DHEA and Hormones

By: Michael Lam, MD, MPH



What is DHEA?

DHEA is the most abundant of all steroids and is released from the adrenal glands. DHEA is involved in the manufacturing of testosterone, estrogen, progesterone and corticosteroids. The decline of DHEA parallels that of growth hormone. By age 65, the body makes only 10-20% of DHEA that was made at age 20. It has been shown in animal studies to act as an agent of anti-obesity, anti-cancer, anti-autoimmune disease, anti-stress, anti-infectious disease. In other words, it is an all around anti-aging drug. It may also boost the function of the brain as the brain tissue contains 6 times more DHEA than any other tissue in the body.

Who should take DHEA?

The most common use of DHEA is for people who want to take it as hormone replacement therapy. This is particularly true for women than men, as they experience a more significant drop in hormones during peri-menopausal and post menopausal years. Supplementation with DHEA can improve wellbeing, energy levels, moods, and libido.

When to start?

You can usually start after age 40, but for those who need more energy; you can start in the mid-thirties as well. For those who are younger, it is a good idea to get a blood DHEA-sulfate for baseline before commencing.

When to take DHEA?

It’s best to take DHEA during the morning due to its energy enhancing effects.

What dosage?

Different doses appear to do different things. Low dosages (15- 25 mg) tend to bring improved specific health benefits and well-being. High dosages (100-200 mg or more) can lead to a repartitioning of body mass as a result of the conversion of the DHEA into more androgenic steroid hormones.

MuscleShould athletes take DHEA for muscle mass enhancements?

That is not too good an idea because there are much better alternative means, such as using creatine.

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Should pregnenolone be used together with DHEA?

Many on the forefront of anti-aging research are advocating the use of both pregnenolone and DHEA, both in low doses. 15 mg to 25 mg each of pregnenolone and DHEA seems to do the trick in many women to bring them a renewal sense of well-being. Men are less hormone sensitive and the results may not be as evident. For men, direct testosterone precursors such as androstenedione (and its metabolite androstenediol) may be more effective.

Are there any drug interactions between DHEA and prescription medications?

Since DHEA is a slight mood elevator, it could potentially clash with anti-depressants. Theoretically, the dosage of anti-depressants could be lowered if DHEA is taken. People on cholesterol lowering drugs as well as blood thinning medications, such as coumadin, may need to watch their medications, as well as the requirements, because these may well be reduced since DHEA has both a cholesterol lowering and blood thinning effect. Studies have shown that DHEA also reduces appetite, so those who want to lose weight may benefit from DHEA, and those who are already on weight reduction pills may need less.

Blood sampleCan DHEA be taken long term?

There are currently no long term studies to conclusively lead us to the proper conclusion. In hormonal replacement therapy, it is important not to overdo it. Low dose DHEA supplementation, if monitored with blood test to ensure physiological level, is very safe and an effective anti-aging tool.

DHEA and the neuroendometabolic (NEM) stress response

As previously mentioned, DHEA levels produced become significantly lowered over the age of sixty five, and one of its functions is that of anti-stress. A long with cortisol, DHEA is produced by the adrenal glands and they both play a role in reducing stress. The adrenals are a part of the neuroendometabolic (NEM) stress response complex, responsible for managing levels of stress in our body and maintaining at a level that does not affect the body negatively. However, in situations chronic stress is experienced and the systems and organs under the NEM’s complex are overburdened, such as the adrenals, decapitating symptoms can occur such as adrenal fatigue. The interference of the hormonal response can present with symptoms such as an intolerance for exercise, lowered libidos, low energy in afternoon, infertility, reproductive complications and hair loss. It is therefore important to allow the body to recover in stressful periods and to also consider supplements when ageing.

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7 Comments

  • Helen Thomas says:

    A saliva test showed low cortisol in the morning and low DHEA. I am 54 and hypothyroid. I am now on Armour and take my dose at 4.45am to increase my cortisol (as per Paul Robinson – Recovering with T3). Taking it about one and a half hours before waking helps stimulate more cortisol production for the day. I am using about 5mg DHEA cream (vaginally as read on Dr Mercola website) and 1mg Pregnenolone cream at night (5mg is too much and makes me very sleepy during the day). I plan to re take the saliva test after 60 -90 days. Do these quantities sound ok? I seem to be responding very well so far. Also, do you offer phone consultations from the UK? Thank you!

    • Dr.Lam says:

      What you are doing is quite standard and the appraoch is to stimulate the output of T3. This works well short term but has long term issues that can haunt you. I am not a fan of this other than short term use. Click Adrenal Fatigue & Hormone Therapy for more information. We do have a phone coaching program and in fact have many from the UK, most of them have gone thru what you are going thru now and eventually got worse. You can call my office and I will explain to you why if you are keen.

  • Amie says:

    Could low DHEA be contributing to hair loss? I feel like my hormones are just all out of whack and im suspecting my adrenals are the main problem

    • Dr. Lam says:

      The situation for male and female are different. In female, high dhea contribute to hair loss. Women age 30-50 with unexplained hair loss is invariably tied to adrenal issues often. A careful history is needed. Careless administration of DHEA base on low lab values can make both the hair and adrenal weakness worse.

      Dr Lam.

  • Bruce says:

    Hi Dr. Lam, what medical conditions should be considered before starting DHEA supplementation?

    • Newsletter says:

      If you have cancer, are pregnant, lactating, or have hair loss or acne, DHEA can make matters worse. While many people try to take this as an anabolic hormone to enchance physical performance and as an anti-aging tool, do be careful . Here is a FAQ on this issue that will be a good read for you if you have an inquisitive mind.

      Dr Lam.

  • Tom says:

    What would be the easiest way to get off of DHEA, would it be something that I should stop cold turkey? How do I know if I am taking to much?