Dihydrotestosterone Induces Expression of 5AR gene

Hi guys,

I believe that this article is not in the articles section, if it is, sorry. But it is very interesting. Read it carefully.

“A striking finding is that dihydrotestosterone, the product
of 5a-reductase enzyme, positively regulates the expression
of the 5a-reductase gene.”

I remember one member on the old forum healed throught consistent use of Proviron. Proviron is synthetic DHT, am I right?
-How many in here have used Proviron?
-Has anyone even tried to find out in what condition is his 5 alpha reductase?
This might be a key, after all, finasteride blocked the function of this very enzyme 5AR. What do you guys think?

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I agree. Of all the hormone levels we check, we never check the level of 5AR. I’m not sure if there is a blood test that checks that. But it would be interesting to know this level.

The article was interesting. I believe it is saying that DHT causes 5AR production. So the reverse should be true too. Low DHT , low 5AR.

I have heard that it is possible to test for 5AR activity.

Apparently Dr. Crisler does this via 24/hour urine testing for active 5AR metabolites or something…

This is an extremely important paper that may hold the key to solving PFS. I am reposting it from the original post: https://www.pnas.org/content/pnas/88/18/8044.full.pdf

I would be curious to hear what people think about it and the additional points I make below.

Quotes from the paper:
<<These findings indicate that dihydrotestosterone itself controls prostate growth and Sa-reductase activity. They further suggest that prostate growth is controlled by a feed-forward mechanism by which formation of trace amounts of dihydrotestosterone induces 5a-reductase, thereby increasing dihydrotestosterone synthesis and triggering a positive developmental cascade.

These findings imply that dihydrotestosterone controls its own rate of synthesis in a positive manner.

A striking finding is that dihydrotestosterone, the product of 5a-reductase enzyme, positively regulates the expression of the 5a-reductase gene.>>

The article suggests that 5a-reductase activity is promoted by DHT. Therefore, low levels of DHT will downregulate 5a-reductate (paradoxically).

Some additional facts about PFS that check out with the article’s findings.

  1. Many people get PFS when there is a sudden DROP in DHT concentrations. That’s how I got it - from one 5mg pill of Finasteride upon resumption after a period of cessation.

  2. I have extremely low DHT, high Free T and high Progesterone. This may indicate malfunctioning 5a-reducatase.

  3. From Melcangi’s latest study: “In fact, PFS patients showed higher serum and CSF testosterone levels than healthy controls, while other neuroactive steroids, also including DHT, were suppressed”

  4. Not all PFS patients exhibit this hormone pattern and this may be due to variation of other important variables - such as body fat percent, insulin sensitivity, etc. For example, differences in body fat percent may affect amount of E2 produced as a response of higher T levels, which will change the presenting balance of hormones.

  5. We need to be open to the idea that there may be more than one way PFS may be induced as well to the idea that not all post-finasteride symptomatic patients have true PFS.

  6. From Melcangi’s latest study: “For the first time, we demonstrate a tissue-specific methylation pattern of SRD5A2 promoter in PFS patients.” Note: this is the gene encoding for 5a-reducase II enzyme.

Putting all this together, one would wonder whether DHT supplementation may be able to restore 5a-reductase activity. I know people have tried this and the effect has only been temporary (or there has been no effect, or they have gotten worse).

This lack of long-term effect may be due to negative feedback mechanisms where the body suppresses the HPTA in response to the rising DHT levels, which downregulates endogenous 5a-reducase synthesis - or has other oppositional effects.

There is evidence that such adaptation happens in response to DHT supplementation - in this paper originally posted by @Mew:
“Serum concentrations of LH, FSH, E2, T, and SHBG decreased significantly during DHT treatment.”
https://www.ncbi.nlm.nih.gov/pubmed/11932266 .

To oppose such an adaptation and to force the change to happen at the gene expression (and AR sensitivity) level, HPTA hormones (T, LH, etc?) may have to be supplemented as well, and E2 controlled. This will not be easy as there are many feed-back loops in the body, including through estrogen, SHBG, etc.

One way to attempt to achieve temporary high DHT concentrations before other hormones downregulate is through a series of cycles with high-dose DHT supplementation. This has been proposed before (although I don’t understand all of the logic explained here).
Anonymous user's theory: DHT treatment to increase 5AR2 expression .

To test this hypothesis, I intend to try cycles of a DHT cream for two days combined with a high dose Tribulus for 4 days (for lack of a more sophisticated HPTA maintaining TRT protocol). This is unlikely to work quickly but may have a positive effect over time.

I have already tested my blood before and after Tribulus cycles and I know that my T, E2, LH, FSH, and Progesterone all rise due to Tribulus.

The question is how to avoid a crash when supplementation is discontinued. It seems that a cycle approach may be counterproductive in that regard.

Update: On a second thought, this kind of cycles may lead to a crash, as at the end of each cycle one might end up with lower T and possibly lower DHT. It may be important to carefully control T and E2 and discontinue supplementation very gradually instead. Thoughts?

Ideally such experiments would be done in an animal model, where all variables can be controlled and measured precisely. I have long appealed on this forum for the need for such empirically-driven animal studies that we can easily fund, but to no avail. (Notice bitterness).

I admit that I have read very little about androgen biology and no doubt things are a lot more complicated and multi-layered than this. However, the solution does not have to be complicated, at least not from an applied point of view (as long as it is executed properly), just as the PFS-inducing cause was simple enough.

I would appreciate any comments - both on the theoretical aspects and on the proposed protocol.


This is the basis for the CDnuts protocol

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I’ve experimented with doses up to 1000mg proviron and I got no lasting improvements. Even the temporary improvements weren’t very significant.

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I don’t know much about it. Can you elaborate some more? Is there a good place where CDnuts explains the rationale for his protocol or a theory?

Did you supplement T and control E2 as well?

What if Mesterolone works differently than DHT vis-a-vis 5a-reductase? Not impossible.

I tried taking it with T and also taking it with estrofem. I tried many different combinations and got insignificant effects. This led me to the conclusion that our ARs are at fault.

However, there may be another possible mechanism. Recently I read a post by someone saying that the concentration of DHT in different tissues is finely regulated by various mechanisms (for example 3a-HSD which can essentially deactivate DHT). Therefore, it may be possible that whilst the global level of DHT is very high due to exogenous supplementation, the actual level within the tissues essential for sexual function are very low due to malfunctioning regulatory mechanisms. This would explain why our ARs are hypersensitive.


I got extreme improvement on my first week of aromatase inhibition. I can say total reversal of pfs including ed but i made a break for a week then couldn’t replicate it
Now i have way more better sensitivity, normal orgasms, somewhat restored visual lust and high libido compared to my pfs baseline.


Thinking along these lines is very smart. If we ever find the mechanism it will be because we are thinking along these lines.

I may have found something significant with the enzyme 11-B-hydroxysteroid dehydrogenase enzyme 2 (3B-HSD)

It involves the steroid metabolite 3b-adiol

I recently discovered a flagged low 3b-Adiol reading from my labs from 2014. We have looked at 3a-Adiol on this forum in the past but never 3b-Adiol

I’m going to make a tread about what I may have found

It’s time we start taking a closer look at other enzymes


I like this observation. It’s one of the challenges of the various protocol experiment threads here. So much that is being tried is in response to a given individual’s lab work. But labs can implicate totally different potential culprits in someone else dealing with the same symptoms. I’ve noticed this lately looking at old threads about cortisol and thyroid issues.

I can speak to this topic from my own experience, for what it’s worth. In early '15 I tried what was then Dr. Goldstein’s protocol (I know it has evolved since then). It involved direct DHT supplementation with Andractim, T injections, estrogen control, and some other features.

This was my first time trying DHT and it didn’t produce any miracles in me, however I did note that it seemed to restore pre-seminal fluid in me. I have no idea why or how, but this was just one of those strange things that had happened to me after using Propecia – I would never have any precum with an erection. That changed while using DHT, I believe, and even though I stopped using DHT after several months, that change endured. It also had the effect on my lab work that you suggest: My DHT level shot up ~30 points, and my chronically high (since Propecia) SHBG did drop significantly.

Unfortunately, I didn’t get any other changes in my sexual symptoms through DHT, and I don’t think it did anything to help my metabolism, which has seemed very slow since Propecia.


The basis of the CD’s protocol is not simply taking DHT pro hormones in hopes to induce 5ar expression. This was one small part of it. The bulk of his protocol consists of plant based natural treatments to cleanse your body and numerous other methods to create the right environment to heal. It’s not directed toward one avenue such as trying to induce 5ar expression. It’s designed to heal everything that went wrong with our bodies.

The anonymous poster who posted inducing 5ar expression by cycling DHT recommended this as a possible treatment a long time ago. More is known now about PFS to the extent that we know It’s likely more complicated than lacking 5ar or at least lacking 5ar in places they we are going to increase it by cycling DHT. it’s likely more complicated than this involving different receptors being up regulated or down regulated as well as our down stream metabolites being altered.

Cycling DHT has helped some people though. Super R Andro is probable what you want to try if you are going to do it. I have ran about 12 cycles of this and other DHT prohormones over the last few years with no lasting benefit. I just feel a little better while on it. Point being I would not expect a recovery out of it.

This is pretty consistent with most people who have tried these basic approaches. PFS results in having abnormal basic hormonal profile. But it’s clearly not the mechanism.


I think you right about some of your points. PFS is not this straight forward malfunction. It’s complex and there is plenty of evidence through labs and responses to different things that suggest that there are different cases of PFS. Some of us get worse from inhibiting estrogen while some get better. That’s just one example. I also think you are correct in concluding that not everyone who thinks they have PFS really has it.

This is pretty consistent with the majority who have tried this approach. Especially those who use it at as a stand-alone treatment plan.

Cdsnuts used bro science to cobble together a bunch of therapies based on what sounded good. He never sat down and studied each therapy in terms of the science in such a short space of time then relayed the science in deep medical explanations that justified what he was doing. He did not have the medical training to understand deeply how all these therapies affects the body. He simply took the highlights and positives of each therapy from a bunch of articles them sold those ideas to a bunch of sick gullible men.

Looking at his symptoms he had a HPTA crash and not the syndrome. He was still able to respond to dht. The other giveaway is that the natural therapies didn’t cause negative reactions by fluctuations in androgens. His Androgen receptors were not over expressed so he could tolerate various therapies that would act on AR.

However the theory of cycling dht seems to be something that prompts further investigation. Some fasting and a long term exercise protocol for healthy methylation and promotion of natural dht in the body/brain should be enough going forward.

Here is an explanation on androgens which gives us some appreciation of how complicated our bodies are.

Androgens are hormones produced by the gonads and other endocrine organs of vertebrates. Testosterone, along with its metabolite dihydrotestosterone, is critical for the differentiation of the fetal male reproductive tract from an indifferent state, for the development of male traits during puberty, and for the maintenance of reproductive function in mature animals. The androgen signaling pathway is highly conserved in the reproductive system of all vertebrates from fish to humans; therefore, environmental chemicals have the potential to induce adverse effects in any vertebrate species. There are synthetic androgens present in the environment, and several pesticides and toxic substances display antiandrogenic activity. For example, exposure to mixtures of antiandrogens during sexual differentiation results in cumulative adverse effects in male rat offspring. Continued characterization of the role of androgens in reproductive and other systems is warranted to enable better understanding of the potential adverse effects of chemical disruption of androgen signaling.

The androgen receptor (AR) is a nuclear receptor that is activated by binding of natural hormones such as testosterone or dihydrotestosterone (DHT) or synthetic androgenic steroids. Androgen-bound AR acts as a DNA binding transcription factor that regulates gene expression (figure 1). In some cell types, testosterone interacts directly with ARs, whereas in others, testosterone is converted by 5-alpha reductase to DHT, an even more potent agonist for AR activation. Binding of an androgen to the AR results in a conformational change in the receptor, which in turn causes dissociation of heat-shock proteins, dimerization, and transport from the cytosol to the cell nucleus, where the AR dimer binds to a specific sequence of DNA known as a hormone response element. ARs interact with coactivator or corepressor proteins in the cell to up- or down-regulate specific genes. Up-regulation or activation of transcription results in increased synthesis of messenger RNA, which in turn is translated by ribosomes to produce specific proteins. Androgens regulate a wide variety of tissue- and species-specific genes. During mammalian sexual differentiation, testosterone is the AR-activating hormone in the Wolffian duct, while DHT is the main androgenic hormone in the urogenital sinus, urogenital tubercle, and hair follicles.

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I am now of the opinion that cycling of DHT is potentially dangerous because suddenly withdrawing from it may lead to a PFS-like crash. Instead, a longer-term protocol with a gradual tapering may be better.

@Sibelio what do you think of this taken from blooms post below.

It is my belief that the most severe cases of PFS are caused by a 5ar downregulation in the Brain/CNS. So any attempts to increase 5ar and/or DHT peripherally without directly increasing 5ar in the Brain/CNS causes a negative feedback on the HPG axis


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I wonder if allo (very similar to DHT 5ar-metabolite) can induce 5ar expression in the brain. This could explain the benefits from a short course of Brexanolone and SAGE-217.

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