Q: Recently I was diagnosed with hypogonadism and have to start TRT.
However I’m concerned about my possible hair thinning.
Is there any way to protect my hair?
A: It’s a fact that testosterone when is reduced to DHT can lead to Male Pattern Baldness, also known as Androgenic Alopecia.
However this is also linked to genetic predisposition, meaning that some men don’t develop MPH/AA (hair thinning).
Nevertheless, you are able to stop the reduction of T=> DHT, by blocking the enzyme responsible for it; the so called 5a reductase.
This is done by the anti-androgens; finasteride (propecia) and dutasteride (avodart).
Fina blocks type I receptor (prostate), while duta I & II receptors (scalp & prostate); meaning that duta is more potent.
As a matter of fact, dutasteride can actually make hair follicles to grow new hair; while finasteride can just stop hair thinning.
The combo of testosterone with anti-androgens can thicken hair, since the hormone is capable to thicken hair in body.
Hence, in case we block DHT, then instead of alopecia, new thick hair can grow.
Another local application of compounds is the shampoo containing Ketoconazol.
(Nizoral) and the foam Minoxidil (Regain).
Nizoral is mainly for danfur, but it’s able to lower DHT in scalp.
Also minoxidil can improve blood flow in scalp.
An alternative use of dutasteride is in foam with Minoxidil.
In this way we avoid the systemic circulation of dutasteride, minimizing the potential side effects in the mood (depression) and sex drive (lack of libido).
Mind that only testosterone is blocked by anti-androgens.
No other AAS can be blocked by them.
So either synthetic DHT (Mesterolone, drostanolone) or DHT derivatives (stanozolol, oxandrolone, oxymetholone, methenolone) shouldn’t be used.
Nandrolone is a rare case of AAS that metabolizes to DHN, a less androgenic compound than DHT.