Benefits of TRT without DHT?

[bartholamule]

I'm at a crossroads with all this stuff. I've been using androgel for almost a year. The good: better libido, energy, concentration, lean mass. The bad: hair loss and gyno. I'm willing to go the surgery route for the gyno if need be (yech), but the hair loss is a MAJOR issue. I'm 52 and have always had good hair (no MBP) until this.

Rather than discontinue TRT completely and lose ALL its benefits, I've been thinking of adding finisteride to the mix. I know this is a major no-no on this board because it reduces T conversion to DHT which is what boosts libido and helps with ED. The question: without boosting DHT, are there any remaining benefits to TRT? In other words, does adding finisteride negate ALL the benefits of TRT? Thanks.

 

[Britman]

bartholamule

Your post is very similar to a recent post of mine re hairloss and TRT (Androgel in particular) but responses to my post have been poor to say the least

I would have thought using some kind of DHT blocking shampoo would (or should in theory at least) be able to block DHT on the scalp only and still leave DHT in the bloodstream to have 'effects' elsewhere - particularly since Androgel pushes DHT way above range to begin with anyway so I personally don't see how using something like finisteride would then deactivate all the -already above range- DHT with Androgel

Incidently do you know what your TT, e2 and DHT levels are having been on Androgel?

Was it straight away you got the hairloss? (I assume you were not aware of this side before starting) and when did the gyno start as pretty unusual to have estrogen issues with a transdermal

Also a lot of people report poorer erections when on Androgel compared to body's own production (even if TT is <350ng/dL) - I gather you don't have this as a side by way of not mentioning it...

 

[rick055]

I think the better question is whether you will have an adverse event(s) using finasteride.

I started out using gels, same thing happened to me, and I'm waaaay too vain to lose hair. I switched to shots, which slowed the rate of hair loss, and then added finasteride (1.25 mg E3D) with no adverse events. My sex drive actually increased for the first number of weeks, and then leveled out.

Some report inability to maintain erection, even after d/c finasteride. I'm not going to discount anybody's painful experience, but my personal belief is that finasteride potentiates an already existing condition.

I should also state that before TRT, when my T was only 320, my DHT was a little over top of range. I had plenty to begin with.

If you don't have a good TRT doc, you should see Dr. Crisler in Michigan; he also has his own anti-hair loss shampoo which I use with success.

 

[bartholamule]

No one has ever scripted a DHT test even though I asked them to. I don't think they knew how. I just saw a recommended Dr. from this board. He's completely against finisteride so I want to continue my own research on here before making major changes, i.e. starting hgh, hcg etc.

Here's an edited excerpt from my thread "Help: TRT hair loss saga" to fill in some blanks:

"Back in June '08 I was diagnosed with low T--197 on a scale of 241-827.

I started Androgel and worked up to about 10 gm per day by Dec. '08. Throughout that time I applied the gel to just my biceps and shoulders while struggling to keep my total T in the 400's. Then I read something that indicated that it should be applied to my abdomen which I started to do in late Dec.

I immediately felt a major boost in energy, libido, etc. About 10 days later, however, I noticed my hair rapidly thinning at the corners. (I'd noticed some overall thinning before that, but nothing TOO dramatic.)

In late January '09 my tests were as follows--

T 885;
Free T 44.9 on a scale of 7.2-24.0;
Estradiol 20 on a scale of 0-53;
progesterone 20 on a scale of 5-160;
DHEA 186 on a scale of 70-310

Because of continued hair loss, I stopped using the gel in late January. My hair continued to fall out at an accelerated rate even after I stopped. In late March I had my T tested again and not surprisingly it came back really low at 204 out of 241-827!

Since I was really beginning to feel like crap, In early April I went back on the gel at 7.5 gm applied only to the shoulders, inside arms and biceps and NOT the abdomen which upon further reading of this board I now understand is about the worst thing you can do if you want to prevent hair loss."

My test results as of early May were:
Total t: 573 (241-827)
free t: 25.84 (5.00-21.00) HIGH
Estradiol 24
DHEA 323

So that's the deal up to now. My hair loss continues and I'm weighing my options--make major changes or just add some finisteride and hope I retain the benefits of T while stopping or reversing the hair loss.

 

[Bigpete757]

No one has ever scripted a DHT test even though I asked them to. I don't think they knew how. I just saw a recommended Dr. from this board. He's completely against finisteride so I want to continue my own research on here before making major changes, i.e. starting hgh, hcg etc.

Here's an edited excerpt from my thread "Help: TRT hair loss saga" to fill in some blanks:

"Back in June '08 I was diagnosed with low T--197 on a scale of 241-827.

I started Androgel and worked up to about 10 gm per day by Dec. '08. Throughout that time I applied the gel to just my biceps and shoulders while struggling to keep my total T in the 400's. Then I read something that indicated that it should be applied to my abdomen which I started to do in late Dec.

I immediately felt a major boost in energy, libido, etc. About 10 days later, however, I noticed my hair rapidly thinning at the corners. (I'd noticed some overall thinning before that, but nothing TOO dramatic.)

In late January '09 my tests were as follows--

T 885;
Free T 44.9 on a scale of 7.2-24.0;
Estradiol 20 on a scale of 0-53;
progesterone 20 on a scale of 5-160;
DHEA 186 on a scale of 70-310

Because of continued hair loss, I stopped using the gel in late January. My hair continued to fall out at an accelerated rate even after I stopped. In late March I had my T tested again and not surprisingly it came back really low at 204 out of 241-827!

Since I was really beginning to feel like crap, In early April I went back on the gel at 7.5 gm applied only to the shoulders, inside arms and biceps and NOT the abdomen which upon further reading of this board I now understand is about the worst thing you can do if you want to prevent hair loss."

My test results as of early May were:
Total t: 573 (241-827)
free t: 25.84 (5.00-21.00) HIGH
Estradiol 24
DHEA 323

So that's the deal up to now. My hair loss continues and I'm weighing my options--make major changes or just add some finisteride and hope I retain the benefits of T while stopping or reversing the hair loss.

I am new to the HRT world, but have been researching alot the past few months and everything I have seen about finisteride has been really bad. I know you are aware of the potential side effects, but if you do some more research on this board, it seems like it has messed up quite a few people's lives. Granted, most of them used it and then now have to use TRT, but try to explore all other options first in my opinion. I am in similar situation in regards to applying test cream/gel to raise my t levels and are worried about hair loss. My pharmacist said to apply it on your flank/high rib area, and I have experienced good results with this like you, but are concerned about the dht level. I just started with the test cream, applied it to my ab area the first week, had good results, then I increased dosages and put it on my shoulders/trap area and my estrogen got too high and felt like crap, now I am trying to find a happy medium with areas and dosages. I read something awhile back that said the closer you apply the test to your scrotum (abs/inner thigh), that it has a higher chance to converting to dht. Which is why shoulders/trap might be better, this could be bs though. Good luck in the future.

 

[JanSz]

No one has ever scripted a DHT test even though I asked them to. I don't think they knew how. I just saw a recommended Dr. from this board. He's completely against finisteride so I want to continue my own research on here before making major changes, i.e. starting hgh, hcg etc.

Here's an edited excerpt from my thread "Help: TRT hair loss saga" to fill in some blanks:

"Back in June '08 I was diagnosed with low T--197 on a scale of 241-827.

I started Androgel and worked up to about 10 gm per day by Dec. '08. Throughout that time I applied the gel to just my biceps and shoulders while struggling to keep my total T in the 400's. Then I read something that indicated that it should be applied to my abdomen which I started to do in late Dec.

I immediately felt a major boost in energy, libido, etc. About 10 days later, however, I noticed my hair rapidly thinning at the corners. (I'd noticed some overall thinning before that, but nothing TOO dramatic.)

In late January '09 my tests were as follows--

T 885;
Free T 44.9 on a scale of 7.2-24.0;
Estradiol 20 on a scale of 0-53;
progesterone 20 on a scale of 5-160;
DHEA 186 on a scale of 70-310

Because of continued hair loss, I stopped using the gel in late January. My hair continued to fall out at an accelerated rate even after I stopped. In late March I had my T tested again and not surprisingly it came back really low at 204 out of 241-827!

Since I was really beginning to feel like crap, In early April I went back on the gel at 7.5 gm applied only to the shoulders, inside arms and biceps and NOT the abdomen which upon further reading of this board I now understand is about the worst thing you can do if you want to prevent hair loss."

My test results as of early May were:
Total t: 573 (241-827)
free t: 25.84 (5.00-21.00) HIGH
Estradiol 24
DHEA 323

So that's the deal up to now. My hair loss continues and I'm weighing my options--make major changes or just add some finisteride and hope I retain the benefits of T while stopping or reversing the hair loss.

From the tests you posted I can see that you are:

responding relatively well to Androgel (no major thyroid problems, likely not guaranteed)
have about right E2 (common when on Androgel)

Few years back I was in similar situation, that is
only Androgel available
only very few tests available
very limited knowledge
falling out hair

I was using (succesfully) Rogaine, Propecia, Proscar, Avodart, in that order.
Had a good response.
With present knowledge I probably would use Avodart, but only one pill per week because it is very potent and half life is very long so the effects are lasting sometimes up to a year.
-----------------------------------
If you have a means I suggest that you do better blood testing and follow (at least) my list of major goals by making attempt to corect shotcommings discovered by that testing.

My list of tests is on page #2 post #44, between blue lines, here:

https://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13-2.html
it is complete prescription including ICD-9 codes that would allow insurance payment.

That list is ment for test at Quest Diagnostics.

Success ot TRT largely relies on frequency of testosterone delivery.
It needs frequent delivery.
That is no problem when applying daily Androgel.
Shots also have to be frequent, EOD (EveryOther Day) is often enough.
Any TRT should also have HCG shots.

If you switch to T-shots, use only these (very small) needles:

BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b at Hocks.com
BD Ultrafine II U-100 Insulin Syringe 31 Gauge 3/10cc 5/16inch Short Needle--1/2 Unit Markings 100/b Price: $27.80

Start with some dose, adjust latter per blood test, next test 2-3 months after switching to shots.

Use only 200mg/mL testosterone, cypionate or enanthate.
Size of shots.

T-shot=40mg=20units=0.2cc
HCG-shot-250iu

do both shots at the same time, next day free of shots.
do not use Arimidex unless E2 over the range as confirmed by blood test.

My own Goals
DHEAs(500-640)mcg/dL(13.55-17.34)mol/L------------------major player, 95% time overlooked
Progesterone(0.9-1.2)ng/mL
Pregnenolone(> 100ng/dL)
Estradiol, Ultrasensitive(25-29)pg/mL
Estrone, LC/MS/MS (23244X)
do not use Anastrozole if possible or minimize its use
BATest(342, 460-575)ng/dL------------stay around 342 if you need AI to control E2
DHT(60-90)ng/dL
RT3 in lower half of range, TotalT3 in upper 1/3 range
FreeT3~400pg/dL
Body temperature (97.8 - 98.2F) (36.56 - 36.78C); (36.6-37C)(97.9-98.6F)
==============================
==============================
Here is the list for your convenience and completeness:

1 --------- Comprehensive Metabolic Panel w/EGFR
2 --------- Hepatic Function Panel (10256X)
3 --------- VAP TM Cholesterol Test (10270X)
4 --------- CBC w/ diff/PLT
5 --------- Iodine, iodide Panel - (2503)
6 --------- Selenium
7 --------- Copper, serum
8 --------- Zinc
9 --------- Magnesium
10 --------- Phosphate
insurance may not pay($57.75) 11 --------- C-Reactive Protein (CRP), Highly Sensitive, CSF - (17401X)
12 --------- Fibrinogen
insurance may not pay($191) 13 --------- Homocysteine, cardio
14 --------- Lipoprotein (A) Lp(A)
15 --------- Iron and Iron Binding Capacity (7573X) - (356N)
16 --------- Iron, Total (571X) - (24984P)
17 --------- Ferritin (457X) - (22764P)
18 --------- Transferrin (891X) - (30346P)
19 --------- Folate, RBC & Hematocrit - (1768N)
20 --------- Hemoglobin A1c (496X) - (45484P)
21 --------- Hemoglobin, Plasma (514X) - (7211P)
specify 22 --------- VITAMIN SCREEN
specify 23 --------- VITAMIN B PANEL 2 - (9067)
24 --------- Vitamin D, 25-Hydroxy, LC/MS/MS - (17306X)
25 --------- T3, Total (859X)
26 --------- T4, Total (Thyroxine)
27 --------- T3, Free
28 --------- T4,Free
29 --------- T3, Reverse (967X)
30 --------- Ultrasensitive TSH
31 --------- Thyroid Peroxidase and Thyroglobulin Antibodies (7260X)
32 --------- Insuline, serum
33 --------- IGF Binding protein-3
34 --------- IGF-1
35 --------- DHEA Sulfate 402X
36 --------- Aldosterone
37 --------- ACTH, Plasma
38 --------- Cortisol Binding Globulin (Transcortin) (37371X)
39 --------- Cortisol AM/PM
40 --------- Prolactin - (746X)
41 --------- Progesterone, LC/MS/MS 17183X
42 --------- Pregnenolone, LC/MS/MS (31493X) 28373P
43 --------- Androstenedione, LC/MS/MS - (17182X)
44 --------- Estradiol, Ultrasensitive, LC/MS/MS (30289X)
45 --------- Estrone, LC/MS/MS (23244X)
46 --------- Testosterone, Free, Bio/Total (LC/MS/MS) Code: 14966X
47 --------- Dihydrotestosterone (204X)
48 --------- Ceruloplasmin (326X)
49 --------- Coenzyme Q10 (198268)
--------------------------------------------------------------------------------------------------
250.00 ----- 257.2 ----- 780.79
250.01 ----- 272.4 ----- 788.41
255.4 ----- 601.9 ----- 253.3
783.9 ----- 780.4 ----- 255.8
--------------------------------------------------------------------------------------------------
......
.....
.

 

[Britman]

Folks

On another side note re TRT and hairloss due to high DHT....there is a transdermal called Tostran here in the UK - it has been filed with the FDA a few weeks ago to be available in the US in a matter of months - tradename Fortigel (made by Scottish company called ProStrakan). It has a large percentage of the TRT market in Europe - apparently over 30%

I read somewhere that hairloss is less of an issue than with other transdermals

It's main selling point is that it is the first 2% testosterone concentration transdermal on the market and therefore less gel needs to be applied to the body - possibly this is why hairloss is less of an issue... if less gel is being exposed to the skin and therefore 5-alphareductase enzyme which converts T to DHT (just my theory)

The main drawback reported from most is that it takes slightly longer than Androgel to dry but this can be overcome by rubbing in with aloe vera and/or using small amount of talc after application (just reporting what few people have said - not used it myself)


One thing for sure is that If a TRT cream/gel comes out which keeps TT,e2 and DHT in range and therefore less side effects for the majority without the need for adding anything else into the mix it is sure to be a blockbuster drug

 

[pmgamer18]

If your going to lose your hair in time gels can make you lose faster do to the high DHT levels never take finasteride. It will not be long and it will be pulled off the market there are a lot of law suets against them. Just switch to shots do them 2 x's a weeks to keep E2 and DHT down. Read this link to the there forum and read there stories about what happened to them taking this crap.
Propecia Side Effects - Impotence, Low Libido, Erectile Dysfunction, Finasteride

 

[Britman]

For anyone that has lost hair as a result of TRT (Androgel in particular) - is it reversible on stopping TRT or once hair sheds is that it?

 

[1ainslie]

If your going to lose your hair in time gels can make you lose faster do to the high DHT levels never take finasteride. It will not be long and it will be pulled off the market there are a lot of law suets against them. Just switch to shots do them 2 x's a weeks to keep E2 and DHT down. Read this link to the there forum and read there stories about what happened to them taking this crap.
Propecia Side Effects - Impotence, Low Libido, Erectile Dysfunction, Finasteride

I read what you say about Finesteride, there is aan awful lot of people out there who say they have no problems on, mind you I dont think I would try it myself.

Any figures/charts available on which form of T has the lowest DHT, I am on gels and have hair loss, tried regular shots even every day idnt work, planning to try pellets or subq next.

 

[jinxie1]

I think the better question is whether you will have an adverse event(s) using finasteride.

I started out using gels, same thing happened to me, and I'm waaaay too vain to lose hair. I switched to shots, which slowed the rate of hair loss, and then added finasteride (1.25 mg E3D) with no adverse events. My sex drive actually increased for the first number of weeks, and then leveled out.

Some report inability to maintain erection, even after d/c finasteride. I'm not going to discount anybody's painful experience, but my personal belief is that finasteride potentiates an already existing condition.

I should also state that before TRT, when my T was only 320, my DHT was a little over top of range. I had plenty to begin with.

If you don't have a good TRT doc, you should see Dr. Crisler in Michigan; he also has his own anti-hair loss shampoo which I use with success.

1/2 life is too short for E3Ds. If you are using Avodart, try to get it town to .4-..5 mgs and take ED. I've read quite a bit on the subject and .25 - .5 mgs per day can get it done. But E3Ds is going to be much less effective. But if it works well enough, it works!

 

[Britman]

Is hairloss as a result of TRT (Androgel in particular) - reversible then on stopping TRT?