From the Guidelines
To bring down DHT levels, the most effective treatment option is dutasteride (0.5mg daily), which can reduce DHT levels by up to 95% 1. This is because dutasteride inhibits both type I and II 5-alpha reductase isoenzymes, leading to a significant reduction in DHT levels in the prostate tissue. The reduction in DHT levels can help alleviate symptoms of benign prostatic hyperplasia (BPH) and reduce the risk of prostate cancer. Some key points to consider when using dutasteride include:
- It is essential to have a prostate volume of >30cc or PSA >1.5ng/mL for a reliable response to dutasteride 1
- Dutasteride can take several months to show significant improvements in symptoms, so patients should be counseled on the slow onset of action 1
- The medication can cause side effects, including sexual dysfunction, and is contraindicated during pregnancy 1
- Regular monitoring of PSA levels is necessary while on dutasteride, as the medication can alter PSA levels, and the measured serum PSA value should be doubled after 1 year of therapy to accurately gauge disease progression 1 Other treatment options, such as finasteride (1mg daily), can also reduce DHT levels, but to a lesser extent (up to 70%) 1. Lifestyle changes, such as regular exercise, maintaining a healthy weight, reducing stress, and limiting alcohol consumption, may also support lower DHT levels, but the evidence for these interventions is less robust compared to prescription medications like dutasteride 1.
From the FDA Drug Label
The development and enlargement of the prostate gland is dependent on the potent androgen, 5α -dihydrotestosterone (DHT). Type II 5α-reductase metabolizes testosterone to DHT in the prostate gland, liver and skin. Finasteride is a competitive and specific inhibitor of Type II 5α-reductase with which it slowly forms a stable enzyme complex. In man, a single 5-mg oral dose of finasteride tablets produces a rapid reduction in serum DHT concentration, with the maximum effect observed 8 hours after the first dose. The suppression of DHT is maintained throughout the 24-hour dosing interval and with continued treatment Daily dosing of finasteride tablets at 5 mg/day for up to 4 years has been shown to reduce the serum DHT concentration by approximately 70%.
To bring down DHT levels, finasteride can be used, as it is a competitive and specific inhibitor of Type II 5α-reductase, which metabolizes testosterone to DHT.
- A single 5-mg oral dose of finasteride produces a rapid reduction in serum DHT concentration, with the maximum effect observed 8 hours after the first dose.
- Daily dosing of finasteride at 5 mg/day for up to 4 years has been shown to reduce the serum DHT concentration by approximately 70% 2.
From the Research
Methods to Bring Down DHT
To reduce DHT levels, several methods can be employed, including:
- Inhibiting the 5-alpha-reductase enzyme, which is responsible for converting testosterone to DHT 3, 4, 5, 6
- Using herbal extracts, such as saw palmetto, which have been shown to inhibit 5-alpha-reductase and reduce DHT levels 5, 6, 7
- Increasing blood flow to the scalp, as inadequate blood flow can contribute to hair loss 3
Herbal Extracts
Herbal extracts, such as:
- Saw palmetto (Serenoa repens) 3, 5, 6, 7
- Green tea (Camellia sinensis) 3
- Pumpkin seed (Curcurbita pepo) 3
- Rosemary (Rosmarinus officinalis) 3
- Grape seed (Vitis vinifera) 3
- Licorice (Glycyrrhiza glabra) 3 have been suggested to have a potential role in reducing DHT levels and promoting hair growth.
Inhibition of 5-Alpha-Reductase
The inhibition of 5-alpha-reductase can be achieved through: