The Circulating Dihydrotestosterone/Testosterone Ratio Is Increased by Gut Microbial 5α-Reductase Activity in Females

Gut microbiota significantly influences androgen metabolism, impacting hair loss treatments like finasteride. Probiotics, dietary changes, and fecal microbiota transplants may help manage DHT levels and improve hair health.

The conversation discusses the use of 5-alpha-reductase inhibitors like finasteride and dutasteride for hair loss in transgender women, particularly in relation to testosterone suppression. The original poster has been using dutasteride and is considering stopping it due to undetectable testosterone levels.

Dutasteride is a stronger 5AR inhibitor than finasteride and can significantly lower DHT levels. Reduced doses of dutasteride may lower side effects.

The conversation discusses a personal theory on the role of DHT in stress and reproduction, suggesting it converts testosterone for reproductive traits. The discussion includes skepticism and mentions individual differences in physiology and neurochemistry.

Elevated bile acids can inhibit the enzyme AKR1C2, leading to increased DHT levels, which may accelerate hair loss in those predisposed to androgenetic alopecia. Treatments mentioned include topical minoxidil and finasteride.

The user shared their bloodwork results showing DHT at 17 ng/dl and testosterone at 287 ng/dl, with a slight Vitamin D deficiency. They are seeking opinions on these levels and have an upcoming dermatologist appointment.