Dihydrotestosterone: Biochemistry, Physiology and Clinical Implications of Elevated Blood Levels (original) (raw)

This review on dihydrotestosterone (DHT) biochemistry, physiology, and clinical implications of elevated levels in blood clarifies concepts that are important in clinical practice. Benefits associated with lowered serum DHT levels after 5α-reductase inhibitor (5AR-I) therapy in men have contributed to a misconception that circulating DHT levels are an important stimulus for androgenic action in target tissues (e.g., prostate). Yet evidence from clinical studies indicate that intracellular concentrations of androgens (particularly in androgen-sensitive tissues) are essentially independent of circulating levels. To assess the clinical significance of modest elevations in serum DHT and the DHT/T (testosterone) ratio observed in response to common T replacement therapy, a comprehensive review of the published literature was performed to identify relevant data. We examined not only studies where elevated DHT was documented but also those where 5AR-Is were used to suppress DHT. Where appr...