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Dr. Justin Rome: Can Testosterone Replacement Cause Hair Loss?

Androgens like DHT are known hair loss culprits, so is excess Testosterone also bad for hair health? Learn more about testosterone replacement and hair loss.

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Dr. Justin Rome, M.D.

For men who want to look good and feel their best as they get older, they may be looking into ways to help reduce hair loss as well as potentially undergoing testosterone replacement therapy if their levels are low. This often comes along with a lot of questions, as there are a few myths out there regarding testosterone replacement therapy and how it can affect your hair.

Having normal amounts of testosterone in your body can be fine for your hair, as hair loss has more to deal with how your specific hair follicles respond to another hormone which can be derived from testosterone called dihydrotestosterone (DHT). For men who have a genetic sensitivity to DHT, their hair follicles are more sensitive to the damaging effects of the hormone, and may experience hair shrinkage, shortening, and the eventual loss of the hair from DHT hanging around. It is this genetic sensitivity to DHT that is the main culprit behind male pattern hair loss, and not necessarily the testosterone itself.

However, it is important to know your own hair and be aware if you are dealing with hair loss in the telltale pattern of thinning on the crown and a receding hairline in an “M” shape. This could mean that if you go overboard on replacing testosterone, there may be higher levels of DHT around in your body which could potentially accelerate the hair loss pattern you are experiencing. This doesn’t mean that you shouldn’t use TRT to help get your testosterone levels back up to normal, but you should be aware that it is important to keep your levels in a normal range and try to not overshoot or use more than prescribed. Using very high levels of testosterone for replacement may mean that more of it gets converted into DHT, and negatively affects your hairline more (in addition to other negative health effects of too high levels of testosterone). And, even if you are staying within normal limits, you may still have some hair effects if you tend to be more sensitive to DHT.

For men who are starting on TRT that also have male pattern hair loss, and are worried about the negative hair effects, it may be an option to start on a medication to help keep DHT levels lower in the body and scalp. Medications like Finasteride and Dutasteride are called 5-alpha reductase inhibitors, and they work by blocking the enzyme that is responsible for making that conversion of testosterone into the DHT. For men needing help with male pattern baldness, these can help maintain your current hair and may help regrow lost hairs in some.

Talk with your doctor about your current hair concerns before starting on TRT, and always listen to your doctor’s dosing instructions on hormones to help keep your levels within normal limits. For some, using Finasteride or Dutasteride may help avoid worsening male pattern baldness shedding while on TRT. You can have a free online consultation with Strut Health today to see if Finasteride or Dutasteride topical or oral options are a good fit for you.

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