.

240 is well above the lab range and considered high for DHT for what it is worth.

 

[Appassionato]

Hm, if you search research databases such as Pubmed and the National Institutes of Health, and the research from this site, I think that you will find that they are not claims. Age seems to be a factor in how androgens affect hair follicles. It is called androgenic alopecia. I’m not an expert on the subject.

240 is well above the lab range and considered high for DHT for what it is worth.

It isn't called like that anymore since years, because serum androgens has been proven to be unrelated to baldness.
The very founder of the term died knowing his claims were false.
The name used these days is male pattern baldness.
If what you are saying was true, that would have meant that bald people have higher levels of serum androgens and that have been actually the opposite in the vast majority of cases.
Actually young men with all their hairs have the highest levels of testosterone and DHT.

The range of DHT I'm talking about is in pg/mL and it is 112-955 pg/mL.

 

[fifty]

I'm waiting for the day these claims will disappear from the Internet.

Young men with higher DHT levels were shown to be immune to MPB, while their counterpart with higher E2 and an impaired T:E2 ratio were the ones suffering from it.
Serum DHT and scalp tissue DHT are completely unrelated.

I've been losing hairs on a serum DHT of 240.

You’re losing hair at 240 dht. Is that a surprise?

If you block DHT you block hair loss. I don’t know how you’re arguing this.

 

[Gman86]

It isn't called like that anymore since years, because serum androgens has been proven to be unrelated to baldness.
The very founder of the term died knowing his claims were false.
The name used these days is male pattern baldness.
If what you are saying was true, that would have meant that bald people have higher levels of serum androgens and that have been actually the opposite in the vast majority of cases.
Actually young men with all their hairs have the highest levels of testosterone and DHT.

The range of DHT I'm talking about is in pg/mL and it is 112-955 pg/mL.

Very true. And the older the men get, and consequently the lower their dht levels get, their male pattern baldness gets worse, whereas young males with the highest dht levels they’ll see in their lifetime, naturally, usually have no issues. Interesting

Must have to do with ratios of certain hormones. Because elevated dht 100% can increase MBD, so it does definitely have an effect.

 

[Appassionato]

You’re losing hair at 240 dht. Is that a surprise?

If you block DHT you block hair loss. I don’t know how you’re arguing this.

Read the previous message, the range is there.

Regarding why blocking DHT blocks hair loss, it has been discussed in the previous thread I've made where you replied as well.

If DHT would have been the cause of hair loss, using finasteride or dutasteride should have regrown all the hairs in all the patients.

It doesn't. Ask yourself why.

 

[Appassionato]

Very true. And the older the men get, and consequently the lower their dht levels get, their male pattern baldness gets worse, whereas young males with the highest dht levels they’ll see in their lifetime, naturally, usually have no issues. Interesting

Finally someone making some sense out of it.

 

[Jason Sypolt]

Read the previous message, the range is there.

Regarding why blocking DHT blocks hair loss, it has been discussed in the previous thread I've made where you replied as well.

If DHT would have been the cause of hair loss, using finasteride or dutasteride should have regrown all the hairs in all the patients.

It doesn't. Ask yourself why.

The reasoning behind your responses reads as worded in absolutes. No medication works in everyone, and in fact they work in different people to various degrees of effectiveness. By that same finasteride reasoning, the same injection of T should work for everyone in resolving symptoms.

My younger brother was bald as an egg at 22 and his DHT was high. My dad was the same way though he did not have lab tests done many decades ago. There are no absolutes.

 

[Appassionato]

The reasoning behind your responses reads as worded in absolutes. No medication works in everyone, and in fact they work in different people to various degrees of effectiveness. By that same finasteride reasoning, the same injection of T should work for everyone in resolving symptoms.

My younger brother was bald as an egg at 22 and his DHT was high. My dad was the same way though he did not have lab tests done many decades ago. There are no absolutes.

We are not talking about the effectiveness of a drug or not, and not about a symptom. Hair loss is not a symptom of something.
The comparison with T injections doesn't fit, since injecting exogenous T affects a cascade of different hormones, including DHT and E2.
Most of the TRT experienced doctors will tell you that success on TRT depends from balancing a group of hormones, it's a symphony, not a solo.

If DHT is the cause of hairloss, simply targeting DHT and reducing it should revert the effect of that cause. It doesn't, this is a fact.

Your brother case could be the perfect example of a hair loss driven by hormones imbalance. If his 5-ar enzyme was upregulated, that would have left him with an impaired T:E2 ratio, hence the hairloss. Do you have any other hormonal values of him?

 

[Cataceous]

It's hard to dispute a causal link between DHT and hair loss. Stated well here:

Firstly, studies show that DHT is higher in the scalps of men with thinning hair. Secondly, if a man is castrated, his testosterone (and DHT) levels plummet permanently. Men castrated before puberty (i.e., before their DHT levels spike) don’t go bald later in life. And thirdly, men with a genetic deficiency in an enzyme that converts testosterone into DHT in scalp tissues never develop pattern hair loss.

These are pretty indicting findings. Just look at the endpoints: men who never produce DHT never develop pattern hair loss. Men with higher amounts of DHT in their scalps have AGA. Based on these findings, DHT must play some causal role in AGA.

But the same article discusses how the DHT link might still be compatible with the scalp-tension hypothesis:

Question: If DHT causes pattern hair loss, how come eliminating DHT only stops AGA? How come it doesn’t lead to a full hair recovery?
...
Many researchers have hypothesized that this may be due to DHT’s relationship with scar tissue. In scalp tissues, the arrival of DHT seems to also remodel our scalps – causing increased disorganized collagen crosshatchings. In other words, scalp DHT causes fibrosis (or scarring).

In fact, balding scalp regions have four times the amount of excess collagen deposition (scar tissue) than non-balding regions. And as we’ve learned in scleroderma studies, where there’s scar tissue, hair cannot grow.

 

[Appassionato]

It's hard to dispute a causal link between DHT and hair loss. Stated well here:

Firstly, studies show that DHT is higher in the scalps of men with thinning hair. Secondly, if a man is castrated, his testosterone (and DHT) levels plummet permanently. Men castrated before puberty (i.e., before their DHT levels spike) don’t go bald later in life. And thirdly, men with a genetic deficiency in an enzyme that converts testosterone into DHT in scalp tissues never develop pattern hair loss.

These are pretty indicting findings. Just look at the endpoints: men who never produce DHT never develop pattern hair loss. Men with higher amounts of DHT in their scalps have AGA. Based on these findings, DHT must play some causal role in AGA.

But the same article discusses how the DHT link might still be compatible with the scalp-tension hypothesis:

Question: If DHT causes pattern hair loss, how come eliminating DHT only stops AGA? How come it doesn’t lead to a full hair recovery?
...
Many researchers have hypothesized that this may be due to DHT’s relationship with scar tissue. In scalp tissues, the arrival of DHT seems to also remodel our scalps – causing increased disorganized collagen crosshatchings. In other words, scalp DHT causes fibrosis (or scarring).

In fact, balding scalp regions have four times the amount of excess collagen deposition (scar tissue) than non-balding regions. And as we’ve learned in scleroderma studies, where there’s scar tissue, hair cannot grow.

I've discussed it on the thread about hair loss I wrote last week.
Castrated men after puberty still develop male pattern baldness, even in complete absence of androgens. Men castrated a before puberty don't, as you stated.

The huge confusion about the DHT role in hair loss and prostate cancer is that DHT is elevated in the tissues in both cases, not in serum. And, as I said many times, it's because DHT has an anti-inflammatory effect on tissues. Everytime the body senses there's an inflammation, it signals the necessity of an increased concentration of DHT in that tissue.

Now, chronic elevation of DHT in the scalp provoke the thinning of blood vessels, also knows as calcification. No blood supply to the scalp = death of the follicles.
Would you say that DHT is the cause of hair loss then?
The simplest similitude is what happens with lactic acid accumulation in muscles after a heavy workout. Would you say that lactic acid is the cause of soreness or is it the heavy workout itself?

With all that being said, understanding what is causing the inflammation and the epigenetic in play here is quite complicated and could take years.

What I would say is to start finding ways to loosen your scalp in the meanwhile, while trying to find the reason behind your hair loss.
My hairline is basically intact, but I've lost hairs in the crown and mid section of the head, which are the the stiffest sections of my scalp and usually red and itchy.

 

[Cataceous]

...
The simplest similitude is what happens with lactic acid accumulation in muscles after a heavy workout. Would you say that lactic acid is the cause of soreness or is it the heavy workout itself?
...

It is loosely analogous to the scalp-tension hypothesis, with the author of the cited article laying out the entire process thusly:

Scalp tension >> inflammation >> DHT >> TGFβ-1 >> fibrosis >> restricted blood flow >> hair follicle miniaturization >> pattern hair loss​

 

[Appassionato]

It is loosely analogous to the scalp-tension hypothesis, with the author of the cited article laying out the entire process thusly:

Scalp tension >> inflammation >> DHT >> TGFβ-1 >> fibrosis >> restricted blood flow >> hair follicle miniaturization >> pattern hair loss​

Yeah, I've been reading Rob in the past months and he did a great job throughout 10 years of research, even if I don't agree with all he says. And he still underestimates the importance of androgens in men.

But he has been able to regrow his hairs with lifestyle changes and scalp massages.
It didn't work for all of his patients though.

 

[Appassionato]

To add fuel on this discussion, I hope this will help people reconsidering the connection between androgens, DHT and hair loss:

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Quote from this study:
No significant correlations were found between terminal hair development and absolute androgen levels; however, some significant values were observed in the case of the metabolic rate of dihydrotestosterone/testosterone and the proportion of free to total testosterone. The disposition to balding also correlates positively with the latter ratio. Yet the absolute serum androgen concentrations in men with a disposition to balding is lower than in men with no reduction of scalp hair. The widespread assumption that androgen levels are in general elevated in bald‐trait men must therefore be rejected.

More studies on the beneficial effect of testosterone on androgens deprived people, both males and females:

https://jamanetwork.com/journals/jama/fullarticle/654837

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3380548/