Left-over DHT?

[ButterflyMelissa]

Hi all!
So, first things first: happy, happy and more happy. I stand some six months away from the releasing operation, so I'm super excited.
I have a technical question, on DHT. Okay, here's what I know: it's a by product possibly comming from unused testosterone. I have a regular measure-up and with stats like these (estradiol @ 95,6 nG/Dl and testosterone below 2.5 nG/Dl) things cannot go wrong. But...with these figures...just how much DHT is still left? And...wil there still be some after my operation?
Just a techy question. I understand (cis gendered) women have some t in there as well...but...where does the body scrape that up from?
Thanks
Kissies
Melissa

[xAmyX]

Even with a testosterone level of 14 ng/dL, and an estradiol level of 277 pg/mL, I still need to take a 5α reductase inhibitor like finasteride or dutasteride. If I don't, I start to feel more masculine, have a higher sex drive, and my breasts get smaller. I tried stopping before, and shortly thereafter realized it was a bad decision.

I like dutasteride better, because it has a much longer half life, and inhibits both types 1 and 2 isozymes of 5alpha-reductase. It is possible that the testosterone your adrenal glands produces before and after surgery can be converted. Personally, I'd want to take a 5α reductase inhibitor for life.

[xAmyX]

                                                Your Value  Standard Range
Testosterone Total LC/MS/MS        14  ng/dL    250 - 1100 ng/dL
Testosterone, Free                         0.6 pg/mL  46.0 - 224.0 pg/mL
Testosterone, Bioavailable             1.2 ng/dL    110.0 - 575.0 ng/dL
Sex Hormone Binding Globulin         105 nmol/L  10 - 50 nmol/L
Albumin                                      4.4 g/dL     3.6 - 5.1 g/dL

As you can see, they're pretty effective. I was taking finasteride at the time of this testing, but am now taking dutasteride. I'm looking forward to seeing if it makes a difference.

[KayXo]

Dutasteride/finasteride only reduces DHT, not T so would have absolutely no impact on T levels. The vast majority of women seem to do fine without any anti-androgen post-op, even appear to need some extra T, like me, for libido, energy, etc.

Whether the remaining DHT post-op (about 40% of pre-op levels, typically, according to one study) causes issues for you remains to be determined by you and your doctor.

[xAmyX]

She wasn't asking about T. She obviously has that under control. She's wondering about DHT, and whether or not that would be a concern post-op. It's definitely possible. The adrenal glands will still produce T. Also, it can be acquired through oral consumption as well (swallowing male ejaculatory fluid). Even though it's no where near as much T as having testicles produces, it can still be converted into DHT. That's why I'd take finasteride/dutasteride if I was post-op. To each's own I suppose. One thing you can do is get it tested post-op, and see if you would need something to inhibit it. That's a wise decision. I should have DHT tested specifically sometime, but since my free testosterone is so low, I don't think that's necessary. It used to be a lot higher before I was taking finasteride.

Since 5α reductase inhibitors affect free (referred to as bioavailable testosterone), and that testosterone needs to be metabolized in order to be converted into DHT, that does mean that finasteride/dutasteride have an affect on testosterone. Just not in a way people pay attention to.

[KayXo]

since my free testosterone is so low, I don't think that's necessary. It used to be a lot higher before I was taking finasteride.

Finasteride doesn't reduce testosterone levels, only DHT.

Since 5α reductase inhibitors affect free (referred to as bioavailable testosterone)

AFAIK, they reduce neither free nor bio-available testosterone, only DHT. Some studies have actually shown a slight INCREASE in T with finasteride. Unless there are studies you can share with us that show otherwise.

There actually is a difference between free and bio-available testosterone. The former is FREE, neither bound to albumin nor SHBG where the latter includes FREE testosterone AND testosterone (weakly) bound to albumin.

[xAmyX]

AFAIK, they reduce neither free nor bio-available testosterone, only DHT. Some studies have actually shown a slight INCREASE in T with finasteride. Unless there are studies you can share with us that show otherwise.

Gladly:

"Results: Oral finasteride in dose of *mg/day for 9 months improved the scalp hair growth by all types of evaluation. Serum level of free testosterone (FT) and DHT were decreased significally, where total testosterone (TT) was increased, with no changes in other hormonal profiles in treated patients with finasteride."

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0ahUKEwiM4caTrIXYAhUpUd8KHY5zDA8QFggtMAA&url=https%3A%2F%2Fwww.hairlosstalk.com%2Finteract%2Fattachments%2Feffect-of-oral-finasteride-on-serum-androgen-levels-and-aga-in-adult-men-rar.15260%2F&usg=AOvVaw0GhSh6daWy2tWpjdjXc6Wk

It does affect free testosterone, and I didn't say that FT is bio-available testosterone. Read what I said! I said people REFER to it as bio-available testosterone.

By the way, I was taking a similar amount of finasteride daily, and I saw my free testosterone drop significantly just like what was observed in the study, so I immediately assumed since it was so effective at reducing FT levels, that it would have had a great impact on DHT levels as well! Hence why I said what I said.

[KayXo]

Thanks for sharing Amy (please omit doses, you aren't allowed) and sorry for misinterpreting what you wrote. It's interesting information that I wasn't aware of. Again, gracias.

[xAmyX]

Done, and you're welcome. 

Thanks for pointing that out, it completely slipped my mind!

"Free testosterone and albumin-bound testosterone are also referred to as bio-available testosterone"

https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=testosterone_free

They both play their roles.

Just a little proof to the putting. Cheers!