DHT: Pros & Cons For Men


Dihydrotestosterone (DHT) is confusing:

It is attributed as the primary cause behind male pattern baldness and prostate issues, but itā€™s also responsible for many of the characteristics we associate with masculinity.

This article will go over everything you need to know about DHT and clear the air on whether itā€™s a good idea to supplement with DHT blockers or not.

What is DHT?

Dihydrotestosterone (DHT) is a male sex hormone with powerful androgenic properties. It plays a crucial role during puberty and is largely responsible for the development of adult male characteristics. Things like:

  • Deeper voice,
  • Muscle development
  • Body hair, etc.

DHT is quite literally derived from testosterone.

Anywhere in the body where the 5Ī±-reductase enzyme is present (which is everywhere except muscle tissue), testosterone gets converted into DHT.

DHT is 2-3x more potent than testosterone. Furthermore, it remains attached to androgen receptor sites for up to 5x longer.

Testosterone is the active androgen in muscle tissue. Everywhere else - brain, skin, hair follicles, prostate, liver - itā€™s DHT that exerts the androgenic influence.

Does DHT Cause Hair Loss?

Researchers have found elevated DHT levels to be correlated with thinning hair (1).

As such:

DHT is often accused of being the prime culprit behind male pattern baldness (MPB).

Do balding men have higher testosterone levels?

DHT is created from testosterone, and bald men have higher levels of DHT in their scalp.

Does this mean that balding men have higher testosterone levels?

Well, hereā€™s something to think about:

The incidence of hair loss tends to increase with age, even though androgen levels decrease with age.

Clearly, thereā€™s something else going on.

Differentiating Between Serum and Tissue DHT

Diving deeper, we find that there are two types of DHT in our bodies:

  1. Serum DHT
  2. Tissue DHT.

The impact that DHT has on hair-loss is dependent on the type of DHT weā€™re talking about.

Serum DHT

Serum DHT (the type thatā€™s circulating in your bloodstream) has been shown to not correlate with hair loss (2).

One study even found serum DHT to be higher in men without hair loss (3).

So, based on the research:

Serum DHT has no link to hair loss and, in fact, actually reduces the incidence of hair loss.

The DHT in your blood has nothing to do with hair loss.

Tissue DHT

Then thereā€™s tissue DHT, the type thatā€™s bound to the androgen receptors in your scalp, skin, and other areas of your body.

Studies have found tissue DHT to be elevated in the scalps of balding men (4).

As it turns out, higher levels of DHT in the scalp are linked to male pattern baldness.

But another interesting point is that DHT encourages body and facial hair growth (5).

How can it be that DHT causes hair loss in the scalp and hair growth everywhere else?

This is a paradox that, based on the current state of research, remains to be answered.

Plus Points of DHT

  • Men have significantly more DHT than women.ā€‹
  • Men without hair-loss have higher DHT.
  • DHT increases body and facial hair growth.

Downsides of DHT

  • Men go bald more often than women.ā€‹
  • Bald men have elevated DHT in their scalp.

Despite these facts, it remains unclear whether DHT is the root cause of hair loss or not.

But when we expand our scope beyond just DHT, we uncover the fact that hair loss, in both sexes, is closely linked to a hormonal imbalance.

More specifically:

An imbalance between testosterone and estrogen.

Hair Loss and Hormonal Imbalance

Women experiencing hair loss tend to have an elevated testosterone to estrogen ratio (6).

In men, itā€™s the other way around:

A decreased testosterone to estrogen ratio (7).

For men, an increase in estrogen imbalances the ratio, as does a decrease in testosterone.

Itā€™s no coincidence, then, that the rising incidence of hair loss is coupled with a wide generational decline in testosterone levels.

Today, the average man has anywhere from 20-25% lower T compared to the average man from just a few decades ago.

So the bottom line is this:

If you want to minimize your chances of hair loss, you have to optimize your endocrine health. For men, this means naturally increasing your testosterone levels and decreasing your estrogen.

Key Takeaway

Although increased DHT in the scalp can lead to thinning hair, it is not the root cause. Hair loss is more likely the result of both hormonal imbalance and genetic factors.

Does DHT Cause Prostate Enlargement?

Another common misconception about DHT is that it causes dysfunctional prostate growth.

The truth, however, is more complex.

You must understand that there are profound differences between healthy prostate growth (during puberty), growth due to benign prostatic hyperplasia, and cancerous growth.

There are major differences between healthy prostate growth and BPH.

Healthy Prostate Growth

The first type of prostate growth is developmental growth. It takes place during puberty and is caused by an increase in androgen secretion.

Healthy prostate growth is a normal part of puberty.

During the developmental stage, the prostate grows from its prepubescent size to the normal-sized, healthy, and functioning size of an adult male prostate.

The prostate maintains this size during early and mid-adult age, despite increased androgens in the body.

On the flip side, if androgens become blocked during this period (via castration or blocking of 5-AR enzyme), the adult prostate begins to shrink.

Benign Prostatic Hyperplasia (BPH)

In the later years of adulthood, another type of prostate growth begins to occur. This growth is termed benign prostatic hyperplasia.

The exact cause is unknown, but mounting evidence suggests that itā€™s because of an increase in the estrogen/androgen ratio, a common occurrence in aging men.

Researchers hypothesize that an enlarged prostate is most likely the result of increased estrogen.

Researchers hypothesize that an enlarged prostate is the result of increased estrogen. More precisely, an increase in the estrogen/androgen ratio.

In fact:

Studies have shown that increased DHT leads to a decrease in the prostateā€™s size (8).

Cancerous Prostate Growth

Surprisingly, high DHT also tends to be stated as a cause of cancerous prostatic growth. Again, this could not be further from the truth.

Men with prostate cancer tend to experience decreased DHT levels.

Researchers have found that men with prostate cancer tend to have lower levels of DHT compared to the control group (9).

Furthermore, patients with low DHT levels were found to have a decreased survival rate from prostate cancer (10).

Key Takeaway

The only time DHT causes prostate growth is during puberty, whereby the prostate reaches healthy adult size. In BPH and cancerous growth, research has consistently shown DHT levels to, in fact, be lower in men with enlarged prostates compared to men with healthy-sized ones.

The Benefits Of DHT

Now that weā€™ve busted the myths about the negative side-effects of DHT letā€™s move on to whatā€™s good about it.

DHT allows for proper male development.

Before you were born, DHT played a critical role in the development of your primary sexual characteristics. Itā€™s what makes you a man.

Here is an example of why DHT is important:

5Ī±-reductase is the enzyme responsible for converting testosterone into DHT.

Men born with a 5Ī±-reductase deficiency are likely to develop pseudohermaphroditism. In this condition, males are born with an underdeveloped penis and prostate. As a result, they are often raised as girls.

By the time puberty comes around, testosterone levels elevate naturally, and muscular development is comparative to normal male adults.

However, due to the lack of DHT, the penis and prostate remain underdeveloped. Nor is any pubic/body hair developed.

DHT encourages body and facial hair growth.

Everywhere thatā€™s not muscle tissue, DHT is the active androgen.

This means that DHT activates the androgen receptors on the skin.

DHT is whatā€™s responsible for body and facial hair growth.

I guess this could be a good or bad thing, depending on what your goals are. But the more DHT you have, the more widespread will be its influence on the androgen receptors spread throughout your skin.

DHT improves overall well-being.

In one study, mood parameters were measured in hypogonadal men, i.e., men experiencing decreased androgen production.

After giving the subjects DHT and testosterone treatment, the men were shown to experience significant decreases in anger, irritability, sadness, tiredness, and nervousness.

Furthermore, significant increases were seen in energy levels, friendliness, and overall sense of well-being (11).

DHT speeds up fat-loss.

Although not shown in any human studies, DHT could increase cyclic AMP, or cAMP, levels in mice (12).

Cyclic AMP is a cellular messenger that interacts with a host of other cells.

Higher cAMP leads to:

  • Lower blood pressure,

  • Increased vasodilation (dilated blood vessels),

  • Increased bronchodilation (deeper breathing), and

  • An increase in thyroid hormone secretion.

Increased thyroid hormone secretion is linked with increased lipolysis (fat burning).

But what it is also linked with is the protein kinase.

Protein kinase has been shown to activate hormone-sensitive lipases, which are involved in the breakdown of the building blocks of fatty tissue, aka triglycerides.

Bottom line:

Increased DHT leads to increased cAMP, which increases the rate of fat-loss and actually breaks down fatty tissue.

DHT increases strength.

ā€‹How strong you are on a particular movement is dependent on three individual factors:

  1. How much muscle mass you have.
  2. Your neuromuscular adaptations.
  3. Your familiarity with the particular movement.

Testosterone is the active androgen in muscle tissue and the primary factor behind muscle growth. Increased muscle mass translates to you having more strength relative to when you had less muscle mass.

The expression of strength, however, is governed by our central nervous system (CNS). The CNS is what recruits and activates our muscle fibers. Neuromuscular adaptations to heavier loads allow the muscles to contract with more force and efficiency.

In other words:

Neuromuscular adaptations allow us to utilize more of the full potential of our existing muscle mass. ā€‹

DHT is what exerts the androgenic influence in our central nervous system and is the primary factor behind increased neuromuscular adaptations.

Although I was unable to find any promising human research on the topic, a study on DHT administered rats found that it increased their fast-twitch muscle fibers, i.e., the muscle fibers associated with force, power, and strength (13).

The third facet of strength is your familiarity with the particular movement. It would be best if you got better at performing the exercise in order for you to get stronger at it.

For example, how strong you are on the squat is affected by how many times youā€™ve performed the movement. That, of course, can only come with practice.

DHT chisels your jawline

Much of what we attribute as ā€œmasculineā€ in terms of physical appearance can be tied back to bone structure:

  • A deep voice (caused by an enlargement of the larynx or Adamā€™s apple).
  • A square jawline.
  • Broad shoulders and chest.
  • Stature.
  • Large hands and feet.

As you now know, DHT is what exerts the androgenic influence everywhere in the body except muscle tissue.

As such:

DHT is the active androgen in skeletal tissue. ā€‹

Studies have shown DHT levels to be directly correlated with bone density in men (14). So much so, men with lower DHT levels were also at a higher risk of developing osteoporosis.

In rats given DHT treatments for two months, the rats were shown to experience significant increases in skeletal mass by increasing bone growth (15).

DHT fights off anxiety and depression.

Testosterone treatment is well known to have anti-anxiety and anti-depressive effects.

This has been shown in multiple studies where men who were given testosterone treatments reported significant improvements in mood and overall quality of life.

Researchers are now saying that these effects are largely due to DHTā€™s actions on the brain (16).

In another study, researchers found that finasteride (an alpha-reductase inhibitor) has been shown to induce symptoms of depression (17). These symptoms may become induced due to a decrease in DHT.

DHT promotes libido and sex drive.

In one study, six months of DHT treatment allowed subjects to experience significant improvements in erectile function (18).

In another study, researchers looked towards the importance of DHT in stimulating orgasms. They say that orgasms are the dominant aspect of sexual behavior in healthy men. They concluded that DHT concentrations were the independent hormonal predictor of the frequency of orgasms (19).

They also go on to say that a fluctuation of DHT levels is a major predictor of sexual activity in healthy young men.

DHT stabilizes blood sugar.

In a cell culture study, DHT was found to activate the glucose regulating pathway in skeletal muscle cells (20).

In another study, researchers looked at human and rat cells to observe how they respond to different stimuli. One of the findings was that that DHT decreased blood sugar (21).

DHT improves brain health and memory.

DHT status in older men was significantly correlated with cognitive function (22). More precisely, as DHT levels went down, so did the cognitive function.

DHT decreases the risk of cancer.

After analyzing several blood samples, researchers found that men in the advanced stages of a prostate tumor also had lower DHT levels (23). Also, an inverse relationship was found between the size of a tumor and DHT levels:

Lower DHT implied the growth of tumors with bigger volumes.

In another study, researchers found low DHT levels correlated with a lower rate of survival amongst patients with prostate cancer (24).

Key Takeaway

The benefits of DHT far outweigh the possible drawbacks of hair-loss. Is your hair more important than your masculinity?

The Bottom Line On The Benefits of DHT

Given the above list of benefits, it should be clear that decreasing DHT is not a good idea.

Do you want more hair at the expense of your masculinity?

I think the answer is quite obvious.

If you think that going bald is the worst thing that can happen, take a look at the myriad of bald alpha men in Hollywood.

Is being bald so bad?

How to Increase DHT

Increasing DHT comes down to increasing testosterone, but the following bullet points should help get you started:

  • Lean down to the range of 8-12% body fat.
  • Ensure that your vitamin D, zinc, and magnesium levels are optimized.
  • Lift heavy at the gym.
  • Aim for 6-8 hours of high-quality sleep every single night.
  • Eat balanced macros.
  • Become conscious of your body language (shoulders back, chest out)
  • Practice intermittent fasting.
  • Limit exposure to plastics.
  • Relax via meditation (or any other activity).
  • Abstain from long, steady-state cardio.
  • Limit alcohol consumption.
  • Partake in competitive sports.
  • Spark up your sex life.

Conclusion

Thereā€™s a tendency for the human mind to classify things as black and white.

As with most things in life, the thing with DHT is that there are mostly shades of grey. Unfortunately, most people consider it a ā€œbadā€ hormone that serves no function in the body.

After reading this article, hopefully, you have received the required knowledge to draw a better conclusion.

The wide use of 5-AR inhibitors has become very popular, but given the vast array of benefits that come with DHT, this should be given a second thought.

David Becker, RN, CCRN
David Becker, RN, CCRN Mr. Becker is a father, husband, and CCRN in Trauma ICU. You can read his inspiring comeback story From 412ng/dl To 923ng/dl In 6 Months - Without TRT. Feel free to send David a message here.