Any other 21+ guys with MPB wanna check their prolactin levels for me?

Prolactin is AFAIK the only hormone that upregulates 5-alpha reductase. Am I wrong?

If I'm right then hormonal MPB can pretty much only be caused by higher free testosterone (such as in younger people with MPB) or prolactin.

My theory is that most guys whose MPB starts from 16-20 have high free T,and most 21+ MPBers have high prolactin. I don't believe anything binds with prolactin like SHBG binds testosterone but do correct me if I'm wrong.

Of course I believe there are genetic and health factors in MPB but I think the crucial aspect (at least until we master gene therapy!!) is hormonal.

Anyone else wanna test this out and get their prolactin and ideally free T as well checked?

Cheers,

Hoppi

Just had one done a few weeks ago Hoppi. I'm 24 by the way.

Reference range (for males): 2 - 18 ng/ml
My Result: 10

Mine was spot on in the middle of the reference range. Obviously this doesn't always mean optimal, just means I'm central statistically. I've seen other places where normal male prolactin has been said to be less than 15 ng/ml. But I have pretty rapid hair loss and absolutely normal prolactin. It doesn't appear to be my personal problem.

Reference range (Quest Diagnostics): 50 - 210 pg/ml
My Result: 77

My free testosterone is also low-normal. I just be fuckin up yo theory, . No, my hair loss is strange, no hairline recession but diffuse thinning all over the MPB region.

Probably more relevant in alopecia areata, but it does appear to play a role in the upregulation of 5ar activity.

My prolactin result: 9.1

24, male.

No, my hair loss is strange, no hairline recession but diffuse thinning all over the MPB region.


anthonyspencer54

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Honestly this sounds like a ludwig pattern, or Female Pattern Loss. And you mentioned estrogen dominance and low T. Makes sense.

anthonyspencer, have you ever checked your thyroid?

LoT, that is very interesting you mention that. I have been thinking about that quite a bit as of late.
At first I thought, well my free T must just be very high and likewise, DHT and perhaps estrogen are both high as a result. But with a DHT measurement, its difficult to know this and given the low testosterone and high E, it does appear to be something different from normal MPB. It is occurring in the same overall regions (i.e. no loss on the sides or back), however, the hairline has just barely receded and the entire crown has thinned massively. Its strange. I'm going to have to do more research on female hair loss.

Moby, I actually just made a thread about it today. Its strange. My TSH was measured 4.3 a couple of months ago. The latest measurement showed TSH at 1.9, which is completely normal. It seems odd for TSH to spike to pretty hypo levels and than back to completely normal ones. Its indicative of Hashimoto's, but
the TPO antibodies don't show that. I know there is another type of thyroid antibody that the doc didn't test, so perhaps that is key. But I just don't know right now. I am planning on getting a second opinion. Intuitively and based on some of my symptoms, I do feel I am still hypo.

what has changed since a couple months ago and today? Have you been taking your iodine?

But if it's not prolactin OR free testosterone then what on Earth is upsetting the balance and activating 5ar? There's nothing left o.O


If it truly isn't EITHER of these then there must be a hormone I'm missing. Either something else is upregulating 5ar, or something else is binding with 5ar to form DHT.


EDIT -- Wait wait wait, this is wrong, I mean people whose MPB STARTED AFTER 21. Anthony, you said yours started at 17/18, so I'm not looking at prolactin in your case

Plus, in the other thread you said this:

"I am currently suffering a low total testosterone, a high-normal free testosterone, high estradiol, with symptomatic gynecomastia and various other symptoms, mostly related to energy levels and sense of well-being."

Which backs me up perfectly o.O

Ok here is a potential extra layer of complexity. I am trying to learn what upregulates 5ar and what binds to 5ar to produce DHT.

http://www.google.com/search?q=upregulates+5-alpha+reductase

(oh and http://www.google.com/search?q=5-alpha+reductase+converts )

We can see that some other things DO upregulate 5ar, such as DHEA (although apparently DHEA just like testosterone DECLINES with age. We also know that estrogen does NOT upregulate 5ar and does NOT increase androgens SUFFICIENTLY to override the decline in androgens as we age. However estrogen DOES increase prolactin which DOES upregulate 5ar. See where I'm going with this??) and possibly some dietary habits. Of course, many things affect systemic androgens, but if only free T binds with 5ar then this is completely irrelevant UNLESS any of those are upregulating 5ar.

Of COURSE I could be wrong about prolactin, but I strongly believe that even if I am and it is in fact not prolactin, other than free T (which of course will ALWAYS increase MPB as it's basically the fuel), a relatively small group of hormones (and possibly also stimuli) will act on the 5ar enzyme and make it... "upregulate" (which may or may not simply mean "increase in amount")...

like someone already said: someone with hypo will have elevated prolactin levels. I also read such study on pubmed but I can't find it now so that's that.

free testosterone okay why aren't you talking about SHBG? Low SHBG would increase free testosterone.

What else is there? Cortisol? Progesterone?

Here are some ideas that may become more commonly accepted.

Many men with MPB have low testosterone not high.

Younger men with high testosterone typically have very low levels of SHBG with MPB.

As for thyroid measurements, they can be all over the map, however I prefer to see a TSH that ranges
around 1 (and most thyroid TSH ranges are .5 to 5.0).

I prefer to see DHEA high, not low. The testosterone is "bad" idea is an outdated concept.

There are a lot of things that affect the expression of 5-AR. The ones most of us are familiar with
are oxidized (processed) polyunsaturated fatty acids. Many antioxidant inhibit 5-AR.

However, some polyunsaturated fatty acids inhibit 5-AR, such as gamma-linolenic and docosohexaenoic acid.

moby wrote:like someone already said: someone with hypo will have elevated prolactin levels. I also read such study on pubmed but I can't find it now so that's that.

free testosterone okay why aren't you talking about SHBG? Low SHBG would increase free testosterone.

What else is there? Cortisol? Progesterone?

oh yeah totally, apparently many things fiddle with prolactin levels like estrogen, serotonin, hypothyroid (although that may be through the serotonin or estrogen pathway). I'm just trying to work out the closest links in the chain to 5ar first, then we can always work back.

But let's say for argument's sake that hypometabolism increases serotonin which increases estrogen which increases prolactin which upregulates 5ar2 which converts more free T into DHT and causes MPB.

I consider it unlikely that merely pulling prolactin down to healthy levels even without the knowledge of the links in the chain before it will create a massively bad impact on health because after all the prolactin is too high anyway. Of course it's BETTER to hit the chain as early as possible, but the further you go away from 5ar and DHT the more chance there is that a mistake will be made and the "chain" will be wrong. So I want to stick to 5ar and DHT and their immediate triggers just for now.

I think that anyone with low SHBG can therefore have high free T and therefore lose hair. However with age apparently SHBG increases and free T decreases so therefore that can't be the case in all people, as I once thought.

Therefore, something MUST be upregulating 5ar, unless there is another androgen being converted to DHT by 5ar (this is highly unlikely as it flies in the face of modern science).

I don't believe that cortisol and progesterone do upregulate 5ar, but I'm just starting to delve into this so I'm not sure. I think it's unlikely that say 3 or 4 hormones are upregulating 5ar and causing MPB in most people. I would imagine we can narrow this down to 1 or 2, and I still think that one of them is prolactin. Again I am not saying prolactin will be high in all MPBers (the younger ones are more likely to have normal prolactin and elevated free T).

Hoppi,

That was actually a typo, I meant low-normal free testosterone. Again, my numbers probably aren't a good reference for studying typical MPB. The pattern of hair loss isn't consistent with what I'm experiencing. I'm not saying androgens don't play a role, I'm sure they do, but it doesn't appear my androgens are highly elevated. Rather, like LoT pointed out, my pattern of hair loss is more similar to female diffuse thinning which like other forms of hairloss still involves the activity of estrogens and androgens, but not exactly the same. I'm still only beginning to try and research female pattern hairloss, but it seems systemic issues play an even greater role in their hair loss than in MPB. This again, points to probably my gut or thyroid.

Moby,

I've actually significantly reduced my supplement intake since the first test. I stopped taking iodine altogether shortly after the first test. Its odd that my TSH would normalize because of this. I can only speculate about it really, unless it really is a case of Hashimoto's.

CS,

I've been trying to address several systemic causes of hair loss, particular because I've become interested in the diffuse thinning experienced by more women than men. I'm comfortable with my knowledge of the thyroid and the gut (and I say comfortable lightly), but the adrenal hormones are much more confusing for me. Can you help me understand how CRH and cortisol effect hair, because I think they are hugely important and especially in my case. How do these affect hair, and what is the best line of supplementation that we can use to counter these effects? Can we target the scalp specifically or must we attack it systemically?

anthonyspencer54 wrote:Hoppi,

That was actually a typo, I meant low-normal free testosterone. Again, my numbers probably aren't a good reference for studying typical MPB. The pattern of hair loss isn't consistent with what I'm experiencing. I'm not saying androgens don't play a role, I'm sure they do, but it doesn't appear my androgens are highly elevated. Rather, like LoT pointed out, my pattern of hair loss is more similar to female diffuse thinning which like other forms of hairloss still involves the activity of estrogens and androgens, but not exactly the same. I'm still only beginning to try and research female pattern hairloss, but it seems systemic issues play an even greater role in their hair loss than in MPB. This again, points to probably my gut or thyroid.

What about your DHEA?

CausticSymmetry wrote:Here are some ideas that may become more commonly accepted.

Many men with MPB have low testosterone not high.

Younger men with high testosterone typically have very low levels of SHBG with MPB.

As for thyroid measurements, they can be all over the map, however I prefer to see a TSH that ranges
around 1 (and most thyroid TSH ranges are .5 to 5.0).

I prefer to see DHEA high, not low. The testosterone is "bad" idea is an outdated concept.

There are a lot of things that affect the expression of 5-AR. The ones most of us are familiar with
are oxidized (processed) polyunsaturated fatty acids. Many antioxidant inhibit 5-AR.

However, some polyunsaturated fatty acids inhibit 5-AR, such as gamma-linolenic and docosohexaenoic acid.

Wow thanks CS

What do you think about what I was saying about prolactin and DHEA upregulating 5ar?

And is it really true that some PUFAs upregulate 5ar? Darn I didn't even think of foods that might do it...

I think it's unlikely to be foods driving the upregulating directly though... that doesn't seem very plausible to me for most people o.O

Hm, look at this:

http://www.ncbi.nlm.nih.gov/pubmed/16425201


And ok I was partly correct that "upregulate" simply means "increase":

"Similarly, it is possible for the receptors to upregulate or downregulate, to increase or decrease in number, independently of any changes in sensitivity."

http://thinksteroids.com/articles/androgen-receptor-regulation

and what's wrong with extra 5AR? That would just mean more body hair and more beard hair but not necessarily hair loss since many many people are very hairy everywhere else but not losing hair.

moby wrote:and what's wrong with extra 5AR? That would just mean more body hair and more beard hair but not necessarily hair loss since many many people are very hairy everywhere else but not losing hair.

well, if you're not genetically susceptible then it's fine

or possibly if your inflammation levels are crazily low. But what's easier, keeping hormones under vague control or reduces inflammation to nil or changing your genes?


For example, I had a very large increase in body hair and precisely the same time my hair loss started, all at 24

ugh man ._.

This is complex isn't it?

Seems that an enzyme like 5-alpha reductase type 2 can be upregulated in quantity OR sensitivity, and this can be due to these and more:

Prolactin
DHEA
Certain dietary fats
Low androgens (possibly)
DHT (possibly)


Hmph ._.


Perhaps 5ar really is the body's self-defense mechanism against becoming too feminine? So the female hormones start to increase, so the reaction is to convert more of the free T into DHT to boost manliness to make up for it, at the expense of comparatively small details like scalp hair.

hoppipolla wrote:
well, if you're not genetically susceptible then it's fine

stop. just stop. 2000 posts and you still don't get it.

hoppipolla wrote:
For example, I had a very large increase in body hair and precisely the same time my hair loss started, all at 24

right, it could be low SHBG but guess what: it's just that actual SHBG number that's the problem. Low SHBG is a symptom of something else and that something else is what's causing hair loss

moby wrote:

hoppipolla wrote:
well, if you're not genetically susceptible then it's fine

stop. just stop. 2000 posts and you still don't get it.

hoppipolla wrote:
For example, I had a very large increase in body hair and precisely the same time my hair loss started, all at 24

right, it could be low SHBG but guess what: it's just that actual SHBG number that's the problem. Low SHBG is a symptom of something else and that something else is what's causing hair loss

Well, I'm sorry but we completely disagree. I don't even think there is any reason to suspect low SHBG as a universal MPB trigger. Stop making up a POV and then attacking people with differing views.

The unfortunate reality of it is that despite how much we might like to, trying to make generalizations about an incredibly complex series of relationships between hormones is next to impossible with our minds alone. We simply can't grasp that many interactions simultaneously. It would take a very complex model, and unfortunately for that too, a model is only as good as the inputs and there is still so much we don't know. Consider that every hormone in this system can potentially effect every other hormone...it's a statistical nightmare, and for that reason, it's also a scientific one.

To speak on what you are mentioning about DHT though Hoppi, I find my personal case very interesting. My androgens appear to be low and I'm testing high estradiol. Yet, there are many aspects about me physically that are very masculinized. I have a good deal of body hair, a pretty naturally muscular build (even without working out I maintain a lot of muscle), wide shoulders, a deep voice, but in contrast a feminine face incapable of growing much facial hair. If you take a look at a condition like Kleinfelters these are the exact opposite of the typical feminizaton profile, and yet my estrogens are high and androgens low. It just illustrates the complexity going on here, because we have to take into account the conditions in the womb in addition to those at puberty with respect to the hormones as these points in life have a huge impact. It would seem you can have very opposing effects depending on the dose of hormones you get in those two points of development. Like I said, everything besides my face and jaw are very masculine.

anthonyspencer54 wrote:The unfortunate reality of it is that despite how much we might like to, trying to make generalizations about an incredibly complex series of relationships between hormones is next to impossible with our minds alone. We simply can't grasp that many interactions simultaneously. It would take a very complex model, and unfortunately for that too, a model is only as good as the inputs and there is still so much we don't know. Consider that every hormone in this system can potentially effect every other hormone...it's a statistical nightmare, and for that reason, it's also a scientific one.

To speak on what you are mentioning about DHT though Hoppi, I find my personal case very interesting. My androgens appear to be low and I'm testing high estradiol. Yet, there are many aspects about me physically that are very masculinized. I have a good deal of body hair, a pretty naturally muscular build (even without working out I maintain a lot of muscle), wide shoulders, a deep voice. If you take a look at a condition like Kleinfelters these are the exact opposite of the typical feminizaton profile, and yet my estrogens are high and androgens low. It just illustrates the complexity going on here, because we have to take into account the conditions in the womb in addition to those at puberty with respect to the hormones as these points in life have a huge impact.

hm.. is it possibly what I just suggested that the body unregulates 5ar (possibly through hormones like prolactin, but maybe something else in your body) to increase masculinity?

I mean hey, maybe 5ar just upregulates if it detects a drop in T levels (less interacting with it) ._.

You reckon that's possible?

EDIT -- Also, obviously the reason that finasteride doesn't work as well as people might hope is because whatever is upregulating the 5ar enzyme is still in the bloodstream, or the receptors detect even LESS testosterone and so become even MORE sensitive to counteract that. Perhaps the reasons people get fin sides are simply due to increasing estrogen dominance and simply inhibiting TOO MUCH 5ar. All this leads to an unhealthy low level of DHT, already low T, high E, and a general hormonal mess. Darn

I'm not familiar with how the body regulates 5-AR levels at all or what might cause them to fluctuate so
I hesitate to speak on it. To the extent of my knowledge, I'd have to say the primary regulation of things
like this goes on at the hypothalamic-pituitary level. If these areas are feeding back a low level of testosterone, they will upregulate FSH and LH to kick the testicles into gear. Typically the body tends to regulate estrogen by way of SHBG derived from the liver (I'm not sure on regulation of the actual estrogen receptors). There appear to be many things that can alter sensitivity of the androgen receptors. Given these bits, I don't know how realistic it is to think the body would upregulate 5-ar to compensate for low testosterone. Its a massive stretch, but perhaps if there were a defect in testicular function. I doubt it though, because what you tend to see in that case is a huge spike in LH with no other compensatory mechanism for increasing androgens, the reason why men with primary hypogonadism can go for a long time with low t before declining symptoms eventually bring them to the doctor.

anthonyspencer54 wrote:I'm not familiar with how the body regulates 5-AR levels at all or what might cause them to fluctuate so
I hesitate to speak on it. To the extent of my knowledge, I'd have to say the primary regulation of things
like this goes on at the hypothalamic-pituitary level. If these areas are feeding back a low level of testosterone, they will upregulate FSH and LH to kick the testicles into gear. Typically the body tends to regulate estrogen by way of SHBG derived from the liver (I'm not sure on regulation of the actual estrogen receptors). There appear to be many things that can alter sensitivity of the androgen receptors. Given these bits, I don't know how realistic it is to think the body would upregulate 5-ar to compensate for low testosterone. Its a massive stretch, but perhaps if there were a defect in testicular function. I doubt it though, because what you tend to see in that case is a huge spike in LH with no other compensatory mechanism for increasing androgens, the reason why men with primary hypogonadism can go for a long time with low t before declining symptoms eventually bring them to the doctor.

Hm... but... I mean SOMETHING must be causing them to upregulate. It still seems that with MPBers either free T is high, or 5ar2 is too sensitive for some reason. I think it's usually the latter

EDIT -- It's interesting how CS notes that most people with MPB have low T. I wonder if simply manually increasing systemic testosterone would fix the problem or if it's too complicated for that to work.

I also of course wonder what role aromatase plays in this. I would assume that aromatase isn't higher in people with MPB, just T is less?

DOUBLE EDIT -- The only reason I can think of why manually increasing testosterone wouldn't work is if the person had elevated aromatase. However you can inhibit aromatase quite easily too lol