A Pregnenolone Supplement for Adrenal Fatigue

By: Dr. Michael Lam, MD, MPH; Dr. Justin Lam, ABAAHP, FMNM



Pregnenolone supplement should be used with cautionAdrenal Fatigue Syndrome (AFS) is a condition caused by chronic stress that is not well known among conventionally trained physicians. The symptoms of this condition are sometimes vague and difficult to recognize as a pattern that denotes a problem with adrenal output. However, these symptoms can become debilitating. On presenting symptoms of AFS to your physician, he or she will likely focus solely on the symptoms and not on a more comprehensive viewpoint in managing your condition. A pregnenolone supplement may be among the first things recommended, but it is important to consider what is going on with the hormones in the body and why before deciding if this is a good course of action.

Conventional Medicine’s Approach to AFS

Most conventionally-trained physicians are not familiar with AFS and its symptoms. Conventionally trained physicians have no problem identifying excessively high levels of cortisol as being associated with Cushing’s Disease, and low levels of cortisol being associated with Addison’s Disease. However, these two extremes of adrenal function do not take into consideration any state in between. Tests used for these conditions only delineate the extremely high or low levels of cortisol. Those who have normal laboratory results but clinically symptomatic levels are ignored.

This wide range of unusual but not clinically problematic levels is called a subclinical state, and this is where those with AFS typically test.

AFS is difficult to identify using standard medical blood tests. The tests used to check hormones related to the adrenals are designed to pick up extremely high or low levels, and will miss hormone levels that are outside the extremes. You may have hormone levels that are out of balance, or too low for optimal functioning, but these tests miss them.

The result is that patients are told they have normal hormone levels, or that their adrenals are functioning normally, when in fact they aren’t. Conventional medicine offers no help, or symptoms are addressed individually, with little or no relief resulting.

Efforts by conventionally trained physicians aim at the symptoms of AFS only. You may be given antidepressants or anti-anxiety medications, because depression and anxiety are typical symptoms of AFS. You may be given sleep medications, because insomnia is typical of AFS. Pain medications may be used, because pain is part of the symptomatic picture of AFS. The presence of continuing and potentially debilitating fatigue will lead your physician to suggest rest and learning to relax. In severe cases, cortisol may be recommended.

However, this method doesn’t put all of the symptoms into a whole picture of the person’s overall state. Rather than relying on an organ-specific approach to symptoms of AFS, or attempting to address symptoms individually, alternative medicine takes a more comprehensive viewpoint towards healing, such as that of the NeuroEndoMetabolic (NEM) Stress Response model. This model takes the interrelationship of responses from different organ systems of the body into account as an important part of addressing the issue. Hormones such as pregnenolone or cortisol may be used.

Pregnenolone supplement hormone

Hormones and AFS

In this situation, it can be helpful to know what hormones do. In short, they are the messengers between organs and organ systems to control and regulate functions. They stimulate organs to “turn on” and perform certain vital functions or secrete other hormones. For example, hormones stimulate the adrenal glands to turn on and secrete cortisol, the stress fighting hormone.

When your body comes under stress, the hypothalamic-pituitary-adrenal (HPA) axis is stimulated, resulting in this function of the adrenals secreting cortisol. If the stressor is removed, the adrenals stop the cortisol and things go return back into balance, known as homeostasis. However, if stressors continue long enough, the pressure on the adrenals ultimately reduces their ability to secrete cortisol and adrenal fatigue sets in.

However, cortisol is only one of many hormones involved in AFS. The hormones DHEA, progesterone, testosterone, and estrogen are all also involved, among others. All of these hormones have as their common precursor pregnenolone, which is what is known as a prohormone.

Pregnenolone is a steroidal hormone produced mainly in the adrenal glands, but it can also be made in the liver, skin, brain, gonads, and even in the retina of the eye. Synthesized from cholesterol, it has been called the “grandmother” of all the other steroidal hormones. From pregnenolone, DHEA, progesterone, testosterone, and estrogens are made. Because of this, a pregnenolone supplement is one of the first possible avenues considered by physicians who understand AFS.

Pregnenolone levels naturally decline with age. Since it is the precursor for so many other hormones, they also tend to decline as you get older. In fact, levels of pregnenolone are consider to be biomarkers of aging.

When the body is under stress and progressing toward AFS, two of these hormones are typically out of balance: cortisol and DHEA. Cortisol and DHEA, both of which are products of pregnenolone, work optimally when they are in balance, promoting your health and well-being.

Under stress, your nervous system will prompt the release of ACTH, which then leads to the production of cortisol and DHEA. In this way, ACTH stimulates the adrenals which are already pushed to secrete cortisol if the body is stressed.

Too much cortisol will literally burn up your cells in an effort to produce enough energy for the body to work well. High levels of cortisol in the brain can lead to destruction of neurons and will have a significant detrimental effect on memory. Brain fog is a classic symptom. AFS advances from mild to severe. In advanced stages, cortisol level tend to be low. Too little cortisol can slow down needed processes. Pregnenolone levels also tend to be low. This one reason for considering pregnenolone supplement.

DHEA and Pregnenolone supplementHaving more cortisol than DHEA in your body can lead to decreased sensitivity to blood glucose. In stressful conditions, cortisol prompts the release of glucose for energy to fight stress. This can lead to unhealthy levels of glucose in your blood stream. Any time your body’s sensitivity to glucose is impaired, your body’s main energy source is compromised. This can translate into a constant feeling of fatigue.

An elevated ratio of cortisol to DHEA also has a detrimental effect on your immune system. This is seen primarily in the mucosal lining of your body’s cavities, such as in the nose and throat, the first line of defense against pathogens.

In the liver, a high cortisol to DHEA ratio will also depress enzyme systems that are critical in detoxing your body. This detox process is important in ridding your body of heavy metals, chemicals, by-products of infectious agents, and waste products.

Your adrenal glands also have important systems to maintain through this balance. Through secreting various hormones in combination, they govern the burning of fats and the metabolism of proteins. They play a major role in the metabolism of carbohydrates to make glucose. The adrenals are also important in regulating the ovaries. Cortisol, DHEA, estrogen, and progesterone work in coordination to bring about proper functioning of the ovaries.

The thyroid gland is also directed by the adrenals through their output of hormones. A too high level of cortisol compared to DHEA can cause thyroid output to be diminished.

Under conditions of high and continuing stress, hormone balance is very important, and pregnenolone supplement plays an important role in providing your body with the building blocks to produce the hormones it needs.

Using a Pregnenolone Supplement for AFS

One of the first methods for addresses AFS may be to add a pregnenolone supplement to bring all the other hormones into balance. In addition to this, pregnenolone supplement has been shown to be effective in addressing many of the symptoms of AFS, such as:

  • Depression
  • Hypoglycemia
  • Brain fog
  • Craving for sweets
  • Headaches
  • Fatigue
  • Nervousness
  • Concentration problems
  • Insomnia

In the early stages of AFS and under continuing stress, cortisol is constantly being secreted. Increasing pregnenolone can potentially reduce the levels of cortisol closer to normal. Too high levels of cortisol or estrogen can be harmful to the body. Adding more pregnenolone will prevent or at least minimize their effects.

In the brain, pregnenolone has a protective function. Fatigue can injure brain cells; pregnenolone supplement protects these cells from this kind of damage. Its calming effects can provide protection from the stress that leads to production of cortisol.

Pregnenolone supplement can be converted into progesterone and DHEA, both protective hormones in themselves. It also supports the functioning of the thyroid and other glands.

Pregnenolone supplement in natural form of yamsSupplemental pregnenolone is made from wild yams grown in Mexico and southern areas of the U.S. It is molecularly identical to your body’s pregnenolone. Be cautious about the source though. The wild yams used in making supplemental pregnenolone contains diosgenin, a hormone precursor that is converted into pregnenolone in the lab. Your body doesn’t have the enzymes needed for this conversion., so it is important to ensure that any over the counter pregnenolone supplements you buy say they contain pregnenolone, and not simply extracts of wild yams.

Contraindications of Pregnenolone Supplementation

Supplementation with pregnenolone can be beneficial in alleviating symptoms of AFS, but there are some side effects and contraindications to its use.

Due to the lack of solid research into the use of pregnenolone supplements, caution is suggested. Regardless of the scarcity of research, there are practitioners who do not hesitate to use the supplements. Some of these practitioners believe use of these supplements will stimulate your body into making more pregnenolone itself, even after the supplements are stopped.

Some research was conducted on the use of pregnenolone on several populations in the 1930s and 1940s. However, these investigations were replaced by research into other substances in the 1950s because of the possibility of these other substances to be patented by pharmaceutical companies. Since then, little research into the hormone has been conducted.

Clinical use of the supplement has shown potential side effects and reasons not to use it. High doses can lead to irritability. This may increase to aggression, mostly of a verbal nature. Anger is another potential side effect of high doses of pregnenolone. Some of these side effects come from possible over-stimulation brought on by the supplement. The weaker the adrenals, the greater the risk. Panic attacks and adrenal crashes could occur.

Acne or oily skin may also be seen with pregnenolone supplements. Acne may become severe, and can show up only after stopping the supplementation. Hair loss or hair growth on the face is possible. Using pregnenolone supplements daily or for a long time may lead to losing hair on the head. Headaches are common as a side effect if pregnenolone is taken in large doses, or over long periods of time in low doses. Heart palpitations or arrhythmias can happen even with low dosages. This can be especially dangerous for the elderly or those with any kind of heart rhythm disturbance. Insomnia or night sweats can occur if the pregnenolone supplement is taken at night. Women who are pregnant or breastfeeding should avoid pregnenolone supplements.

Any of the above side effects will be worse when you take these supplements in high doses. If taken over a long period of time, withdrawal can be difficult. You may experience restlessness, high levels of anxiety, and nervousness. Some people report depression, fatigue, and even paranoia when stopping the supplement. The safest way of withdrawing from this supplement is to reduce your dosage by no more than 10mg per day.

Testosterone created by the pregnenolone supplementThere also may be interactions with other substances. If you’re taking estrogens, don’t take pregnenolone supplements. They will lead to too much estrogen in your system. The same is true with progestin and testosterone supplements.

In general, supplementation with pregnenolone is safe as long as it is conducted under the supervision of a well-trained physician. It is not something to be undertaken by yourself, although you may have to educate your physician so he/she can best help you.

Pregnenolone Steal: Caution for AFS

In adrenal fatigue setting, the use of pregnenolone needs to be carefully considered. When the body is in need of cortisol, pregnenolone in the body tend to be shunted to make cortisol. This phenomenon is known as pregnenolone steal. In this case, serum pregnenolone levels appear artificially low.

In this situation, supplementing with pregnenolone will not be appropriate and may make matters worse. The more advance the AFS, the higher the risk. Excessive pregnenolone can also lead to dependence and withdrawal issues over time. While pregnenolone has its place in supporting adrenal function, self navigation is not recommended. Always consult an AFS literate health care provider prior to beginning this supplement.

 

References

Kristi Monson, PharmD; Arthur Schoenstadt, MD. (n.d.). Pregnenolone Side Effects. Retrieved December 23, 2016, from http://menopause.emedtv.com/pregnenolone/pregnenolone-side-effects.html

Pregnenolone Side Effects and Possible Health Dangers. (2016). Retrieved December 23, 2016, from http://nootriment.com/pregnenolone-side-effects/

Progesterone Pregnenolone & DHEA – Three Youth-Associated Hormones. (n.d.). Retrieved December 23, 2016, from http://raypeat.com/articles/articles/three-hormones.shtml

 
© Copyright 2017 Michael Lam, M.D. All Rights Reserved.


Dr. Lam’s Key Question

Women may have facial hair or hair loss if there is too much pregnenolone in the body. This is because pregnenolone, the mother of all steroid hormones in our body, is a precursor to testosterone. Testosterone then is converted to DHT which cause hair loss.


The molecular structure of the pregnenolone supplement




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8 Comments

  • Karen Joseph says:

    Hi Dr Lam
    What is your opinion of taking DHEA supplements if suffering from Adrenal Fatigue. I am carrying about 15kg extra weight since the onset of adrenal fatigue. i manage day by day and am much better after being treated by a homeopath with Chinese medications and acupuncture. Unfortunately he emigrated. I love your articles. They are very helpful in understanding what i am dealing with. Regards Karen

  • Kris says:

    Dear Dr Lam,
    I am 54 years old and have been post menopause since 42. I have been suffering from AF/ Chronic Fatigue dince 10 years. My sister died of breast cancer with 43. My mother is a breast cancer survivor. What dp you recommend a post- menopause woman suffering from Chronic/Adrenal Fatigue? I am of course not allowed any supplements which could increase my estrogen levels… Thank you for your help.
    Kind regards,
    Kris

    • Dr.Lam says:

      Avoid the common mistakes people make. There are good supplements that are not estrogenic in nature but everyone needs different things. There is no way to give you a blanket recommendation. My book has many chapters devoted to the pros and cons of each compound that may be good for you to read. If you need a personalized approach, you can call my office to see if you qualify for our telephone coaching program to help get you on the right path. Click Adrenal Fatigue & Hormone Therapy for more information.

      Dr Lam

  • Saundra says:

    Dr Lam,
    I have late onset CAH what supplement or supplements would you recommend for that? could you write an article on late onset CAH too please. Thank you

    • Dr.Lam says:

      The best thing to do is to not to take anything. If you need to it has to be very carefully planned and professionally done. I need a much more detailed history which you can do by submitting via the Ask the doctor section of my website.

      Dr Lam

  • Staislav says:

    Can males also benefit from Preg supplementation if their symptoms suggest tier adrenal are low?