The Hormonal Profile of MPB

lucid&alive

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After some recent blood tests I became interested in the hormonal profile of men with early MPB. The studies below measure serum levesl of various hormones of younger balding men and compare them to the hormone levels of non-balding men. Some of the papers from their hypothesis as whether or not men with early MPB have the same hormonal profile as women with PCOS. Although it doesn't seem to be universally true, it seems reasonable to assume men with MPB have some hormonal abnormalities that could be able to be addressed.

Note: Several of the studies below calculate Free Androgen Index (FAI). [FAI = (Test) * (100/SHBG)] and is meant to measure the dissociation of testosterone from the binding globulin which is then free to be used by the tissues.

Cipriani - 1983 - Sex Hormone-Binding Globulin and Saliva Testosterone Levels in Men with Androgenetic Alopecia

Design: 64 males aged 16-41 years (average age 26 ± 5 years) with androgenetic alopecia and forty males within the
same age range without androgenetic alopecia were studied.

Tests Performed: DHT, SHBG, Total Testosterone, Saliva Testosterone, T3, T4, TSH, LH, FSH, prolactin, estradiol,
estrone

Results:
- SHBG significantly lower than controls
- Saliva testosterone significantly higher than controls

From Discussion: The decrease of SHBG would seem to suggest an increase of the unbound and active fraction of
testosterone. Such increase appears to be confirmed by the statistically significant increase, in men with
androgenetic alopecia as compared with controls, of saliva testosterone which is closely correlated with free
testosterone (Smith et al., 1979).

Knussmann - 1992 - Relations Between Sex Hormone Level and Characters of Hair and Skin in Healthy Young Men

Design: One hundred and seventeen healthy young men between the ages of 20 and 30 years (average = 24.1)
Full Scalpe Hair (n = 95)
Reduced Scalp hair (n = 15)

Tests Performed:
Serum Testosterone (Tser), DHT, Salival Testosterone (Tsal), DHT/Tser, Tsal/Tser

Results:
- The ratio of Tsal/Tser correlates positivley with balding
- Testosterone and DHT were significantly lower in balding men

From Discussion: Yet we found a relationship, not between the disposition to balding and the ratio DHT/Tser but
between the disposition to balding and Tsal/Tser. An elevated rate of dissociation from the binding globulin
fits in well with the findings of Cipriani et al. (1983) that men with androgenic alopecia exhibit a significant
reduction in sex hormone binding globulin (the same is true for bald-headed women: Mortimer et al., 1984).

Schmidt - 1991 - Hormonal Parameters in Androgenetic Hair Loss in the Male

Design:
65 males with MPB average age of 24.31 years of age compared against 58 males w/o MPB average of 24.61 years of age

Tests Performed: Testosterone, DHEAS, Free testosterone, progesterone, LH, FSH, Estradiol, SHBG, prolactin

Results:
Signficiantly elevated hormones
- Androstenedione
- LH
- Estradiol
- Cortisol

From Discussion:

Androstenedione was the only androgen significantly elevated in hair loss patients. This androgen has only weak
intrinsic androgen activity but has its relevance mainly as precursor hormone for the active androgens testosterone
and dihydrotestosterone.

A most interesting aspect of the investigation is the role of cortisol. Increased cortisol levels support the role
of the suprarenal glands and thus a possible stress component in hair loss. This finding may serve as starting
point for systemic treatment approaches that aim at the suppression of increased adrenal funtion.

Schmidt - 1994 - Hormonal Basis of Male and Female Androgenic Alopecia: Clinical Relevance

Design
65 male and 46 female patients with AGA compared against 58 age-matched male and 45 female controls

Tests performed: Androstenedione, LH, estradiol, cortisol, DHEAS, free testosterone, progesterone, FSH, SHBG,
prolactin, testosterone

MEN

Significantly elevated hormones
- Androstenedione
- LH
- Estradiol
- cortisol

Hormones elevated but not significantly
- DHEAS
- Free testosterone
- Progesterone
- FSH
- SHBG
- Prolactin
- Testosterone

WOMEN

- Cortisol significantly elevated
- Prolactin significantly elevated
- Normal androgen levels
- Secondary hypothyroidism

From Discussion:


An interesting finding was the significant elevation of cortisol in 18% of patients. Cortisol was also
significantly elevated in females with androgenic hair loss, who had normal levels of all androgens. E2,
in contrast, was significantly decreased in these patients [7] (table 2). On the other hand, males had elevated E2
and LH levels.

From the endocrinological point of view, the importance of androstenedione lies in its peripheral activity [8], as
supported by Schweikert et al. [9], who found androstenedione as a major metabolite in hair roots of patients with
androgenic alopecia. The involvement of androstenedione and the noninvolvement of major androgens suggest a mainly
peripheral increase of androgen metabolism in both males and females with androgenic hair loss. This is supported by
elevated E2 levels, as 80% of E2 in the male stems from peripheral conversion of androgens to estrogens.
The association with increased LH levels suggests a role of the hypophyseal-adrenal axis.

Starka - 2004 - Hormonal Profile of Men with Premature Balding

Tests Performed: 37 men with premature blading compared against normal references values obtained ina group fo 256 males ages 20 - 40
(interesting thing about this reference group is it is from a study of iodine deficinecy, not picked specifically for
this study so there may be some prematurley balding men in that group.)

Tests Performed: Testosterone, TSH, Free thryoxin, Prolactin, Cortisol, Estradiol, Progesterone, Androstenedione,
FSH, LH, DHT, Epitestosterone, SHBG

Results:
Significantly sub-normal values
- SHBG
- FSH
- epitestosterone
- testosterone

From Discussion: In the group presented here of premature balding men rather lower total testosterone levels were
found; however the free androgen index FAI was not reduced in comparison with the control male group, even though
there was an insignificant higher number of elevated values of FAI. This is due to significantly lower SHBG values
in balding men. Low SHBG is often associated with insulin resistance or hyperinsulinaemia.

Note: The last paragraph of the paper describes a paper (Choi et al., 2001) in which epitestosterone was found
to be lower in balding scalps and the author mentions epitestosterone epitestosterone is often lower
in the serum of balding men. In this study 22% of balding men had levels of epitestosterone below
the reference range. Epitestosterone is a 5AR inhibitor.

Starka - 2006 - Premature Androgenic Alopecia and Insulin Resistance. Male Equivalent of Polycistic Ovary Syndrome?

Design
: 30 men with premature hair loss compared against normal references values obtained ina group fo 256 males ages
20 - 40 (same reference group as in the Starka 2004 paper)

Tests: Total testosterone, androstenedione, DHEAS, epitestosterone, DHT, estradiol, SHBG, TSH, LH, FSH, FAI,
insulin tolerance, prolactin

Results:
Significantly subnormal values
- SHBG
- FSH
- Total Testosterone
- epitestosterone

Balding men further broken down into two hormonally distinct groups:

- Group 1 (n = 19): No hormonal changes or only SHBG is low compared to controls

- Group 2 (n = 11): Low SHBG and low FSH or low SHBG and high FAI compared to controls and was more insulin
resistant

From Discussion: It is obvious from our results that the males with precocious hair loss starting under the
age of 30 and exhibiting similar hormonal changes as females with PCOS (e.g. low SHBG and low FSH or low
SHBG and high FAI) show higher frequency of reduced insulin sensitivity, which is also reported in a part of
females with PCOS. These males might therefore represent a male equivalent of PCOS.

Note: This study also measured various physical traits and found bald men to be significantly shorter than
non-balding men. In every other measure they were found to be less 'masculine' however the differences were
not statistically significant.

Narad - 2013 - Hormonal Profile in Indian Men with Premature Androgenetic Alopecia

Design:
50 men with AGA younger than 30 compared against 50 age matched controls

Tested: Total testosterone, DHEAS, LH, FSH, SHBG, insulin, fasting blood sugar

Results: Decreased SHBG and high FAI in men with AGA

From Discussion: To summarize we could state that in spite of normal levels of total testosterone in balding men,
lower levels SHBG reveals genetic susceptibility for the action of free testosterone in balding men. However it
does not fulfill all criterions corresponding to PCOS in females like hyperandrogenism, altered pituitary hormones
and increased insulin resistance.

Sanke - 2016 - A Comparison of the Hormonal Profile of Early Androgenetic Alopecia in Men with the Phenotypic
Equivalent of Polycystic Ovarian Syndrome in Women


Design:
57 men aged 19 - 30 with AGA compared against 32 age-matched men with no evidence of hair loss

Tests Performed: Testosterone, SHBG, DHEAS, LH, FSH, prolactin, glucose, insulin, insulin resistance, FAI

Results:
- Hormones significantly increased in AGA men: LH, DHEAS, total testosterone, prolactin
- Hormones significantly decreasd in AGA men: FSH, SHBG
- The LH/FSH ratio and FAI was significantly higher in men with AGA

From Results: The mean (SD) value of insulin was higher in the AGA group (6.34 [3.92] μIU/mL) than among controls
(5.09 [3.38] μIU/ mL),but the difference was not statistically significant (P = .07). Twelve men with AGA (21%)
had IR compared with 3 men (9%) in the control group. There was no statistically significant association between
severity of grades of AGA (grades 3-7) with the various hormone levels or with IR. There was no significant
association between positive family history of AGA with grades of AGA or hormone levels.

From Discussion: Twelve (21%) of our participants with AGA showed IR compared with only 3 (9%) of the controls.
Though this difference in IR was not statistically insignificant (P = .06), it is clear that a larger proportion
of those with AGA than controls showed IR.

From Conclusion: We found significantly increased LH, DHEAS, total testosterone, and prolactin levels along with
significantly decreased FSH and SHBG levels in our AGA group. The LH/FSH ratio was higher in men with AGA. These
hormonal parameters more or less resemble the profile of women with PCOS, and we propose that these men can be
considered phenotypic equivalents to women with PCOS.


Here's a table I made showing tests performed and whether the values were significantly elevated, decreased, or had no difference

hormonegraph.PNG
 

baccheion

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Seems like it's something causing brain inflammation. 5-AR increased in the brain leads to an increase in the scalp.

One symptom of progesterone deficiency is MPB.

There's one that mentions megadose melatonin for balding (Jeff T Bowles)..

LH + prolactin + cortisol + estradiol. Seems like serotonin.

Overmethylation is associated with higher dopamine + serotonin, dry mouth, and balding.
 
Last edited:

tallglass13

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Super interesting and helpful. DHT did not have any significance except for 1 being low. Now, how to increase SHBG and FSH. All these years seems like we wanted to lower SHBG to get more T. Not such a good idea after all. Does anyone know if Finasteride increases SHBG? Maybe that is why it works for some. Ray did mention that High estrogen raises SHBG. Fin does raise estrogen and testosterone, and as the chart shows more people had low total serum testosterone. So fin works by increase in test and SHBG?
Also Epitestosterone, was significantly lower. Need to find how to increase. Finasteride I heard , does not go to Cortisol like Progesterone does. So maybe fin also lowers cortisol.
 

Inaut

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tallglass13

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Symptoms of Low SHBG Levels

Symptoms of low sex hormone binding globulin levels are similar to those of excessive male sex hormone levels.

In females, they include [48, 49, 50, 51, 52]:

  • Excessive body hair/male-pattern hair growth (hirsutism)
  • Acne
  • Dandruff
  • Baldness
  • Voice deepening
  • Increased muscle mass
  • Reduced breast size
  • Irregular or absent periods
  • Enlargement of the clitoris
  • Weight gain
Though rare, low SHBG in males may cause:

  • Early puberty (in children) [53]
  • Acne [54]
  • Baldness [54]
  • Increased body hair [54]
  • Aggression [55]
  • Erectile dysfunction [56]
  • Gynecomastia (breast growth) [57]
  • Infertility [58]
Low SHBG increases available testosterone and produces the symptoms of high testosterone in women and girls, including male-pattern body hair growth, acne, voice deepening, and irregular or absent periods.
 

tallglass13

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4) Dietary Changes: Mediterranean Diet

A study on 27 obese men found that a low-fat, high-fiber diet, with exercise, effectively increased SHBG levels [138].

Additionally, the following foods and beverages increased SHBG production. However, additional clinical studies need to be done before these findings are considered conclusive:

 
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So wait, low SHBG is more-or-less bad for hair growth? CRAP!
I've been taking Nettle Root Extract for the last 7 months in my hair growth experiment (binds to SHBG). Looks like I was barking up the wrong tree. What if there's nothing wrong with my hair growth and it has been falling out due to all my attempts to keep it?

I don't want to tAkE tHe FiN, I don't want to eAt Ze bUgS.
 

Lucas

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Super interesting and helpful. DHT did not have any significance except for 1 being low. Now, how to increase SHBG and FSH. All these years seems like we wanted to lower SHBG to get more T. Not such a good idea after all. Does anyone know if Finasteride increases SHBG? Maybe that is why it works for some. Ray did mention that High estrogen raises SHBG. Fin does raise estrogen and testosterone, and as the chart shows more people had low total serum testosterone. So fin works by increase in test and SHBG?
Also Epitestosterone, was significantly lower. Need to find how to increase. Finasteride I heard , does not go to Cortisol like Progesterone does. So maybe fin also lowers cortisol.
After 8 months of using 1 mg of finasteride my estradiol dropped, my testosterone increased at first and now it's back to baseline and my progesterone has increased by almost 30%. There were no effects on SHBG. What really affects SHBG in my case is the use of T3.
 
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After 8 months of using 1 mg of finasteride my estradiol dropped, my testosterone increased at first and now it's back to baseline and my progesterone has increased by almost 30%. There were no effects on SHBG. What really affects SHBG in my case is the use of T3.

How has your hair growth been? Any improvements at all?
 

tallglass13

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After 8 months of using 1 mg of finasteride my estradiol dropped, my testosterone increased at first and now it's back to baseline and my progesterone has increased by almost 30%. There were no effects on SHBG. What really affects SHBG in my case is the use of T3.
Interesting, being that Finn is mostly progesterone, it makes sense that it could lower estradiol at some point.
Are you saying t3 increases your shbg?
 

lucid&alive

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I'm uploading my latest lab tests against the Sanke numbers. I have SHBG that's actually a little above the upper limit of the reference range. My LH is high and FSH is low and LH/FSH ratio is what you would expect for a balding male. My DHEAS is low actually near the lower limit of the reference range. Not shown is my estradiol and cortisol. Estradiol is right in the middle of the reference and morning cortisol was on the higher side as was demonstrated to be characteristic of AGA by the Schmidt papers. I'd be interested for other people to post their labs so we can compare because I don't think any single hormone level can tell the tale but perhaps there is an underlying dysfunction that's common to all cases. My hairline was maturing at 17 and I have been more or less steadily losing hair since then and I'm 29 now.mevsanke.PNG
 

baccheion

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I'm uploading my latest lab tests against the Sanke numbers. I have SHBG that's actually a little above the upper limit of the reference range. My LH is high and FSH is low and LH/FSH ratio is what you would expect for a balding male. My DHEAS is low actually near the lower limit of the reference range. Not shown is my estradiol and cortisol. Estradiol is right in the middle of the reference and morning cortisol was on the higher side as was demonstrated to be characteristic of AGA by the Schmidt papers. I'd be interested for other people to post their labs so we can compare because I don't think any single hormone level can tell the tale but perhaps there is an underlying dysfunction that's common to all cases. My hairline was maturing at 17 and I have been more or less steadily losing hair since then and I'm 29 now.View attachment 23940
What was cortisol : DHEA? Prolactin? Any sign of inflammation or oxidative stress? How's sleep quality? Consider sustained-release melatonin. See: Jeff T Bowles. Body fat percentage? Allergic to any foods?
 

lucid&alive

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What was cortisol : DHEA? Prolactin? Any sign of inflammation or oxidative stress? How's sleep quality? Consider sustained-release melatonin. See: Jeff T Bowles. Body fat percentage? Allergic to any foods?
Cortisol : DHEA = 16.1/183 = 0.088
Prolactin is on there it's 9.7
Not sure what signs of inflammation or oxidative stress are.
Sleep is okay as long as my day wasn't too stressful. If it was I tend not to sleep well, wake up in the middle of the night, etc.
I'm a little afraid of melatonin because I know Ray recommends against it
I became allergic to Milk recently, it started giving me gas so I quite it.
 

cjm

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Consider sustained-release melatonin. See: Jeff T Bowles.

Consider me interested. I'm male, 34, 6'1" 155 lbs., balding, rapidly approaching Norwood 6, thinning profusely. There are over 200 references on the one article with Bowles name on it, 16 citations with melatonin in the title of the referenced study:


Haven't gone through them yet. I'm looking for the high dose studies. I got the recommendation to take melatonin from my brother-in-law, an electrical engineer for magnetic levitation trains. 2-3mg was the only thing that helped him stay asleep and sleep deeply without waking up or have annoying mind-puzzle dreams. I didn't take melatonin seriously because of Ray's attitude towards it, which is my fault, but I'm encouraged by the research. I plan to experiment with the higher doses.
 

baccheion

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Consider me interested. I'm male, 34, 6'1" 155 lbs., balding, rapidly approaching Norwood 6, thinning profusely. There are over 200 references on the one article with Bowles name on it, 16 citations with melatonin in the title of the referenced study:


Haven't gone through them yet. I'm looking for the high dose studies. I got the recommendation to take melatonin from my brother-in-law, an electrical engineer for magnetic levitation trains. 2-3mg was the only thing that helped him stay asleep and sleep deeply without waking up or have annoying mind-puzzle dreams. I didn't take melatonin seriously because of Ray's attitude towards it, which is my fault, but I'm encouraged by the research. I plan to experiment with the higher doses.
Meh. May have worked better if caught earlier. Still may as well give it a try. Look at his entire stack and read all his blog posts.

May as well also add in the scalp massages and some topical (SSKI/iodine-protocol? MSM lotion? Something..).
 
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