Monday, September 10, 2007

DHEA supplementation...helpful or detrimental to you fertility?

To understand whether DHEA supplementation is right for you its important to have an understanding of what is happening with this hormone and how it relates to other hormones and reproductive health.

DHEA is converted into a hormone called androstenedione which is a precursor to testosterone. In other words androstenedione then gets converted into testosterone and testosterone gets converted into estradiol mainly in the ovaries of a premenopausal female. Estradiol is the estrogen closely associated with fertility.

Okay enough science out of the way. Here is what to consider when considering DHEA supplementation. Since DHEA is close to the top of the hormone chain as you can see in the chain below, it can effect many hormones down the line.
Cholesterol

Pregnenolone (this is only one of the pathways for the conversion of this hormone)
l
DHEA
l
Androstenedione - > Estrone (estrogen in fat tissue)
l
Testosterone
l
Estradiol (ovaries)
l
Estrone

So supplementation of DHEA could increase testosterone in some people which would be a good thing IF testosterone were low. 7 Keto DHEA is supposed to NOT increase testosterone but I have seen with saliva tests that testosterone did increase significantly in one patient who was taking the 7 Keto DHEA. Blood results did not reveal the high testosterone that was evident in the saliva tests. Normal for saliva results for testosterone would be 15-90 and this woman's was 1500.

If testosterone were already high supplementing with DHEA could be disastrous and account for some of the negative side effects of DHEA Supplementation. Therefore someone who has high levels of testosterone like in PCOS in my opinion is NOT likely to benefit from DHEA supplementation. You don't have to have PCO to have elevated testosterone in the tissues so its always good to get a baseline.

Also supplementing with DHEA may make no difference what so ever if DHEA is low because free cortisol is high. Cortisol is one of your stress hormones and it has an inverse relationship to DHEA. This means that if free cortisol is high, then DHEA is likely to be low. So getting cortisol down is the answer, not adding more DHEA. DHEA is not a nutrient, like a vitamin, its a hormone and therefore can be linked with the activity of other hormornes. When a vitamin or mineral is truly deficient in the body adding more in your diet or supplementation program could help. If you are deficient in Vit C taking more of it can help you, but if your body isn't utilising Vit C well enough because there is too much sugar in your diet, then you can take all the vitamin C you want, if your glucose levels aren't addressed, the supplement is not likely to help you.

Vitamins and minerals also effect the conversion of hormones from one to another and so does stress. These can range from the B vitamins, iron, folate, vitamin E, Vitamin A (in the form of betacarotene), zn, Vit C, Magnesium and others.

So until you know the levels of hormones present in the tissues (through saliva testing) I suggest to NOT take DHEA supplementation to try to improve your fertility. Saliva tests by the way, are accurate and used by governmental bodies and NASA in the United States to assess the health of the military and astronauts. Saliva tests look at not just what is floating around in the blood but what actually has gotten absorbed into the tissue. Conventional medicine does not use them often but these can be ordered by your naturopath or physician.

In my opinion before a person should start taking DHEA they should check the levels of DHEA, testosterone, estradiol, estrone, androstenedione and progesterone through saliva tests spread out over 2-4 weeks (1 day each of those weeks) to see if DHEA supplementation is going to hinder or help their situation. But keep in mind that supplementation with DHEA alone is unlikely the only factor that can improve your situation. A proper diet, a healthy gut along with supplementation program is essential as well. Addressing stress is also very important because stress can increase cortisol over time and actually accelerate the aging process of all your cells. Always remember that your eggs, ovaries, follicles, endometrial lining and semen and sperm are made up of cells.

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