It is used in conjunction with testosterone to detect 5a-reductase 2 deficiency in XY disorders of sexual differentiation (DSD). The trouble is, it is not very good for this purpose, for reasons that are probably soundly biological rather than methodological. Androgens are subject to reduction by at least one other 5a-reductase, and the circulating level of DHT may not therefore reflect DHT generation at target sites by 5a-reductase 2. In contrast, urinary steroid profiling provides 100% concordance with genotyping. By happy chance, the 5a-reductase for cortisol appears to be almost exclusively 5a-reductase 2, so ratios of 5a/5B tetrahydrocortisol are diagnostic and can still be used if gonadectomy has been done. Of course, urinary steroid profiling can also provide positive identification of most other steroidal causes of DSD..
Norman Taylor
Consultant Clinical Biochemist
King's College Hospital (Viapath)
________________________________________
From: Clinical biochemistry discussion list [[log in to unmask]] on behalf of Elizabeth Palmer (Cwm Taf UHB - Biochemistry) [[log in to unmask]]
Sent: 25 June 2015 16:13
To: [log in to unmask]
Subject: Dihydrotestosterone and gender reassignment
Dear Mailbase,
We are seeing an increase in the number of requests for dihydrotestosterone in gender reassignment.
What is the value for DHT in gender reassignment and when is it appropriate/inappropriate please?
Many thanks,
Liz Palmer
Trainee Clinical Biochemist
Clinical Biochemistry
Cwm Taf University Health Board | Prince Charles Hospital | Merthyr Tydfil | CF47 9DT
Bwrdd Iechyd Prifysgol Cwm Taf | Ysbyty'r Tywysog Siarl | Merthyr Tudful | CF47 9DT
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