I've been thinking about the hormone dysregulation associated with male/female pattern balding. What people often see is a more prominent hairline towards the middle of the forehead, which peaks as a point in women, often referred to as a 'Widow's peak', and is more rounded off in men and can curve upwards towards the outskirts of the forehead. This is not 'True Hairloss' and accounts for the reasons why many people especially men will choose hair replacement procedures. True Genetic hair loss begins at the crown of the head in a circular pattern not the front of the foreline.
Men have higher levels of testosterone and lower levels of oestrogen and progesterone than women who have higher levels of oestrogen and progesterone and lower levels of testosterone. The symptoms attributed to this type of hair loss are genetic and will be most present before the age of 35 but are attributed to excess aromatising oestrogens in males and excess aromatising testosterones in females. DHEA is the steroid building block to testosterone and oestrogen in both men and women. One would find that in androgenic genetic hair loss, the DHEA will be elevated out of range, however in men the testosterone will be low/below threshold and oestrogen ie. measured as oestrodiol will be high/elevated out of what the normal range is for men owing to more DHEA being put towards producing more oestrogen rather than testosterone. In Women, the testosterone levels will be high/ elevated out of range and oestrodiol levels will be lower owing to more DHEA being put towards Testosterone production. Progesterone levels are not relevant here especially with women because their oestrodiol and progesterone levels are hard to read because of their menstrual cycles.
The key I think in this is for men not to just supplement with testosterone and women to supplement with HRT because the additional testosterone will just be converted to oestrodiol in men, and additional oestrogen will be converted to testosterone in women, and this will exacerbate the prominent opposite gender sexual characteristic formation in both genders including body discomposition and worsening of hair loss. One should use GnRH blockers ideally to block the excess conversion of DHEA into the wrong hormones for both genders, then do regular serial hormone panels until the correct levels of DHEA/testosterone/oestrogen are in the normal range for men and women and monitor hair loss & regrowth. Then once the hair loss is under control continue the GnRH blockers but then possibly consider the use of supplemental bioidentical testosterone in men/oestrogen HRT in women, and continue regular monthly blood hormone panels of DHEA/Testosterone/Oestrogen (Oestrodiol) in either gender with assessment of hair regrowth. If no further hair growth is noticed within a 3-6 month period then the male/female HRT should be stopped unless they feel any additional benefit to this compared to no HRT supplementation.
The first step would be to do a DHEA/Testosterone/Oestrodiol panel to see where One lies within the normal range for their gender. Age is irrelevant to the hormone level ranges, what is key here is where DHEA/Testosterone/Oestrodiol levels lie in sync with each other for the gender specified not age.
With hair loss one would predate that only DHEA/TESTOSTERONE/OESTRODIOL are the only things that need to be tested biochemically. There is no hair loss attributed to cortisol dysfunction/chronic stress. If all 3 hormone levels are within normal range this would indicate that the hair loss is due to either external factors ie. Diet, hair treatment eg. Chemical processing, harsh brushing, poor products, and also hair behaviours which can be owed to stress relieving behaviours such as picking/pulling the hair out; or internal factors such as malnutrition; or scalp disease which will be obvious via the scalp's condition. Therefore, there is no need to do extensive tests to this eg. Vitamin panels, anaemia panels. If no hormone level dysfunction is noted on the above TRIO PANEL, it is clear the hair growth problems are attributed to the individual's LIFESTYLE. One will be able to identify this by looking at the integrity of the individual's hair, scalp, facial and bodily skin, as well as body composition.
The permanent solution if True Genetic Hair Loss is detected via this TRIO hormone panel test would be to CRISPR it out.
The interesting thing here is that oestrogen is measured as oestrodiol in humans, but in women oral contraceptives and HRT are given as supplemental oestrogen not oestrodiol which may be why women do not respond well/optimally with supplemental 'oestrogen' because it is not in the right format, ie. Oestrodiol.
NEWA
First Published Online @ 19:54 16th July 2024
By Professor Dr Katy Win
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