Mechanisms of Disease: Selective Inhibition of 11β-Hydroxysteroid Dehydrogenase Type 1 as a Novel Treatment for Metabolic Syndrome

The conversation discusses the hypothesis that a lack of the enzyme 3-alpha hydroxysteroid dehydrogenase (3α-HSD) on the scalp may contribute to hair loss by allowing DHT to accumulate. Despite interest in this theory, no recent research has been conducted, and current treatments like finasteride and minoxidil remain the most supported options.

Insulin resistance may increase DHT production, contributing to hair loss, and addressing it through diet, nutrients, and natural DHT blockers like saw palmetto and pumpkin seed oil could help reverse hair loss. Some users prefer medications like finasteride for more effective results.

Corticosterone inhibits GAS6, affecting hair follicle stem-cell activity, with potential implications for stress-related hair loss. Ashwagandha and Vitamin K are suggested for reducing cortisol, but their effectiveness is debated.

The user has been taking 1mg finasteride daily for a year with no improvement in hair loss and reports low cortisol levels, sleep issues, and anxiety changes. The conversation includes discussions on the potential effects of finasteride on cortisol and neurosteroids, with suggestions to consult a doctor and consider other factors.

High sugar diets may worsen hair loss by increasing 5α-reductase activity and androgen levels, especially in women with PCOS. A low sugar diet might reduce scalp DHT levels, similar to finasteride, but genetics also significantly influence hair loss.

Controlling insulin levels through intermittent fasting and a low glycemic diet may improve hair quality by reducing androgens. It's important to maintain proper nutrition, including electrolytes and protein, during fasting.