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Testosterone as a hair loss theory is based entirely on correlation. What it fails to explain is why, if testosterone is the culprit, hair grows in other place

Testosterone as a hair loss theory is based entirely on correlation. What it fails to explain is why, if testosterone is the culprit, hair grows in other places later in life. A much more compelling theory is that hair loss is due to the stretching of the scalp as the muscles and bones in the face grow in aging. It also explains why men have more hair loss then women. The force diagrams match male pattern baldness perfectly. (yes, also correlation)

synu 4y ago
Would people who got male pattern baldness in their early twenties just have particularly stretched heads relative to younger age?
- nervousvarun 4y ago
  As said up thread it doesn't explain the successful transplants of follicles to these areas. If follicles transplanted to these areas also failed, then the mechanical explanation would hold more water, but they empirically don't...so something is obviously different at the follicle level.
Dig1t 4y ago
There are examples online of FTM trans people who start balding after taking testosterone for a while, those anecdotes seem pretty compelling to me.
- jjoonathan 4y ago
  Yes, exactly, we can (and do) mess with hormones and see what happens. This causal link is extremely well established and rubicon33 does not know what they are talking about.
  - voisin 4y ago
    > rubicon33 does not know what they are talking about. He simply says it the theory is based on correlation which you agree to in your first sentence.
    - jjoonathan 4y ago
      Quite the opposite. Using control to establish causality is study design 101.
aghostincarrot 4y ago
deanmoriarty 4y ago
How would you then explain all the double-blind clinical trials that demonstrated the majority of patients on Finasteride (a popular DHT inhibitor) slowed down, or slightly reversed, their hair loss, compared with the patients who were on placebo? (please Google for the studies and data, I don't have links ready but have reviewed them in the past, there are tons by different groups of researchers across many countries)
Traubenfuchs 4y ago
If it is not DHTs fault (and by proxy Ts, as more T = more DHT) then why do finasteride and dutasteride work so very well? At this point, rejecting as main culprit for AGA either too much DHT or a DHT sensitivity that is to high or, worst case, both at once in one man, is nothing but crazy fringe science. To stress this out, the vast majority of men will keep their hair forever with oral minoxodil and oral finasteride and someone not keeping it on oral dutasteride instead of finasteride is a freak of nature.
deleted 4y ago
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stormbrew 4y ago
I believe there have been studies where they've transplanted hair from and to different parts of the body and found that they largely continue to grow the way they did at their original site, implying that follicles from different parts of the body just respond to hormonal environment differently. Also the current understanding is that it's specifically DHT (a second order type of testosterone) that causes head hair follicles, and hormone treatments that modulate conversion of T into DHT one way or the other have fairly predictable effects on hair loss patterns. There probably isn't just one single cause here, but hormones are definitely a big part of it.
- jjoonathan 4y ago
  You're underselling modern medicine and giving rubicon33 way too much credit. This isn't merely academic, it isn't merely correlations, it isn't speculative, and it isn't a mess of competing explanations. Hair transplants are a common and reliable intervention for male pattern baldness. If MPB were due to a tension mechanism, transplants wouldn't work. But they do. If MPB were due to a tension mechanism, surgical intervention would be simpler than transplanting thousands of follicles. But it isn't. If MPB is due to an endocrine mechanism, which it is, transplanted hair would behave differently than adjacent "native" hair against the progression of balding. It does. Billions of transplanted follicles on millions of balding heads testify to the fact that rubicon33 is way off base.
  - voldacar 4y ago
    To me it's probably a combination of stress from dht exposure and mechanical stress that causes thinning and baldness once the total stress level around the follicle surpasses some threshold. You can't just dismiss mechanical stress that easily, it would be an insane coincidence for scalp tightness to correlate so closely with dht sensitivity in the absence of any causality.
  - stormbrew 4y ago
    I really don't know what in my post made you feel like I was giving the GP any credit at all. This is a weirdly combative reply for a vehement agreement?

synu 4y ago

Would people who got male pattern baldness in their early twenties just have particularly stretched heads relative to younger age?

nervousvarun 4y ago
As said up thread it doesn't explain the successful transplants of follicles to these areas. If follicles transplanted to these areas also failed, then the mechanical explanation would hold more water, but they empirically don't...so something is obviously different at the follicle level.

Dig1t 4y ago

There are examples online of FTM trans people who start balding after taking testosterone for a while, those anecdotes seem pretty compelling to me.

jjoonathan 4y ago
Yes, exactly, we can (and do) mess with hormones and see what happens. This causal link is extremely well established and rubicon33 does not know what they are talking about.
- voisin 4y ago
  > rubicon33 does not know what they are talking about. He simply says it the theory is based on correlation which you agree to in your first sentence.
  - jjoonathan 4y ago
    Quite the opposite. Using control to establish causality is study design 101.

aghostincarrot 4y ago

deanmoriarty 4y ago

How would you then explain all the double-blind clinical trials that demonstrated the majority of patients on Finasteride (a popular DHT inhibitor) slowed down, or slightly reversed, their hair loss, compared with the patients who were on placebo? (please Google for the studies and data, I don't have links ready but have reviewed them in the past, there are tons by different groups of researchers across many countries)

Traubenfuchs 4y ago

If it is not DHTs fault (and by proxy Ts, as more T = more DHT) then why do finasteride and dutasteride work so very well? At this point, rejecting as main culprit for AGA either too much DHT or a DHT sensitivity that is to high or, worst case, both at once in one man, is nothing but crazy fringe science. To stress this out, the vast majority of men will keep their hair forever with oral minoxodil and oral finasteride and someone not keeping it on oral dutasteride instead of finasteride is a freak of nature.

deleted 4y ago

[deleted]

stormbrew 4y ago

I believe there have been studies where they've transplanted hair from and to different parts of the body and found that they largely continue to grow the way they did at their original site, implying that follicles from different parts of the body just respond to hormonal environment differently. Also the current understanding is that it's specifically DHT (a second order type of testosterone) that causes head hair follicles, and hormone treatments that modulate conversion of T into DHT one way or the other have fairly predictable effects on hair loss patterns. There probably isn't just one single cause here, but hormones are definitely a big part of it.

jjoonathan 4y ago
You're underselling modern medicine and giving rubicon33 way too much credit. This isn't merely academic, it isn't merely correlations, it isn't speculative, and it isn't a mess of competing explanations. Hair transplants are a common and reliable intervention for male pattern baldness. If MPB were due to a tension mechanism, transplants wouldn't work. But they do. If MPB were due to a tension mechanism, surgical intervention would be simpler than transplanting thousands of follicles. But it isn't. If MPB is due to an endocrine mechanism, which it is, transplanted hair would behave differently than adjacent "native" hair against the progression of balding. It does. Billions of transplanted follicles on millions of balding heads testify to the fact that rubicon33 is way off base.
- voldacar 4y ago
  To me it's probably a combination of stress from dht exposure and mechanical stress that causes thinning and baldness once the total stress level around the follicle surpasses some threshold. You can't just dismiss mechanical stress that easily, it would be an insane coincidence for scalp tightness to correlate so closely with dht sensitivity in the absence of any causality.
- stormbrew 4y ago
  I really don't know what in my post made you feel like I was giving the GP any credit at all. This is a weirdly combative reply for a vehement agreement?