Low Testosterone, Low DHT Levels — and Still Have Hair Loss

Stats: Male, 26, 156lbs., 6’1″

Dr. Rassman,

I’ve been diagnosed with low testosterone, and I have had low testosterone since I was a teenager. As of a year or two ago, I started taking dutasteride. My DHT tests at 6 on a scale of (20-60.) To me, this sounds like the ideal envrionment for an absence of hairloss, or at least /very/ slow hairloss. However, my hairline has been receeding ever since I hit 19. I find this alarming, as testosterone and more specifically the metabolite DHT have been widely generalized to be “90%” of the cause of MPB.

Have you ever heard of a case of low testosterone and very low DHT levels STILL causing progressive hairloss? Have you any idea why this might occur?

You can have a very HIGH level of DHT and still have NO hair loss, so while DHT is a cause of male pattern hair loss, you must have the gene (or genes) for hair loss. Unfortunately for you, it seems you do have the genes for hair loss and these genes could be very active. If you have the hair loss genes, than even low levels of DHT will cause hair loss.

Did your doctor prescribe dutasteride to you? Considering your age, I would not be taking dutasteride as it is not yet approved by the FDA to treat hair loss and the long term effects are not known. Amongst the side effects are sterility in a small number of men on that drug. The drug is FDA approved to treat prostate issues, and the ages that were part of the drug studies were of an older set (double your age) that had a need for prostate medication.