Does Testosterone Optimization Therapy Cause Hair Loss?
By Jay Campbell
November 17th, 2022
Whenever men ask me about using therapeutic testosterone for the very first time, this is the #1 question I always receive:
“Does testosterone optimization therapy cause hair loss?”
This fear is far greater than shrinking balls, “roid rage”, needle phobia, and all the rest combined.
If there’s anything I’ve learned over the past two years of explaining why and how hair loss actually works, men really, REALLY hate losing their hair.
They’ll sacrifice literally anything to have and keep a full head of hair — a stable high-paying job, a functioning penis, their friends, and even their lives.
For this alarming reason alone I am writing this short yet much-needed article to alleviate any concerns or misunderstandings people have about testosterone and hair loss.
Read this article and you’ll never have to second-guess your decision to start using testosterone therapy!
Can Testosterone Cause Hair Loss?
Unlike my many other articles where I present a bunch of scientific evidence and then state the conclusion at the end, I’m just going to give you the straight answer from the beginning.
I addressed the question “Does testosterone therapy cause hair loss?” in an old 2016 article.
And here’s a summary of what I said:
“Testosterone can exacerbate or speed up the rate of hair loss because it’s an androgen. However, hair loss is entirely genetic.
MPB (male pattern baldness), a.k.a. androgenic alopecia (AGA), is a genetic condition. It is inherited from your mom’s side of the family, and if you’re going to be genetically predisposed to hair loss, it will happen regardless of whether you use testosterone or not.
If you are genetically predisposed, using testosterone will speed up the rate of hair thinning/shedding regardless of the delivery system.
BUT, there’s no guarantee it will. Father Time catches up to everybody and your hair will eventually thin and recede on the crown of your scalp.”
It was true six years ago and it is still true today.
Yet the scientific community is still largely misinformed and strongly believes higher natural testosterone levels necessarily mean an increased likelihood of hair loss.
This is due to the conversion of testosterone into dihydrotestosterone (DHT) via the 5-alpha-reductase enzyme, and DHT is part of the “androgenic theory of hair loss”:
“5-alpha reductase enzyme activity, which converts testosterone to dihydrotestosterone (DHT), increases in balding scalp. DHT increases in balding scalp.Number of DHT receptors on the hair follicles increases in balding scalp, Blocking conversion of testosterone to DHT delays progression of AGA.”
I won’t get much deeper into this flawed thinking as my ultimate guide to hair loss thoroughly debunks the notion that DHT is the main culprit of balding in males.
For the final and last time:
BLOOD FLOW RESTRICTION TO THE SCALP…..is the primal cause of hair loss for both Men and Women.
But the connection between hair loss and testosterone levels is even more confusing when you look deeper into the overall body of scientific evidence.
There are men who suffer a specific type of hair loss – female pattern hair loss – that is linked to low testosterone levels.
That alone means on some level, hair loss can happen independently of high or low testosterone levels.
It’s enough for us to reach the following conclusion:
There is no DIRECT proven link to suggest testosterone is causing hair loss and the relationship between the two is highly misunderstood.
In other words, it is possible there are many more factors at play that contribute to the phenomenon of hair loss.
Will TRT/TOT Cause Hair Loss?
While the last section pertained to the natural testosterone levels in our body, now we’re looking at whether the administration of therapeutic testosterone into the body causes hair loss.
Thus we arrive back at the original question posed at the start of this article, being “Does testosterone optimization therapy cause hair loss?”
If you look at any of the bodybuilding forums online, you usually see extended discussions when somebody presents a story that goes something like this:
“I’ve been taking 200 mg of TRT/TOT and 200 MCG of Gonadorelin for 6 months now, and I started experiencing hair loss in the past 4 months or so.
It’s actually gotten really bad in the past 2 or 3 months, especially the last few weeks. I’ve had to unclog my tub twice in the past 4 weeks.
Clumps of hair come out when I comb it in the tub or even when I just pass my hands through my hair. Hell, even if I just shake my head hard enough, hair falls out.
I’ve been using special shampoos and conditioners, DHT blockers, and finasteride for the past 4 years to prevent as much hair loss as possible, since my father and brother started experiencing hair loss at my age.
All the preventative measures I’ve been taking have definitely been helping up until recently.
These past 3 or 4 weeks, my hair loss has gotten so bad, and it’s really been triggering my depression like nothing else I’ve experienced in a long time.
Is this normal for anyone else taking TRT? And does it eventually stop? If so, will the hair come back?”
Anecdotal reports like this are everywhere you go, which makes you wonder what the truth is.
But as many hair loss clinics will tell you (here, here and here), there is no definitive clinical evidence demonstrating a causative link between the start of therapeutic testosterone and the onset of hair loss.
While there are some studies looking at this link, they are contradictory in the results they produce and the multiple variables of the study population being examined (age, genetics, fitness level, etc.).
For instance, we have this 1965 study where bald men noticed hair growth after an androgen cream was applied to their scalps:
“…androgen creams were applied to the scalps of 21 bald men. Approximately 75% of the group showed some stimulation of hair growth, as indicated by longer, thicker, more pigmented hairs in the bald area. Within five months of treatment approximately 10% to 15% of the follicles were stimulated to produce terminal type hairs.
The probability of regrowth is dependent neither on the duration of the baldness nor on the age of the subject. The enhanced growth is not thought to be an expression of the hormonal activity of testosterone, which in predisposed subjects is a prerequisite for common baldness, but rather a pharmacological local effect on the synthetic activities of the underlying connective tissue”
On the other hand, we have this 2007 in vitro study where testosterone administration led to suppression of hair growth:
“Hair follicles from 14 biopsies, taken from the vertex areas from male AGA patients, were cultivated for 120-192 h in vitro with normal William’s E medium (control) or William’s E medium containing different concentrations of testosterone and/or caffeine. Hair shaft elongation was measured daily and at the end of cultivation, cryosections of follicles were stained with Ki-67 to evaluate the degree and localization of keratinocyte proliferation.
Significant growth suppression was found in hair follicles treated with 5 microg/ml testosterone… Moreover, caffeine alone led to a significant stimulation of hair follicle growth. These results were confirmed immunohistochemically by Ki-67 staining.”
Long story short, whether you experience any hair loss or not is HIGHLY dependent on the individual.
Common Causes of Hair Loss in Men
If we exclude testosterone and DHT as a cause of hair loss in men, what else could be factored into the equation?
I won’t be able to write out every single variable in this article and talk about them in depth, but just know the list is fairly extensive.
Some common causes of hair loss in men can include:
- Improper hair styling
- Genetics (i.e. family history of male pattern baldness)
- Disease states associated with a lack or over-abundance of a given hormone/vitamin/nutrient
- Chronically elevated stress levels
- Poor lifestyle (bad diet, lack of sleep, smoking, etc.)
- Cellular health
Short of a bad set of genes, the good news is the overwhelming majority of hair loss causes are entirely within your control.
Furthermore, ALL these factors are linked to systemic inflammation in one way or another.
Fix the inflammation and you will solve all of the hair loss problems that cannot be attributed to genetics alone.
How to Prevent Hair Loss While Taking Testosterone
If you want to know how to avoid hair loss on TRT (testosterone replacement therapy), this section was written just for you.
First, ignore any article (such as this one) telling you the solution is the use of Minoxidil, Finasteride, or any form of DHT-blocking medication.
You’ll save yourself an awful lot of money and a long laundry list of undesirable side effects that range from temporary and mild to permanent and severe.
Second, focus on living a fully optimized lifestyle that focuses on lowering your bodily inflammation and maximizing your hormonal profile.
Even if hair loss is inevitable, you can minimize the amount of cosmetic damage you do to your hairline by using plain common sense.
Third, make sure you pick up several orders of Auxano Grow V2 if you are dead serious about reversing any kind of genetics-induced hair loss.
Not only is it 100% free of side effects and backed by hundreds of real-world results, but it also will not interfere with your testosterone regimen at all.
You can get 15% off with code JAY15, and the deals we offer our exclusive email newsletter subscribers are even better!
Those three things, as simple are they are, are all you need to know about how to prevent hair loss while taking testosterone.
So in the end, does testosterone optimization therapy cause hair loss?
The answer, as with all complicated things in life, is “it depends”.
We are all biochemically unique and N of 1 when it comes to our individual profiles, and there is no exception when it comes to testosterone therapy and losing your hair.
But allow me to convince you of the life-changing magic of testosterone with this final thought:
Are you going to choose to suffer from the symptoms of low testosterone to maintain your hair, or would you rather be optimized and feel amazing from the positive health benefits of testosterone and lose your hair?
If I’m that guy who has to make the choice, I’m shaving my hair and becoming Mr. Clean.
The benefits far outweigh the horrific ‘suffering in silence’ you will experience.
Raise Your Vibration To Optimize Your Love Creation!
PS – To see more commonly believed health myths fully debunked by my +30 years of coaching over 10,000 people and decades of underground medical research, join The Fully Optimized Health Private Membership Group.
It’s your greatest opportunity to fully optimize your health and gain total access to me and my network of high-level men and women living their highest and best life.