‹ Back to summariesNext topic: Dopamine

DHT

Overview

DHT is the most potent androgen the human body produces. It's roughly 5-8x stronger than testosterone at the androgen receptor and it is what actually defines the male phenotype: facial structure, the V-shape, penis length and bone strength. It opposes cortisol at the glucocorticoid receptor, antagonises estrogen, inhibits aromatase, promotes mitochondrial biogenesis, acts as a neurosteroid with antidepressant effects comparable to ketamine, and unlike testosterone it cannot aromatise into estrogen. Because DHT is a downstream hormone, taking too much can lead to unpredictable results. Daily use is something to avoid; the right use of DHT is targeted and intermittent, layered on top of an already corrected metabolic foundation.

Key Points

  • One milligram is the daily dose if it is genuinely needed. For someone with a definite problem to fix, like osteoporosis or cancer, one milligram of DHT per day, dissolved in tocopherol or taken with fat, is enough to see the effect. The same logic applies that applies to testosterone: a person could spend five years optimizing thyroid, calcium, magnesium, protein, vitamin D, vitamin E, pregnenolone, and DHEA before even thinking about supplementing the endpoint androgen.

  • DHT is safer than testosterone because it cannot convert to estrogen. If a male has a severe androgen deficiency he cannot otherwise correct, DHT is a less risky choice than testosterone, since it bypasses aromatase entirely. By contrast, testosterone clinics routinely inject 50 to 100 milligrams at a time, when a healthy young male produces only four or five milligrams of testosterone per day, so most of that overdose ends up converted to estrogen and does more harm than good.

  • DHT belongs to the family of stabilizing steroids that hold the organism in its shape. Progesterone, DHT, and the other 5-alpha-reduced steroids are essential for holding the organism in its shape and determining its future shape, the way it coils and uncoils. The 5-alpha-reductase enzyme family also produces bile acids, which are crucial for digestion, and converts cortisol into a much less potent reduced form that in some cases acts as an antagonist at the cortisol receptor. Blocking these enzymes has effects far beyond sexuality, hitting digestion, stress regulation, and brain morphogenesis.

  • Caffeine amplifies DHT's effect at the androgen receptor by 300 to 400 percent. A 2004 case of a Portuguese bodybuilder who got huge results on tiny doses of steroid combined with 200 milligrams of caffeine led researchers to test the combination in vitro, where caffeine increased the transcription effects through the androgen receptor by 300 to 400 percent. The favourable steroids, progesterone and androgens like DHT, stabilize the cell so it can expel calcium and sodium, suppress glycolysis, and shift into the oxidizing state, and caffeine works by an analogous electron-attracting mechanism.

  • The standard story that DHT causes hair loss is wrong. The belief in testosterone or DHT as the cause of male pattern baldness is similar to the old belief that testosterone caused prostate cancer, and there is no evidence that excess androgens are responsible. When you measure hormones in people losing their hair, you find excess prolactin and cortisol, while higher testosterone makes the hair shaft grow thicker and faster. Prolactin is the hair-shedding hormone; in birds it is the molting hormone.

  • DHT can play a role in interrupting prostate or breast cancer. In breast or prostate cancer, DHT can give a big push to the system if you are wanting to interrupt the disease process. Men who originally have the highest natural testosterone have the lowest mortality from prostate cancer; men with low natural testosterone, where it is being converted to estrogen, are the ones at the highest risk.

  • Pregnenolone first, then DHEA, before DHT is even on the table. Pregnenolone is the first thing to use, then DHEA if a more androgenic effect is needed. Androgens push the neurosteroids, which are the crucial regulating substances you do not want to throw out of balance - DHT carries a real risk of doing this. Correcting thyroid, vitamin D, DHEA and pregnenolone will usually bring DHT up to where it should be on its own.

  • DHT is roughly five to eight times more potent at the androgen receptor than testosterone and is what masculinises the body. DHT is synthesised from testosterone by the enzyme five alpha reductase. It is responsible for facial masculinisation, the V-shape, penis length, bone strength, and basically every feature of the male sexual phenotype. Testosterone alone is a much weaker androgen agonist, so although it is the more famous hormone, DHT is what actually does most of the masculinising work.

  • The theory that DHT causes prostate cancer is wrong, and a DHT cream is officially approved in Europe to treat prostate enlargement. The drug Andractim is a transdermal DHT gel approved in much of the world outside the US. The prostate expresses more five alpha reductase than any other organ, so over 90% of injected testosterone is converted to DHT inside the prostate, which kills the argument that androgens damage that organ. There is no proven causal relationship between DHT and prostate cancer, only the observation that DHT makes the prostate grow.

  • DHT is a strong opposer of cortisol and estrogen at the receptor level, which accounts for most of its anabolic effect. About 80 percent of the anabolic effect of androgens is actually anti-catabolic, meaning blocking cortisol at the glucocorticoid receptor in muscle and bone. The remaining 20 percent is direct stimulation of DNA and RNA synthesis. DHT has a similar affinity for the glucocorticoid receptor as testosterone but is a stronger estrogen antagonist and a stronger stimulant of overall protein synthesis. Androgens in general promote mitochondrial biogenesis by opposing estrogen and cortisol, the two main stress hormones.

  • DHT is a neurosteroid with dramatic antidepressant effects comparable to ketamine. Both DHT and ketamine reverse depression within roughly a week, including treatment-resistant depression that does not respond to electroconvulsive therapy. DHT also has an unusually calming, almost zen-like quality at low doses; two to five milligrams produce a state where nothing perturbs you. Because DHT is fully saturated with no double bonds, it has the calming, pro-metabolic, relaxing profile typical of saturated steroids, in contrast to unsaturated steroids that drive a hyper, agitated, cortisol-running state.

  • DHT is what actually protects bone health, not estrogen, even in postmenopausal women. Studies originally in rats and now repeated successfully in humans showed DHEA preventing and treating osteoporosis in postmenopausal women, and the women supplemented with DHEA had abnormally high DHT levels. When researchers gave an androgen receptor antagonist to block DHT, those women developed fractures again, showing that the protection was coming from DHT specifically.

  • The Idealabs DHT prostate cancer study showed tumour growth completely stopped or fully cured. Using a human-cell prostate tumour model in immunocompromised mice, the DHT-only group had tumour growth flat-lined for the entire study. The aromatase-inhibitor-only group also flat-lined. The combination group of DHT plus aromatase inhibitor had two of three full cures with the tumour completely disappearing. This was done specifically to use the exact androgen mainstream medicine claims causes prostate cancer, and to use a non-aromatisable one so the result could not be explained away as an estrogen effect.

  • DHT lowers prolactin and is approved in several countries to treat gynecomastia. Non-aromatisable androgens lower prolactin.

Notable Quotes

"In general, things like that (DHT) are not to be messed with unless you have a very specific knowledge of a deficiency because if you take a little too much, any of those defining feature-creating hormones can change the whole system in an unpredictable way."

[Ray Peat — Thyroid Function & Pulse Rate, Weaponized Culture, Finasteride as an "Insane Decision"]

"I think of that category progesterone, dihydrotestosterone, all of the stabilizing steroids, as essential to holding our organism in its shape and determining its future shape, the way it coils and uncoils."

[Ray Peat — Thyroid Function & Pulse Rate, Weaponized Culture, Finasteride as an "Insane Decision"]

"It's a major brain hormone that you're messing with when you try to stop the production of DHT."

[Ray Peat — Safe Supplements with Ray Peat (Generative Energy #31)]

"In my experience, nothing terminates a severe stress reaction for me like a few milligrams of DHT. But my experience is that it's not something that can be used on an ongoing basis without interruption. It's more like the emergency fix when you're really in trouble and you don't feel like taking three grams of aspirin or you don't have them with you. DHT works in minutes like a charm."

[Georgi Dinkov — Heat Shock Proteins, Antibiotic Resistance, DHT Safety, Energy and Aging with Ray Peat, PhD]

"There's a DHT cream on the market called andractim in Europe. It is officially approved drug for treating prostate enlargement."

[Georgi Dinkov — interview discussing testosterone and DHT dosing]

"DHT is approved in several countries for treating gynecomastia, which is well known to be caused by high prolactin... So DHT does not increase prolactin. In fact, it lowers it."

[Georgi Dinkov — interview on aromatization and prolactin]

Important Things To Consider

DHT can throw off your neurosteroid balance. Androgens push the neurosteroids, which are crucial regulating substances, and a strong androgen like DHT carries real risk of disturbing them. This is the main reason for correcting thyroid, vitamin D, DHEA, and pregnenolone first, since these usually bring DHT to the right level on their own without that risk.

Continuous daily use is not the intended pattern. Even when DHT works dramatically, it is not something that can be used on an ongoing basis. The intended use is intermittent and emergency-oriented; if you find yourself reaching for it constantly, this is a sign of an underlying metabolic issue that needs to be addressed.

The feel-good effect is itself a risk. DHT can make you feel so good that you get stuck on it and stop fixing the whole energy system that produced the problem in the first place.

The whole foundation needs to be in place first. Before introducing any endpoint androgen, thyroid, calcium, magnesium, protein, vitamin D, vitamin E, pregnenolone, and DHEA need to be optimized. Aspirin, coffee or caffeine, progesterone, adequate sugar, and cutting proteins high in methionine, cysteine, and tryptophan do most of the work that people are hoping the androgen will do.

Topical application has systemic effects. Steroids placed on skin or mucous membranes act systemically, not just locally. Women using vaginal estrogen creams have shown blood estrogen levels higher than some oral pills produce. The same logic applies to topical DHT or DHEA: do not assume a topical preparation is somehow "local only."

Five alpha reductase inhibitors like finasteride and dutasteride are extremely damaging and have triggered class action lawsuits. These drugs do not improve survival in prostate cancer and do not reduce the progression of BPH into prostate cancer. They inhibit the synthesis of pregnenolone and DHT, raise prolactin, can act as androgen receptor antagonists, and have been linked to depression, suicide, feminisation, liver cancer, and an aggressive castration-resistant type of prostate cancer. Dutasteride inhibits all three isoenzymes of five alpha reductase and is used to convert males into females in transition therapy. Finasteride class action lawsuits are forming in the US over destroyed sexual function, mood, and fertility persisting years after stopping the drug.

Topical dosing differs significantly from oral and varies by application site. Steroids dissolved in vitamin E or coffee oil generally need two to three times the oral dose if applied topically, with onset around 30 to 45 minutes but effects lasting the full 24 hours. Scrotal application has 50 to 75 percent absorption and is the route used by most approved testosterone creams. Penile skin has roughly 30 to 50 percent absorption and is the route Andractim uses for the micro-penis indication. Navel application can rival intravenous administration but the surface area only allows a few drops.

For women, high doses of DHT or DHT-derivatives can be masculinising. In the 1940s and 1950s testosterone and DHT were used in high doses to cure terminal estrogen-receptor-positive breast cancer in women. DHT worked even better than testosterone, but many of the women grew beards. The infamous theory that DHT causes polycystic ovarian syndrome does not hold up under scrutiny, since the studies showing progestin-driven PCOS use synthetic progestins that are themselves estrogenic and act on the mineralocorticoid receptor.

Want to go deeper?
Search Ray’s interviews for “DHT”Search Georgi’s interviews for “DHT”