#220 Wnt vs DHT: Understanding Androgenic Alopecia and the Top Treatments to Slow Hair Loss

In this solo episode on androgenic alopecia, the host explains that hair loss is slow and progressive, driven largely by genetics and DHT-mediated miniaturization of follicles across the anagen, catagen, and telogen cycle, and stresses early detection using periodic photos of the temples, hairline/vertex, and crown. He frames hair growth as a "battle" between Wnt signaling (promotes growth and anagen entry via stem cell activation) and DHT signaling (suppresses Wnt and increases inhibitors like DKK, TGF-beta, and PGD2), noting advanced loss involves inflammation, fibrosis, and irreversible follicle loss. He reviews contributors like poor scalp blood flow, iron deficiency (most evidence), possible zinc/B12/folate deficiency, thyroid dysfunction, and insulin resistance, then covers treatments: finasteride (oral and topical) and dutasteride as DHT blockers with potential systemic side effects, plus minoxidil and microneedling (home vs professional) as key options, with add-ons like ketoconazole shampoo, PRP, red light, and cautions about anabolic steroids and high-dose testosterone increasing DHT pressure.

Hair loss diagnosis and treatment https://www.aad.org/public/diseases/hair-loss/treatment/diagnosis-treat

Androgenetic alopecia https://medlineplus.gov/genetics/condition/androgenetic-alopecia/

DHT and WNT signaling https://pubmed.ncbi.nlm.nih.gov/29549490/

Finasteride https://medlineplus.gov/druginfo/meds/a698016.html

Topical finasteride https://pmc.ncbi.nlm.nih.gov/articles/PMC6609098/

FDA warning on compounded topical finasteride https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-providers-compounders-and-consumers-potential-risks-associated-compounded

Post-finasteride syndrome https://pubmed.ncbi.nlm.nih.gov/35983808/

Dutasteride https://medlineplus.gov/druginfo/meds/a603001.html

Minoxidil https://www.aad.org/public/diseases/hair-loss/treatment/diagnosis-treat

Microneedling for hair loss https://pubmed.ncbi.nlm.nih.gov/23960389/

Ketoconazole shampoo https://pubmed.ncbi.nlm.nih.gov/31858672/

Topical caffeine https://pubmed.ncbi.nlm.nih.gov/39997270/

Pumpkin seed oil https://pubmed.ncbi.nlm.nih.gov/24864154/

PRP for hair loss https://pubmed.ncbi.nlm.nih.gov/30882509/

Red light / low-level light therapy https://pmc.ncbi.nlm.nih.gov/articles/PMC8906269/

Stem cells / exosomes for hair growth https://pmc.ncbi.nlm.nih.gov/articles/PMC12433634/

Iron, zinc, B12, and folate deficiencies https://pmc.ncbi.nlm.nih.gov/articles/PMC6380979/

Thyroid testing https://medlineplus.gov/thyroidtests.html

Insulin resistance / metabolic syndrome https://medlineplus.gov/metabolicsyndrome.html

Testosterone / TRT https://medlineplus.gov/druginfo/meds/a605020.html

Tretinoin https://medlineplus.gov/druginfo/meds/a682437.html

Anastrozole / Arimidex https://medlineplus.gov/druginfo/meds/a696018.html

Anabolic steroids https://nida.nih.gov/research-topics/anabolic-steroids

Show Notes

00:00 Welcome to the Hart2Heart Podcast

00:56 What Is Androgenic Alopecia

02:17 Hair Follicle Life Cycle

03:55 Miniaturization and Early Detection

06:51 DHT Basics and Other Causes

09:27 WNT Versus DHT Explained

13:10 Nutrients Thyroid and Insulin

16:26 Finasteride Benefits and Risks

19:21 Topical Finasteride and Dutasteride

25:01 Minoxidil Growth Booster

27:19 Microneedling for WNT Activation

30:21 Extra Treatments and Add Ons

37:04 Testosterone TRT and Steroids

40:16 Wrap Up and Key Takeaways

The Hart2Heart podcast is hosted by family physician Dr. Michael Hart, who is dedicated to cutting through the noise and uncovering the most effective strategies for optimizing health, longevity, and peak performance.

This podcast dives deep into evidence-based approaches to hormone balance, peptides, sleep optimization, nutrition, psychedelics, supplements, exercise protocols, leveraging sunlight, and de-prescribing pharmaceuticals — using medications only when absolutely necessary.

Beyond health science, we explore the intersection of public health and politics, exposing how policy decisions shape our health landscape and what actionable steps people can take to reclaim control over their well-being.

Guests range from out-of-the-box thinking physicians such as Dr. Casey Means (author of "Good Energy") and Dr. Roger Sehult (Medcram lectures) to public health experts such as Dr. Jay Bhattacharya (Director of the National Institutes of Health (NIH) and Dr. Marty Mckary

(Commissioner of the Food and Drug Administration (FDA) and high-profile names such as

Zuby and Mark Sisson (Primal Blueprint and Primal Kitchen).

If you're ready to take control of your health and performance, this podcast is for you.We cut through the jargon and deliver practical, no-BS advice that you can implement in your daily life, empowering you to make positive changes for your well-being.

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