DHT - Dihydrotestosterone
This test measures the amount of dihydrotestosterone (DHT) in the blood. Low DHT has been associated with low libido and high DHT has been linked to acne, hair loss and benign prostatic inflammation in a minority of men.
Dihydrotestosterone (DHT) is synthesized from testosterone in the prostate gland, testes, hair follicles, and adrenal glands by 5-alpha reductase. Dihydrotestosterone exerts its action similar to testosterone, which binds to and activates androgen receptors. Dihydrotestosterone is responsible for forming male primary sex characteristics and most male secondary sex characteristics during puberty, such as muscular growth, facial and body hair growth, and deepening of the voice.
Table of Contents
What is DHT ?
Dihydrotestosterone (DHT) is synthesized from testosterone in the prostate gland, testes, hair follicles, and adrenal glands by 5-alpha reductase. Dihydrotestosterone exerts its action similar to testosterone, which binds to and activates androgen receptors. Dihydrotestosterone is responsible for the formation of male primary sex characteristics and most male secondary sex characteristics during puberty, such as muscular growth, facial and body hair growth, and deepening of the voice.
This test is performed with the sensitive liquid chromatography/mass spectrometry assay that has no interference with supplements like biotin used in hair growth.
With the exception of estradiol, no hormone is more misunderstood than dihydrotestosterone, DHT. In fact, many men actually fear DHT, going out of their way to lower it and frustrate its biological activity. However, DHT is actually a critical hormone, one that men need for sexual and prostate health, cognitive function, skeletal strength – and many other reasons. Like everything in life, there are downsides to DHT, but the upside of healthy DHT levels far outweighs the challenges it can present.
DHT – Where it Comes From
The principal hormone produced in men is, of course, testosterone. When testosterone is produced by the testicles (or injected/absorbed by a man on testosterone replacement) an enzyme, 5-alphareductase (5-AR) sets to work converting a portion of that testosterone to DHT. This conversion actually prevents some portion of testosterone from reaching the androgen receptors in the brain, genitals, skin, and other tissues. Initially, that may sound as if the body is being deprived of a needed hormone – testosterone. However, for the most part, this conversion is actually in a man’s best interest. DHT binds much more efficiently to androgen receptors, estimates vary, but it would seem that DHT is 300 to 500 percent more efficient at reaching and binding to the receptors, and is far more potent than testosterone. If tissues were deprived of DHT, if 5-AR hadn’t done its job, there would be dramatic physiological changes. While it is true that testosterone remains the primary, active androgen in muscle/muscle development, DHT is still critical for the full performance enhancing effects of testosterone. Specifically, the impact of DHT on the central nervous system which bring about increased neurological efficiency/strength.
DHT – Positive Effects
To understand DHT’s androgenic properties, consider the following.
- Male Development – Physical and sexual development in the human male is DHT-dependent. DHT is responsible for the growth and development of the penis, the prostate, and the testicles. It not only helps with sex differentiation during fetal development, it also supports the changes that occur during puberty and adulthood.
- Libido – A healthy sex drive is supported by DHT. Men with optimal levels of the hormone report a far stronger drive than men with lower levels.
- Prostate Health – It seems that men with balanced levels of DHT may have fewer prostate health issues.
- Cognitive Function – One study indicated that administering DHT to men between the ages of 34 and 70 resulted in memory improvements. The androgenic properties of the hormone encouraged the retrieval of stored memories as well as the archiving or new ones. Low/lower levels of DHT were linked to a decline in cognitive function in elderly men.
- Blood Sugar Management – Higher levels of DHT help to reduce the risk of diabetes by controlling sugar levels and preventing hyperglycemia. DHT can improve insulin sensitivity, support efforts to lose weight, and may provide adjunctive support in treating diabetes.
- Cardiovascular Health – Men with coronary artery disease may benefit from higher levels of DHT since lower levels of the hormone have been shown to actually increase the risk of cardiovascular disease. It may be a simple association – higher levels of DHT might lower the mortality associated with heart disease.
- Stroke Risk – Researchers followed a group of men for six years and learned that higher levels of both DHT and testosterone seemed to lower the risk of stroke.
- Depression – In one study, men who used finasteride, a drug that blocks 5-AR and, thus, generate lower levels of DHT, had higher rates of depression than a control group. DHT may well be necessary to support mental and emotional health.
- Anti-Aging – Higher levels of DHT, testosterone, and estradiol seem to slow the decline associated with aging. Lower levels of all three hormones brought about cellular changes seen in the elderly. Higher levels were associated with “younger” cellular function.
- Bone and Skeletal Health – Along with estradiol, appropriate levels of DHT support and maintain bone density in men.
DHT – The Downside
The DHT story is strongly, but not universally, positive. The drawbacks of DHT must be considered.
- Baldness – Hair loss is probably the number one DHT – negative in the minds of most men who are involved in testosterone therapy. Studies have shown that higher levels of DHT are linked to an increase in male-pattern baldness. In women, elevated levels of DHT can actually lead to male-like patterns of hair growth.
- Cancer – DHT is critical for the normal development of the prostate, but high levels of the hormone have been associated with prostate cancer risk. However, studies on DHT and prostate cancer are contradictory.
- Acne – Inflammatory acne flares have been linked to DHT.
DHT – The Bottom Line...a Friend or Foe?
For men, DHT is clearly a friend, and an important one. However, like virtually every hormone in the body, the key to health is balance. If DHT levels drop too far, men open themselves to low libido.
DHT is not likely to be tested in most men undergoing testosterone replacement therapy. Some clinicians fail to recognize the importance of DHT for men’s health and libido – and so they fail to monitor it. It’s entirely possible, even likely, that some men are not obtaining the maximum benefits of testosterone replacement because (unbeknownst to them) their DHT levels are not optimal.
How to Increase DHT
There are natural ways to boost DHT levels if one is not on a testosterone replacement protocol. Here are a few things that can be done.
Exercise more – particularly resistance training and high-intensity training.
Increase your intake of caffeine, creatine, or green tea supplements.
Boost the amount of zinc in your diet, either via the food you’re eating or via a supplement.
Take a DHEA supplement if your DHEA blood level is low. Get a DHEA blood test
Optimize your testosterone blood level if low.
Last but not least, use a scrotal testosterone cream. Applying compounded (alcohol free) testosterone cream to the testicular skin has been shown to increase DHT considerably.
How to Decrease or Block DHT?
It should be clear that the vast majority of men have no reason to suppress their DHT levels. However, Propecia is still prescribed regularly for men anxious about losing their hair. As was noted, Propecia will stop or suppress the 5-AR activity that produces DHT. By stopping or slowing the work of 5-AR, male pattern baldness, one of the possible, negative side effects that DHT can produce, may be prevented or arrested. Unfortunately, there is evidence that some men who take this medication may risk lowering their libido and mood.
For reasons still not clearly understood, this medication can produce a syndrome in some men very similar to those symptoms associated with hypogonadism. Loss of libido, weak erections, malaise, and fatigue plague many men even after they have stopped the use of the drug. While it’s true that no one wants to lose their hair, no man wants to wind up with what has come to be known as post-finasteride syndrome.
With proper attention, DHT can be not only a friend, but an ally in the search for optimal health. Don’t fear it – accept it and have it work to your advantage.
FREE BONUS: EBook: Beyond Testosterone
Suggested Reading: Testosterone Replacement Blood Test Targets
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