Welcome to the series of posts called Protocols. While healing is an individual approach, foundational protocols can help you by providing some “self-help” options.
What is DHEA?
Dehydroepiandrosterone, or DHEA, is a hormone precursor shown to have direct effects on the immune system. DHEA and its sulfated form, DHEAS, are produced predominately by the adrenal glands. Youthful levels are at the high end of the range; levels decrease with age and are usually at the lower end of normal in healthy middleaged individuals.
DHEA is a natural steroid and precursor hormone synthesized from cholesterol and secreted by the adrenal glands. The adrenals are walnut-sized glands located right above your kidneys. The average adult makes about 25 mg of DHEA per day (some more, some less) with dwindling production as we get older. Men at all ages have more DHEA than women.
➔ Low DHEAS can be caused by adrenal exhaustion and is commonly seen in accelerated aging and diseases such as cancer
➔ High DHEAS is associated with insulin resistance/PCOS (polycystic ovaries) or DHEA supplementation
Natural DHEA production is at its highest in your twenties. By the time we reach seventy we only make about 20% of the DHEA we had when we were young. A decline in DHEA with the passage of time is clearly what nature intended — and as far as we know, a healthy process.
While cortisol takes center stage, there is a whole ensemble of hormones that the adrenal glands produce, including adrenaline and norepinephrine, estrogen, progesterone, testosterone and DHEA. If the adrenal glands aren’t able to do their job, a host of hormonal imbalances can really create chaos in the body.
Think of an exhausted mother. Like her, your adrenals work tirelessly to meet the demands placed on them until they are utterly tapped. Without adequate support, they spiral downward into adrenal imbalance and eventually adrenal exhaustion.
Your lifestyle, diet and stress levels all contribute to the amount of DHEA your body can produce in a given period. Checking DHEA levels is one of several diagnostic tools to assess the health of your adrenal function.
Symptoms of low DHEA level include:
- Extreme fatigue
- Decrease in muscle mass
- Decrease in bone density
- Aching joints
- Heart palpitations
- Loss of libido
- Lowered immunity
Supplementing with DHEA
For the women who need it, adrenal support with DHEA supplementation can make a big difference. I’ve seen it help clients “get going again” when they feel like they’ve hit rock bottom. But it’s never as simple as just popping a pill. When used appropriately — and after testing to determine if there is even a deficiency — DHEA is a critical component to jumpstarting hormonal balance.
Simply adding more DHEA to the equation is not the answer — despite what some of the popular products claim. DHEA alone can’t fix adrenal imbalance, but it can be an important factor in a combination approach that includes hormonal and nutritional support, lifestyle changes, and proper rest.
Remember that DHEA is just one stop along the metabolic pathway — it doesn’t work in a vacuum. How it gets converted comes down to your individual biochemistry — some women may use it to make more estrogen, others may make more testosterone. Just throwing a pill into the mix without understanding the bigger picture is never a wise choice. Having too much DHEA, or converting DHEA into too much of one hormone and not enough of another, can be as upsetting to your body as not having enough.
DHEA dose responsiveness is highly individualized. Each person’s body will handle DHEA differently. Prior to using DHEA, it is important to understand it is a contraindication to use in individuals with hormone-sensitivities and may interact with a variety of prescription medications. Side effects are uncommon, but women may experience changes to skin, hair, voice, menstrual periods, and other effects. Men may also have unwanted effects, while either gender may experience changes in sleep or mood.
In order to understand the best approach to DHEA dosing, specific goals should be determined. Available research provides validation for a variety of dosing levels based on these goals. (Please do not self-dose.)
Bone Health: DHEA supports the healthy balance of osteoblast and osteoclast activity. Dosing with 50 mg daily for up to two years combined with vitamin D and calcium has demonstrated support of healthy bone maintenance in women.
Mood Health: Several clinical trials have shown that using between 25 mg and 50 mg daily to maintain DHEA levels in the brain is effective in supporting brain health and mood in the elderly. Women have been shown to have positive results after 25 mg daily for six months. Additional studies showed response to 50 mg a day after six months for both men and women.
Sexual Health: Numerous studies have shown beneficial impacts on sexual health with one study demonstrating effectiveness with a 10 mg daily dose for one year in postmenopausal women. Men also had a favorable response to 50 mg once daily for six months.
As a quick recap, your healthcare practitioner should follow these steps when utilizing dehydroepiandrosterone (DHEA):
- Determine contraindications to use
- Choose appropriate starting dose, typically between 10 and 50 mg, based on goals
- Determine best dosing time
- Test DHEA levels periodically to ensure levels remain with normal limits
Monitor for side effects
DHEA for Women | How DHEA Converts to Hormones
You can’t look to DHEA supplementation as a stand-alone solution. It just doesn’t work that way. DHEA is one part of the whole concert of hormones at work every moment in your body. Before you tinker with that balance it’s a good idea to understand what is going on in your life on all levels — physiologically and emotionally.
After menopause or a hysterectomy, the adrenals become the primary hormone factory. So it’s important that they function optimally to sail into aging gracefully.
If DHEA is converted primarily into testosterone, it outweighs what’s converted into estrogen and progesterone. This can cause bouts of increased irritability and unusual body hair growth, especially when DHEA supplements are given without prior and follow-up testing of total and “free” testosterone levels.
“Free” testosterone is the portion of the hormone that is biologically active in your bloodstream. After menopause, a woman may have volatile levels of free testosterone at work, which accounts for some of the annoying male-pattern facial hair that’s common during the transition. Most doctors only test total testosterone levels, not the combined amount. Adding DHEA to this scenario can tip the scale drastically.
On the other hand, some women convert most of their DHEA into estrogen. In this case, DHEA supplements create a different kind of estrogen-progesterone imbalance with symptoms similar to PMS, including breast tenderness and mood swings (estrogen dominance).
So instead of self-medicating, be sure to test first. Ask me about how to get access (at the best price) to the Dutch Test.
Pregnenolone Steal Due to Stress
When faced with constant stress, always being in a state of fight or flight (sympathetic dominant mode), pregnenolone is used to make progsterone and not DHEA. Constant stress reduces DHEA, testosterone and estrogen formation.
When we’re under stress our bodies respond by producing the hormone cortisol. We need pregnenolone to produce cortisol so if we’re chronically stressed, more pregnenolone needs to be diverted to produce more cortisol. To do this it just sends more cars down the cortisol path. Mission accomplished, right?
Not exactly. Every car sent down the cortisol path is a car that’s not sent down the other path. This means that there is less traffic on this second path and less cars taking the exits (making other hormones) on this path. That’s the “pregnenolone steal”. Our stress leads to a demand for cortisol which directs more of our precious pregnenolone towards cortisol production, which in turn steals it from the production lines of other hormones.
Test First. Always.
DHEA is a potent steroid and without a comprehensive test it’s impossible to know what your DHEA levels are. Just because you’re getting older doesn’t automatically mean you’re deficient. Remember, this is a natural substance — our bodies can produce more or less of it depending on our nutrient support, metabolism, hormonal balance, activity level and emotional state.
You can improve your DHEA levels naturally by:
- maintaining a body mass index of 19-25;
- getting adequate rest and exposure to sunlight;
- exercising regularly (including sexual activity);
- eating healthy; and
- fostering more “downtime” in your life
Taking DHEA alone won’t do any good if your adrenals are exhausted. You must know the status of your adrenal function and your other hormones before you can even begin to know what kind of combination of support your body needs.
The test I frequently recommend is the DUTCH test by Precision Analytics. I always listen to how a client is feeling, what demands she’s placing on her body — particularly her adrenals — and ask about her emotional state. Sometimes a woman can test normal by conventional standards and still need a slight, temporary boost.
What If I Need DHEA?
If tests indicate the need for DHEA supplementation, often we start with as little as 1-5 mg, under the tongue, two times per day. It’s possible to slowly increase the dosage if further tests warrant it, but I find I rarely need to use more than 10–12 mg sublingual per day — a physiological dose. (Note that sublingual versus capsule dosing will vary.)
Once you are taking DHEA, I encourage a repeat of the DUTCH test after 8 to 12 weeks to assess how you are metabolizing the hormone. Many clients don’t need to take DHEA for an extended period of time — once our bodies return to balance and we make lifestyle changes, we’re usually more than capable of making what we need. Once balance has been restored and symptoms even out, most women produce enough DHEA on their own.
That brings me to the point I most want to make about DHEA for women — it’s connection to joy.
The Best Way to Make More DHEA: Connect to Joy
DHEA is just one small part of a much larger picture — one that you can exert considerable influence over. Our bodies produce DHEA all the time. It’s possible to marketedly boost your body’s own production of DHEA naturally.
People with a positive outlook actually create a self-sustaining cycle of DHEA production: they produce more DHEA, which may affect their levels of serotonin (the happy neurotransmitter); which in turn gives them a better outlook — which ups DHEA and so on.
One proven way to boost levels of DHEA naturally is to find ways to connect to joy in your life. This can mean different things to different people but overall there are some common threads when weaving this web of joy:
Connection. Human beings are social creatures — we like companionship. Connecting with family and friends in a healthy, loving way is one of the best joy-makers around. Think long and hard about what you like to do for pleasure and reach out. Join a local class or group that shares your interest.
Exercise. Moving your body, even through deep breathing and mild stretching, reduces stress, oxygenates your cells, and boosts mood-elevating substances in your bloodstream called endorphins. This process can actually change your body chemistry for the better. Meditation is also useful in this way.
Spirituality. The ability to entertain the idea of some sort of larger power, be it natural or divine, is a powerful component of joy. Rituals of worship and contemplation, from a walk in the woods to yoga to prayer, helps us make space in our busy lives to focus on what is truly meaningful to us and who we really are.
Play. Is it a coincidence that our levels of DHEA decline as we enter the grown-up world of work and responsibility? Who knows? It would be interesting to find out. But one thing is certain: playtime isn’t just for kids. Kick up your heels — it’s good for your health!
I know none of this is easy to do in today’s non-stop world. Everything around us pushes us to have more, do more, be more — is it any wonder our bodies eventually throw up a huge stop sign? The best time to foster hormonal balance, adequate DHEA levels, and healthy adrenals is before you hit that stop sign. So give yourself a time-out and check-in. You may find, with a little help, your body and mind are more than capable of taking care of themselves.
Final Thoughts on DHEA for Women
Feelings of health and well-being are never static. Like all things natural, they depend on a kaleidoscope of moving parts — always changing, always unique. DHEA for women is just one part of this evolving pattern, one you can influence to create a better picture by changing your lifestyle and taking care of your adrenals.
Visit here for information on adrenal health and what to eat!