Testosterone, DHT and Aromatase problems

A lot of men share some of the same fears, age old fears. Topping the list are: being perceived as weak, becoming impotent, and  losing hair. All signify loss of power. These are deep seated fears, and men will do anything to keep them at bay.

These fears drive both young and middle-aged men to work out,  and to take nutritional supplements of questionable quality formulated on equally questionable scientific premises.


The Testosterone Dilemma

Men identify with testosterone, and for good reason. After all, it is adequate levels of testosterone that sustain their masculinity. As men age, their free testosterone levels tend to drop. This will cause them to eventually lose muscle mass and muscle tone. It will decrease their mental sharpness and their drive, including of course, their sexual drive. So men, and most male doctors, will see testosterone as the essential fuel for remaining a high functioning male. Some men choose to take synthetic testosterone in the form of supplements, and some physicians will prescribe testosterone supplementation therapy for men whose free  testosterone levels have declined below accepted reference ranges. Testosterone is an androgen and therefore a hormone. The problem is that in the body, nothing is static, and every component, including testosterone, is being constantly built up and broken down. It is like when you walk into a forest and see young trees growing and old broken stumps decaying. It is the same inside the human body: this is what is known as metabolism. Metabolism includes anabolism (building up) and catabolism (breaking down).


5-alpha reductase and DHT

Testosterone is broken down and converted into DHT by an enzyme called 5-alpha reductase. As men age, more of their free testosterone tends to be converted into DHT. High levels of DHT have been associated with BPH and prostate cancer. So many men have been taking finasteride which blocks conversion of free testosterone into DHT.


Why DHT is Important

Nature is not stupid, and nature decided to make DHT a part of male physiology. If men take finasteride to block DHT by inhibiting 5-alpha reductase, they may fancy they are protecting themselves from prostate issues and retaining their testosterone for muscle building and sexual prowess. Guess again. Stopping testosterone from naturally metabolizing into DHT will potentially lead to the following:

  • hair loss (alopecia)
  • erectile dysfunction (ED)
  • prostate cancer

Why? Because DHT (dihydrotestosterone) is an androgen that plays an important role in sexual performance, secondary sexual characteristics, and protection from cancer. Yes, I know that in conventional thinking DHT is seen as pro-carcinogenic. But in fact this is at best a half truth. (Please read allied posting on Prostate Cancer Drugs for more details). Cutting out DHT is similar to amputation: not amputation of a body part, but amputation of a key metabolite.

DHT and Protection From Prostate Cancer

While DHT initially can start a cascade towards cancer, if left alone, a major part of DHT will metabolize into 3-b Adiol, which is a man’s internal protection against prostate cancer. The key here is the ratio: ensuring that your 3-b Adiol levels are greater than your DHT + 3-a Adiol total levels.


DHT and Aromatase

Another mistake men make is separating out DHT and aromatase. DHT and aromatase must be understood in combination. Aromatase is an enzyme present in abdominal fat, and aromatase levels will often be elevated as a consequence of excess cortisol production. Cortisol is the major stress hormone, so stressed out men who try to work it off by pumping iron or extreme aerobic exercise are  not necessarily getting to the core of the matter. They may burn off some calories, but they are not shifting their pre-set stress levels. If these men are unable to shed excess poundage at the waistline, the likelihood is that their aromatase levels will be heightened. Aromatase decreases male libido and enhances feminizing characteristics.  Elevated aromatase together with elevated DHT can potentially lead to prostate inflammation and tumor growth. A man might easily have artificially big muscles and a weakened sexual energy, plus a dangerous predisposition to aggressive prostate cancers if he is on finasteride.