5a-Androstanediol is a testosterone metabolite that is more androgenic than b-Androstanediol. It is metabolized via the 5-alpha metabolic pathway (= increased 5α-reductase activity). In contrast, the 5-beta metabolism makes androgens less potent.
Increased 5a-reductase activity may be accompanied by clinical signs of androgenicity (excess facial hair growth, scalp hair loss, acne, irritability, oily skin, prostate issues in men...etc).
It's important to look at this marker and compare it to 5b-Androstanediol. If your 5a-Androstanediol (this marker) and 5a-DHT are increased and 5b-Androstanediol is normal to low then you can do things to lower the preference of your body to move towards that 5-alpha metabolic pathway.
If your overall testosterone is elevated as well, please refer to the main testosterone biomarker as you have to address the overall testosterone level and which pathway (alpha vs. beta) your body is choosing.
Technically, 5a-Androstanediol can also be formed from DHEA metabolites without going through the testosterone pathway, but they generally tend to correlate with testosterone production.
Androgen deficiency can lead to:
- decreased sexual function
- fatigue
- depression
- bone loss
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If your 5a-Androstanediol and 5a-DHT levels are increased, and your overall testosterone levels are normal (or even high) then your body is leaning towards the more androgenic 5-alpha metabolism pathway.
Possible symptoms:
If you are going down the alpha pathway towards 5a-DHT/ 5a-Androstanediol (= elevated values), the symptoms are usually your typical PCOS-like symptoms like facial hair, acne, anger and irritation and hair loss on the head. Males might experience pattern baldness, prostate enlargement (BPH = Benign prostatic hyperplasia). You might have completely normal levels of testosterone (please check your testosterone marker in this test to verity) and, yet, have a bad case of acne, are irritated or thinning scalp hair. If your 5a- DHT / 5a-Androstanediol is increased this would be an indication that you are favoring the alpha pathway that’s quite aggressive on your skin, hair and other places.
How to potentially address increased 5-alpha pathway preference:
The reasons for your body choosing the alpha pathway can certainly be genetic, but it is often due to inflammation, blood sugar / insulin dysregulation, having extra adipose tissue, etc.. If you can address these underlying issues then your body will balance out the alpha and beta pathways and it will improve the symptoms.
In addition to addressing the underlying conditions (inflammation, glucose/insulin dysregulation, etc), there are things that can be done from a lifestyle perspective to mitigate the symptoms by blocking the alpha pathway, such as:
(before starting a supplement regime, please consult your doctor first)
- Zinc
- Saw palmetto
- Stinging and dwarf nettle
- Pygeum extract (bark)
- Reishi mushroom
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11b-Hydroxyandrosterone, 11b-Hydroxyetiocholanolone, 2-Methoxyestrone, 5-alpha-Androstanediol, Allo-Tetrahydrocortisol, Alpha-Pregnanediol, Alpha-Pregnanediol / Beta-Pregnanediol Ratio, Beta-Pregnanediol, Cortisol/Cortione 11B-HSD II, Cortisol: Metabolite Ratio, E Quotient, Free DHEA, Tetrahydrodeoxycortisol
