DHT - Male

Introduction

As a Florida-based functional medicine telehealth provider, I emphasize evidence-based education on key hormones. Dihydrotestosterone (DHT) is a powerful androgen converted from testosterone by 5-alpha-reductase in tissues such as the prostate, skin, and liver. It drives male secondary sexual characteristics but must remain balanced for optimal health.

Clinical Implications of Abnormal DHT

Low DHT

Insufficient DHT associates with increased risk of cardiovascular function events—including heart disease and stroke—and may contribute to testosterone deficiency, manifesting as low libido, fatigue, and muscle loss. Genetic 5-alpha-reductase deficiency can also blunt DHT synthesis and require medical oversight.

High DHT

Elevated DHT underpins conditions like acne (via sebaceous gland stimulation) and androgenic alopecia in genetically predisposed individuals. It also fuels prostate growth—leading to benign prostatic hyperplasia (BPH)—with urinary and cancer risk implications.

Factors That Influence DHT Levels

• Metabolic Syndrome & Insulin Resistance: Both upregulate 5-alpha-reductase, increasing DHT and exacerbating hair loss and acne .
  
• Medications:
  
  • Increase DHT: Anabolic steroids and testosterone therapy.
    
  • Decrease DHT: 5-alpha-reductase inhibitors (e.g., finasteride) and anti-androgens (e.g., spironolactone).

     

DHT Ranges

• Standard Adult Male Range: 12–65 ng/dL
  
• Optimal Functional Range: 50–65 ng/dL

   

Maintaining DHT in the upper optimal window supports muscle, sexual health, and mood.

Integrative Management Strategies

Lifestyle Optimization

Regular exercise, stress reduction, and a diet rich in antioxidants and omega-3s help modulate hormone balance and reduce insulin resistance.

Nutritional & Supplement Support

Nutrients like zinc and vitamin D support healthy testosterone total – male synthesis, while botanicals such as saw palmetto may gently inhibit excessive DHT production.

Personalized Hormonal Care

Assessing DHT alongside other androgens allows tailored interventions—from bioidentical therapies to targeted supplementation—under the guidance of a functional medicine practitioner.

In conclusion, integrating DHT assessment into a holistic health strategy—guided by a functional medicine nurse practitioner—addresses root causes rather than just symptoms. This integrative model—combining precise biomarker profiling, personalized nutrition, and lifestyle medicine—builds resilience, preventive care, and longevity. Explore our Longevity Medicine service to further optimize your androgen balance and wellbeing.

Further Reading

• Kunelius, P., Lukkarinen, O., Hannuksela, M. L., Itkonen, O., Tapanainen, J., & Andersson, L. C. (2002). The effects of transdermal dihydrotestosterone in the aging male: a randomized, placebo-controlled study. The Journal of Clinical Endocrinology & Metabolism, 87(4), 1467-1472. https://pubmed.ncbi.nlm.nih.gov/11932266/

• Idan, A., Griffiths, K. A., Harwood, D. T., Conway, A. J., & Handelsman, D. J. (2010). Long-term effects of dihydrotestosterone treatment on prostate growth in healthy, middle-aged men without prostate disease. Annals of Internal Medicine, 153(10), 621-632. https://pubmed.ncbi.nlm.nih.gov/21079217/

• Ly, L. P., Jimenez, M., Zhuang, T. N., Celermajer, D. S., Conway, A. J., Handelsman, D. J. (2001). A double-blind, placebo-controlled, randomized clinical trial of transdermal dihydrotestosterone gel on muscle strength, mobility, and quality of life in older men with partial androgen deficiency. The Journal of Clinical Endocrinology & Metabolism, 86(9), 4078-4088. https://pubmed.ncbi.nlm.nih.gov/11549629/

• Roth, M. Y., & Page, S. T. (2011). A role for dihydrotestosterone treatment in older men? Asian Journal of Andrology, 13(2), 218-219. https://pmc.ncbi.nlm.nih.gov/articles/PMC3192006/