Can testosterone replacement, “testosterone boosting” herbs like Tribulus Terrestris, or supplements like Creatine contribute to hair loss?

Answer:

Yes, it’s considered risky for those susceptible to hair loss. We know in the body, testosterone gets converted to DHT dihydrotestosterone, a known trigger for hereditary hair loss or androgenetic alopecia.

Although we don’t know the specific action or effectiveness of many of these “testosterone boosting” herbs and supplements, the use of Tribulus Terrestris may in fact be risky for those with hair loss. But, as of now, there’s no definitive answer. Though the herb T. Terrestris (Tribulus Terrestris) was popularized by a 1970’s bodybuilder to increase the body’s natural testosterone, human studies have failed to prove that it increases testosterone or strength. Animal studies in rats, rabbits and primates have demonstrated ambiguous results or results that were not statistically significant. Only one single animal study showed that it altered sexual behavior in castrated rats by theoretically stimulating androgen receptors in the rats’ brains. Another animal study found that administration of Tribulus terrestris extract produced statistically significant increases in levels of testosterone, dihydrotestosterone and dehydroepiandrosterone, and produces effects suggestive of aphrodisiac activity. This is where things get risky for hair loss patients.

The most important thing for your readers/viewers to understand is that if they are genetically predisposed to hereditary hair loss (male pattern hair loss), ANYTHING they do which increases the body’s testosterone level naturally or unnaturally poses a risk to the hair follicles because testosterone becomes dihydrotestosterone (DHT) in the body. Dihydrotestosterone is the primary trigger for male pattern baldness. For example, testosterone replacement can significantly accelerate the hair follicle miniaturization associated with male pattern baldness, unless they are on a medical hair loss management regimen.

If someone is not sure if they are at risk for hereditary hair loss and wants to check, there’s a simple cheek-swab genetic DNA test for that called HairDX as well as other non-invasive evaluations that can be performed using HairCam dermoscopy and HairCheck cross-sectional bundle measurement comparisons. These are evaluations we commonly perform during an initial hair loss evaluation at Bauman Medical Group.

Bodybuilders, pro athletes, hormone replacement patients and many others often seem to have trouble maintaining good quality hair growth. However, there are many effective medical hair loss treatments to help stop and reverse the effects of the DHT: finasteride, minoxidil, laser therapy, nutraceuticals, cell therapy (PRP), etc. and there are ways to scientifically evaluate and measure what is going on at the level of the scalp before, during and after anything that may boost DHT so we know what is working. Advanced treatments like compounded finasteride FinPlus, compounded minoxidil Formula 82M, the powerful/portable/discreet LaserCap, nutritionals, Platelet Rich Plasma with ECMs like BioD are all at the leading edge of treatment.

On a separate note, we’ve seen supplements like Creatine–commonly found in pre-workout and post-workout recovery shakes–now proven in humans to increase DHT dihydrotestosterone, confirming the hair loss risks we predicted years ago after we saw hair loss in those patients using it. (Therefore, supplements can sometimes cause trouble for hair loss patients!)

When it comes to hair regrowth, which can be subtle at first, self-monitoring rarely works so encourage your viewers to seek out a board-certified hair restoration physician that can perform seasonal HairCheck cross sectional bundle measurements, diagnostic genetic testing (if needed), prescribe an effective medical regimen and track the progress. Good luck!

Sincerely,
Dr. Alan J. Bauman, M.D. – Diplomate, American Board of Hair Restoration Surgery – Medical Director, Bauman Medical Group

About Dr. Alan J. Bauman
Alan J. Bauman, MD, ABHRS, IAHRS, FISHRS is a full-time hair transplant surgeon who founded his medical practice in 1997 and has treated nearly 30,000 patients and performed over 10,000 hair transplant surgeries and over 10,000 PRP hair regrowth procedures to date. His compassionate, patient-centered philosophy and individualized artistic approach to protecting, enhancing, and restoring the appearance and health of the hair and scalp is what sets him apart from non-specialists and other practitioners. Currently located in Boca Raton, Florida, Dr. Bauman received his M.D. degree from New York Medical College and surgical residency training at Mt. Sinai Medical Center and Beth Israel Medical Center in New York. Dr. Bauman is one of only approximately 200 physicians worldwide to achieve certification from the esteemed American and International Board of Hair Restoration Surgery (ABHRS), be an accepted member of the International Alliance of Hair Restoration Surgeons (IAHRS) and also recommended by the American Hair Loss Association. Dr. Bauman has achieved the coveted Fellow status within the International Society of Hair Restoration Surgery (FISHRS) and is a frequently invited faculty member at numerous international scientific meetings, live surgery workshops, and major beauty industry events. Dr. Bauman is the first-ever hair transplant surgeon to be formally accepted as an Intercoiffure Industry Partner. He is also an Advisory Board Member for the World Trichology Society and an active Trustee of the Greater Boca Raton Chamber of Commerce; he credits part of his early and ongoing success thanks to his involvement in local and national professional networks. He is also the author of numerous articles and textbook chapters on the science of hair care and hair transplantation, including eyelash transplant surgery, and has been extensively featured in the world’s leading mass media as a medical expert and successful early-adopter and pioneer of some of the most advanced technologies in the effective treatment of hair loss. Dr. Bauman's international reputation and his exceptional team at Bauman Medical attracts patients from all corners of the globe for hair loss diagnosis and the latest and most effective hair restoration treatments and procedures. Dr. Bauman has been voted “North America’s #1 Top Hair Restoration Physician” year after year by Aesthetic Everything and was recently named a Top 5 Transformative CEO in Forbes. His accessible and interactive presence on social media has garnered millions of video views on YouTube and thousands of subscribers, connections, and followers on the most popular platforms. A recent Live Hair Transplant Surgery broadcast directly from the procedure room in his Boca Raton office gained over 100,000 simultaneous views from more than 20 countries. Dr. Bauman also has been a member of the highly respected Pantene Hair Research Institute, a global network of leading hair experts focused on the advancement of hair science, technologies and products. Personal appearances, interviews, and profiles include the Today Show, The Early Show, Good Morning America, Extra, Access Hollywood, The Doctors, and Dateline NBC among other TV appearances. Newspaper and Magazine articles and feature stories include The New York Times, Forbes, Newsweek, Cosmo, Elle, Vogue, Allure, O – The Oprah Magazine, and Men’s Health among others. In addition to serving as the CEO of Bauman Medical and teaching and consulting internationally, Dr. Bauman personally treats patients at his Bauman Medical Hair Transplant and Hair Loss Treatment Center in beautiful Boca Raton, Florida. For complete details visit https://www.baumanmedical.com

If you or someone you know has hair loss, hair thinning, baldness, or eyebrow / eyelash concerns, click to start either a long-distance virtual consultation OR an in-person, in-office consultation with Dr. Bauman. You can also Ask Dr. Bauman a Question or simply call Bauman Medical Group  at +1-561-394-0024.