5-alpha reductase activity, which converts testosterone to DHT and is linked to hair loss, has a strong genetic component and can be influenced by factors like insulin resistance and obesity.

“These hormones will go up now they go up depending on a number of factors 5-alpha reductase has quite a strong genetic component so some men are very strong 5-alpha reductase producers and they're going to make a lot of DHT by the way this is responsible for one of the side effects of testosterone which is hair loss so a lot of hair loss is driven by DHT and the Androgen receptor and therefore if you're susceptible to that and you give five if you give testosterone and you make more DHT you're going to accelerate hair loss”