You might have heard of DHT as it is commonly mentioned when you start looking into hair loss, because it seems to be a big culprit in a thinning head of hair.
What is DHT?
DHT, or Dihydrotestosterone, is a hormone that is derived from the Testosterone in your body, for both men a women. Men have much more of this hormone than women, since they have much more Testosterone production. But, regardless of gender, about 10% of the Testosterone produced in your body will likely be converted into DHT. DHT tend to get a bad wrap once people hear about its hair loss issues, but it is in your body for a reason, and actually contributes greatly to the physical development of manly characteristics.
In men, DHT can help to produce healthy male genitalia in the womb, plus helps with penile and testicular development during puberty. It also contributes to a lower voice for males plus body and facial hair growth.
In women, this hormone plays a much smaller role, but is thought to help with body and pubic hair growth during puberty.
How does DHT damage your hair?
Mostly in men (but sometimes in women) the DHT which is around in your body attaches to receptors on your hair follicles and can lead to them becoming damaged.
Your sensitivity to DHT is thought to stem from you already being genetically susceptible to male pattern hair loss. Basically, look at your father and grandfathers, if they developed bald spots, receding hairlines, or baldness, it is likely that your genes may carry that same predisposition.
Once the DHT attached to the follicles in the scalp, it causes problems in a few ways. Firstly, it causes them to start miniaturizing, meaning that they will start producing thinner and shorter hairs over time, and potentially then stop producing a hair altogether. In addition to the miniaturization, the hair cycle for the follicle can be thrown off, making the growth phase shorter, causing the hair to shed more often.
Altogether, these DHT effects can mean bald spots, a receding hairline, or progressive baldness.
What can cause higher levels of DHT?
If you have more Testosterone in your body, this could mean that more DHT will be produced, since 10% will likely convert into DHT.
Men may have elevated levels of DHT due to a naturally occurring higher production of Testosterone, taking Testosterone precursor supplements like DHEA, or being on Testosterone replacement therapy.
For women, higher levels of DHT may develop due to supplementing with precursors to testosterone like DHEA, hormone replacement therapy with Testosterone, or from disorders like PCOS.
If you are planning on starting Testosterone hormone replacement therapy and you are concerned about DHT levels. Talk with your doctor about your concerns, and avoid overshooting normal Testosterone levels.
What can help reduce your DHT levels?
There are medications available that can help reduce the conversion of the Testosterone in your body into DHT.
The most common class of medications which help to achieve this are 5-alpha reductase inhibitors. The two medications in this class are Finasteride and Dutasteride. Both of these medications are FDA-approved to treat prostate enlargement (BPH). Only Finasteride is FDA-approved to also treat male pattern hair loss, although the closely related Dutasteride is commonly prescribed off-label for the male pattern hair loss indication.
These medications work to prevent the formation of DHT in the body, by blocking the 5-alpha reductase enzyme. This enzyme is responsible for catalyzing the reaction which turns Testosterone into DHT, so by blocking it, less DHT will be produced.