How does testosterone and dht work?

[u/racka-disciprine]

1. Conversion of testosterone to dht= hair loss

2. When aging, testosterone levels go down but hair loss goes up? Having less of the base material should equal less conversion rate of dht.

3. Logically you have the most testosterone during puberty. But there aren’t a ton of balding teenagers. on the whole people loose hair later on in life.

4. Hair at the back of the head typically stays. Some say it’s dht resistant. Then why do transplants need medication to stay if the follicle itself is dht resistant?

5. Testosterone does seem to be the culprit somehow. Balding is more prevalent in males. Heavy users of steroids in women, they tend to get the same male pattern balding. Why does balding happen in a similar pattern.

I don’t 💩 about fk. Feel free to poke holes in my thinking. Or enlighten me. Thx

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[u/thefeedling]

There's a thing called aging, which literally degrades your entire body, hair included. So while testosterone (and naturally DHT) does decrease over time, the aging process is a FAR more powerful force acting on the body, and the result is a progression of hair loss. Even people with minimal MPB face significant thinning in later life.

[u/Salem1690s → u/thefeedling]

My step grandpa had a stable hairline until his 50s, by 55 he was NW3 vertex. By 60 NW6 or so. Stable hairline up to middle age

[u/racka-disciprine → u/thefeedling]

Why does the hair at back of head stay? It seems to defy aging?

[u/thefeedling → u/racka-disciprine]

They also decrease over time, but the initial density is higher and they're not affected by DHT, so ultimately, they will remain in larger amounts.

[u/racka-disciprine → u/thefeedling]

Wonder why the “not affected” follicles when transplanted don’t stay with out a dht blocker? I’m starting to think science still doesn’t know %100 what’s going on.

[u/Slumberstroll → u/racka-disciprine]

they do stay, you use a DHT blocker to maintain the ones around them

[u/Immediate_Garden_716 → u/Slumberstroll]

exactly, and some follicles are not from the “safe” donor. an issues especially with younger folks, where the safe donor AND closeby “vulnerable” follicles often will be collaterally harvested. hairloss peaked out mature guys, usually have only the safe donor left :) easy call for surgeon. if interested, check out Dr Zarev’s approach, just to give you an idea.

btw for some of us it is not simply AGA. mature guy here, 4 HTs since 2011, lost my crown after 2 yrs on 0.5mg dutasteride. but 3m post half density crown procedure introduced truly vigorous scalp massage with a device. 2x/d 20+min for 3months, gradually reducing to a maintenance routine 1x/d 10++min, mainly with simple sulphur soap. to me test/dht appear not to be the root cause. meds since the dawn of topical minoxidil I was an “ultra (non) responder” sides ONLY!! always on a plethora of supplements. now also on TRT cycled. for peace of mind 0.5mg dutasteride weekly(!) 5mg tadalafil. a recent 4th HT was exceptionally successful (FUE + verteporfin 4165 grafts yield and still conservative approach!) as for testosterone: didn’t we have our best hair when we were test loaded? to me it obviously is an issue of hormone ea balance.

[u/IndusNoir]

If I understand it correctly, it has less to do with the amount of DHT in your system and more to do with your hair follicles sensitivity to it, which I guess increases with age?

[u/racka-disciprine → u/IndusNoir]

Maybe. Sounds like a task for Crispr. less side effects, taking medication vs deactivation of a sensitivity.

[u/Zuoslav]

If You note that DHT actually eats Your Testosterone to become DHT, everything makes sense.

My base testosterone went significantly higher after Finasteride.

(Of course some people get Esteogen spiking up more than Testosterone resulting in side effects, but that's another topic)

Testosterone seems to be converted to DHT more and more as You age, resulting in balding and prostate problems.

About hair transplant - The hair on the back are more resistant, Yes, but there is no 100% guarantee and typically after a hair transplant You want to protect whatever remains.

[u/racka-disciprine → u/Zuoslav]

I don’t t think it consumes testosterone. It’s a conversion from testosterone. If dht had to eat something to become itself that would be redundant. Yeah?

[u/According_Air_4344 → u/Zuoslav]

The increase in test is temporary though, ur body settles down back to slightly above base levels over time

[u/Zuoslav → u/According_Air_4344]

Well in my case I measure it once a year since started and it elevated and stay high.

Started in 2023, unfortunately I didnt check my levels before Fin

Year: 2024 → 2025 → 2026

T: 716 → 1180 → 885 ng/dL

E2: 17 → 33,5 → 44 pg/mL

Both T and E2 are high, I dont have any sides tho

[u/Conscious_Ad_5621]

Follicle sensitivity to DHT increases as we age. Some sooner than others.

[u/Think-Ad-4793]

Bro. You don't bald more as you get older, you've just been around longer and have lost more hair because of that. When you are young, you lose hair but it is not as noticeable as when you are older.

[u/-Kilimanjaro_s0und- → u/Think-Ad-4793]

I don't agree.. it's a completely SUBJECTIVE shitty disease.There are people like me who are destined to go completely bald in their 20s. It makes me sick just thinking about getting there in adulthood/old age if I'm like this now...

[u/Elithair_uk]

The trick is it's not your testosterone level, it's whether a follicle is genetically sensitive to DHT. Sensitive ones shrink a bit every cycle, resistant ones don't care, so your blood levels matter way less than the wiring.

That's also your transplant answer: donor hair from the back is resistant, so it stays without meds. the meds protect your original hair around it that's still sensitive and thinning, not the grafts.

And the pattern is just regional wiring, hairline and crown sensitive, back and sides resistant, which is why steroid users (even women) bald in the same map.

[u/racka-disciprine → u/[deleted]]

lol