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Low DHEA - to supplement or not? Low DHEA - to supplement or not?

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Unread 04-08-2010, 11:08 PM
Re: Low DHEA - to supplement or not?

None of those links says that estrogen in any form is actually produced in or by the adrenals, if you read them carefully. The sex hormones they are referring to are the androgens, testosterone and others, which are precursors to estrogen but which require certain enzymes to convert to estrogen, which enzymes are not present in the adrenals.

It is just not possible for estrogen to be produced in the adrenal glands. As I mentioned before, that conversion takes place in abdominal fat cells, which have the needed enzyme, as does the blood to some degree (varies).

And the reason DHEA does not work as well in terms of supplying needed quantities of all of the hormones in women without ovaries is because we tend not to have enough of the enzyme that's needed to make the conversion.

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Unread 04-09-2010, 09:24 AM
Re: Low DHEA - to supplement or not?

Ok here's another example I found. This helps even me understand it a bit more.

Adrenal Pathway image

Maybe the supplement of Pregnenolone is better.
Unread 04-09-2010, 11:42 AM
Re: Low DHEA - to supplement or not?

By that way of thinking, why not just eat a very high cholesterol diet and be done with it? (I'm just kidding, of course, but it's true that cholesterol is needed for hormone synthesis so people on extremely low cholesterol diets can have deficiencies.)

You're assuming that a body without ovaries is capable of automatically producing the needed amounts of each hormone in the right proportions... just ain't so. Removing the ovaries upsets things tremendously. It also affects our levels of the enzymes needed to make all the different conversions.

the best way to deal with symptoms of hormone loss is to replace the hormones you know are causing the symptoms. If you're not sure, then a methodical, trial and error approach with good record keeping, while tedious, is the surest way to get there eventually. It just isn't fun sometimes.

Unread 04-09-2010, 03:26 PM
Re: Low DHEA - to supplement or not?

Ok, I'm sorry, you misunderstood my intentions then. I wasn't saying to take DHEA for estrogen (or estrogen alone anyway). She would need HRT for that. She mentioned her adrenals were weak and that taking DHEA will definitely help that. The Pregnenolone is actually better for the adrenals as well as the estrogen too.

I KNOW that our bodies w/o ovaries won't produce the same amount of estrogen. That's a given and I wasn't saying that the adrenals were going to produce the same amount, just that wantever little TINY amts they do make is all we have. The conversions do get messed up as well. My theory actually is that the estrogen the rest of our body (fat) does make is all we have left and once our body stops making that conversion altogether, we are truly in menopause. Cuz some people can live w/o HRT and not have symptoms. That's one of two things I think... 1) They have enough estrogen in their body that IS converting that they can deal with whatever little symptoms they DO have or 2) they are fully in menopause and their body has stopped converting whatever estrogen was left. Just a theory tho.
Unread 04-09-2010, 03:57 PM
Re: Low DHEA - to supplement or not?

This is a forum for women in surgical menopause who are not able to or do not wish to use estrogen.

As menopause is defined as the cessation of periods and ovulation (with surgical menopause being the same thing but precipitated by surgery), we're in menopause the moment surgery occurs, whether or not we have enough belly fat and enzymes to make enough estrone to make the symptoms bearable or even nonexistent. The symptoms are not what define menopause.

Most of us who are in surgical menopause would take serious issue with any medical professional who tried to tell us that we were not in menopause because we could still make a teeny amount of estrogen in abdominal fat cells. By that definition, no woman with ovaries could ever be in menopause unless she took an aromatase inhibitor, which makes no sense.

IF one believes that we are able to make all the hormones we need from DHEA, then women who cannot use HRT (ie women in this forum) should avoid DHEA like the plague in favor of non-hormonal symptom relief. And IF one actually wants to have estrogen in the body to relieve symptoms, the better way to get it is to just use estrogen rather than using DHEA and taking chances that the body is somehow going to be able to figure out how to make the right amounts of each hormone even though it lacks ovaries, which it will not be able to do 99 times out of 100. As far as the action of DHEA itself on the tissues in the body, this is not understood at all at this point in time. There are a lot of theories but no reliable data of any sort in humans.

What we do know is that DHEA supplementation can be helpful for many (but not all) otherwise healthy people who have adrenal insufficiency. However, there is a difference between adrenal insufficiency and the normal decline of DHEA levels that occurs with age, and it's a HUGE leap to jump from one (DHEA test level result) to the other (pathological condition involving the adrenals). And there are no data on the validity of DHEA supplementation in women without ovaries - and it would definitely make a difference.

This link contains the best summary I've seen of the state of knowledge about DHEA, and really, there is nothing in there that supports its use in surgically menopausal women with or without tested low DHEA levels:


Unfortunately, a multimillion dollar industry has developed around convincing people that they should take DHEA supplements to stay young, retain libido and host of other things when there are no data suggesting whether or not this is safe or efficacious for anyone other than people with a documented case of adrenal insufficiency. The same thing was starting to happen a few years ago with perimenopausal women and pregnenolone, but to a lesser extent, probably because the focus was only on women.

(((Milashka))) if your estrogen level is low and your doctor wants it higher, the way to do that is to use estrogen replacement. If you don't want to use estrogen replacement but do want to take DHEA, which may or may not raise your estrogen level but will surely raise your testosterone level more and you cannot control the proportion between them, well that does not really make much sense. At least with HRT you can control how much of estrogen and testosterone you are getting and use an extremely low dose of either if you want to make sure not to get too much. DHEA is a shot in the dark, imho, and not a very accurate one.

Unread 04-09-2010, 05:33 PM
Re: Low DHEA - to supplement or not?

Back to your original statement Milashka, but I too take DHEA due to adrenal fatigue. My levels were also low & felt relief soon after starting it. Definitely keep an eye on your cortisol levels, DHEA & maybe even ask the doc to test your ACTH levels as well. That's just another test to see how your adrenals are doing.

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