If You Could Block 100% of DHT, Could You Never Have Hair Loss?

Dr. Rassman, if more Finasteride blocks more conversion of testosterone to DHT in the 5-alpha-reductase Type II, then why would it not be better for preventing more hairloss? I heard of people who up their dosage if it starts to lose effectiveness and it works for a period of time. Also, what would happen if 100% of DHT is blocked and you had no side effects, in theory could you never have hairloss? Lastly, why cannot Saw Palmetto be used in conjunction with Propecia to block more DHT?

Regards

To make DHT, your body must have the enzyme 5-alpha-reductase. We know this because some people are born with this enzyme missing and when that happens:

1. They do not develop sexual differentiation and become hermaphrodites
2. They do not become bald
3. They do not develop prostate cancer

That suggests that DHT is the cause of hair loss when interacting with a person’s genetics. I can not be sure that DHT and 5-alpha-reductase type I or II are totally responsible for genetic male pattern balding, but it is highly suggestive. It may not be as simple as blocking one hormone, so we may not really be sure of the science.

Lastly, I do not believe there is good scientific evidence of saw palmetto blocking DHT the same way Propecia does. I reviewed this subject fairly completely and could find conflicting discussions from good scientific sources that show evidence that saw palmetto may work on blocking DHT… or it may not. Saw palmetto is a herbal medicine that has been traditionally used for prostate (not balding) problems in men, so studies on balding are not very complete or scientifically studied with good double blind clinical research projects. Finasteride is a medication that has been used in high doses (5mg) to treat prostate enlargement in men with a unexpected side effect of growing scalp hair in balding men. The value of both Propecia and saw palmetto will probably give more side effects, particularly the negative impact on libido.