In today's livestream Georgi and Roddy talked a lot about hairloss, specifically estrogen's (proposed) causative role. Georgi also talked about the side effects many people get when taking ai's like exemestane and anastrozole. For those who don't have time to watch the video, here are some of Georgi's comments (not direct quotes as I had to cut out a lot of unnecessary words to keep it short. The general points remain the same)
Georgi on aromatase inhibitors causing hairloss as proof for estrogen being a 'hair healthy' hormone:
"There is not a single aromatase inhibitor that is specific for aromatase. All of them actually end up also lowering progesterone."
"The studies showed that it is the level of expression of the estorgen receptor in the scalp specifically that was responsible for the hairloss. When they administer estrogen systemically, it did not have the hair loss effects that it had when they applied it topically. So, the aromatase inhibitor they are taking is dropping estrogen systemically [a few inaudible words due to an internet issue], but that doesn't mean much about your scalp."
"It's the whole dichotomy between blood levels [of estrogen] and tissue levels, and specifically in stressed tissues such as a scalp losing hair. So, if your thyroid is low we have already talked about this before, your skin will pick up the slack and start producing all of these steroids. There are a few studies that actually looked at the hormone in the scalp. Estrogen and Prolactin were both high. For whatever reason, yes, DHT was also high, but somehow the medical industry took that partial finding and started running with it while completely ignoring that other hormones. Estrogenic hormones were also high."
"And again, nobody so far has proven conclusively that dht causes hairloss. I know people who have actually massaged masterone, dht, proviron, and a bunch of other dht-derived drugs on their scalp, and some of them actually started regrowing hair. It didn't work in many people, maybe only 20%, but none of them lost more hair. It's totally anecdotal and doesn't have statistical significance, but that would be my response to people saying everyone knows aromatase inhibitors cause hairloss. Show me a selective aromatase inhibitor that does nothing else other than inhibiting aromatase, and lets see if it causes hairloss or not. To my knowledge, there is no such aromatase inhibitor on the market."
"We had this discussion a little bit on the forum, because people were saying "oh, if estrogen is not important for the bones, howcome when I take an aromatase inhibitor I get joint pains, like my bones are cracking, all these studies showing bones are thinning"; again, you have not covered the fact that it [aromatase inhibitors] lowers pregnenolone, lowers progesterone, and lowers dhea as well."
"The different enzymes, both the ones that synthesis estrogen from precursors, and the other steroids that synthesize progesterone and dhea, are very similar in structure. It's very hard to develop something that is so uniquely specific to aromatase without touching other steroids and steroidal pathways."
"Ironically, progesterone maybe one of the most selective aromatase inhibitors out there. There are people taking progesterone who have managed to tank their estrogen, specifically using progesterone as an aromatase inhibitor, like women that didn't care about tanking their testosterone, or whatever other reason men are scared of taking progesterone. None of them got bone pain, none of them got cracking bones, none of them got osteopenia; in fact, their bones improved."
"All of these side effects that people blame on the too low estrogen from aromatase inhibitors, to me the evidence for that is lacking. If anything, we can say that non selective aromatase inhibitor cause issues, but to blame it completely on the lack of estrogen, I don't think there's evidence for that."
"What was the other thing? Oh yes, people getting treated with estrogen [who subsequently regrow hair]. I looked at those studies. Most of them are about people doing transgender, basically switching genders, and I think in the vast majority of cases these people got a combination treatment of a progestin and estrogen. The reason for this is the vast majority of cases [gender transition], if not all of them, wasn't very popular in the 20th century, all the way up to the early 90's. By that point medicine has already realized that giving people only estrogen is very, very dangerous. So, you'll be hard pressed to find transgender studies that only use estrogen. If you find one and show me that this led to hair regrowth I'll consider it; but so far, the only studies I have seen always had something else, either the person got estrogen and testosterone, if it was a female to male; or basically, the person who was converting from male to female, they actually got castrated; keep in mind that actually drops estrogen..."
Roddy:
"and serotonin, and prolactin"
Haidut:
"That's right. So, the studies I have seen have not been able to isolate the estrogen as a cause of hair regrowth, and I don't believe it is. I don't know of a study that is well designed and has managed to isolate, to claim a cause. If you have such a study, please send it to me. I have looked at all of this, and almost all of them are progestin and estrogen. Or, male to female and they got castrated."
There was also a lot of discussion about minoxidil after this for those interested.
What are everyone's thoughts on these comments?
Anecdotally, exemestane accelerated my already significant hairloss when I took it during my years on testosterone replacement therapy. I only used a small dose and my serum estradiol was always kept in the middle of the range (so not too low), but my progesterone was often undetectable. I had ~0.40 nmol/L progesterone on testosterone when not using exemstane, and my levels would drop to < 0.15 nmol/L (assay didn't go any lower) whenever I introduced it. The average progesterone level for a man is 1.23 nmol/L +/- 0.23, so both of my results were low, but exemestane took it lower.
With that said, I've been off testosterone for a while now, and despite my progesterone levels rising to 1.4 nmol/L, my hair loss has continued at the same rate. Like most here I don't subscribe to the notion that DHT casues hairloss; but likewise, the comments Georgi made don't really address the fact that almost no man on this forum who has taken progesterone (and there has been many) has reported the halt or reversal of male pattern baldness. In many cases, this was also whilst taking thyroid and other estrogen inhibiting substances, like vitamin e, aspirin, vitamin K2 etc.
Either way, I thinks it's great that both Danny and Georgi are offering an alternative view. Looking forward to hearing other's thoughts on these comments.
Georgi on aromatase inhibitors causing hairloss as proof for estrogen being a 'hair healthy' hormone:
"There is not a single aromatase inhibitor that is specific for aromatase. All of them actually end up also lowering progesterone."
"The studies showed that it is the level of expression of the estorgen receptor in the scalp specifically that was responsible for the hairloss. When they administer estrogen systemically, it did not have the hair loss effects that it had when they applied it topically. So, the aromatase inhibitor they are taking is dropping estrogen systemically [a few inaudible words due to an internet issue], but that doesn't mean much about your scalp."
"It's the whole dichotomy between blood levels [of estrogen] and tissue levels, and specifically in stressed tissues such as a scalp losing hair. So, if your thyroid is low we have already talked about this before, your skin will pick up the slack and start producing all of these steroids. There are a few studies that actually looked at the hormone in the scalp. Estrogen and Prolactin were both high. For whatever reason, yes, DHT was also high, but somehow the medical industry took that partial finding and started running with it while completely ignoring that other hormones. Estrogenic hormones were also high."
"And again, nobody so far has proven conclusively that dht causes hairloss. I know people who have actually massaged masterone, dht, proviron, and a bunch of other dht-derived drugs on their scalp, and some of them actually started regrowing hair. It didn't work in many people, maybe only 20%, but none of them lost more hair. It's totally anecdotal and doesn't have statistical significance, but that would be my response to people saying everyone knows aromatase inhibitors cause hairloss. Show me a selective aromatase inhibitor that does nothing else other than inhibiting aromatase, and lets see if it causes hairloss or not. To my knowledge, there is no such aromatase inhibitor on the market."
"We had this discussion a little bit on the forum, because people were saying "oh, if estrogen is not important for the bones, howcome when I take an aromatase inhibitor I get joint pains, like my bones are cracking, all these studies showing bones are thinning"; again, you have not covered the fact that it [aromatase inhibitors] lowers pregnenolone, lowers progesterone, and lowers dhea as well."
"The different enzymes, both the ones that synthesis estrogen from precursors, and the other steroids that synthesize progesterone and dhea, are very similar in structure. It's very hard to develop something that is so uniquely specific to aromatase without touching other steroids and steroidal pathways."
"Ironically, progesterone maybe one of the most selective aromatase inhibitors out there. There are people taking progesterone who have managed to tank their estrogen, specifically using progesterone as an aromatase inhibitor, like women that didn't care about tanking their testosterone, or whatever other reason men are scared of taking progesterone. None of them got bone pain, none of them got cracking bones, none of them got osteopenia; in fact, their bones improved."
"All of these side effects that people blame on the too low estrogen from aromatase inhibitors, to me the evidence for that is lacking. If anything, we can say that non selective aromatase inhibitor cause issues, but to blame it completely on the lack of estrogen, I don't think there's evidence for that."
"What was the other thing? Oh yes, people getting treated with estrogen [who subsequently regrow hair]. I looked at those studies. Most of them are about people doing transgender, basically switching genders, and I think in the vast majority of cases these people got a combination treatment of a progestin and estrogen. The reason for this is the vast majority of cases [gender transition], if not all of them, wasn't very popular in the 20th century, all the way up to the early 90's. By that point medicine has already realized that giving people only estrogen is very, very dangerous. So, you'll be hard pressed to find transgender studies that only use estrogen. If you find one and show me that this led to hair regrowth I'll consider it; but so far, the only studies I have seen always had something else, either the person got estrogen and testosterone, if it was a female to male; or basically, the person who was converting from male to female, they actually got castrated; keep in mind that actually drops estrogen..."
Roddy:
"and serotonin, and prolactin"
Haidut:
"That's right. So, the studies I have seen have not been able to isolate the estrogen as a cause of hair regrowth, and I don't believe it is. I don't know of a study that is well designed and has managed to isolate, to claim a cause. If you have such a study, please send it to me. I have looked at all of this, and almost all of them are progestin and estrogen. Or, male to female and they got castrated."
There was also a lot of discussion about minoxidil after this for those interested.
What are everyone's thoughts on these comments?
Anecdotally, exemestane accelerated my already significant hairloss when I took it during my years on testosterone replacement therapy. I only used a small dose and my serum estradiol was always kept in the middle of the range (so not too low), but my progesterone was often undetectable. I had ~0.40 nmol/L progesterone on testosterone when not using exemstane, and my levels would drop to < 0.15 nmol/L (assay didn't go any lower) whenever I introduced it. The average progesterone level for a man is 1.23 nmol/L +/- 0.23, so both of my results were low, but exemestane took it lower.
With that said, I've been off testosterone for a while now, and despite my progesterone levels rising to 1.4 nmol/L, my hair loss has continued at the same rate. Like most here I don't subscribe to the notion that DHT casues hairloss; but likewise, the comments Georgi made don't really address the fact that almost no man on this forum who has taken progesterone (and there has been many) has reported the halt or reversal of male pattern baldness. In many cases, this was also whilst taking thyroid and other estrogen inhibiting substances, like vitamin e, aspirin, vitamin K2 etc.
Either way, I thinks it's great that both Danny and Georgi are offering an alternative view. Looking forward to hearing other's thoughts on these comments.
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