DHEA and Adrenal Imbalance
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. Because 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.
A delicate hormonal balance
So, 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, when your adrenals become the primary hormone factory, we see women in whom the ratio of DHEA that is converted into testosterone 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, I’ve also seen patients who 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. For more information, see our article about estrogen dominance.
Even though we’ve been trained in our culture to expect a one-size-fits-all drug cure for every health issue, ingesting a powerful hormone like DHEA can be unpredictable — and in some cases, risky. That’s why we advise our patients not to self-medicate.
The trouble with over-the-counter DHEA supplements
Nowadays you can buy DHEA over-the-counter as a matter of course in a confusing variety of doses and combinations. Most of these DHEA products are geared toward men, but I’m seeing more and more aimed at women.
The labels claim DHEA will help us lose weight, rev up our libido, lift depression and give us back the strength, immunity, and stamina we had when we were 20 — the age at which our bodies naturally produced the most DHEA. While on the surface this is appealing (who wouldn’t want to feel 20 again?), it’s obviously not what nature intended. We also don’t know enough about DHEA to be conducting such a large, unregulated public experiment. DHEA is a potent steroid — that’s why it’s been in the headlines and why it should be approached with due diligence.
Without a comprehensive medical 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.
In fact, there are many studies that show 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), and fostering more “downtime” in your life — but more on that in a moment.
Also remember that any time you buy a supplement at a health food store, you have no guarantee that what you are buying is the real deal. There are few regulations in place to police the manufacturing process or the product itself. This is the reason we have formulated our own Women to Women supplements, made specifically for us by a manufacturer who tests every single batch.
Many of the DHEA supplements I see at my local store have very high dosages — way too high for most women (often as much as 20 times what I start my patients on!). While there’s no way to tell how much of that you might actually absorb, I think it’s especially unwise to experiment with DHEA at these levels without medical supervision.
Furthermore, taking DHEA alone won’t do any good if your adrenals are exhausted. There are too many other factors at work. You need to 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.