Super high DHT -- How Much to be Concerned?

[junk2222yard]

Last time I did my blood I got DHT done for the first time. It came back so high it was not measurable!

DHT > 8600 [Range 860-3406 PMOL/L]

So my DHT was somewhere beyond 8600 PMOL/L. How concerned should I be?

I have read about high DHT and see things like "high levels are bad for your hair", "good for libido", "make you prone to anger/aggression". But I don't read a lot about people being overly concerned about high DHT? (One guy said he was forever 3x the upper physiological range and didn't notice anything bad about it?)

Also, I just stopped taking Saw Palmetto the week before I was tested. Is it possible there was an artificial "DHT rebound" based on stopping the saw? (A known 5 alpha-reductase inhibitor.)

[asiandudexxx]

I'm also interested in this.

Have you measured progesterone at all? I've read that progesterone antagonizes DHT and vice versa. If anything, I'd be concerned about the possibility of too low progesterone due to high DHT (too high progesterone is also a bad thing).

[junk2222yard]

I don't have a result for progesterone.

Can no one share some thoughts on how concerned should I be having a DHT level beyond the limit of the test? (Over 2.5x the high end of the range!)

[steroid.com 1]

Any hormone over the physiological reference range is not a good situation as homeostasis is corrupted.

Probably the biggest concerns are the symptoms hair loss being one and the possibility of prostate morbidity - but this is an argument that some agree with and most other oppose.

With your levels I'd be concerned about hair loss; Tocotreienols are a special form of Vitamin E that help with hair growth and slowing down hair loss so make sure to add it to your supplements.

Don't take any DHT blocking hormone like finasteride as they can have very bad effects as well.

Either lower your testosterone dose or live with it if you don't have any serious side effects.

How's you libido? Any anger or aggression issues? Sexual aggression?

[junk2222yard]

I am in the process of lowering my Test dose and slightly increasing my AI. Libido is better than pre-TRT (I want it sex every day) but I am not ready to jump on anything that moves. Aggression is normal. My labs just before the next Test inject were:

Total T	32.8	[5.8 - 30.4 NMOL/L]
Free T	176.4	[15.6-146 PMOL/L]
E2**	139	[40-161 PMOL/L]
DHT	>8600	[860-3406 PMOL/L]
SHBG	23	[10 - 55 NMOL/L]

**E2 is standard assay, not the extra sensitive which is not available in Canada.
Also, I realize my numbers are all super-physiological, and I am reducing Test dose as I said. However, except for DHT they are close to range, so I expect even with Test reduction my DHT will still be quite high.

[Allaaro]

Those numbers all look fine to me.....DHT isn't a concern. E2 is a crap shoot but looks okay, T/Free T is bit high but nothing that long term would hurt you.

I'm above 8600 also and don't have any aggression problems....well, not because of the DHT hah. Ptren causing some aggression for me...but that isn't for this section in TRT.

No hair loss also....libido is okay but could be better. Think my E2 needs go up bit more...as I feel best libido around 170-180...since that E2 test is shit and I'm sure that the high DHT levels are lowering the E2-levels you'd see if you got a sensitive test like ppl in states.

[junk2222yard]

Think my E2 needs go up bit more...as I feel best libido around 170-180...since that E2 test is shit and I'm sure that the high DHT levels are lowering the E2-levels you'd see if you got a sensitive test like ppl in states.

Hey Allaaro, are you in Canada, too?

Are you saying you want your E2 to be beyond the top of the scale? That is what feels best for you?

From my reading I have seen some people say that it is when E2 is high as well as DHT being high that you can have prostate issues and hair loss. Have you heard about this?

Also, my "just over" numbers are a little misleading because I did my labs just before my next Test shot, so I was obviously more over the line during the peak. (Which was the day before, because I inject every 3 days, not 3.5 or 7 like some people.) I have already reduced my dose. I am aiming for 80% or so of the upper limit.

[Allaaro]

Yeah I'm in Canada.

Also, correct, I want me E2 above the range slightly. That E2 test is crap...sensitive tests are needed to get an idea what is going on....which we don't have access to. E2 really is just a guide. When I was near just below 200 had best sex drive in my life.

High E2 and high DHT can promote prostate...I have heard this..but not sure if believe it or not...but in relation to both of us...our DHT is high and our E2 is low when you look at it being compared, since DHT is off charts. But then again...crap E2 test. I haven't had any hair loss but think that's mostly genetics ppl blaim on other things.

I honestly wonder what my DHT levels are....I've been >8600 from start on 100mg test per week...at near 200 now.

[junk2222yard]

Don't take any DHT blocking hormone like finasteride as they can have very bad effects as well.

Either lower your testosterone dose or live with it if you don't have any serious side effects.

I know to avoid "5-alpha-reductase inhibitors" like Finasteride and Saw Palmetto. But I am wondering, is *anything* that lowers DHT a "5-alpha-reductase inhibitor"? For instance, Pygeum Africanum looks like it may inhibit DHT by another mechanism (see http://www.add-hair.com/dht-blockers.htm), and I have read that somehow pregnenolone can reduce DHT too. (Currently I take 25mg of preg in the AM. Maybe I can keep bumping the dose and see the effect?)

I am hoping I can find something that will lower my DHT that does not have the (small but real) risk of causing post finasteride syndrome?

At the moment I am 43 with a reasonable head of hair, but I do think it is thinning in the front lately. Aside from that, there may be other issues (like prostate risks) which cause me to want to have lower DHT.

[ctenosaura]

I am in the process of lowering my Test dose and slightly increasing my AI. Libido is better than pre-TRT (I want it sex every day) but I am not ready to jump on anything that moves. Aggression is normal. My labs just before the next Test inject were:

Total T	32.8	[5.8 - 30.4 NMOL/L]
Free T	176.4	[15.6-146 PMOL/L]
E2**	139	[40-161 PMOL/L]
DHT	>8600	[860-3406 PMOL/L]
SHBG	23	[10 - 55 NMOL/L]

**E2 is standard assay, not the extra sensitive which is not available in Canada.
Also, I realize my numbers are all super-physiological, and I am reducing Test dose as I said. However, except for DHT they are close to range, so I expect even with Test reduction my DHT will still be quite high.

I'm curious as to how much test your taking and how often?

[junk2222yard]

I'm curious as to how much test your taking and how often?

I was taking 60mg every 3 days of Test E., plus .25 iu of hCG the day before Test. All SQ. (I have now reduced Test dose.)

[junk2222yard]

I popped in with a different question, but figured I would update this thread. I have been doing TRT since 2012, and my DHT has been too high the entire time. And.... I am going bald now, so decided to shave my head. I may be once of the few men on the planet that doesn't care too much about that. Life is easier with a shaved head!

But what I do care about is my prostate. I have suffered 2 bouts of prostatitis in the past 2 years. One had me bed ridden for 3 days. Plus, in general I have a weak urine flow. I have symptoms of BPH, though a rectal exam (supposedly) indicated my prostate was normal sized. So.... I am trying to lower my DHT again. Hoping this might help.

Here is my regimen, and as it has been for years:

Testosterone : 175mg/wk (via 2 Test E injections subq)
HCG : 250iu every 2 days
Adex: .25 pill every 2 days
Saw Palmetto: 480mg daily

As of a week ago, I am:
Reducing Test to 140mg/wk (might go even lower to 100)
Using 20mg Prog Cream per day
Taking 800mg Saw Palmetto
Eating 1 cup of raw pumpkin seeds per day

I had bloodwork done before the new regimen, and will do it again in 6 weeks. (Should I wait longer?) I am determined to bring my DHT down, in order to see if it helps my prostate. The keys are: less Test, and Progesterone. The pumpking seeds are just a shot in the dark (but based on real research.)

I will update in 2 months to help others.

[kelkel]

Glad to see you're reducing your T dose. It will help. I have always done copious amounts of BW and my dht runs just above range even on 120-140 mgs of T per week.
A few years ago my psa jumped up from its norm of .07-.08 to 1.2. This got me curious so I checked it again two weeks later and it was a 2.0. Went and got a 3T MRI (non invasive thank god) and all was well.

Ended up starting on Finasteride and it came back down to around 1.2 I believe. I then went off the Fina for a few months to experiment and pulled BW for psa again. Came back at 7.0 with 4.0 being the top of the range. Sooo, back on Fina. It's quite effective and keeps my dht sub-normal even on elevated mgs of test pw. I've had no issues while being on it. Obviously if you can avoid it, do so. I could not.

Consider 5-10 mgs per day of Cialis. It's approved by the FDA for BPH. Mix that with 1-2 mgs of Doxazosin per day and it will help even more. Doxa is an alpha blocker / smooth muscle relaxer (your weiner is smooth muscle) thus they work synergistically and will help your prostate. Your doc should have written you for Cialis a long time ago actually.

ps: There are even some studies on the effectiveness for serms in controlling BPH:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3179830/

An important area of study that is lacking in BPH research is prevention. Since the manifestation of BPH takes decades, preventatives, especially those that target ARs and/or ERs can be utilized over time to determine their efficacy for a particular individual or type of BPH. In this regard, the androgen pathway has been the most studied and clinically used. However use of SERMs in the prevention and/or treatment of BPH [129] has merit. For example, Ellem and Risbridger argued in 2007 that potential therapies based on anti-estrogen action in the prostate will depend critically on understanding the “differential effects of ER-α versus ER-β activation” [129]. A potential strategy to inhibit proliferation in the prostate would be to block ER-α but promote ER-β activation. Perhaps the greatest promise in future anti-estrogen strategies for BPH lies in therapy with SERMs. Tamoxifen, 4-hydroxy-Tamoxifen, Toremifene, and Raloxifene inhibit proliferation of both prostatic epithelial and stromal cells in vitro [195, 196]. In another study, Raloxifene and Tamoxifen did not affect proliferation induced by E2 of a stromal cell line (WPMY-1) or BPH epithelial cell line (BPH-1), but both SERMs inhibited proliferation of prostate stromal cells in a rat model of prostatic hyperplasia induced by estrogen and androgen treatment [197]. In a study of seven beagles with spontaneous BPH, treatment with the SERM Tamoxifen resulted in decreased prostate volume [165]. A randomized trial of Tamoxifen in dogs with BPH showed an average 28.5% decrease in prostate volume compared to placebo [198]. SERMs are well-tolerated in men, and have been shown to ameliorate side effects of androgen ablation therapy in men with metastatic prostate cancer, reduce fracture risk and improve lipid profiles [199, 200]. The added prostate cancer chemopreventive benefit of SERMs furthers the attractiveness of these compounds as potential adjuvant or alternative therapies for men with BPH and LUTS [124].

[junk2222yard]

Hey KelKel,
thanks for the reply. I remember you from back in the day. Good to see you are still kicking!

I actually do 5mg of Cialis a day for the BPH. (I appreciate the side benefits, too.) So me and my doc on were on top of that one.

I have not heard of Doxazosin, so will look into that.

I may have mentioned earlier in this thread I am trying to avoid Finasteride. I am sure everyone here knows about the horrors of post-finasteride syndrome. I am sure it is only affecting a small % of people, but if possible, I just don't want to take a chance on that one. BUT!! If my other measures don't work, and if my prostate continues to flare up, I will do more research regarding a conservative dose. It is the heavy hitter for reducing DHT after all.
(FWIW I just gulped down another cup of raw pumpkin seeds; they are starting to wear a bit thin on me, lol. Pretty sure if they have any impact, it will improve things about .001% anyway.)