T Nation

TRT, Elevated DHT and Prostate Cancer

Just throwing it out there gents. Since starting TRT my test levels are sitting just above the highest physiological range. I believe it has raised my DHT levels substantially and has brought on some hair loss which I can cope with - prefer not but it is what it is. I am concerned though about the increased risk if any of elevated DHT and prostate cancer risk. I get bloods etc done every 12 weeks and will discuss this with my doctor during my next appointment but just reaching out to the gents on this forum for some further advice. Thanks in advance.

TRT does not increase the risk of prostate cancer. It’s been reported that TRT for at least one year decreases the risk of prostate cancer. The thinking now is the low testosterone with high estradiol increases the risk of prostate cancer. A recent study linked low vitamin D to increased risk of prostate cancer.

Also hypogonadal people who Aquire prostate cancer tend to have much more aggressive and fast progressing prostate cancer when compared to those who have normal or high normal testosterone/DHT concentrations, other hormones such as E2 also play a big factor in prostate cancer risk, so control E2. what is your reference range? Many reference ranges in Aus say anything above like 700ng/dl is supraphysiologic, however that simply isn’t true. I’ll post the study later but In one of the few studies that examined healthy, lean, young men’s testosterone levels, the normal range (defined by bottom and top 2.5th percentile) was 350-1200ng/dl or something like that with the top 1 percent being 1322ng/dl the average T level was 700 and something Ng/dl (around 25nmol). Are you on gels or injections, gels will raise DHT more if that is a concern to you, however DHT is also responsible for promoting secondary sexual characteristics such as facial hair and is vital for libido. take a vitamin D supplement, Especially if you don’t get enough sun exposure (vitamin D is good for you) and take fish oil ( health benefits)

Thanks for the replies gents - appreciate it. My last labs were as follows : 46.3 nmol/l with ref 9.9 - 27.8. That’s a trough level of 1330 using your measurement. My estradiol was pmol/l <160 and free test was 1196 pmol/l with a ref of 170-670. Hope this all makes sense. I will look into the vitamin D. I know it’s a taboo topic but is Finasteride and option for controlling high DHT and hair loss?

Also I’m on shots. 30mg of test and 250IU of HCG EOD taken with .25mg of anastrozole.

Finasteride could be an option, however it causes sexual problems for many, finasteride stops hair loss by stopping he conversion of testosterone to DHT, DHT is needed for adequate libido, therefore finasteride is generally a bad idea. You can get a hair transplant, how old are you? 20s 30s 40s?

I thought that by taking Finasteride with high levels of DHT it would just bring them back to a ‘normal’ level and therefore I might avoid the sides. I’m in my mid 40s and although I like my hair i don’t like it enough to bother with transplants etc.

It would seem lots of guys start down the proactive road only in the end worsening their situation, PFS is very real and irreversible for some as it’s thought to eliminate the enzyme that converts testosterone into DHT in the same way arimidex lowers the enzyme that converts testosterone into estrogen thereby lower the conversion rate.

There are men who claim to wake up a completely different person with a host of nasty, unbearable side effects than can ruin your life. Some guys notice a dramatic side effects after only one pill and others take months to years to develop symptoms, often it’s already to late one symptoms are first experienced.

There are NO studies proving these doctors claims that high DHT “causes” prostate cancer, only that it can exacerbate cancer once it’s already begins. We humans once roamed this earth with much higher hormones levels than today before being introduced to a world of chemicals and toxins.

However there are studies showing men with low testosterone having more problems with prostate cancer in a low DHT and high estrogen environment. Taking a DRUG that alters how your body functions naturally is always a bad idea.

Prostate:

  • E2 is risk factor, all the more if T and DHEA are not opposing estrogens.
  • Inflammation is a big deal and a good amount and variety of anti-oxidants is important.
  • Clearing the seminal vessels with orgasms is helpful as old seminal fluid can lead to inflammation that spreads to the prostate.

The medical community misled itself and everyone else. The fact that elimination of T shrinks the prostate was perverted to the idea that testosterone was the cause. Very low T levels simply will cause the prostate to whither whether healthy or not.

Some doctors still have this old idea. They probably then also think that T causes heart attack risks when the opposite is true.

When my E2 was slightly elevated, no controlled, my PSA went up slightly as well. Control e2.