Hydroxysteroid Dehydrogenase (17β-HSD3, 17β-HSD5, and 3α-HSD3) Inhibitors: Extragonadal Regulation of Intracellular Sex Steroid Hormone Levels

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.

The user has been using oral minoxidil and dutasteride for hair loss without success and is considering adding topical 17α-estradiol, Pyrilutamide, Clascoterone, or cetirizine. They have confirmed low serum DHT levels and are exploring additional treatments due to genetic sensitivity to DHT and prostaglandin D2.

The conversation discusses the mechanism of action of alfatradiol (17 alpha estradiol) in treating hair loss. It explores theories that it either inhibits 5 alpha reductase to prevent T->DHT conversion or aromatizes scalp T into 17-alpha-estradiol to save hair.

17-alpha-estradiol may work for hair loss by inhibiting 5-alpha reductase, similar to finasteride. It might lower testosterone in the scalp, reducing DHT conversion.

The conversation discusses the molecular structures of compounds that reduce DHT levels, including finasteride and Ashwagandha. It explores the potential of using Ashwagandha topically as a 5a reductase inhibitor.

The conversation is about gathering serum DHT data from individuals taking dutasteride to investigate its efficacy, especially in cases with unexpectedly low DHT reduction. The aim is to explore potential genetic factors affecting drug metabolism.