Read time: 10 minutes
The Hair Loss-Testosterone Connection
When I was diagnosed with pattern hair loss, the only thing I knew was that hair loss had something to do with testosterone. After a little research, I learned the following:
Dihydrotestosterone, or DHT, is a byproduct of testosterone. DHT levels are elevated in those with thinning hair. Because of this connection, DHT is often considered the cause of hair loss in men and women.
That’s simple enough. I thought to myself, “If DHT is made from testosterone, and I have high DHT, that must mean my body is producing too much testosterone. This obviously means I am too manly for own good, so my hair is falling out.”
I wasn’t alone in this conclusion. A lot of hair loss sufferers, and even some researchers, think the same way.
It’s an easy logical jump. But is it true?
If You Have Male Pattern Baldness, It Doesn’t Mean You Have High Testosterone
The idea that all men with thinning hair have high testosterone doesn’t hold validity. This has been shown in a few ways:
- Studies have shown that balding and non-balding men have similar testosterone levels
- Aging males typically have lower levels of testosterone, but they have higher incidences of hair loss
- Male pattern loss has been observed in both high and low-testosterone males
Obviously, something else has to be going on here. Testosterone can’t be the only implicating factor in hair loss. So what’s actually happening?
DHT Is More Complicated Than Most People Think
The hormone DHT can be broken down into two categories. Firstly, there’s serum DHT (the kind that circulates in your blood). Secondly, there’s tissue DHT (the kind that binds to your skin, your scalp, and many other places in your body).
Many people assume that all kinds of DHT – both serum and tissue – are bad for your hair. But research on this is mixed.
Let’s start with serum (blood) DHT. Some studies suggest serum DHT has no correlation with pattern hair loss. Others suggest that serum DHT is higher in young men without hair loss! This contradicts the widely preached dogma that DHT is universally bad for hair. Based on the evidence, serum DHT is either uncorrelated to or protective against male pattern hair loss.
But what about tissue DHT? Is tissue DHT correlated with baldness?
Yes. The distinction between serum and tissue DHT matters. It turns out that tissue DHT is elevated in the scalps of balding men. Tissue DHT in the scalp is linked to pattern hair loss. Where DHT collects in the scalp, hair loss tends to follow.
Beyond this, DHT gets extremely complicated.
For one, tissue DHT is associated with hair loss in the scalp, but paradoxically, tissue DHT also encourages body and facial hair growth. How can that be? How can tissue DHT encourage both hair growth and hair loss, depending on location?
Here’s another paradox: while men’s testosterone tend to decline with age, their serum DHT levels stay about the same (up until ~80 years old). At face value, that doesn’t make much sense. DHT is made from testosterone. When testosterone decreases, we’d expect DHT to also decrease. But it doesn’t. Why?
It turns out that testosterone (specifically, free testosterone) converts to many byproducts aside from DHT. As men’s testosterone levels decline, their bodies also begin shifting the conversion of free testosterone toward DHT and away from other testosterone byproducts. This is how serum (blood) DHT levels remain constant, even when men’s testosterone levels plummet.
The point of all this is… DHT’s role in pattern hair loss is still debated. Men produce more DHT than women. Men bald more often than women. Tissue DHT is present in the scalps of balding men. But beyond that, it’s still unclear whether DHT is the root cause of hair loss, or just a consequence of inflammation.
So, what happens when we extend our scope beyond DHT and ask, “Based on the evidence, is there a hormonal profile specific to a balding person?”
Yes. If we look beyond DHT and only consider our blood hormonal profiles, hair loss is closely connected to a few different hormonal imbalances. These hormonal imbalances vary based on the age, gender, and type of hair thinning from which a hair loss sufferer has. But typically, they all are suggestive of one thing: systemic inflammation.
Example #1: Young Men With Androgenic Alopecia (AGA) Have Similar Hormonal Profiles To Women With Polycystic Ovarian Syndrome (PCOS)
It might be shocking to discover, but young men with pattern hair loss have a hormonal profile akin to women with polycystic ovarian syndrome (PCOS).
Polycystic ovarian syndrome is a chronic condition that occurs in at least 10% of first-world women – most often starting around puberty. Its tell-tale symptoms: insulin resistance which precipitates hormonal dysregulation which precipitates the formulation of hair follicles (i.e., “cysts”) on the ovaries.
The hormonal profiles of PCOS-affected women generally include elevated levels of prolactin, free testosterone (different from total testosterone), and a higher ratio of luteinizing hormone (LH) versus follicle-stimulating hormone (FSH). And fascinatingly, young men who are balding have the same hormonal profile: higher prolactin alongside a higher LH:FSH ratio.
What makes this incredibly interesting is that PCOS is also the leading chronic condition in young women compounding with pattern hair loss (androgenic alopecia). That means that the connection point between young male and female pattern hair loss sufferers is literally this hormonal profile.
And that’s not the only thing this hormonal profile indicates. This same profile is associated, in the long-run, with chronic ailments like metabolic syndrome and heart disease. Why? Well, researchers aren’t entirely sure… but the leading theory is that this specific hormonal profile is a barometer to gauge someone’s degree of systemic inflammation (inflammation from within the body).
When we evaluate young male AGA against other diseases, this begins to make more sense. There’s evidence that early-onset male AGA might even predict inflammatory-based diseases – like heart disease – later in life.
The takeaway: early-onset male (and female) AGA is associated with the same imbalanced hormonal profile… and this profile tends to suggest high degrees of systemic inflammation for both sexes.
And that’s not the only hormonal profile associated with thinning hair.
Example #2: Testosterone:Estrogen Ratio Imbalances
While PCOS-affected women with pattern hair loss (AGA) tend to have higher free testosterone levels, so do peri-menopausal women who are losing their hair but aren’t suffering from PCOS. And while younger balding men tend to have PCOS-linked hormonal profiles, they also have been found to have elevated estrogen levels.
So, it seems like in younger men males and older females, an imbalance of testosterone:estrogen is associated with pattern hair loss. How should we think about this? For younger men, the imbalance usually looks like this:
For men, even if testosterone levels stay constant, higher estrogen will imbalance the ratio, increase DHT conversion, and lead to hair loss.
For older women, the imbalance usually looks like this:
The ratio of testosterone:estrogen (t:e) – for both younger men and older women – can be used as a predictor of someone’s overall systemic inflammatory load. With healthy t:e ratios, you’re bound to have less inflammation. With imbalanced t:e ratios, you’re more likely to have a lot of inflammation (at least if we reference normal ranges).
For men, the increasing rise in hair loss incidence should come as no surprise. With the current state of most first-world diets, men’s testosterone levels today are 22% lower than men of the same age 30 years ago.
For women, whom often experience hair loss after menopause, it should be no surprise that estrogen levels post-menopause drop by up to 90%. It looks like there really is a testosterone-estrogen connection.
What is in charge of regulating all of these hormones? Your endocrine system. More specifically, your thyroid.
Testosterone:Estrogen Levels Are (Partly) Regulated By Your Thyroid
Your endocrine system, but specifically your thyroid, is the body’s center for hormone production and regulation. If you have an underperforming thyroid, you probably often have cold hands/feet, poor circulation, nagging fatigue, irritability, a low body temperature, and imbalanced hormone levels. Another external symptom of a suppressed thyroid gland (or hypothyroidism) is a decrease in eyebrow hair thickness on the outside of your brows.
For many men, an underactive thyroid often coincides with a lower-than-desired testosterone:estrogen ratio (the inverse is true for women – though the levels are all still regulated by the thyroid). Poor thyroid function is also associated with a host of other diseases worth avoiding.
If I Improve My Thyroid, Will I Stop My Hair Loss?
It depends, but the short-answer: probably not.
While hypothyroid-related hair loss is certainly a huge issue in the first-world, it’s also a different form of hair loss versus androgenic alopecia. Whereas hypothyroid-related hair loss leads to a hair shedding disorder, androgenic alopecia leads to hair follicle miniaturization. While both things cause hair loss, these two types of hair loss look totally different morphologically.
Whereas hair shedding disorders can resolve by addressing systemic inflammatory insults (diet, lifestyle, etc.), androgenic alopecia is only exacerbated by these same insults. Therefore, while improving your thyroid health via diet and lifestyle might resolve your testosterone:estrogen levels and hypothyroid-related hair loss… it won’t resolve your androgenic alopecia.
Why? Because, again, when it comes to androgenic alopecia – it’s not our circulating hormones that determine if we’ll develop the condition! It’s our scalp tissue hormones and the degree of DHT arriving to AGA-prone balding sites.
Long-story short: this is just one example of why our hormones and hair loss are just so complicated.
Rob English is a researcher, medical editor, and the founder of perfecthairhealth.com. He acts as a peer reviewer for scholarly journals and has published five peer-reviewed papers on androgenic alopecia. He writes regularly about the science behind hair loss (and hair growth). Feel free to browse his long-form articles and publications throughout this site.
182 thoughts on “Men: Stop Thinking Your Hair Loss Is Due To High Testosterone”
This is a very interesting and informative article. I never knew the relation of hair with testosterone-estrogen ratio. I just thought the hair loss happens due to some sort of genetic issues or improper care and food habits. I am a patient of Dr. Simmons of chtc.ca in Toronto for treating hair loss. He told me to have food rich with vitamins, proteins and other nutrients. I was worried if I needed any hair transplant surgery, but the doctor told me my condition can be cured without any surgery.
Mr. Reeves, What diet (proteins, vitamins, etc) did Dr. Simmons, put you on?
hair loss is caused by our autoimmune systems nothing else
the system attacks the hair follicles
now you know!
among the dumbest most brainwashed concept out there. i’m not insulting you, but the i am insulting the information you posses. calling it out as a parrot response. you trust old science, and doctors who learn from pharma drug pushers but never research these topics on their own. you can find a wealth of accurate information about the truth of natural hair regrowth by looking at research done in universities such as the athens school of medicine in greece, and other non-american regions. we cannot legally patent nature. this is why pharmaceutical companies MUST create a synthetic drug by tweaking natural compounds. it is the only way they are allowed to patent off an idea. think about it. why would someone want to patent nature??? absolute control over human resources. this is why it became illegal to patent nature, to make sure that reasonable and intelligent people would continue being allowed to use the plants and medicine the earth provides naturally. jim you are brainwashed, and probably suffering health conditions needlessly because you trust the health monopolies, who not only one hundred percent of the time must peddle completely synthetic chemicals with more side effects than all your current ailments combined, they also are human and experience fear, for example running out of money before creating a new drug THAT ACTUALLY WORKS, motivated by that fear, and in the same way you or many many students you knew in high school Labs for chem or bio, “fudged” the numbers / outcomes in their experiments when they saw other teams getting different results, or if they didn’t get the result they wanted. Those who cheat in high school never change. they just get better at it, they end up cheating to save their lives, in their own mind, because losing a job, or missing a deadline, or wasting millions on drug research and producing one with zero positive effect- they still “need” to push something…
one of the drugs my wife was made to be on by doctors back in high school, now today over a decade later is known to cause blood cancers. now she has leukemia, and the drug never worked as intended. it was poison. its MURDER on a delayed schedule, though in reality, the people doing the Murdering have no idea how toxic their fake treatment pills really are- if it “puts you to sleep”, “calms you down”, “gives you a head high”, whatever it is, if there is some “effect”, they know they can market it for a while. No one “died” in the year they tested it so they think it’s safe, and “even if it doesn’t work, there will be some positive testimonials because of the placebo effect, and it’s not like we’re killing anyone, we’re just finding a way to pay the bills and give a perfect life for our loved ones”
Everyone thinks they are the good guy, but motivated by fear and money people will make assumptions that are wrong, cheat a little (if “no one gets hurt”), sell you things they think are at least safe, even if not effective. but in the end you die sooner. your hair falls out earlier and never comes back. trying to prevent cancer, they scanned you so many times they gave you cancer.
and they have the money and all the lawyers in the world to shut people like me down who will tell you the truth.
on the other hand think about what fruits nature brings us without chemical or genetic tweaking. these things cannot be patented for a REASON. to make sure all humans have CHANCE to live, as long as they aren’t too lazy to do their own research and studies, and remember the wisdom of natural healing methods known, well known and practiced, for thousands of years. people think they are smarter today. no with sleep deprivation, so much stress, so many visuals and sounds bombarding us every day. you cant even remember a sentence in a paragraph a minute after it’s been spoken anymore. thousands of years ago, people could listen to a story, hours long and then retell it years later from memory (almost) verbatim (almost because of how pride and ego change how stories are retold and retold until finally, they are legendary tall tales)
We are stupid today, collectively, with so much information freely accessible on the net we have no excuse not to know how to heal ourselves. but because you are so bloody tired and tressed all the time, you’d rather feed off the energy of pride (medical knowledge, smart asses like “house”), or insult/shaming (making fun of the natural path, or ‘tin foil hat type’), knowing all the doctors who make so much money must have “trust and legitimacy” for all their training and hard earned money.
Doctors are exactly like the people behind the phone stands at the kiosk. Exactly like comfort sleep bed sales reps
or those guys at the mall who try to sell you hair, or beauty products as you walk by
they all are out for “your best interest”
but what they all have in common are these two things
1. their best interest: money (motivated of course, well usually, by more noble concepts such as family and maybe even tithing more at church)
and this next one is key, absolute key:
2. they are all PUSHING a PRODUCT that SOMEONE ELSE made.
Thats why your doctor can look you in the eye, and tell you the truth: “this drug can help with your diabetes / your cancer / your parkinsons / your HAIR LOSS” and no matter what, they look like they are telling the truth, because to them, they are. If it were the scientists who created the drug, also prescribing TO you, I bet you’d read them better and know if they actually fully believed their drug would help or not.
Doctors (and the pharmadrug pushers) READ about what drugs the scientists whipped up. they’ll hire a speaker who had nothing to do with the research (or pretend to, wouldn’t be surprised) in order to “sell” the idea and get backers.
Fear and greed motivated the early release, and forged trial data of the drug, success in previous scams earned them the money to forge the data, protect the data, and fight the legal battles to shut down others who have been curing these things naturally for thousands of years, all so they can make about ten thousand percent profit on the pill they made.
cancer is cured, all types. but they keep shutting down your resources, or using their vast wealth to generate smear campaigns or take natural healers to court. natural things are cheaper, so less profitable, so evil wins the legal battles
and now YOU know
PS. this whole rant is aimed not at jim, but everyone who agrees with the concept jim holds, and / or the blind faith in people who did as little research about the drug as you did : NONE
“what do you mean doctors didn’t research the drug?”
I mean they didn’t do the research to put the drug together, they have blind faith in the lab scientists as you have blind faith in the doctor.
Can you please how should I cure my hair loss problem??
I don’t do any kind of intoxication neither I take protein supplements nor its genetic in my home??
So please can you tell me what should I do??
These questions aren’t necessarily easy (or straightforward) to answer. I’d recommend reading a few more articles on the site — so that you can better understand what sort of hair loss you’re suffering from, what your treatment options are, and what to target to reverse your hair thinning:
Honestly if testosterone alone were responsible for hair loss then why is it that younger men have beautiful hair that is full and lush after all they have the highest levels at that age!
in fact testostereone comes with a balance of “correct” estrogens these estrogens that help grow your hair but no manboobsand thats the reason there is no bald teenagers and most of them are slim
Unfortunately DHT comes with a balance of steroidal estrogens these estrogens actually dont help hair but you got risk developing ginecomastia
Thanks. A good diet can help mitigate future hair loss, so if your objective is to maintain your current head of hair, diet (along with lifestyle changes) are good starting points. And, while you can be genetically predisposed to hair loss, if you eliminate/limit the environmental factors that alter gene expression in your scalp, it doesn’t have to be your genetic “destiny”.
I would avoid a hair transplant. There are more natural, less expensive, and more effective ways to reactivate dormant follicles and regrow hair.
what are they pls tell me
I would like to know aswell
I would love to know the ways i can naturally, less expensive and effective ways to reactivate my hair and regrow it.
My front hair line is creeping back and the hair in the center of my head is starting to thin. I would love to regrow my hair and hair line back to its original state and thicken my hair in the center again. Please tell me how,
The pictures look unbelievable. However my diet isn’t the best, meaning i’m not getting in the needed vitamins & nutrients that i need, which i know is a contributing factor. Which i am working on. But going my those pictures i need the help.
Thanks Jon from Ireland.
Thanks for reaching out. Diet is definitely a factor, but while an undernourishing diet can contribute to the inflammation that precipitates hair loss, often just a good diet alone isn’t enough to reverse hair loss. I opt for a combination of dietary and lifestyle changes, along with specific massage techniques to address what diet/lifestyle can’t. I’m in the process of updating the book now and am hoping to have it finished and rereleased in the next couple weeks. The book and video series spells out the process in detail and is the best resource I can offer at the moment. So hang tight! And thank you for the comments about the photos.
Thanks for your reply.
Apologies on my delayed reply, my diet has seen an increase n fruits and veg, nut’s etc. And feeling much better in myself already.
I would would say that being vitamin deficient isn’t helping. But that’s changing…i’m looking forward to my hair changing big time, so i’m certainly looking forward to your book and video. Desperate is an understatement.
Can you guarantee i will 100% see changes?
Hey Jon – I can’t guarantee results, but this new book is designed to maximize everyone’s chances for success. A lot of people have seen some pretty remarkable changes, and the new book focuses on the commonalities of the best-of-the-best responders (their diets, lifestyles, massage techniques, etc.). On top of that, the new book also has contingency and troubleshooting plans that have shown to be very effective for those who don’t see significant gains from the regimen. So I think there’s a good chance the book (and its resources) will be helpful and lead to positive hair changes for you, but to say with 100% certainty is impossible.
Hi ! i just purchased your ebook and for some reason i am not able to see the video. i think its because my itunes is not working and usually videos open up on itunes , is there any way you can send me a link of your video or is there some other way i would be able to see it? THANK YOU I WOULD APPRECIATE IT 🙂
Thanks for letting me know. I’ll follow up with you via email now. Have a great weekend!
Ankit – I think you might be asking about the video attached to the eBook. If not, let me know.
your article is quite informative , i have male baldness pattern for last 2 years now and just like Dave i was also worried that i might have to get a surgery done coz m facing it at very young age. so if you could suggest some natural therapy to cure it and as far as thyroid is concerned i dont think i have any symptoms mentioned above.
Under-active thyroid symptoms can manifest in a variety of different ways (chronic cold hands/feet, low body temperature, lethargy, weak or overactive immune responses, poor skin health, hair loss, etc.).
As far as natural therapies for hair regrowth, they exist and are extremely effective when implemented correctly. The book presents an executable action plan to address the underlying factors involved (inflammation, calcification, fibrosis, lymphatic drainage, hormones, etc.). But if you’re not interested in the book, that’s okay too. Look into mechanostimulation for calcification removal, and dietary + lifestyle changes to mitigate the hormonal imbalances that precipitate hair loss. Since hair loss is so multifaceted, there’s often not one single change that will allow for hair regrowth. But with the right plan and commitment, you can achieve the results you want.
I am just 21 years old and I have been experiencing hair fall from last 18 months..
I always try to maintain my diet..and I do not have baldness issue from my maternal or paternal family.
However I was wondering if it could be because of DHT.
If so ? How can I control it ??
DHT is just one of many factors in hair loss. The reality seems to be that there are many larger underlying issues that precede DHT – like calcification, fibrosis, and chronic localized scalp inflammation. You should really focus on resolving those. Two big influential levers are diet and lifestyle. To resolve the localized inflammation, mechanostimulation and massage therapy are very effective too. The book goes into much more detail, but I’d start there.
Yes, but DHT leads to a cascade of events that cause the symptoms most experience in mpb.. Increased size of sebum glands stems from an over abundance of androgens and leads to conditions such as seborrheic dermatitis which I turn leads to oily hair, yeast infections, and inflammation.
DHT is THE MAIN FACTOR. However, testosterone and its importance in mpb is still unknown. A lot of men use pills such as finasteride and for whatever reason, their hairlines recede further. So in a sense you a correct, however Castration stops mpb which means androgens are the main cause.
I was detected hypothyrodic an year and half a ago, and priscribed with eltroxin 100mg. a month ago I tested my blood for tsh which went as low as .13. the problem is that ever since my hair fall has increased so drastically that even a finger through my hair brings 3-5 strands with it. now im on 50mg dose of eltroxin but the hairfall is getting worse day by day. this is killing me as im loosing it very badly.
can you help me
It’s a difficult question to answer without more information. Hypothyroidism manifests for so many different reasons. Birth control contraceptives, dietary triggers, gut dysbiosis/leaky gut… these are all associated with hypothyroidism and often precede the actual condition. You often need to resolve these in order to resolve hypothyroidism, and to halt hair loss. I would say compare your dietary/lifestyle choices to the ones outlined in the book, and see if there are mismatches. That’s a good first step. Afterwards if you still have questions I’m happy to help.
I just wanted to thank you , because I too changed my lifestyle because of this . From eating healthier to changing my attitude and stress levels . Your book gave me hope & been doing the massages for about 4 months now & I see lots of hairs growing and some thicker 🙂 . Thank you for what you do .
Hey Pau – congratulations! I’m really happy for you. Always feel free to reach out with any questions, and keep it up!
I bought your book three weeks ago on Gumroad and started doing detumescence immediately, and I have implemented some dietary changes. The distinction you make between genetic disposition vs. genetic destiny is very appealing, and I sure hope it’s true 🙂 I would like to hear your comments on a couple of things about baldness/body hair and shedding.
Studies have shown that there is a proportional connection between testosterone level and body hair, and it’s a fact that a lot of (severely) balding men has quite a lot of body hair (chest/back). Body hair also seems to increase in amount at about the same pace as scalp hair amount decreases. I can’t help thinking that a balding man with this pattern of body hair growth/scalp hair loss may not necessarily respond to treatment that may work for a balding man without significant amount of body hair, simply because the overall behavior of their follicle genes is so different even though they are both balding. I have no idea if there is any validity to this, because research seems to be focused on baldness as such, without considering if baldness coincides or don’t coincides with body hair growth. Any thoughts …?
Also I’m a bit concerned about shedding. I’ve used Minoxidil earlier without any success, and neither did I experience any shedding, just the usual gradual thinning. Now the same seems to be happening with detumescence – I have been doing this for three weeks, and my scalp is a lot looser (extremely loose at the crown part) and there is dandruff coming off, but there is no shedding. This may sound strange, but I would love to see some shedding, because that’s supposed to be a sign of progress. Do you now if regrowth is dependent on an initial shedding? Is regrowth possible without experiencing shedding?
I’m sorry for this lengthy response. Comments are highly appreciated. Keep up the good work 🙂
Thanks for reaching out, and for the questions! Would you mind linking me the studies your read? For the relationship between testosterone levels and body hair, are you referring to total testosterone, free testosterone, or DHT metabolism/conversion? I’ve never seen a study suggesting that higher absolute total testosterone levels means higher body hair in men. But, I’ve seen evidence that suggests relatively higher levels of DHT conversion (as a result of changes in free testosterone, total testosterone, and a few other levers) increases body hair. I just need more clarity to help best answer your first question.
Secondly, I wouldn’t be concerned whether or not you’re shedding. Some people shed a little bit, and some people don’t — but shedding is definitely NOT always a good sign (as you know). Some shedding is normal because of the nature of the massages. However, some people also shed because they create too much friction on the scalp skin, or they don’t allow for enough recovery time in between sessions. That’s not the good type of shed. So, don’t worry about not shedding 🙂 Regrowth is possible with or without the type of shedding you’re looking for.
A good rule of thumb: when starting your second session of the day, your scalp should feel 90-95% recovered from your first session. So play with intensity until you’re able to achieve that balance. Your scalp shouldn’t feel sunburnt or in pain, but it also shouldn’t feel completely perfect. You’re going for just the slightest increase in sensitivity — one that’s not painful at all — by the start of your second session of the day.
If a person sufferings from male pattern baldness(mainly due to dht imbalance) take in supplementes which increase testosterone(like fat burners etc).. Will it cause increase in DHT n cause further hair loss??
It depends on a few things. First, you’d need to know if your free testosterone increases in proportion to total testosterone and/or DHT. Secondly, you’d want to know if there are any changes to DHT conversion/metabolism. In many cases, I think that supplementation does more harm than good. Most people supplement blindly without understanding or tracking the multitude of changes that occur within the body. That’s not to say you shouldn’t supplement, but if you decide to do it, do your research and do it smartly. I’ve always found diet and lifestyle to be far more effective, for myself and many others.
Thanks for your reply.
Actually I wasn’t referring to a specific study in the question about body hair/testosterone, but a general summary on FAQ page on the website Lab Tests Online. I quote:
Studies have shown a proportional relationship of testosterone levels to the amount of body hair. The hair growth response to testosterone differs in different parts of the body. Hence, in some men, for example, testosterone promotes hair growth in the abdomen and back while hair growth is suppressed in the scalp, leading to male pattern baldness. Genetics plays a major role in the expression of the enzyme 5-alpha reductase, which converts testosterone to the hair-altering compound dihydrotestosterone, leading to a family tendency towards balding. The drug finasteride (Propecia®) inhibits the action of 5-alpha reductase and can reverse male pattern baldness in some men.
As you see, this is a very general statement and might very well imply that increased amount of body hair is related to DHT conversion, not to the overall testosterone level.
Good to now that I shouldn’t worry to much about shedding or lack of shedding. I’ve been doing the massage exercises for one month, and I’ve noted the following change the last week:
My scalp is not in a full dome, but has a dome shape in front and at the back, and there is a dip on the suture line between the parietal and frontal bones. I assume this misshaping has to do with balding, but I wasn’t really aware of my scalp when I had more hair. Anyway, by doing the massage, I seem to “break down” the elevated areas, making the head more flat and even. A couple of hours after massage, the parietal and frontal eminences are visible again, but by continuing the massage, I hope to make the flat and even condition permanent. I’m not really sure what’s going on, if I’m breaking down tissue or pressing down the bones, but I hope this is a good sign 🙂
Thanks for sending the link. Okay, now I understand where you’re coming from. Overall, I disagree with the site’s claim about the relationship between increased testosterone and increased body hair. Without more information, the statement is incomplete. But in any case, I agree that there’s a relationship between increased body hair and increased scalp hair loss. If you decide to get any of the lab tests on the site, let me know which ones beforehand and I’ll tell you if they’re worth getting.
RE: massages– that’s also very normal 🙂 If you get bored of the monotony of the massages, you should also consider incorporating headstands for warmups. People find that sets of 1 minute headstands for 5 reps (or just 5 minutes of total headstand time) seem to make the massages exponentially easier (more elasticity).
First of all thanks for the work you put into the e-book and the video, it’s very informative!
I’ve been doing DT for just over two weeks now, and I spray 1 part Apple Cider Vinegar to 1 part water on my hair/scalp daily. I’ve experienced a pretty significant shed, I’m quite sure it’s from DT as nothing else has changed, I take this as a good sign. The hairs that I shed seem, for the most part, the kind of wimpy, not 100% healthy hairs. Also, they seem like “whole” hairs, not like I broke them or anything from improper massage.
I’m 99% sure I’m doing the massage right though, I put a LOT of force/pressure on my scalp, then make circular/rubbing motions (mostly circular) with some pretty serious force. However, I make 100% sure that I am not creating friction between my scalp and fingers so that I don’t damage the hair. I actually spend about 10 minutes doing this type of general, STRONG massage, THEN move onto the pinching portion of DT (I still have to pinch with two hands mostly, hopefully that will change soon), then maybe 10 minutes of pinching at least, then another 10 minutes of the same type of strong, general massage, focusing on my problem areas (temples and vertex). People focus a lot on the pinching (which in my opinion is the most difficult and complicated part), but I feel the general massage portion of DT is just as important.
The only thing that worries me is that I’m not seeing much dandruff, but I kind of cured my dandruff problem after stopping Minoxidil about a year ago and overhauling my diet. I do however get sebum, and occasionally some glue-like substance, which is awfully nasty and makes me wonder how much other crap is under my scalp! I get dandruff but not much. I actually get a lot of dead skin if I take my boar bristle brush, place it on my scalp and press down without moving it.
My scalp definitely feels hot after a DT session with all the blood that flowed to it, but it doesn’t really feel sore or hurt, even though I go really strong and intense with DT. Funny thing though, above my left temple near the vertex is one of my problem areas, and after a session, when I bend over to flip my hair back into place (I have long hair), I feel a nice sharp pain there, so something must be working.
So I’m really enthusiastic about DT, especially with the shedding that occurred so soon, that tells me something HAS to be working.
Thanks again Rob!
Thanks for reaching out. Shedding is very common – especially because of the nature of the massages. With that said, excessive shedding isn’t desirable. Some people see regrowth after sheds, but at the same time, some people don’t shed at all and see regrowth. So as long as you’re not shedding a ton of hairs to the point where any reduction in density or hairline becomes visible, then you’re probably fine.
As far as dandruff — it’s normal not to experience dandruff, especially when just starting out. Dandruff release is something that occurs for most people, but not all.
If you’re worried at all, send me a video of your technique (use DropSend — it’s free). Otherwise, it sounds like you’re doing fine. But I’m happy to help any way I can.
Thanks Rob, really appreciate it!
I’ll keep updating my progress. My shedding isn’t really…SEVERE, in the sense of pulling out large clumps of hair, it’s just that I notice a lot more single strands than normal.
I’ve seen some nice progress pictures lately on immortalhair too!
The only thing are those cold showers. That takes guts! I’m trying to go gradually.
I actually incorporate two pinching methods, one is with my nails (making sure they don’t slide across the scalp, just to grip it), and the other is the two handed pinch. My scalp definitely feels looser, there’s no question about that, so this certainly works in that aspect!
This therapy has also helped me to relax my face. I noticed that if I accidentally raise my eyebrows while doing DT, the scalp is almost immobile. This made me realize that throughout the day, my eyebrows are always like this due to stress. I am convinced this is one of the factors that led to my tight scalp. I am working very hard now to change that.
This therapy has given me the best feedback out of any treatment I have tried so far, so I’m pretty optimistic about it!
I’ll definitely keep track of my progress, and report back with results. Thanks again Rob!
I’m really interested to buy up your book along with the email support but I have some questions to ask of you before that. I have been unable to find your email id. Please reply to them here.
1. Is there a need to use some medicine or supplement at any stage of time ? I Dont want to use any such things as I prefer going the natural way.
2. Will any superfood mentioned by you in the e-book not available in my country(India) ? In such instance, the book won’t be useful for me.
3. How frequently will you be able to follow up with me or anyone via mail ?
Thanks for reaching out. I’ll follow up with you via email to simplify communication. Here are the answers to your questions:
1) No. I don’t advocate the use of any supplements.
2) I don’t mention any superfoods, so you won’t have to worry about this.
3) This all depends on the complexity of the questions. I’ll explain more in email.
HI there thanks for the info,
can someone suggest the best thing to do or take to balance the ratio between the 2? or to lower estrogen
I suffer from MPB and I’m looking for something that can slow down the hair loss or prevent it.
Hey Benjy – unfortunately, achieving hormonal balance is often a long process that requires a series of dietary and lifestyle overhauls. I’ve never found one single supplement to help decrease symptoms of high estrogen, or low testosterone, or high DHT, etc. What I can say is that when you’re eating right, exposing yourself to enough sunlight on a daily basis, and feeding your gut flora correctly — everything works much better. A series of weeks/months like this and you’ll slowly begin to notice how quickly symptoms of hormonal imbalances dissipate. So, I’d say if hormonal imbalance is a concern of yours, go for a more holistic approach to solving the problem – it’s more effective than any supplement I’ve ever tried.
Can you suggest how to eat to balance hormones or at least what NOT to eat? A taboo and do list would help. Thanks!
I’ll try to put a guide together! Thanks for the suggestion.
This comment probably should have been sent directly to you, but I can’t find any contact info on your site, so I’ll post it here.
I’m two months into the massage therapy and still seem to be loosing coverage. Looking in the mirror and just being patient about it, is very difficult at times, and I’m starting to worry if I’m not doing things correctly. My scalp loosens during massage, but it quickly gets hard again. One thing that’s become more prominent lately is the sound of the massage: I can literally hear that I’m breaking down the scalp. It’s a bit uncanny, but it’s probably the sound of cracking tissue, and I assume it’s safe.
Being impatient, I have also started to supplement with Vitamin E Tocotrienols, though I know taking supplements is not something you recommend. Link to tocotrinol study:
Is it OK if I contact you directly for support in another couple of months (4 months into the therapy) if I’m still loosing coverage? I will provide receipt for your ebook per email.
It’s definitely okay for your to contact me via email. In fact, my email address is all over the book, in at least four or five different places. I just don’t put it online for spam reasons.
For two months in, you’re where you need to be. Your scalp is still adjusting to the exercises, and there are still a multitude of changes that need to take place before your scalp is in a health enough condition to begin hair thickening/regrowth.
The vitamin E supplement is fine, though I recommend red palm oil over any supplements for vitamin E. You can contact me whenever you’d like via email just by searching for it in the book.
Hey Rob and all
Sorry to sound paranoid but I am still experiencing a lot of shedding (although my hair might be naturally cycling out new hair), I was wondering, I do DT for at the bare minimum 40-50 minutes a day, usually over an hour, and basically I do it like a deep scalp massage, pinch a bit of scalp with both hands and press together and down, then move on. Sometimes I like to put my hands on either side of my scalp, or one hand on each temple and press them together to decompress that whole area. I do this for the front area consisting of the temples and widow’s peak, and then put both hands on the side of my head by my ears near the top of my skull, and scrunch the vertex together. Then I pinch a bit of skin with 3 or 4 fingers, usually with my nails so I can grip it and not slide over my scalp and break hairs (mostly the skin around my receded temples, other areas are mostly too tight except in non-thinning areas).
But I’m also doing some scalp exercises similar to Tom Hagerty’s, and I was wondering, would this counter-act DT? I really don’t think it would but I’m currently doing DT, scalp exercises, and a topical from Immortal Hair, and I was wondering also if the topical, which is anti-inflammatory, would be interfering with the acute inflammation caused by DT.
It’s still early in DT for me though, especially since I had to stop for about a month due to some events.
My biggest worry (just like a lot of people doing this I’m sure) is that I still might not be doing it right, which isn’t good, but it’s alright, but if I’m doing it wrong enough to cause damage…That’s bad.
One glimmer of hope is that I finally got those brown “cradle cap” patches that JD Moyer talked about in his DT post on his blog. I scraped one off too early and saw a tiny bit of blood, so I waited a few days and dabbed some ACV on the area, and then it scraped off pretty easily, so that’s a really encouraging sign.
Looking forward to more DT updates and articles, thanks Rob!
Oh one more thing, people on IH keep mentioning “pressure alopecia” being caused by DT making you lose hair, I don’t really buy this theory though since I sleep with my head turned sideways on my pillow and the hairs on the sides of my head are perfect.
I was wondering because I do a kind of deep scalp massage as part of my DT session.
Does anyone have any insight into this?
I have seen you have currently suspended the book download and I have been trying for 3 days now to perform the massage (I first read about it on jdmoyer’s site). However, I am not really feeling any sort of sensation or feeling doing these massages which makes me think I am not doing it right, even though I have attempted different techniques, it sort of feels like I can’t “get to grips” with my head. However, this isn’t the case when a) I do it using shampoo and b) when I use an actual head massager (just those cheap claw shaped units). I feel a sensation of sorts this way, like there’s an effect, but just nothing with my hands/fingers. Any advice?
Hey Matthew – the idea is to stimulate blood flow and generate some very slight, acute, inflammation that resolves quickly after the massages. Be sure to plant your hands firmly while pinching / pressing as to not cause any friction. A head massager isn’t going to do work better than your hands as the exercises are dynamic and based off feedback from the scalp skin – whether it’s elasticity changes, thickness, sebum release, etc. The book and video explain in much better detail than I can in a comment section, and I’m working to get those updated and back online as soon as possible.
Actually my e-mail explains it much more clearly Rob, than my previous 2 posts
Hey rob n all
Please Give give me the detail about the book.many of u mentioned about DT. What is Dt guyz??
Hey Deependra – check out Detumescence Therapy – that’s DT and you can find the paper online. Best, Rob
I really got into this article. I found it to be interesting and loaded with unique points of interest. I like to read material that makes me think. ThanksThank you for sharing this great content.
Hi rob, intresting, well . There is no way to purchase the book , so i wantes to know,first some tipa to get hormonal balance , i use maka powder,it said it do just that , also i eat a lot of dry goji berry ,chia seeds,flax grand, and i eat enough protein from vegetrian diet organic , also. I do use suppelment, of sAw palmetto/nettle root/ginko biloba/vitamins b ,vitamin d, sibiran ginseng ,biotin, i dont understnd whats the harmfull of this , if you dont exceed overdose, im sure the herbs inside the capsules are good, mybe the vitamins suppelmenta are the harmfull ones ,please explain your opnion , thanks
Have just come across your page. Having had alopecia areata (verging on universalis) for 9 years now – and having read up quite a bit on hair regrowth – I am very impressed with your articles. A lot of the info you provide seems to be resonating with a lot that i have already found and adopted. I have less stressors in my life now and am having a little success with a naturopath subscribing the likes of calcium carb., silica, ustilago etc. I sometimes wonder if at this stage activation by means of topical application or massage may be helpful. Do you think your approach/ebook may be helpful in my situation?
Hey Lee — thanks for reaching out. I responded via email as well, but to reiterate, there’s no harm in also experimenting with diet, lifestyle, and massage for pattern hair loss. I found it well worth it. I’m still updating the book but in the meantime, JD Moyer’s blog is a great resource for questions about technique and the process.
But as far as efficacy, the massages are likely far less effective for alopecia areata vs. male pattern hair loss. The reason why, as I’m sure you’ve researched, is because alopecia areata is autoimmune in nature (the body attacks the hair follicles), whereas male pattern hair loss is a symptom of a chronically inflamed scalp (loss caused by arterial calcification, fibrosis, sebum / dandruff buildup, etc.). If you’re looking to resolve alopecia areata, I’d first look into autoimmune therapies and gut flora. Helminthic worms show promise. Alopecia areata regrowth is mentioned briefly in an interview with Chris Kresser and Moises Velasquez-Manoff, a writer / researcher with the same condition:
All my best,
Your article helped me understand more how dht works, my hair has recently started thinning really fast and I am 22 although when I was 17 I stupidly started taking winstrol after seeing the results of older people in my gym taking them but I was just over a quarter of the way through my oral course when I was caught taking them so I stopped abruptly as I had never heard of a pct cycle coming off them I was wondering if you think it’s just the winstrol that’s caused this rapid thinning 5 4/5 years later or do you think I have messed with my hormone balance but taking them so young and that has inturn messed with my thyroid which is now causing hair loss? Thank you for taking the time to read my problem and home to hear from you soon!
Hey Kieran – it’s possible Winstrol might play a role, but oftentimes hair loss becomes apparent by your late teens / early twenties anyway, so it’s impossible to say for sure. There are a lot of anecdotes of Winstrol and it’s relationship with accelerated hair loss, even after stopping ingestion:
HI Rob,i would like to know, is hypersexuality causes more hair loss?
i am 30/m and i have hair loss from last ten years,now my norwood scale is 5.
i used to masterbate much in early 20.is that leads to my hair loss.
Hey Amol – It’s tough to say, but personally, I don’t think it has much of an impact until masturbation frequency reaches high extremes (many ejaculations per day, and for years).
The basic principle behind the hair loss-masturbation connection is that masturbation increases serum (blood) levels of prolactin, which can increase 5-AR in certain tissues (though this is still up for debate) and therefore might increase the conversion of free testosterone to DHT (serum levels).
First, sex and masturbation release two different hormonal profiles, sex being less problematic, at least according to those who believe in the masturbation-prolactin-hair loss theory. So let’s just keep this about masturbation.
In any case, I don’t totally buy the connection. For one, 5-AR receptors are found in tissues all over the body. So while there’s evidence that women with hair loss have slightly elevated prolactin levels, we still don’t know if it’s because that elevated prolactin is turning on more 5-AR in scalp tissues, and then that 5-AR is converting more free testosterone to DHT. That research is still ongoing. But that could be one pathway in which prolactin impacts hair loss.
But on the flip side, there are buddhist monks who abstain from masturbation most of their adult lives and still lose hair. So chronically elevated serum prolactin levels driven solely by masturbation probably aren’t a main driver of hair loss.
With all that said, it’s possible that frequent masturbation might increase cortisol levels and suppress the thyroid. I believe there’s a connection between frequent masturbation and an under-active thyroid. And I believe poor thyroid health can result in hair loss. But as far as the rest of the argument outlined above, I think there are still a lot of holes to fill in, and contradiction that need to be addressed. That’s not to say there aren’t benefits to no-fap or abstaining from masturbation. There are definitely benefits. But unless you’re operating in the extreme frequencies, it’s probably only a slight factor for hair.
Thanks for all your posts. It’s a relief to find them
I totally understand the reasons why you decided to stop selling the book however I feel the need to ask you:
Please, Could you allow me to buy the book so that I can do something about my problem? I am experiencing a very bad moment in life because of this and It would be very healthy for me to actually do something about it.
(Money is not a problem, I would pay suggested price if needed)
Thanks in any case for your help, Hope you get to read this post.
Hi, the reason why i decided to investigate the influence of estrogen and testosterone in male pattern baldness is because I know that a lot of people using Anabolic steroids will lose their hair, which is my case. I tried steroids only once and right after my cycle, i noticed an obvious loss of hair. The weird fact that made me doubt about dht being the main responsible factor for hair loss is that it occurred after the use of steroids and when i say after, I mean it’s been 1 or 2 years and it’s far worse now than it was during my testosterone cycle. I need to add that right now I’m using a DHT derivative, called turinabol, for bodybuilding purposes and i noticed that my hair is getting thicker for the past few weeks. I was wondering if you could find a reasonable explanation to this very weird phenomenon, because there is no doubt that if I’m using a DHT derivative, my DHT levels are higher, but my hair gets thicker. I have used oxandrolone last summer and the same thing happened. I also read that prostate enlargement was caused by high dht levels, though some scientifics say it’s more of an issue caused by an imbalance between testosterone and estrogen, high estrogen being the main cause of prostate enlargement. This seems to coincide with your point of view, and i even read that in Europe, some doctors treat prostate enlargement by increasing DHT levels in their patients to restore proper androgen-estrogen ratio. So regarding my case and regarding the new approach scientifics have towards prostate enlargement, my question is: could dht be the cure instead of the opposite? Hope to get a response cause i think this is a pretty interesting subject
It’s an interesting phenomenon, and one that gets complicated pretty quickly. I wrote about some of this in response to Antonymous’ comments, but here’s evidence that supports your claim of thicker hair:
First, we know that men with non-balding scalps generally have higher levels of blood DHT, which is counter-intuitive to the DHT-causes-hair-loss argument.
Additionally, evidence suggests that DHT exerts anti-inflammatory effects on certain tissues.
Also, 5-AR (what converts testosterone to DHT) is higher in balding regions of the scalp. So based on this evidence, you can argue that higher levels DHT is a response to localized inflammation of the scalp. It’s not necessarily the cause of hair loss, but the byproduct of inflammation and something further downstream from the problem.
Does this mean that supplementing with DHT will benefit scalp hair? I don’t know. But I think that your experience with hair thickening might be caused by some other effect of Turinabol. The reason why is that, according to some steroid researchers, Turinabol doesn’t bind well to 5-AR, and so probably doesn’t increase blood DHT levels.
So to answer your question: the research is still ongoing! But DHT appears to be a consequence, not the cause, of hair loss. And that problems like localized chronic inflammation of the scalp and its subsequent side effects (calcification, collagen remodeling, etc.) are further upstream than DHT.
Really, your article is very informative. Yes, there’s no direct connection between hair loss and testosterone levels.
There is a correlation between body hair and scalp hair loss. I and others have been regrowing our scalp hair by removing our body hair from the follicles. It was found that there was more dht in the balding area than the hairy area, and more 5 a-r in the hairy area than the balding area. That shows that the follicles in the balding area are dormant by a lack of 5 a -r and cannot absorb dht and produce no hair, the follicles in the hairy area have enough 5 a-r to absorb and utilize dht and produces healthy hair. By removing the body hair, the 5 a-r that is wasted on it flow to the scalp follicles and revives them. Simple, dht and no 5a-r = no hair growth, dht and 5 a-r = hair growth. The reason no dht is found in the hairy area is because it is being utilized by 5 a-r.
There was a 2015 study about plucking enough hairs from a small enough of an area to see regrowth within that area five-fold:
But this study was done on rats. And pretty much everything regrows hair on rats. So I’m hesitant to try it out myself or recommend that to anyone.
With that said, do you have any evidence for the theory? I’m happy to hear it out.
Best is to check Thyroid also growth harmone works well with T3 and not forgetting Tricotin DHT Inhibitor
Hi rob, I am pleased to have come across your site as I have been battling with mpb for quite some time, deep down I have always believed there is a cure for this as I believe there is a cure for every disease and misalignment in the human body. For anyone reading this I also believe your hair will regrow in the same amount of time it took to lose it so if you lose hair quick or will regrow quick for e.g how can I purchase your book or could you give me your email?
I am using rogain and propecia pills everyday for last 2 years. But I feel like I did a mistake by starting that medication because it is not helping. Because since I started to use this medication, I have been losing my hair faster. And now the condition is that I am thinking for a hair transplant to get rid of my baldness.And one more question:- which is better to reduce dht level (to exercise)or(propecia pills). I am really scared about the side effects of propecia
Hi Yash – I can’t legally tell you which medications to take or avoid since I’m not your doctor. But please read through the available information and consult with a medical professional.
As far as trying to reduce DHT levels to reverse hair loss, it’s a more complicated story. Instead of focusing on DHT, you should focus on reversing chronic localized inflammation of the scalp as well as the fibrosis and calcification that follow. A diet and lifestyle that support the thyroid, as well as scalp massages, should get you started on the right path.
When will the eBook be available again?
I’ve been reading more and more articles about the myth that hair loss is due to high testosterone. I’ve been dealing with hair loss for awhile now and after reading some of your articles, I’m interested in purchasing your ebook. Will there be a timetable when it would be available again?
I am 28 yrs old and facing hair fall problem from part 3 years. I had very thick hair pattern now the hairline is gone back around the temples about an inch formed M shape. Can your e book treatment help me to retain whatever the hair am having presently (if regrowth of lost area hair is not possible) if it is am interested to buy your book. Am having 50% of grey hair, I used to color it with L’Oreal paris black now am using herbal henna to avoid chemicals.Usually I shed 150-200 hairs daily…… Please help me
The evidence all suggests regrowth and recovery are possible, as does anecdotal evidence from those who commit to the massages, dietary and lifestyle changes. You can check out JD Moyer’s blog posts about hair for more information. Otherwise the book will be ready in two months time.
i am suffering from hairfall since last 1 year.when I was below 18, I have healthy hairs and hair growth too,but now my hair going thinning and hairfall,please tell me if my condition can be cured by medicines and healthy diet,if yes please suggest me a healthy diet plan………thank you
Nitin – I advocate for a moderate carbohydrate paleo diet. Through research and experimentation, I find that to be the least inflammatory (for me).
Thank u very much for the information. You have really done a great job from a different point of view. i have read many articles that confirms DHT as an evil for hair. They are all even very sincerely ready to help you block that evil with medical treatments, they dont tell us that you are going to lose the sexual drive. But yeah can happily have hair on your head as long as u use drugs like finasteride but just have to compromise a little, ” No children”
When will the book be available again? I’m currently in college with terrible hair loss and im desperate. I had extensive blood test recently and my testosterone levels are that of a 65 year old man at 21. I can’t get in with an endocrinologist in my area for another month, in the meantime time I have been thinking about testosterone replacement treatment… Just wondering your thoughts on this. My diet is impeccable, I exercise 6 days a week(despite being chronically fatigued). I also have a terrible leaky gut issues/candida that I just can’t get rid of no matter how healthy I am. I can’t live like this anymore and any help will be greatly appreciated. Thanks.
Hey Mike – the book will be available in ~2 months. In the meantime, I’d consider looking more into your diet and exercise regimen. If you’re suffering from chronic fatigue, leaky gut/candida and low testosterone then there’s a chance diet and lifestyle are driving much of the problem. I’ve experimented with veganism, vegetarianism, the Gerson Therapy, low carbohydrate paleo, moderate carbohydrate paleo and even juicing diets. All of these diets claimed they’d be the “best” diet for me. My blood work disagreed. So did my thyroid. As far as testosterone replacement therapy, I’d hold off until you exhaust all dietary and lifestyle variables.
Mike – any update on your progress? I would be most interested in how you may have remedied your concern for low T and the other things you mention. Thanks!
You can cure leaky gut in 24 hours by eating a generous handful of sunflower seeds. Sunflower seeds contain something which is particularly tasty to the bacteria that make up the coating of your large intestine. Within a day or two, you will notice that your poop slips out like a greased pig.
Your articles are very informative.it is a remarkable job about having such an extensive study and information with all your efforts.i am suffering from serious hairfall problem.pls suggest from where to get the videos and ebook and results which seem to b unavailable on the link now.
Hey Vikram – thanks for the comments. When the updated book is ready in about two months, I’ll link the site to it. Best, Rob
Not sure if I got it, if androgen – estrogen ratio favours estrogens, Dht increases in order to absorb as much T as possible? How does that happen, more Dht is released on blood or just more 5 alpha reductase (not named in the article) is produced on receptor sites? Because we know most transformation in Dht happens on receptor sites, follicles among those, you yet talk about blood (serum?) Dht, there is a difference I guess, but both are, I still guess, an effect of 5ar produced and T interacting with it.
I know balding sites produce more 5ar than the rest of scalp, but 5ar is separated from receptors, so are all head follicles potentially receptors in spite of how much 5ar they produce? In such case though they would still be sensitive to blood Dht, if they have the same receptors.
Also I’m confused, it’s officially explained that non balding people have less sensitivity to Dht and that’s the explanation for people either balding or not or to different extent, with similar levels of testosterone: Have they less receptors in the balding zones and/or they also produce less 5ar in the follicles, or they have less sensitivity to Dht reception too?
Officially it all boils down to genetic predisposition, of course, but if that accounts for less 5ar produced by follicles, it also means less Dht.
Otc’s and medication seem to mainly tackle the follicle with less concerns for the circulating Dht, Finasteride binds with 5ar preventing it from metabolizing T into Dht, Spiro binds instead to receptors sites, that’s why it’s even more dangerous.
Curiously the organism reacts to Fina producing more testosterone, probably because it hinders Dht from being accepted *where it’s needed*, and this compensation leads to tolerance and decreasing effectiveness, apparently, not always but so it’s explained, I mean :).
With the awareness of 5ar being produced in the follicles, on tops of prostate, liver, etc, can this holistic approach lower the 5ar in the follicles as well?
As above mentioned testosterone decreases in older age, so the organism compensates with more Dht? Curious, I explained that to myself as a weakness of the official explanation and as some increased sensitivity of follicles, as not always cumulated damage holds much water for those people who have been immune all the way to their 60’s.
If the Dht increases, though, it means 5ar also increases on the follicle as well, but that doesn’t make much sense as dht produced close to follicles is immediately metabolized by them.
These are great questions. I’m going to do my best to answer, but I’m also going to follow up with you via email in case I’m not clear enough. Of course, you can always just comment back here. I’m just a bit slower at responding to blog comments.
RE: testosterone:estrogen ratio and DHT conversion–
As we age, the reasons why and the mechanisms by which testosterone begins to favor converting to DHT are not fully understood. I wish we had research papers tracking blood, tissue, and saliva levels of DHT and hair loss in men throughout a lifetime. But I’ve yet to see a paper like this and I don’t know of any research teams currently trying to tackle it. If you come across something, please let me know.
And you’re right that the type of DHT matters (blood, tissue, saliva, etc). Non-balding scalps generally have higher levels of blood DHT, which is counter-intuitive to the DHT blanket argument. This is where the DHT-driven hair loss theory falls apart for me. There’s a correlation, but something further upstream to DHT is probably causing the process to begin.
But what we do know is that testosterone levels in men decline with age. We should expect estradiol to decrease with this, since a major source of estradiol for men comes from testosterone converting to it. But we don’t. Instead, we see estradiol levels remain constant, and in some cases increase, all as a result of increasing aromatase:
So as men age, their testosterone:estrogen levels tend to decrease as a result of lower T, same E. Blood DHT levels remain the same as we age, even with decreased total testosterone, likely the result of increased expression of the forms of 5-AR:
Again, I’ve never seen sound researching explaining why these changes take place (increased aromatase resulting in increased DHT and estrogens, or why some body sites begin to express 5-AR earlier). As far as I know, researchers have only identified the process, not necessarily the reasons why it’s happening.
But based on available information, my guess is that 5-AR expression increases probably because of the localized symptoms observed in the balding regions of scalps. The biggest marker — inflammation.
Evidence suggests DHT exerts anti-inflammatory effects and is part of the healing process.
By this logic, if you have a chronically inflamed scalp, then as you age, EVEN if your testosterone levels decrease, you will begin to favor converting more free testosterone to maintain the same blood DHT markers as to combat the localized inflammation of the scalp. That is, if the research is right and DHT mitigates the inflammatory response.
I think this is why we see increased 5-AR in balding tissues. Maybe it’s not that certain individuals are more sensitive to DHT. Maybe it’s that increased 5-AR is a response of an inflammatory state, and that 5-AR and DHT are the byproducts, not the cause, of hair loss. They’re probably markers to identify hair loss is happening, but as you mentioned with Finasteride and Spiro, playing with those variables can yield dangerous consequences. And since we often don’t see significant regrowth for those taking Finasteride or Spiro, there has to be other factors involved.
RE: holistic approach–
Rei Ogawa and other researchers are starting to show that through mechanical stimulation of tissues, you can alter gene expression. Through mechanical stimulation Ogawa’s team also demonstrated potential for hair thickening and upregulation of genes associated with hair growth phases:
We’re still waiting on more research. But the next step is to see how mechanostimulation impacts 5-AR, tissue DHT and collagen remodeling of the scalp skin.
As far as holistic approaches outside of massaging, I’m an advocate for dietary and lifestyle changes that support the thyroid, decrease systemic chronic inflammation and reverse arterial calcification. I think the next phase of MPB research will move into mechano-stimulation and the microbiome (for example, bacteria that eat arterial plaque). But only time will tell.
Thanks so much for the response.
Sorry for a more summary reply, I lost the last one and you know how frustrating can be ^_^ O_o.
In short, castrated and eunuchs seems to maintain their hair compared to their twins, same for trans women, but it might be the estrogen, which makes them stop or even, to some extend reverse their hair loss.
If Dht remains constant with age, shouldn’t there be less dht deficit related problems?
The official and complementary explanations both have contraddictory points it seems. But it’s good to approach the problem from as many possible sides.
It still seems dht and immuno response related, as we have, as I got more in depth, that we produce 5ar all over the skin, so that enzime is not the discriminating factor, it seems.
I noticed severely balding people tend more to thin at their sides with old age, that’s not just an uniform thinning. People with slower Mpb or little to no, also tend to thin less on sides too, within range of variation and overlaps.
The official viewpoint apparently has a contraddiction, beyond the possible fact that with decreased T the Dht stays stable, as I said some people starts to thin in their 50 and 60’s, other get it faster, for other it slows down and stop.
It’s possible that many factors might concur to an heightened sensitivity, as we all age differently and to different extent as well. Depending on a cross product of genetic and environment plus genetic modified expression.
But why mpb happens mainly on top, while sides, albeit possibly related, are neatly separated and have their own patterns.
I know the galea and tension – bloodflow theory, cumulated toxin, bad environment etc, plus androgenic bone expansions, some other say, they seem logic to explain different patterns and recessions, vertexes too.
Yet I realized they have a hole, temple points, like pariedal and side hair, is right above the temple muscle which aids in chewing! Even closer for that matter, which hair there, for some people is the first to go, while others maintain them even when bald.
Actually some claims seems to suggest that transplanted hair acquire traits of the recipient hair, body hair, especially chest, getting gradually longer if transfered on head and hair gradually shorter in eyebrow transplants
“The eyebrow hair growth will slow down over time and the hair will begin to assume some of the characteristics of the original eyebrow hair hair due to influence of the recipient site.”
Others sites instead claims there is no evidence for recipient dominance.
Which kind of diet would you suggest? I guess you also have /have had problems with your hair and that worked for you :).
Hey Antonymous – thanks for the comments and the points. I’m sorry you lost your first reply! And thanks for the research about transplanted hair follicles acquiring traits of its donor site. I’ll dig into the research. If it’s true, that’s great news for hair transplant surgeons – they could just continuously donate body hairs to the back of the head where donor hairs are selected for transplants, then wait a few years until they take the same shape as donor hairs, then transplant them to balding regions (though how long those hairs would last, or if they would stay, is still up for debate).
As far as diet — I’ve experimented with veganism, vegetarianism, low carb paleo, Gerson Therapy, Danny Roddy / Ray Peat, and for the last few years I’ve maintained a moderate carb paleo diet (no ketosis). I find that diet to be the least inflammatory for me.
Would you say a muscular as well as a skinny one bald guy, has less T than a skinny thick haired one too?
I read we might as well have to convert more T into estradiol by aromatase, for example as excess dht is seen as a consequence of excess T non metabolized by enough agents on top of 5ar. So estrogens, if not excessive might hve their role in preserving hair health, I dunno.
Now it’s possible that both excess testosterone and excess estrogen can result into excess dht for opposite reasons!
While too little Dht where it’s needed, consequence of allopatic external interference with global testosterone convertion by Otc’s or such, makes so testosterone increases maybe in conjunction with 5ar and receptor sensitivity, same for excess androgens.
Thanks for reaching out – let me know if these answers make sense and I’m happy to clarify.
RE: muscular skinny bald guy vs skinny thick-haired guy–
I don’t think we have enough information to determine who has the least testosterone of these two. But if you’re objective is to shift testosterone conversion away from DHT and toward estradiol, that’s usually one of the unintended consequences of 5-AR inhibitors like finasteride. The makers of Propecia claim that Finasteride use often results in a 15% increase in both testosterone and estradiol:
You’re right that estrogens do have some protective role in hair health. Research on that is still developing, since estrogen comes in many forms and testosterone’s conversions to those forms of estrogen (beyond estradiol) is less understood.
And you’re right that excess testosterone and excess estrogen are also associated with excess DHT. We’ve seen this through testosterone replacement therapy, where exogenous testosterone is injected. Total testosterone levels increase, but much of that is converted to different forms of estrogen, and the testosterone that isn’t converted to estrogen is often converted to DHT. So injected testosterone –> increased testosterone –> increased aromatase to DHT and estrogens.
This is a reason why I advocate against supplements and 5-AR inhibitors… because while supplements/drugs might be effective for the control variables, they often result in other unintended reactions in the body. It’s still speculative, but I think with the research available so far, it’s probably best to first try to control these variables using diet, lifestyle, and for the localized symptoms of MPB, massage.
You cant control it with diet, life style that is why people are still using propecia. Many many healthy fit men in variety of sports are bald so its pretty clear your diet wont save you.
All anyone asks for is a viable alternative to finasteride and they people will stop using it. No such thing exists. Its very easy to criticize existing treatments versus making a new viable alternative.
Hey Joe – I just wanted to clarify that I’m not saying you can reverse MPB with diet and lifestyle alone. I think the right diet and lifestyle can significantly slow, and in some cases, arrest the process of MPB. But for regrowth, you need to break up fibrotic tissue, clear away vessel calcification, and restore blood flow to thinning areas. In this regard, diet and lifestyle are limited.
As far as alternatives to finasteride and minoxidil — I advocate for massages and my own interpretation of detumescence therapy, with some modifications. I found mechanical stimulation far more effective at addressing the above factors than any other regimen I’d tried in the last 10 years. Mechanical stimulation is also free, which in my opinion, makes it a more viable solution to anyone experiencing thinning.
iam suffering from hair loss last 1.5 years on wards and when i contacted to the doctor he said because of dht so that my hair became weak and am losing hair. so how can i stop hair fall please give a solution for this
im losing my hair since 1.5 years .my hair is very thin and weak and when i went to the doctor he said male pattern baldness.you are losing because of high dht . so how can i strenghthen my hair.please tell me some remedies.im getting nervous day by day.
Can you please add the book and video back? I won’t email you about questions if that’s the only thing keeping us in the dark. We all should get to use this technique no?
The book should be back up in the next two months. It’s an updated version that focuses on the best responders. Until then, please check out JD Moyer’s blog posts about his hair. He goes into detail about a lot of the book and the massage techniques, and it should help get you started.
Hi ROB I am suffering from male pattern baldness from last 7 years.How can I get this e book+video.Please help me
Hey Papanna – I’m updating the book and it should be ready in about two months! When that happens, I’ll let you know.
Pls help me.. i am 36, habing hair fall and almost went bald when dr advised to have fenasteride for 8 months.. its ben 2 months now am having 1mg daily.. and since past 2 weeks i noticed low libidi.. and forcefully when i wanted to ejaculate.. the sperms came out which were very watery not the thick it used to be and also no erection at all.. is this some sie effect of the fenasteride drug.. based on ur article. if i had to do thyroid test.. can you please advise me wht do i tell the pathologist to do.. and how do i read it once i get the report.. shall i stop this fenasteride right away.. and do somethign else abt it.. am sure there is no genetics here my mom and day both are having good hair… pls pls help…
Hey Arif – I’d talk to your doctor about your side effects and what could be causing them. Based off the information above, finasteride sounds like it could be contributing to the problem, but I’m operating off incomplete information as I don’t know anything else about your lifestyle, diet, medications, etc. I’m also not a doctor and so legally I can’t tell you what to do. But I can say that finasteride use is associated with the symptoms you’re describing.
I agree with what you say Rob. Very interesting. How do we download the book? It says you are all full. Are you opening up more downloads?
I’m updating the book now and should be finished in two months time. When that’s finished, I’ll let you know!
Rob, can you send me an email? I would love to buy your ebook.
Hi Rob. Interesting post!
So, I am a little confused. If DHT levels, Hormonal Imbalance, etc. are contributing factors to hair loss, why then can hair transplants provide lasting results to the transplanted hairs? I realize other hair in the transplanted area will continue to thin, bu the transplanted hair remains.
For this reason, I always assumed it was not the DHT as much as the follicle’s immunity to the effect of DHT that was the determining factor in hair loss.
By genetic makeup, some men/women have hair follicles that are more susceptible to DHT than others in the top scalp area.
Is this not accurate?
Thanks in advance!
Thanks for the message. RE: hair transplants–
A number of years ago, researchers published a paper about hair transplants AND exactly what you’re referencing. Scientists took thick healthy hairs from non-bald regions in the back of the scalp and transplanted them to balding regions. These hairs continued to grow normally for the duration of the study, and so scientists concluded that these hairs would continue to grow in perpetuity because they were protected, for reasons unknown, from MPB.
This paper became the basis of support for all hair transplant surgeries, but there were flaws with the study’s design. The problem: the study wasn’t long enough.
Transplanted hairs weren’t tracked over a series of hair cycles, but rather for relatively short periods of time. During this time, it was concluded that transplanted hairs weren’t miniaturizing at the same rate of other hairs in the same region, so the transplanted hairs must be protected from MPB. This turns out to be a misleading conclusion. In actuality, the transplanted hairs begin to miniaturize and eventually fall out, but the process takes a long time because the transplanted hairs are so healthy to begin with.
The reason why isn’t yet 100% clear, but based on the evidence, my guess is because these hairs are transplanted into regions of the scalp suffering from fibrosis, calcification, excess sebum/dandruff build-up, collagen remodeled skin, and a host of other localized symptoms of MPB. The conditions for MPB are present years before the symptoms (hair loss) begin to show. So, we can assume that if these conditions precede hair loss, then it must also take time for thick healthy transplanted hairs to miniaturize after being moved to a relatively more calcified region in the scalp.
Anecdotally, I’ve spoken to a lot of people with hair transplants. Of the group who received them 5-10 years ago, almost all of them claim that most of their transplanted hair is already gone. I have a friend with a hair transplant who’s experiencing the same problem right now. It’s one of those weird cases where the science doesn’t add up with the anecdotal evidence.
To make matters worse, all hair transplant surgeons are aware of this. It’s why they ask you to go on finasteride and minoxidil after a transplant (in hopes it will address some of the conditions of the MPB-affected scalp). They also ask you to join a hair club, and some now even mandate massages to promote elasticity (you can find YouTube videos of doctor demonstrations on this).
You’re right that some individuals appear to be more sensitive to DHT than others in the top scalp area. We see this with men having similar testosterone levels but varying degrees of hair loss. I believe that with the right inputs (diet, lifestyle, massages to address local symptoms of MPB) you can compensate for these sensitivities, change gene expression and reverse the process. So I see genetics is a starting point but not a destiny.
Let me know if this helps!
“You’re right that some individuals appear to be more sensitive to DHT than others in the top scalp area.”
So it is from Dht?
I actually noticed those suspicious suggestions as well, toward transplanted patients, so I wondered why would they suggest such drugs if the point of transplant is not needing them anymore.
It has been countered from a patiend (well a notorious testimonial in a hair loss(hairtransplant?)forum, he said that the drugs are suggested to help keeping the remaining indigenous hair or to help yielding I dunno :D. Such patient got good results with little to no hair left on top, with numerous transplant sessions.
That’s why he said that, in such cases, the drugs can be discontinued once the hair yielded.
He also shown a video with scalp exercises, the rationale was “helping scalp laxity to max the donor for eventual future transplant” ^_^. But nothing which might give any complementary theory some slack. Cunning ;).
btw this is 4 years old, but already 3 transplant which now date 13 years ago and he seems to maintain here’s an indirect link
Although as I said some partial recipient dominance seems to apply.
Is it then the repeated transplant incision which keeps the hair? Not that i’m looking too much ahead of punching my scalp to renew the hair net :D.
The skin there is quite thick too, compared to a balding scalp.
But the cause and effect are always chasing each other, so it gets confusing.
Thanks for the comments and info. I should’ve been more specific with the DHT comment – it appears some men are more sensitive to DHT, but the data is conflicting as to whether that’s a driver or a symptom (what we were talking about in another comment).
The hair transplant stuff is interesting. Thanks for sharing. It’s confusing… I don’t know whether to believe doctors when they say they advocate for those drugs to maintain existing hair or to increase the possibility of a successful transplant. Here’s one of the articles that rooted my opinion:
“Micrograft survival rates in hair transplantation have been frequently described in private conversations by hair transplant doctors as variable at best. References in medical literature may grossly underestimate the prevalence and magnitude of poor growth. This is probably because most hair transplant surgeons are concerned that publication of a significant incidence of poor growth would reflect negatively on their practice.”
My guess is that transplant success is based on a variety of factors (depth of follicle insertion, state of the scalp skin in transplanted area, plus partial recipient dominance as you say).
And you’re right about cause and effect chasing each other. I think once we identify what causes calcification / soft tissue calcification and why it accumulates in the scalp (gravity theory, skull expansion theory, and all others out there), we’ll uncover the “root” of MPB soon thereafter. But research money goes more towards drug testing than pathology, and those drugs are targeting the same causes and effects that keep chasing each other.
My hunch is the answers will come from the microbiome and from Aubrey De Grey’s research about oxidized cholesterol, 7KC, etc:
Is there something that I can do so that I can be notified when you re-release your ebook?
Looking forward to purchasing it 🙂
Hi David – you can enter your email into a sign-up form to the right of this article, or click on the subscribe button on the homepage. This way I can email you when the book is ready.
I am female, and just found out I have very low estrogen and DHEA, high testosterone and DHT, and I have hypothyroidism (this I already knew).
Hair falling out,and have lost about 75% of my hair. Also have an inflamed scalp. Dermatologist has prescribed a topical cortosteroid. What type of diet should I follow to correct my hormonal imbalance?
Please help, I am desperate to fix this.
What’s your age? When did you first notice hair loss and in the years preceding, what was your diet and lifestyle like?
Thank you for the free information!
I am looking forward to purchasing your ebook!
Do you have a re-release date in mind?
Hey Tim! I’m shooting for early September.
I have been losing hair in the last three years. I live in Toronto, Canada and have noticed that this is not only a case of race, bio type, or stress. I have noticed an epidemic of hair loss in men and women of any ages and races. I am very convinced that either it is something that the large population consume (ex; City water) or it is due environmental agents (ex; Polution). I have noticed that if you wash a glass and let it sit over the counter, after a few hours you will see a thick white dry powder on the glass surface. That is chlorine, fluoride, and all other chemicals in the water, that must have a real impact on our skin and scalp. I tried to use Saw Palmetto and a Herbal Glo for three months and got a few new strong hairs. However during the last week I noticed that my scalp and hair got a bit more “oiled” than use to be and then all the thin hairs started to fall off.
How confident are you that an increase in Test, Estrogen, and DHT in unison keeping a healthy balance would not cause hair loss. I have varicocele which I want surgery for. If I do this, my testosterone will increase naturally (i researched this heavily, checked meta analysis and difference studies) and I am fairly certain my DHT and estrogen will increase in unison (and not a negative outcome). I have no hair loss, but I know this surgery will increase my testosterone naturally, would this cause a natural increase and a good ratio as you explained in the article? The increase would be 100-150 T. If you could shoot me a email that would be great, because I don’t know how I will know if you responded to this.
Thanks again for the article it was eye opening.
Essentially I am worried the increase in testosterone will cause hairless, but you seem to say that the ratio will cause the hairless and I am wondering and assuming my ratio will be fine considering I have no other issues
Hey King of Kings – this is a difficult question to answer since everyone has different genes and gene expression. This article doesn’t necessarily make the claim you’re suggesting. It states that a commonality among men with MPB and females with FPB is an imbalanced testosterone:estrogen ratio. Hormonal imbalances are often precipitated by poor diet and lifestyle choices, and you can significantly influence your hormonal profile through those levers in an attempt to match someone without MPB or FPB. It’s often a good first step. But as far as increasing testosterone, estrogen, and DHT simultaneously and how that will impact your hair, there are too many variables at play (for instance, your propensity to convert free testosterone into tissue DHT) to make a statement one way or the other.
As far as getting rid of the varicocele, I think that regardless of your hair health, this is a condition worth addressing. A varicocele is linked to prostate enlargement and that alone should be enough for you to want to tackle this.
But before you get your surgery, have you tried this approach?
That’s a significantly strong success rate, and it might allow you to avoid an invasive surgery entirely. You can buy those supplements in the US online. Just make sure you’re dosing it correctly.
From what I gathered it won’t cause an imbalance. But it will cause a shift. A shift over a month, that will increase my test, and all the other markers up slightly. Will this cause MPB?
Sorry for blowing this up, but so you don’t have to do the research into varicocele or waste your time. Will naturally increasing my testosterone cause MPB or hair loss? Yes it runs in the family, but later in life. It is essentially increasing it naturally over the course of a month after the surgery. The ratios will remain good but I want to know will the change cause anything. Thank you so much
I m 32 yrs old & facing tremendous hair fall for last 3 yrs. I m also having problem of sculp seboric psoraisis, so can it also be a reason for hair fall & thinning?
I dont know I think MPB is almost 99 percent soley androgen mediated almost independent of all else. If you remove androgens before any MPB ever begins because once it does other processes kick off.
Hey Joe – it’s a great point and I agree with you that androgens play a role. The castrate studies prove exactly what you’re saying.
The challenge is that there are males with high serum total testosterone and zero hair loss. There are males with high serum DHT and zero hair loss. There are also males with low serum DHT who are bald. So the next question to ask is, “Why do the same androgen levels mediate hair loss in some men while other men remain protected?” The old dogma used to be, “It’s your genes.” But since the completion of the Human Genome Project, the studies of identical twins with different levels of hair loss, and new discoveries in epigenetics, that dogma no longer holds validity. So yes, androgens most likely have to be present in order for pattern hair loss to occur. But those androgens don’t necessarily determine your destiny. Most of the research now leans towards epigenetic expression being the big influencer. And epigenetic are influenced by your environment – which includes your diet and your lifestyle.
As I found good information in this article and it has to be very important to understand about androgenic alopecia and their myths also but few questions/things in my mind like why some people having higher tissue binding of DHT from other,and AA if it is genetic problem so how hair will regrow or will prevents hair fall without genetic therapy,why some people having frontal hair fall or some vertex and why especially in particular region of head or others body hair remains stay/increase like beard or armpits,if finsteride stops conversion of testosterone in DHT so testosterone level will increase?if not so serum level also reduce and testosterone will make other byproduct which will be harmful to the body or excessive level in body.Second thing is if it is imbalance between Testosterone and Estrogen which is because of Thyroid level/functions so patient shall be go on thyroid medication not on DHT blockers or nutrients so Please give you valuable reply.I would be thankful and appreciate it.
Thanks for reaching out. These are great questions, and they’re all answered in the book update! The new book will be released around mid-September. In the next couple weeks, I’m also going to post articles about the pattern of hair loss and the DHT paradox — which will answer 3/4’s of your above questions anyway. To try and answer them in a comments section won’t suffice as there’s a lot of material to cover.
Thanks and I am waiting for your book and above questions answer.Please also inform how I get your book in india.
Im 21 years old. I began losing hair at 18. Ive been searching for some kind of answer to reverse this hair issue for a year now. I have tried paleo diets. Alkalizing diets. Taking loads of supplements. I have never seen solid “before and after” pictures in regards to hair improvement. I am coming to realize that there is no cure. I am simply going to have to stop fighting and give up. Accept my reality. Accept a mediocre life. Do you have before and after pictures? Is there solid proof that this works? What makes your book different from everything else ive read?
Hey Nate – in my experience (and working with others), diet might help slow and sometimes arrest pattern hair loss, but it rarely (if ever) reverses it. I’ve tried vegan, vegetarian, juice diets, water fasts, Gerson Therapy, low carb paleo, moderate carb paleo, Ray Peat diets, high carb, high protein… The list goes on. I’ve tried dozens of supplements. I’ve tried dozens of topicals. I’ve given all these a fair shake – at least three months on each diet, at least three months on any one supplement or topical (though at times there was overlap). The regimen that I found success with was a modified moderate carbohydrate paleo diet, lifestyle changes to support the thyroid, and mechanical stimulation exercises to upregulate genes associated with hair growth phases and downregulate genes associated with hair loss – along with specific wounding / healing scalp massage techniques. Altogether, this approach helped reduce inputs contributing to chronic, localized inflammation of the scalp, as well as address and reverse the scalp conditions that precipitate hair loss (blood vessel calcification, perifollicular fibrosis, galea fusion, decreased blood flow, decreased subcutaneous fat, etc.). It worked for me so I share the methods.
If you’re interested in other readers’ progress, there are some before/after photos from readers I worked with from the first book. These are on the front page (https://perfecthairhealth.com). There are more inside the new book as some readers didn’t want their photos online but were okay sharing them in the book. Again, since these photos were submitted by readers, the quality of each photo varies. You can decide whether they show hair improvement.
Lastly, I don’t believe MPB relegates somebody to a mediocre life. One of my best friends is nearly fully bald. He doesn’t care. He’s the life of the party. He’s the funniest person I know. And women love him. So while MPB isn’t something anyone looks forward to, I think ultimately it’s the person – not the condition – who decides whether it’s going to affect their happiness.
This is a really good read and right up the alley of personal research that I’ve been doing for my own hair loss. Some big questions I would have is how this estrogen imbalance can be fixed which I awhile back realized may have been the case with my own loss. I had been looking into getting a dim supplement but never really followed through. I wonder if this would solve it? Also does chlorine have any effect on hair loss. I say this because I started using purified water to wash my head instead of regular shower water and I noticed no shedding period! I don’t know what do you guys think
Hey Christian – I think diet and lifestyle are the first factors worth experimenting with when it comes to balancing your testosterone and estrogen levels. Aqueous chlorine from tap water interacts with other compounds not filtered out of tap water – like NSAID’s, medications, and nano-particles from personal care products. The interaction with these compounds can create endocrine disruptors that can potentially interact with your tissues. While I don’t think chlorinated water is the driving factor in hair loss, it does have the potential to alter hormone levels, depending on how well your water is filtered.
Hey Rob 🙂
Can this technique work at telogen effluvium?
Hey Marrie – it’s tough to say because telogen effluvium is often the term physicians use to identify any type of sudden onset hair loss that they can’t explain. Oftentimes it resolves itself in months, other times it doesn’t. In any case, if the telogen effluvium is pattern hair loss-related, these methods should all be a step in the right direction.
I have no choice but to start TRT since no matter what my body simply won’t make testosterone. What do you suggest for those that have to use TRT to not upset the delicate Test/Estrogen balance?
Hey Bob – I’d consult with your doctor. Probably a good start is to make sure you’re on the right aromatase inhibitor to prevent too much estrogen conversion, but this stuff gets complicated very quickly. Not even doctors can account for all the hormonal reactions from TRT. Did your doctor tell you why your body can no longer produce testosterone?
Hi rob thanks for the reply, There is defect with my testicles. I do know that TRT increases my estrogen and DHT, were going to start arimidex for estrogens
What type of payment is the new book gonna require ? Hope it isnt expensive Also hope it isnt delayed again
Do you think if you see areas of the scalp developing miniturized hair, is it OK to start the massage? I often shed when I do the massage, so I am worried to massage the areas of my scalp where there is still hair density and has miniturizing hair.
I massaged areas with miniaturized hair. Some shedding is normal and due to the nature of the massages, but excess shedding that results in visible changes to hair density (thinner hair) is more an indication that you should consider revising your technique.
Just wanted to ask how long untill the ebook release? I only ask so i know when i need to keep some money saved for it. Very sorry if i seem to be hassling you. Really appreciate all the help you’ve given us.
Hey Akeel – I think I’m less than two weeks away from a launch. I’ll announce it over email in the next couple days.
Awesome!! I seriously cant wait :D!!
If the thyroid is responsible for keeping hormones balanced, it makes sense to help the thyroid do it’s job and perform optimally.
How does a person do this?
i am just 23 years and I am going bald.
I need help with my hair. There is hair loss emerging near the crown and after having done some research I am applying onion and garlic juice on my scalp and leaving it over night.
Can you explain to me clearly what will help in calcification and fibrosis since you have mentioned these are the causes?
What diet and what things you have to avoid like chocolate or crisps or meat or whatever it is that causes this?
Also what will help cure this ? Is there a herb or medication ?
Please help as I need to identify how this will stop my hair loss
Hey Enrique – it’s tough to summarize in a blog comment how to do all this, which is why I wrote the 250+ page book and made the demonstration video. The gist is that diet and lifestyle changes can help arrest the develop of calcification and fibrosis, while mechanical stimulation exercises (massage and otherwise) seem to help reverse it.
In your book you don’t recommend Testosterone therapy.
There is another way of hormonal therapy – with DHEA. Usually this helps to increase testosterone level. I know that opinions in Internet are mixed, but my personal experience shows that DHEA is very powerful. Perhaps, not for everybody.
Another point which you don’t address in your book – there are drugs which can change the estrogen/testosterone ratio. Dostinex, for example.
Thanks for reaching out. You’re right — in the book FAQ I form an argument against testosterone replacement therapy. But I’m curious to learn more about your experience with DHEA. I’ve heard mixed reviews as well but am always open to personal anecdotes. How long did/have you taken it, how have you been taking it, and what have you noticed during your experiment?
And yes! In the book, I don’t directly address drugs’ interactions with testosterone or estrogen (aside from Finasteride). But I do try to build a case against taking many drugs. Either way, you bring up a great point. Certain drugs have a significant impact on testosterone and estrogen levels – and it’s better to become educated about these potential interactions before taking anything.
But if fibrosis and calcification are the main causes of hair loss, why do we usually experience baldness in the crown and vertex area, and not for example around the ears? Is there a different kind of scalp there that prevents itself from becoming calcified?
Hey Nicholas, I just finished an article that highlights all the attempts to explain this. In short – all the evidence points to a specific interaction between the galea (which stretches across the scalp but not across the sides where we don’t lose hair), inflammation, and androgens. But no theory is yet set in stone:
I would like to get a hold of your ebook and videos. How can I go about doing so?
Thanks for reaching out. You can access the book and videos here:
Please let me know if you have any questions.
I’m 21 yrs old
I’m suffering from hair loss since 2013 I tried finax,minoxidil and lot more stuffs,but it only slowed down my problem. Since past 4 month up im facing a severe hair thinning in the hair temple and upper region of my scalp. Plz guide me about my problem
Hey Miheer – the best guidance I can offer is inside the book and video(s), but there’s also plenty of information available inside each article. Otherwise, it’s hard for me to advise without knowing more background information.
Thank you very much for this very interesting and insightful page on hair loss in both sexes.
In deed, this was the same hypothesis:”testosterone/estrogen imbalance” that I proposed and came up with about 11 years ago as past findings in various studies done. However, they were different studies done involving the roles of a particular plant, which was found to be very effective in its pro-fertility functions such as increased sperm count and enhanced libido among other observed benefits to say the least, as a scientist (reproductive endocrinologist) and a medical doctor.
No doubt, this hypothesis appears to be the main factor responsible for hair loss in both sexes.
Please, feel free to contact me on this as the case may be.
Read this amazing article and I was amazed by the small bacteria and it’s effect on human health.This article is fantastic. Good job!
By the way, Truth Nutra has confirmed that their Floracil50 probiotic contains both l.reuteri ATCC PTA 6475 and DSM 1798. Wonder what’s DSM 1798 effect is? Would u know about this strain, Rob?
Here is the link to their product
Please tell me the ways so I can stop my hair fall.
I eagerly waiting for your reply.
This can save my future ..
Please help me I am poor.
Hello Rob how do I purchase your book?
Thanks for reaching out. You can check out the book packages here:
If you have an imbalanced testo-estro-ratio, should you try to increase testo aswell as decrease estrogen in a male? Is there any typ of blodtest to check these hormones?
An imbalanced testosterone:estrogen ratio in men is often just a biomarker for systemic inflammation. So rather than attempt to manipulate those hormones, an even better approach is to find out what’s causing the inflammation, and then eliminate it. Typically it’s something as simple as a nutrient deficiency, an allergy, a poor diet, or chronic sleep deprivation — or as complex as the early stages of autoimmunity and problems with the gut. But the key here is to resolve the inflammation first, and the ratio should likely course-correct itself.
Just had a question but I noticed my hair thinning on the crown of my head. The other weird thing is I noticed my beard growth to be very slow. I use to trim my beard every three days and now it’s like once every week or even two. I also feel a tingling sensation where the hair is thinning? What can this mean? i hope you respond! Thanks!
I have dandruff… I have hair loss… Just want a natural solution… Can you please help I’m only 17
Hey Rob, i bought your book and i’ve read most of your articles but i still have some questions….
1) I touched the scalp of my sister and my mom, they had definetly a thighter scalp than mine even tho i’m balding, why they’re not loosing their hair while i’m balding even if my scalp is more loosen and soft?
2) Do you think that your regime is enough to mantain your Norwood 1 hairline/density till your fifties/when you’ll get older?
3) Over the course of the years, did your clients started to notice again a shedding/thinning/receding phase again? Are the results long lasting? I’m starting to think that maybe the massage/diet could not be enough to mantain over times or to counteract the negative role of fibrosis/dht in the scalp
4) Is your approach/ideas changing over the years? have you discovered something new about hair loss since your last book?
5) What do you think about the subcutaneous fat layer? massagging doesn’t adress this, maybe it could be a really important role.
6) do you think that there will be some new effective treatment that could help with MPB? Like Histogen, Tsuji, RCH-01, Way, ecc what do you think?
Thank you again for your reply and your great work, you’re an inspiration!
[…] Beyond its role in sexual maturation, studies also show that DHT can over-express in tissues as a response to inflammation – and that specifically, DHT is anti-inflammatory. […]
This is a fascinating article to me. I always believed DHT was the major hair loss culprit as evidenced by younger males abusing high androgenic anabolic steroids but this doesn’t seem to be the driving factor. The endocrine system is obviously very complex and this information really changed my perspective.
Hi Rob, what do you think of theories and newest studies connecting AGA to Coronary Artery Disease? Like this one:
Great article, but I wanted to see if you could fill in some pieces:
* Can you point to any reference that documents a healthy range for the testosterone to estrogen ratio?
* Serum and tissue DHT are different, but do they have any relationship? If someone takes supplemental testosterone or DHT and ends up with higher serum DHT levels, does this imply that they will get higher tissue levels of DHT? Or does the tissue DHT remain constant even in face of higher serum DHT?