Why some people experience problems on Finasteride/Dutasteride (my theory)

Keynotes:
5ARIS - 5-alpha-reductase-inhibitors

DHT - dihydrotestosterone

T - testosterone

E - eostrogen

AGA - androgenic alopecia

AR - androgen receptor

First of all, hello everyone.

It's a well established fact that a small percentage of people experience side effects while on finasteride. Lots of people come up with theories as to why that may be the case such as living a sedentary lifestyle or not living a healthy and active lifestyle that promotes healthy hormonal levels. I think there's more to it than that. There are users who despite leading healthy and active lifestyle still end up experiencing side effects, leaving them confused and frustrated. Well they're not doing anything wrong, that's the thing. The problem isn't due to ''hormonal levels'' or ''high DHT levels'', the real culprit is androgen receptor density in the scalp. Ever wonder why some people can grow crazy body hair and really dense facial hair (which are conventionally signs of ''high'' androgen levels) and still maintain full heads of hair? This is because they don't have high AR density in their scalps meanwhile their AR densities in the rest of their bodies are relatively high. THIS is the main deciding factor for hairloss: it's your AR density, not your DHT levels. So, what can we make of this? Well a few conclusions can be made here: 1.Finasteride/Dutasteride doesn't necessarily get to the root of the problem. Sure you reduced your androgen levels and therefore less androgens are present to bind to AR in your follicles to induce hairloss but you didn't eliminate all androgens at your scalp. And for context yes, testosterone does cause hairloss as BOTH DHT and T are androgens. It's just that DHT is several folds more androgenic than T. 2. Side effects due to 5ARIS are caused when your hormonal profile is naturally dominated by DHT. Say for example if you're someone who's naturally producing higher amounts of 5-alpha reductase enzymes than the next guy then this will lead to a higher rate of conversion of T into DHT, making your hormonal homeostatis more dependent on DHT, rather than T. So when you take something like Finasteride or Dutasteride suddenly you tanked your DHT levels when your hormonal status is DEPENDENT on the DHT. So your overall androgenicity has been compromised, to a point where testosterone cannot quite compensate for it. The reason why lots of men don't experience side effects is because they're not DHT dominant. They can eliminate their DHT without much problems.

Conclusion: side effects on finasteride/dutasteride is most likely not a lifestyle issue, but a predisposition due to hormonal status (like being DHT dominant)

for those who experience side effects on these drugs, your next best course of action is using topical antiandrogens which will block androgen receptors locally preventing androgens from binding and leading to hair loss, without impacting hormonal production.