AustrianMogger
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Massiv copeDHT is an essential male hormone, not just for libido or feeling manly, but for health as a whole. This guide will cover all aspects of the importance of the hormone DHT for the human body.
DHT is synthesized from:
- Testosterone through the enzyme 5 alpha reductase (5AR)
- 17-hydroxypregnenolone and 17-hydroxyprogesterone via the “backdoor” pathway
- 5α-androstane-3α, 17-β-diol (dihydroandrosterone/3α-diol) through the intracrine reverse synthesis pathway involving 3α-hydroxysteroid dehydrogenase (3α-HSD)
DHT is 2.5-10 times more potent than testosterone and here’s why:
- DHT has 4 times higher affinity to androgen receptors (AR) than Testosterone
- Binding of DHT to the AR transforms the AR into it's DNA-binding state
- DHT upregulates AR synthesis and reduces AR turnover
- The dissociation rate of testosterone from it's receptors is 3-5 times faster than that of DHT (meaning DHT exerts a much more powerful effect on AR than testosterone)
However, circulating DHT is usually only about 10% or less that of testosterone and high concentrations of intracellular T can shift androgen receptor binding away from DHT by mass action
Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels
Circulating levels of DHT in response to testosterone replacement therapy (TRT) do not correlate with those found in androgen sensitive tissue due to homeoacademic.oup.com
In the blood SHBG binds with 5 times higher affinity and for more than 3 times longer to DHT compared to testosterone.
To maximize the androgenic benefits of DHT we have to maximize 5AR and inhibit the binding of DHT to SHBG.
This article presents you what happens when men have high DHT or supraphysiological amounts of it.
DHT is essential for libido and sexual function
It’s probably well known that DHT is very important when it comes to libido and sexual function.
According to this study, serum DHT concentration was the only independent hormonal predictor of the frequency of orgasms. An increase in concentration of 1.36 nmol/l corresponded to an average increase of one orgasm a week.
This shows that DHT directly opposes the anti-libido effects of prolactin.
Inhibiting DHT synthesis impairs corpus cavernosum growth and trabecular smooth muscle relaxation, endothelial function and increases connective tissue deposition. This all contributes to erectile dysfunction, even in the presence of physiological levels of total testosterone.
DHT is also critical for activating gene expression of neuronal and endothelial nitric oxide synthases, which are critical physiological mediators of penile erection.
Furthermore, DHT is also essential for spermatogenesis and thus fertility.
Estrogen is thought to be essential for sexual function in men. However, administrating high doses of DHT lowers estrogen dramatically and doesn’t reduce sexual function.
DHT isn’t just neutral towards sexual function as shown below, but is essential for it.
Human male sexual functions do not require aromatization of testosterone: A study using tamoxifen, testolactone, and dihydrotestosterone - Archives of Sexual Behavior
This study was designed to examine whether testosterone needs to be converted to estradiol in order to exert fully its effects on sexuality in the human male. Administration of the estrogen receptor antagonist tamoxifen and the aromatase inhibitor testolactone were without effect on parameters...link.springer.com
DHT doesn’t cause prostate cancer
For many decades it was thought that DHT promotes prostate cancer. However that thinking is luckily starting to change. It’s about time, since there has been a lot of research in the last two decades showing that DHT doesn’t promote prostate cancer.
There isn’t a correlation between circulating DHT and intraprostatic DHT. The prostate regulates it’s own DHT levels, which is about 10 times higher than circulation.
Giving testosterone might cause issues, since it can convert to estrogen, but giving DHT directly could actually help shrinking the prostate as it can lower estrogen. Estrogen and Prolactin are the driving causes that promote prostate cancer.
A few studies (1, 2, 3)found that supraphysiological amounts of serum DHT levels and DHT gel treatment didn't significantly increase total, central or peripheral prostate volumes, as measured by ultrasonography, nor was serum prostate-specific antigen (PSA) elevated. Additionally, International Prostate Symptom Scores (IPSS) remained unchanged in men treated with DHT gel for 6-24 months.
This 1.8 year old survey of 37 men aged between 55-70 years treated with daily percutaneous DHT suggested that high plasma levels of DHT (> 8.5 nmol/l) effectively inducing clinical benefits while slightly but significantly reducing prostate size.
DHT isn’t the bad guy when it comes to hair loss
Hair loss and prostate cancer are two of the main reasons why people want to lower their DHT.
DHT is needed for beard growth, but it’s thought that DHT promotes scalp hair loss.
Take a look at this reference:
Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels - PMC
Benefits associated with lowered serum DHT levels after 5α-reductase inhibitor (5AR-I) therapy in men have contributed to a misconception that circulating DHT levels are an important stimulus for androgenic action in target tissues (e.g., prostate). ...pmc.ncbi.nlm.nih.gov
The claim above is supported by the fact that men who are exposed to exceptionally high levels of DHT in response to the daily application of DHT for a long period of time didn’t experience acne, male androgenic alopecia or other androgen-associated skin pathology.
Furthermore, the differences in mean values of DHT were not significant according to the types of alopecia and the control group. And increased serum concentrations of DHT is not correlated with the advance of alopecia. This study speculates that hair loss severity is affected by factors other than DHT, such as the duration of alopecia or the sensitivity of hair follicle cells to androgens.
Some people with hair loss have high DHT and others don’t. Some with high DHT have normal hair whereas others don’t.
So what’s going on with hairloss, if it’s not DHT?
You also might be wondering: “If DHT is not involved, why does 5-AR inhibitors work?“
This study found that although 5α-reductase inhibitors are effective in treating male androgenic alopecia, DHT does not appear to play a primary role in the pathogenesis of male androgenic alopecia or acne.
Reasons for hair loss are:
- Androgen receptor polymorphism and differences in androgen receptor concentrations and steroid-converting enzymes as the principal contributors to male androgenic alopecia
- An initial experimental study by Eun discovered that DHT does not directly cause inhibition of hair growth but it induces the release of transforming growth factor beta 1 (TGFß1) which results in the miniaturization and hair loss.
Controlled clinical trial for evaluation of hair growth with low dose cyclical nutrition therapy in men and women without the use of finasteride
Aim: To evaluate possible results with the stimulation use of minoxidil and the strengthening of hair roots with nutritional cyclical supplements, resulting in increased hair regrowth, without the use of anti androgens and enzyme blockers.Methods: This prospective controlled clinical trial...www.oaepublish.com
Shin et al followed this research further with cultured androgen sensitive dermal papilla cells and the addition of DHT to this androgen sensitive cell caused an accumulation of free radicles ROS within the cultured cells, which in turn induced the release of TGFß1.”
So a better approach than lowering DHT is to:
There are many more reasons for hair loss, but I won’t be diving into that in this article.
- Positively modulate the skin microbiome (think sunlight, micronutrients, clean environment, etc.)
- Inhibit excess ROS production
- Prevent excess activation of TGFß1
- Reduce stress
DHT for metabolic syndrome
Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke and diabetes. Metabolic syndrome includes high blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels. The syndrome increases a person’s risk of heart attack and stroke.
Insulin sensitivity
This randomized, controlled, double-blind trial provides evidence that DHT specifically (and to a much lesser extent, testosterone), improves insulin sensitivity and decreases plasma leptin level without notable side effects
Testosterone treatment caused prostatic nodular hyperplasia, benign at biopsy, whereas DHT didn’t.
Androgens, especially DHT, upregulate insulin receptor expression and activity and increase glycogen synthesis and cholesterol uptake in the liver.
Health Risks Associated with Long-Term Finasteride and Dutasteride Use: It's Time to Sound the Alarm - PMC
5α-dihydrotestosterone (5α-DHT) is the most potent natural androgen. 5α-DHT elicits a multitude of physiological actions, in a host of tissues, including prostate, seminal vesicles, hair follicles, skin, kidney, and lacrimal and meibomian glands. ...
Low DHT or lowering DHT with a 5AR inhibitor, such as Finasteride or Dutasteride, is associated with an increase in blood glucose and glycosylated hemoglobin A as well as the risk of type 2 diabetes. Studies: 1, 2, 3
5AR is necessary to inactivate cortisol, so blocking 5AR increases cortisol, which promotes insulin resistance and liver disorders, such as NAFLD, steatosis, etc. Studies: 1, 2
Heart, liver and kidney function
DHT therapy in men with coronary artery disease (CAD) decreased myocardial ischemia and improved left ventricular diastolic function.
This in vitro study found:
The findings above could explain some of the previously described clinical observations of the relationship between low T and DHT and peripheral vascular disease and the anti-ischemic effects of acute infusion of testosterone in men with CAD and similar effects by DHT gel treatment.
A few more facts:
- 5AR inhibition may result in the development of kidney dysfunction.
- Dutasteride, a 5AR inhibitor, treatment increased activities of liver alanine aminotransferase and aspartate aminotransferase, suggesting dysregulation of liver metabolism.
- DHT is a biomarker for reduced risk of stroke, which means that DHT is inversely correlated with stroke
- Higher DHT was associated with lower ischemic heart disease mortality in older men
Vascular function
Blood pressure
- DHT increases the synthesis of nitric oxide through eNOS phosphorylation thus improving circulation and vascularity (R).
The following in vitro study shows that DHT has anti-inflammatory and protective effects in the vascular system:
Cholesterol
DHT:
- Reduces lipid accumulation and cholesterol synthesis via increasing expression of carnitine palmitotyltransferase1 (CPT-1) and phosphorylation of 3-hydroxy-3-methyl-glutaryl-CoA reductase
- Inhibits ox-LDL–induced foam cell formation and atherosclerosis
- DHT administration for up to 2 years in normal men, didn’t cause any thrombotic events or detrimental shifts in total cholesterol, HDL and LDL cholesterol, or triglycerides. Nor were exceptionally high levels of DHT associated with a change in right carotid intima-media thickening
- Inhibiting 5AR with dutasteride resulted in increased total cholesterol, and low-density lipoprotein cholesterol levels
Georgi (Haidut) posted a while ago:
Mitochondrial function and energy production
Androgens, especially DHT:
- Stimulate lipolysis and down-regulates lipoprotein lipase activity and increases the expression of fatty acid-binding protein leading to an increase in fatty acid oxidation and in oxidative phosphorylation.
- Increase the expression of pyruvate dehydrogenase, which increases the production of oxaloacetate and acetyl-CoA leading to a stimulation of the tricarboxylic acid (TCA) cycle.
- Increase the expression of succinate dehydrogenase and aconitase, also upregulating TCA and increasing oxidative phosphorylation.
- Increase the expression of cytochrome c oxidase, which leads to an increase in oxidative phosphorylation. The increase in oxidative phosphorylation leads to a decrease in reactive oxygen species and an increase in insulin sensitivity
Fat loss
DHT:
- Inhibits preadipocyte proliferation and adipocyte differentiation, which prevents the excess formation of fat cells
- Stimulates lipolysis
- Stimulates lipid disposal
- Downregulates lipogenesis, which reduces the conversion of carbs to fat
- Prevents the downregulation of the leptin receptor
Gynecomastia
Gyno is known to be due to high estrogen and prolactin and low DHT and DHT treatment can reverse it.
Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels - PMC
Benefits associated with lowered serum DHT levels after 5α-reductase inhibitor (5AR-I) therapy in men have contributed to a misconception that circulating DHT levels are an important stimulus for androgenic action in target tissues (e.g., prostate). ...
Fun fact: One of the most known treatment of gynocomastia isn’t a SERM but transdermal DHT.
Brain & cognition
Studies: 1, 2, 3, 4
- DHT promotes stress resiliency. Blocking 5AR enhances cortisol release during stress, whereas DHT blunts it, most likely through CRH suppression.
- DHT promote insane memory.
- DHT protects against neurodegeneration, by antagonizing TGF beta.
In this case study someone with a demyelinating disease (Charcot-Marie-Toot 1) was able to induce neuroregeneration with 20mg/day of Anavar (Oxandrolone).
Lastly:
DHT is needed for blood flow
Lower T or DHT levels, but not E2, is associated with symptoms of intermittent claudication in older men.
Bone
High doses of DHT can completely shut down LH and testosterone production and cause a major drop in estrogen. This might be a concern for some people because it’s mainly estrogen that’s been thought to be beneficial for bone, however, there is evidence that estrogen isn’t needed for bone strength/growth.
Finasteride increases the risk of fractures, which indicates that it weakens muscle strength and bone quality.
Eyes
DHT is needed to keep the eyes moist and prevent dry eyes. 5AR inhibition may result in the development of dry eye disease.
Androgen deficiency produces pathophysiological changes manifested in the reduction of tear production and evaporative dry eye conditions.
Suppression
DHT doesn’t have a suppressive effect on testicular steroidogenesis, similar to estrogen. DHT actually suppresses testicular aromatase. DHT inhibits steroidogenesis on a hypothalamic level, and doesn’t affect LH secretion at a pituitary level.
Anabolism/Catabolism
DHT isn’t very anabolic, however, DHT derivatives, such as Anavar or Masteron are much more anabolic than DHT, and this is partly due to much slower clearance through the liver.
Apart from it not being very anabolic, DHT is anti-catabolic. This study found that people who experience muscle wasting from AIDS, retained more muscle mass if their DHT was normal, compared to those with low DHT.
Low dihydrotestosterone and weight loss in the AIDS wasting syndrome - PubMed
24 consecutive AIDS patients with wasting, and who had never received anabolic therapies, were evaluated to determine their profile of sex hormones and whether transformation of testosterone (T) to the nuclear androgen, dihydrotestosterone (DHT), was impaired. Eleven (46%) patients had normal...pubmed.ncbi.nlm.nih.gov
Anavar, a DHT derivative, is used to preserve muscle mass in people with wasting disease and to help them add more muscle for recovery.
Even 5mg was enough to stop catabolism, whereas higher doses such as 15mg daily were needed for muscle growth in these patients.
Furthermore, DHT upregulates androgen receptors.
Serotonin excess and cancer
DHT downregulates tryptophan hydroxylase 1 (TPH1; the rate-limited enzyme in serotonin synthesis in the body), thus protecting against the formation of tumors. Serotonin is also potent inflammatory and causes vasoconstriction, so DHT protects against that as well.
This is why DHT is an essential hormone for the human body and why the use of 5AR's should be refrained from.
Other cool studies:
- PMID: 20927745
- PMID: 29224108
- PMID: 32869255
- PMID: 30206635
- PMID: 30905792
- PMID: 34479019
- PMID: 33814544
- PMID: 30863034
- PMID: 34741573
- PMID: 37697052
All credits to @20/04/2008, he did all of the research for this work.
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Average finasteride/dutasteride user who claims he has no side
