Serum concentrations of dihydrotestosterone are associated with symptoms of hypogonadism in biochemically eugonadal men

cupofcoffee

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Abstract​

Purpose​

Symptoms of hypogonadism are often reported by subjects with normal serum testosterone (T) levels. We aimed to assess the association between clinical symptoms in andrological outpatients and sex steroids levels.

Methods​

This is a retrospective cross-sectional cohort study in an Academic clinic and research unit. International Index of Erectile Function (IIEF, EF domain) and Aging Males Symptoms scale (AMS) questionnaires were completed by 635 and 574 men, respectively (mean age: 47.3 ± 13.9 and 47.4 ± 13.8 years, p = 0.829), free of interfering medications with complaints possibly related to hypogonadism.

Results​

Serum total/free T as well as dihydro-T (DHT) was associated with IIEF-EF and AMS scores in the overall population using univariate analyses. Multivariate approaches revealed DHT concentrations in subjects with normal T levels (n = 416, Total T > 12 nmol/L) to be significant predictors of AMS scores. A 0.1 nmol/l serum DHT increase within the eugonadal range was associated with a 4.67% decrease in odds of having worse symptoms (p = 0.011). In men with biochemical hypogonadism (Total T < 12 nmol/L), total and free T rather than DHT were associated with AMS results. This association was not found for IIEF-EF scores. Indirect effects of age and BMI were seen for relations with hormone concentrations but not questionnaire scores.

Conclusion​

DHT can be associated with symptoms of hypogonadism in biochemically eugonadal men. Serum DHT measurement might be helpful once the diagnosis of hypogonadism has been ruled out but should not be routinely included in the primary diagnostic process.
 
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These guys probably have very low amounts of androgen receptors in the brain, so even mild increases in DHT exert potent negative feedback on their gonadotropins, crashing LH & FSH further. However the DHT is merely a scapegoat in this scenario (similarly to how it is in hair loss and most other conditions where it is commonly blamed).
 

cupofcoffee

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These guys probably have very low amounts of androgen receptors in the brain, so even mild increases in DHT exert potent negative feedback on their gonadotropins, crashing LH & FSH further. However the DHT is merely a scapegoat in this scenario (similarly to how it is in hair loss and most other conditions where it is commonly blamed).
agree

edit. No i don't, i'm misreading stuff today. Need more coffee.
 
Last edited:

schultz

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These guys probably have very low amounts of androgen receptors in the brain, so even mild increases in DHT exert potent negative feedback on their gonadotropins, crashing LH & FSH further. However the DHT is merely a scapegoat in this scenario (similarly to how it is in hair loss and most other conditions where it is commonly blamed).

I'm not following you. How is DHT being blamed? The study is saying that low DHT may be the cause of sexual dysfunction in men with normal T levels, so the authors are suggesting that an increase in DHT would increase sexual desire, sexual function, etc.
 
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I'm not following you. How is DHT being blamed? The study is saying that low DHT may be the cause of sexual dysfunction in men with normal T levels, so the authors are suggesting that an increase in DHT would increase sexual desire, sexual function, etc.

You're right. When reading this part:

A 0.1 nmol/l serum DHT increase within the eugonadal range was associated with a 4.67% decrease in odds of having worse symptoms (p = 0.011)

I have mistaken "decrease" for increase. The only conceivable way they could get worse from an increase in DHT would be via increased suppression, but you'd probably need exogenous DHT in supraphysiological amounts to achieve that.
 
T

TheBeard

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These guys probably have very low amounts of androgen receptors in the brain, so even mild increases in DHT exert potent negative feedback on their gonadotropins, crashing LH & FSH further. However the DHT is merely a scapegoat in this scenario (similarly to how it is in hair loss and most other conditions where it is commonly blamed).

Exactly, hence my question to OP, what do you do with this info?
 

schultz

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You're right. When reading this part:

A 0.1 nmol/l serum DHT increase within the eugonadal range was associated with a 4.67% decrease in odds of having worse symptoms (p = 0.011)

I have mistaken "decrease" for increase. The only conceivable way they could get worse from an increase in DHT would be via increased suppression, but you'd probably need exogenous DHT in supraphysiological amounts to achieve that.

Sometimes the wording is a bit confusing in studies as well.

They mention 5ar inhibitors and how they can lower libido/sexual function without affecting testosterone.

"Lower DHT levels might therefore provide an explanation for increased severity of symptoms in otherwise “healthy” subjects. Further support in these regards comes from clinical reports from subjects undergoing treatment with 5-alpha-reductase-inhibitors, who develop depression, fatigue and sexual symptoms within the classical eugonadal range of T concentrations."

"Our results contribute to the observations by which 5-alpha-reductase inhibitors can affect male sexual function even within the eugonadal range of T."



They also mention that PUFA is a 5ar inhibitor.

"It is also possible that nutritional factors such as polyunsaturated fatty acids, zinc, and green tea as well as riboflavin influence 5-alpha-reductase activity."

The paper they cite says...

"Polyunsaturated fatty acids, found in vegetable oils, have been found to inhibit human and rat microsomal 5α-R activity. In this group, y-linolenic acid is the most potent compound tested. Since 5α-R isozymes are intrinsic membrane proteins, their activity may depend on the unique environment of the lipid bilayer. Whether and how fatty acids may function as endogenous regulators of 5α-R remain unknown."
 
T

TheBeard

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It's not uncommon to see men with strong builds, hairloss, strong beard, strong facial bones, to be very joly and overall in a good mood.
All signs of naturally high DHT.

They take life on the easy side, nothing is a big deal, they seem to be mentally strong, it's like their facial muscles are naturally drawn to smiling.

People with pale complexions, hair full of hair, little to no facial hair, slender faces, tend to look a lot more anxious and depressed, while having normal testosterone levels.
 
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It's not uncommon to see men with strong builds, hairloss, strong beard, strong facial bones, to be very joly and overall in a good mood.
All signs of naturally high DHT.

They take life on the easy side, nothing is a big deal, they seem to be mentally strong, it's like their facial muscles are naturally drawn to smiling.

People with pale complexions, hair full of hair, little to no facial hair, slender faces, tend to look a lot more anxious and depressed, while having normal testosterone levels.

That is absolutely fascinating
 

swarrior

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It's not uncommon to see men with strong builds, hairloss, strong beard, strong facial bones, to be very joly and overall in a good mood.
All signs of naturally high DHT.

They take life on the easy side, nothing is a big deal, they seem to be mentally strong, it's like their facial muscles are naturally drawn to smiling.

People with pale complexions, hair full of hair, little to no facial hair, slender faces, tend to look a lot more anxious and depressed, while having normal testosterone levels.
Maybe can be my case.

For example, im a man 33 years old, good levels of T total and free in the lab works, i can say good muscular developing (not average person not advance athlete) but…
I have a lot head hair, i have not beard or body hair (very little of both)
My libido is always changing but is not like a big libido, is normal with downard trend.
Since 3 years all my lab work are ok but FSH and LH are increasing, its mean that the pituitary its work hard to maintence this levels.
I think that is some kind of resistance or i have very low density of receptor. Im very worried about that.
Im trying diferents supplements stack.
I think that im gonna try proviron.
Thanks
 

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