Posts Tagged ‘DHT’

WHAT CAN BE DONE WITH DHT?

// October 29th, 2010 // No Comments » // Hormones

Our group has been involved in projects using DHT in gel form to treat two groups of men — those with a condition called AIDS wasting syndrome (AWS) and elderly men with low serum testosterone levels.

We have used DHT gel to reverse some of the ravages of AWS. Men with AWS suffer a progressive weight loss and become disabled and fatigued and are unable to do any meaningful work. In our short-term studies of men with AWS, we found the following.

Prior to treatment, all men with AWS had established a pattern of progressive and intractable weight loss. During only eight weeks of daily DHT treatment, these desperately ill men reclaimed their appetite, put on weight, and increased their strength. Treatment with DHT gel allowed them to reverse course: to eat more heartily and have a significant increase in their total body weight and capacity for physical work. Unlike other AWS treatments, where fluid retention or increased fat accounted for most of the weight gain, the DHT-gel-treated men’s weight gain was entirely due to buildup of increased muscle — lean body — mass.

We have been encouraged by our results in men with AWS and along with others are now evaluating DHT gel in elderly men with low testosterone levels.

You will undoubtedly hear more about DHT in the near future.

PROPECIA FOR MEN WITH MALE-PATTERN BALDNESS

// October 29th, 2010 // No Comments » // Hormones

Symptoms of balding are not subtle. Men will note some early hair loss simply by looking in the mirror. Almost all men experience, and accept, some thinning of the hair as they age, but when there is an accelerated hair loss at an early age, men do become concerned. The 1-mg finasteride pill sold under the name of Propecia is prescribed for younger men who are troubled by the distinctive and selective pattern of hair loss, commonly referred to as male-pattern baldness.

The striking observation that scalp hair loss (balding) never occurs in men with low serum DHT levels was the stimulus for this research. Doctors were to determine whether lowering a man’s DHT level would reverse or slow down the rate at which he became bald. Only limited studies have been done on this topic, but those that are available indicate that the 1-mg dose of finasteride (Propecia) does lower serum DHT levels by about 65 percent and slows down the rate of hair loss in men with male-pattern baldness. Hair growth resumes with continued use of Propecia and starts to fill in areas that had started to bald. But proving this turned out to be an unusually onerous task.

Balding studies are more difficult to do than studies on urinary flow and prostate size. To give you an example of how demanding this research is, consider the following. In evaluating the effect of finasteride on prostate symptoms, all investigators had to do was ask their patients to fill out a questionnaire on their patterns of urination and arrange for ultrasound studies to determine prostate size before and after treatment.

To do hair-loss studies, doctors had to identify and mark out a single twoinch circular area on the top of a man’s scalp as the target area. Then at each visit, they had to count one by one each and every hair in that target area before, during, and after treatment. The results of two combined studies involving more than 1,500 men yielded the following. Men who had 876 hairs in the target area before had on average 983 hairs after treatment, for a net gain of 107 hairs after one year. This does not seem like much but may be enough for those who are distressed by their hair loss. Men with male-pattern baldness age 18-41 years who take Propecia seem to be pleased with the results.

Side effects were similar to what was observed when the 5-mg finasteride (Proscar) dose was used to treat BPH. Sexual side effects, including impotence, loss of sex drive (libido), and ejaculatory problems, occur in about 4 percent of men who take finasteride at this lower 1-mg dose. This once again raises questions about the importance of DHT as a sexually significant male hormone.

AIDS AND TESTOSTERONE

// October 29th, 2010 // No Comments » // Impotence

A below-normal serum testosterone level (hypogonadism) is the most common hormone abnormality found in men with acquired immunodeficiency syndrome (AIDS). In some cases, this is the result of viruses or other microorganisms invading and disabling the testicle’s testosterone-producing capability. More often, the hypogonadism results from subnormal pituitary signals to the testicle, a condition referred to as secondary hypogonadism. Dr. Adrian Dobs of Johns Hopkins University Medical School was one of the first to note that men with AIDS experience many of the symptoms of hypogonadism. In one of her earlier studies in men with AIDS, she noted that 28 of 42 (67 percent) complained of decreased libido, and 14 Of 42 (33 percent) said they were impotent. In addition to the common symptoms immediately attributed to their hypogonadism, men infected with the AIDS virus often experience unexplained decline in weight and loss of muscle mass. This condition is referred to as the AIDS wasting syndrome (AWS) and, in addition to all the other problems AIDS patients have to cope with, AWS is a major cause of morbidity and premature death. We know that in men with spontaneous hypogonadism, loss of weight and muscle mass is common and that for these hypogonadal men, testosterone treatment helps restore weight and strength. Could testosterone treatment work as well in men with AWS?

Preliminary data from Drs. Judith and Richard Rabkin of the College of Physicians and Surgeons, Columbia University, suggest that providing supplemental testosterone or a testosterone analogue, like mesterolone, to men with AIDS who have low serum testosterone levels is beneficial, producing clear improvements in sexual interest, arousal, and overall sense of wellbeing. Some have even speculated that supplemental testosterone may also have a positive mood-elevating impact similar to that seen with traditional antidepressant therapy.

Men with AIDS were treated with a conventional dose of 100 mg of testosterone per week for eight weeks. They had a significant gain in weight and noted enhanced sexual interest and more energy, suggesting that this form of androgen supplementation is effective in alleviating many of the problems that men with AIDS find so troubling.

As more men with AIDS were subjected to detailed hormonal studies, it became apparent that not all, even those who were suffering from AWS, had below-normal testosterone levels. In June 1996, Dr. Richard Horton of the University of Southern California Medical School found that some men with AWS have normal testosterone levels but are unable to efficiently convert testosterone to a second male hormone, dihydrotestosterone (DHT). He speculated that it was the subnormal DHT levels that were most likely responsible for their inability to gain weight in AWS.