DHT in Men: Clinical Overview


What Is DHT?

  • Dihydrotestosterone (DHT) is a potent androgen derived from testosterone via the 5α-reductase enzyme.
  • It is responsible for many of the masculinizing effects during puberty and plays a role in adult androgen function.
  • DHT binds more strongly to androgen receptors than testosterone and is non-aromatizable (cannot convert to estrogen).



Normal DHT Levels in Men~30–85 ng/dL (lab dependent)

Levels vary with age, testosterone levels, and 5α-reductase activity



Functions and Benefits of DHT

  • Development of male genitalia in utero and puberty
  • Maintenance of prostate, skin, and hair follicles
  • Supports libido and sexual function
  • Enhances cognitive sharpness, motivation, and drive
  • May influence muscle density and body composition



  Causes of Low DHT

  • Low total testosterone
  • 5α-reductase enzyme deficiency or inhibition (e.g., finasteride, dutasteride)
  • Aging or chronic illness



   Symptoms of Low DHT

  • Reduced libido and erectile quality
  • Brain fog, low motivation
  • Loss of facial or body hair
  • Low energy or mood changes



   Clinical Considerations

  • DHT elevation may contribute to:
  • Male pattern baldness (androgenic alopecia)
  • Acne, oily skin
  • Prostate hypertrophy
  • DHT deficiency can impair sexual function and motivation, even with normal testosterone



   Diagnostic Testing

     Measure DHT when :

  • Testosterone therapy not improving symptoms
  • Symptoms of high or low androgen activity
  • Evaluating finasteride or dutasteride effects

Recommended Labs:

  • Total and free testosterone
  • DHT, SHBG, estradiol, LH, FSH



     DHT Modulation

  Increase DHT:

  • Testosterone therapy (injections > gels)
  • Avoid 5α-reductase inhibitors
  • DHT transdermal cream (off-label)

   Reduce DHT:

  • Finasteride, dutasteride (5α-reductase inhibitors)
  • Zinc, saw palmetto (mild natural inhibitors)



    Safety and Monitoring

    High DHT risks: prostate growth, hair loss, acne

  • Monitor DHT in men on TRT or with androgenic symptoms
  • Use cautiously in men with prostate cancer risk



   Adjuncts and Support

  • Adaptogens and lifestyle: stress reduction can help normalize DHT/testosterone dynamics
  • Nutrition: Zinc, magnesium, protein, cholesterol support androgen synthesis
  • Topicals: Ketoconazole shampoo (anti-DHT at scalp for hair loss)



Summary

DHT is a key androgen in male health, vital for sexual function, drive, and hair/skin physiology. Understanding how to measure, modulate, and monitor DHT levels is critical in managing men's hormonal health—especially in the context of testosterone therapy or symptoms of androgen imbalance.

go back