Hair Loss Bloodwork

[MattJacko]

I recently got a number of tests for bloodwork related to my hair loss, which I have been experiencing for about 5 years now.
Below are the specific results I have concerns with and would like a second opinion on:

ALT - 48 (HIGH)
Cholesterol, Total - 210 (HIGH)
Triglycerides - 160 (HIGH)
LDL Cholesterol - 128 (HIGH)

DHEA - 567 (HIGH)
SHBG - 8.8 (LOW)
Vitamin D - 27 (LOW)
Prolactin - 15 (NORMAL HIGH)

DHT - 8.5
DHT, Percent Free Dialysis - 2.7
DHT, Free - 2.3

For context, I am a healthy 27 y/o male with an athletic build. My diet consists mostly of meat, white rice, fruit smoothies, oatmeal and dairy. I recently cut out eggs for cholesterol concerns.
My Testosterone and Estradiol levels are normal and my TSH is 1.39 so I am ruling out hypothyroidism for now

Any insights will be helpful, thank you!

 

[AnonE]

Well an obvious one would be improving the vitamin D, it's a hormone involved in over 700 cellular processes IIRC.

Vitamin D Deficiency and Hair Loss: What's the Connection?

So that's an easy one to fix. Many people supplement 3k - 10k IU daily and have good levels.

Regarding cholesterol, didn't we establish that eggs aren't a problem? My understanding is perhaps the cholesterol isn't being converted to where it needs to go for various downstream steroids.

Eating 12 Eggs A Week Does Not Increase Risk Of Heart Disease

This study probably won't come as surprise to forum users given what Ray has said and written about cholesterol. Without much fanfare, after more than 60 years of officially demonizing cholesterol in 2017 the FDA quietly reversed its position on recommending avoiding cholesterol. However, to...

raypeatforum.com

Hopefully someone more knowledgeable can chime in :)

 

[Kaur Singh]

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

 

[tallglass13]

With a slightly, very slightly elevated Cholesterol, a very high Prolactin, and high DHEA, it does show that you have some "stress" going on , and thyroid may be suppressed. Adrenals seem to be in overdrive for some reason. Prolactin needs to be around 7 tops. Progesterone will lower Prolactin and Estrogen. My uncle at one point had 76 estradiol and 19 Prolactin. I gave him Progest E. His last Estradiol was 15 pg and Prolactin was 10.
Your SHBG should be higher, as we have seen this low in many balding men. Ray Peat mentions Protein and getting estrogen lower.
What are the Reference Ranges on your labs for DHT?

 

[md_a]

Another important marker I think is PTH.

I picked up from Danny Roddy:

Ray Peat on Parathyroid Hormone (PTH) as "The Final Common Path" of Metabolic Stress

“It is well known... that estradiol increases the expression of PTH...”

— Thys-Jacobs S., et al. (2000)

"These results show that an excess of plasma prolactin is associated with an excess of plasma PTH and vice versa."

— Raymond, J., et al. (1982)

"...Our results suggest that serotonin could be one of the factors regulating PTH secretion and/or contributing to PTH hypersecretion..."

— Zimmerman, D., et al. (1980)

"Glucocorticoids acutely elevate plasma calcium, probably because they stimulate PTH secretion..."

— Martin, C. (1985)

"Growing evidence points to a bi-directional and positive relationship between the RAAS and PTH."

— Vaidya A., et al. (2015)

Adrenaline, Lactic Acid, and PTH

"Adrenaline is released during exercise and is a secretagogue for PTH that can stimulate secretion despite hypercalcemia both in vitro and in animal experiments."

"An elevation of PTH was even observed for several days during recovery from prolonged strenuous exercise."

"In both running exercises there was a statistical relationship between the rise in lactate and the increase in serum PTH...."

"...A sustained, albeit moderate, secondary hyperparathyroidism might cause bone loss..."

Intact serum parathyroid hormone levels increase during running exercise in well-trained men - PubMed

.........

Effects of epinephrine and norepinephrine on serum parathyroid hormone and calcium in normal subjects​

Abstract​

Infusions with stepwise increasing concentrations of epinephrine (from 2.5 to 10 micrograms/min) and norepinephrine (0.5-2.0 micrograms/min) were given to normal subjects. During infusion of epinephrine there was a clear rise of the serum parathyroid hormone (PTH) levels already at the lowest concentration. Concomitantly there was a fall in the serum concentrations of calcium. The PTH levels returned to baseline promptly after termination of infusion whereas hypocalcaemia persisted up to 30 minutes, indicating a primary response of PTH to epinephrine. When propranolol was given prior to and during the epinephrine infusion no significant changes occurred for either PTH or calcium. During infusion of norepinephrine no consistent significant changes were noted for either PTH or serum calcium. Thus, our data do not support any concept of a basal adrenergic tone which normally modulates the secretion of PTH. However, during conditions of stress the beta-adrenergic stimulation night be of importance.

Effects of epinephrine and norepinephrine on serum parathyroid hormone and calcium in normal subjects - PubMed

Infusions with stepwise increasing concentrations of epinephrine (from 2.5 to 10 micrograms/min) and norepinephrine (0.5-2.0 micrograms/min) were given to normal subjects. During infusion of epinephrine there was a clear rise of the serum parathyroid hormone (PTH) levels already at the lowest...

pubmed.ncbi.nlm.nih.gov

 

[MattJacko]

Well an obvious one would be improving the vitamin D, it's a hormone involved in over 700 cellular processes IIRC.

Vitamin D Deficiency and Hair Loss: What's the Connection?

So that's an easy one to fix. Many people supplement 3k - 10k IU daily and have good levels.

Regarding cholesterol, didn't we establish that eggs aren't a problem? My understanding is perhaps the cholesterol isn't being converted to where it needs to go for various downstream steroids.

Eating 12 Eggs A Week Does Not Increase Risk Of Heart Disease

This study probably won't come as surprise to forum users given what Ray has said and written about cholesterol. Without much fanfare, after more than 60 years of officially demonizing cholesterol in 2017 the FDA quietly reversed its position on recommending avoiding cholesterol. However, to...

raypeatforum.com

Hopefully someone more knowledgeable can chime in :)

I have lived in a warm climate for about 3 years now so I thought the extra sun would do the trick for vitamin D but supplementation will have to do, thanks!

 

[MattJacko]

With a slightly, very slightly elevated Cholesterol, a very high Prolactin, and high DHEA, it does show that you have some "stress" going on , and thyroid may be suppressed. Adrenals seem to be in overdrive for some reason. Prolactin needs to be around 7 tops. Progesterone will lower Prolactin and Estrogen. My uncle at one point had 76 estradiol and 19 Prolactin. I gave him Progest E. His last Estradiol was 15 pg and Prolactin was 10.
Your SHBG should be higher, as we have seen this low in many balding men. Ray Peat mentions Protein and getting estrogen lower.
What are the Reference Ranges on your labs for DHT?

I have read that Vitamin E and B6 are helpful in lowering prolactin so I’ve been getting more on that end, as far as shbg goes…I have no idea how to get this up. Unfortunately my tests did not provide a reference range for DHT but my thoughts are that it is elevated

 

[MattJacko]

Another important marker I think is PTH.

I picked up from Danny Roddy:

Ray Peat on Parathyroid Hormone (PTH) as "The Final Common Path" of Metabolic Stress

“It is well known... that estradiol increases the expression of PTH...”

— Thys-Jacobs S., et al. (2000)

"These results show that an excess of plasma prolactin is associated with an excess of plasma PTH and vice versa."

— Raymond, J., et al. (1982)

"...Our results suggest that serotonin could be one of the factors regulating PTH secretion and/or contributing to PTH hypersecretion..."

— Zimmerman, D., et al. (1980)

"Glucocorticoids acutely elevate plasma calcium, probably because they stimulate PTH secretion..."

— Martin, C. (1985)

"Growing evidence points to a bi-directional and positive relationship between the RAAS and PTH."

— Vaidya A., et al. (2015)

Adrenaline, Lactic Acid, and PTH

"Adrenaline is released during exercise and is a secretagogue for PTH that can stimulate secretion despite hypercalcemia both in vitro and in animal experiments."

"An elevation of PTH was even observed for several days during recovery from prolonged strenuous exercise."

"In both running exercises there was a statistical relationship between the rise in lactate and the increase in serum PTH...."

"...A sustained, albeit moderate, secondary hyperparathyroidism might cause bone loss..."

Intact serum parathyroid hormone levels increase during running exercise in well-trained men - PubMed

.........

Effects of epinephrine and norepinephrine on serum parathyroid hormone and calcium in normal subjects​

Abstract​

Infusions with stepwise increasing concentrations of epinephrine (from 2.5 to 10 micrograms/min) and norepinephrine (0.5-2.0 micrograms/min) were given to normal subjects. During infusion of epinephrine there was a clear rise of the serum parathyroid hormone (PTH) levels already at the lowest concentration. Concomitantly there was a fall in the serum concentrations of calcium. The PTH levels returned to baseline promptly after termination of infusion whereas hypocalcaemia persisted up to 30 minutes, indicating a primary response of PTH to epinephrine. When propranolol was given prior to and during the epinephrine infusion no significant changes occurred for either PTH or calcium. During infusion of norepinephrine no consistent significant changes were noted for either PTH or serum calcium. Thus, our data do not support any concept of a basal adrenergic tone which normally modulates the secretion of PTH. However, during conditions of stress the beta-adrenergic stimulation night be of importance.

Effects of epinephrine and norepinephrine on serum parathyroid hormone and calcium in normal subjects - PubMed

Infusions with stepwise increasing concentrations of epinephrine (from 2.5 to 10 micrograms/min) and norepinephrine (0.5-2.0 micrograms/min) were given to normal subjects. During infusion of epinephrine there was a clear rise of the serum parathyroid hormone (PTH) levels already at the lowest...

pubmed.ncbi.nlm.nih.gov

Can PTH be tested from bloodwork?

 

[BetterCallSaul]

Low SHBG -> lots of free, unbound hormones, especially androgens, leading to the destruction of your hair.
This also ties in with you poor lipid panel

 

[MattJacko]

Low SHBG -> lots of free, unbound hormones, especially androgens, leading to the destruction of your hair.
This also ties in with you poor lipid panel

Thanks for the response, my SHBG levels are far below normal…is there a way to raise this?

 

[Korven]

Thanks for the response, my SHBG levels are far below normal…is there a way to raise this?

Low SHBG goes together with insulin resistance and sluggish liver. Anecdotally high carb vegans tend to have both high T and SHBG, you could try increasing dietary fibre from fruits and vegetables, lower fat and/or switch to MUFA fats like olive oil, and include some anti-endotoxin spices like ginger. Eating cooked meals (no cold juices, ice cream etc) and drinking hot water is also very helpful for stimulating digestion and improving liver health.

 

[tallglass13]

I have read that Vitamin E and B6 are helpful in lowering prolactin so I’ve been getting more on that end, as far as shbg goes…I have no idea how to get this up. Unfortunately my tests did not provide a reference range for DHT but my thoughts are that it is elevated

DHT on my labs have a reference range of 12-65 ng, so there is a chance you are low.

 

[MattJacko]

Is your test in ng/dL? Could be a difference in measurements

also the attached picture shows a reference range listed for DHT but I’m not sure for which exact test this applies for out of the 2