..soo most people havent experienced sides from topicals??...
My comment suggested the opposite. Topical administration has hardly any side effects, compared to systemic/oral use, due to the so-called
first-pass effect.
... does spiro significantly lower blood dht levels?
Consider this. Elevated scalp levels of the testosterone metabolite, DHT, produce an inflammatory condition. The body regards this inflammatory condition as a threat, and initiates an immune reaction by producing higher levels of anti-bodies in hair follicles. The inflammatory state and the ensuing immune action and reaction within the follicles combine to damage hair follicles by shrinking them and eventually destroying them, leading to hair loss. While this is not the only pathway that leads to hair loss, it still demonstrates how what usually starts as an androgenic action eventually leads to hair-thinning and loss. Spironolactone appears to inhibit, or at least, reduce the ability of DHT to enter hair follicles, thereby reducing hair loss and stimulating hair growth. As for blood DHT levels, the concomitant use of an inhibitor of the alpha-5-reductase enzyme, that converts testosterone into DHT, may be a useful option. Personally, though, I prefer to regard hair loss as a complex inflammatory event that should be dealt with from many angles. These include the use of DHT modulators, topical free-radical quenchers, endothelial-cell-lining rejuvenators, and topical super-oxide dismutase, one of the most potent hair regrowth stimulators around.
