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Understanding and Managing DHEA Levels for Better Health

Learn about the role of DHEA, its impact on health, associated conditions, therapeutic uses, and ways to optimize levels through lifestyle and supplementation. Discover how DHEA influences immune function, metabolism, and overall well-being.

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Understanding and Managing DHEA Levels for Better Health

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  1. Hormone Testing in Clinical Practice: Part 2 Meridian Valley Laboratory 24-hour Urine Tests

  2. Urinary Hormones • Part 1: Sex Hormones • Estrogen • Progesterone • Testosterone • Part 2: • Adrenal Hormones • Growth Hormone • Thyroid • Sodium/Potassium Ratio • Enzyme Activity © 2010 Meridian Valley Laboratory

  3. Metabolism of Selected Steroids 5 5 © 2010 Meridian Valley Laboratory

  4. Pregnenolone • The “mother” hormone • Synthesized from cholesterol • Involved in the steroidogenesis of: • Progesterone • Estrogens • Androgens • Glucocorticoids • Mineralocorticoids © 2010 Meridian Valley Laboratory

  5. ADRENAL HORMONES © 2010 Meridian Valley Laboratory

  6. Adrenal Hormones Cholesterol Pregnenolone Progesterone DHEA Mineralocorticoids Glucocorticoids(Cortisol, et.al.) TestosteroneEstrogens © 2010 Meridian Valley Laboratory

  7. DHEA © 2010 Meridian Valley Laboratory

  8. DHEA Cholesterol Pregnenolone 17-OH Pregnenolone Androsterone DHEA Androstenedione Etiocholanolone Testosterone Estrone © 2010 Meridian Valley Laboratory

  9. DHEA • Produced in: • Adrenal Glands • Gonads • Brain • DHEA  Androsterone  Testosterone & Estrone • Peaks around 30 years of age • Most abundant steroid hormone © 2010 Meridian Valley Laboratory

  10. DHEA • Low levels associated with • Immune dysfunction • Autoimmune disease • Type II Diabetes • Cancer • Hypertension • Cardiovascular disease • Depression • Cognitive dysfunction © 2010 Meridian Valley Laboratory

  11. DHEA • Low levels associated with • Low libido • Osteoporosis • Suppressed by • Stress • Excess cortisol © 2010 Meridian Valley Laboratory

  12. DHEA • Therapeutic Uses •  pro-inflammatory cytokines • Anti-glucocorticoid effects • Increases effectiveness of vaccination • Decreases body fat • Increases lean body mass • Increases insulin sensitivity • May increase activity of exogenous thyroid hormone © 2010 Meridian Valley Laboratory

  13. DHEA Cholesterol Pregnenolone +Rhodiola rosea +Tribulus terrestris -Prednisone +Meditation -Stress DHEA © 2010 Meridian Valley Laboratory

  14. DHEA © 2010 Meridian Valley Laboratory

  15. PREGNANETRIOL © 2010 Meridian Valley Laboratory

  16. Pregnanetriol Cholesterol Pregnenolone 17-OH Pregnenolone Progesterone Pregnandiol Pregnanetriol 17-OH Progesterone Glucocorticoids(Cortisol, et.al.) © 2010 Meridian Valley Laboratory

  17. Pregnanetriol • Byproduct of cortisol biosynthesis • Useful in assessment of adrenal health • Increased: • Congenital Adrenal Hyperplasia • Adult onset Adrenal Hyperplasia • Progesterone Supplementation © 2010 Meridian Valley Laboratory

  18. Pregnanetriol © 2010 Meridian Valley Laboratory

  19. GLUCOCORTICOIDS © 2010 Meridian Valley Laboratory

  20. Glucocorticoids Cholesterol Pregnenolone Pregnanetriol Progesterone 17-OH Progesterone 11β-OH Androsterone Cortisol 11β-OH Etiocholanolone Cortisone Allo-Tetrahydrocortisol Tetrahydrocortisol Tetrahydrocortisone © 2010 Meridian Valley Laboratory

  21. Cortisol • Produced in the adrenal glands • Primary stress hormone • Weak mineralcorticoid activity • Urinary reflects circulating • Primary functions: • Gluconeogenesis • Suppression of inflammation • Fat, protein and carbohydrate metabolism © 2010 Meridian Valley Laboratory

  22. Cortisone • “Storage” form of cortisol • Cortisone  Cortisol via 11β-HSD • A normal ratio with Cortisol = 0.7 © 2010 Meridian Valley Laboratory

  23. Cortisol & Cortisone +Insulin Resistance +Human Growth Hormone +Testosterone +Obesity Cortisol +Licorice Cortisone 11β-HSD I 11β-HSD II -Hyperthyroidism © 2010 Meridian Valley Laboratory

  24. Elevated Cortisol or Cortisone Cushing's syndrome / Cushing's disease Ectopic ACTH Production Unipolar Depression Sleep deprivation Generalized Anxiety Disorder PTSD Panic Disorder, early stage Exogenous Cortisol supplementation Cortisol & Cortisone © 2010 Meridian Valley Laboratory

  25. Elevated Cortisol or Cortisone Licorice root supplementation Intensive physical exercise Acute ingestion of Alcohol (Cortisol) Cortisol & Cortisone © 2010 Meridian Valley Laboratory

  26. Decreased Cortisol or Cortisone Adrenal Insufficiency Chronic Fatigue Syndrome Fibromyalgia Rheumatoid Arthritis Panic Disorder, late stage Cortisol & Cortisone © 2010 Meridian Valley Laboratory

  27. Cortisone & Cortisol © 2010 Meridian Valley Laboratory

  28. Adrenal Insufficiency Clinical Manifestations Fatigue Exercise intolerance Hypoglycemia Salt craving Depression Insomnia Irritability Positive Hippus test Low blood pressure © 2010 Meridian Valley Laboratory 28

  29. Adrenal Excess Clincal Manifestations Insomnia Anxiety Insulin resistance Obesity © 2010 Meridian Valley Laboratory 29

  30. Cortisol & Cortisone Metabolites Cholesterol Pregnenolone Pregnanetriol Progesterone 17-OH Progesterone 11β-OH Androsterone Cortisol 11β-OH Etiocholanolone Cortisone Allo-Tetrahydrocortisol Tetrahydrocortisol Tetrahydrocortisone © 2010 Meridian Valley Laboratory

  31. Cortisol Metabolites 1763 © 2010 Meridian Valley Laboratory

  32. ALDOSTERONE © 2010 Meridian Valley Laboratory

  33. Aldosterone Cholesterol Pregnenolone Progesterone Deoxycortisone Corticosterone Aldosterone © 2010 Meridian Valley Laboratory

  34. Aldosterone • Major mineralocorticoid • Acts to increase the reabsorption of sodium and water and to secrete potassium • Receptor blocked by Spironolactone • Age related hearing loss © 2010 Meridian Valley Laboratory

  35. Aldosterone © 2010 Meridian Valley Laboratory

  36. OTHER MINERALOCORTICOIDS © 2010 Meridian Valley Laboratory

  37. Mineralocorticoids Cholesterol Pregnenolone Progesterone Deoxycortisone Corticosterone Aldosterone 5α-THB (Allo-Tetrahydrocorticosterone) THA (11-Dehydrotetrahydrocorticosterone) THB (Tetrahydrocorticosterone) © 2010 Meridian Valley Laboratory

  38. Mineralocorticoids © 2010 Meridian Valley Laboratory

  39. Mineralocorticoids Cholesterol Pregnenolone Progesterone Deoxycortisone Corticosterone + ↑↑Acute Stress -↑Salt + ↑↑Acute Stress THA (11-Dehydrotetrahydrocorticosterone) -↑Stress -↑Chronic Stress -↑Chronic Stress -Dehydration + Pregnenolone -Spironolactone 5α-THB (Allo-Tetrahydrocorticosterone) Aldosterone + ↑↑Acute Stress THB (Tetrahydrocorticosterone) -↑Chronic Stress © 2010 Meridian Valley Laboratory

  40. HUMAN GROWTH HORMONE © 2010 Meridian Valley Laboratory

  41. Growth Hormone Hypothalamus GHIH Somatostatin – GHRH + GH Somatotropin Anterior Pituitary Growth Factors Adipose Tissue Muscle Cellular Repair and Regeneration Skin Cartilage Bone Kidney © 2010 Meridian Valley Laboratory

  42. Growth Hormone Deficiency Symptoms: Short Stature (in children) Exercise intolerance Strength  Body fat Glucose intolerance Dyslipidemia Fragility of skin and blood vessels  Immune function © 2010 Meridian Valley Laboratory 42

  43. Growth Hormone Excess: Pituitary Adenoma most common cause Thickening of bones Sweating Muscle weakness  SHBG © 2010 Meridian Valley Laboratory 43

  44. Human Growth Hormone © 2010 Meridian Valley Laboratory

  45. Growth Hormone + Secretagogues + Glutamine (Older people) + hCG + Arginine (Younger people) + Melatonin + Resistance Training + Thyroid + Vigorous Exercise + Progesterone + Adequate Protein + Estrogen + Deep Sleep + Testosterone – Sedentary Lifestyle – Inadequate Protein – Poor Sleep – Insufficient endogenous hormones © 2010 Meridian Valley Laboratory

  46. THYROID HORMONES © 2010 Meridian Valley Laboratory

  47. Thyroid Hormones • Thyroid Hormones Control • Speed of Protein synthesis • Energy use • Sensitivity to other hormones • T3 and T4 • Tyrosine • Iodine • T4 more stable • T3 active • T4  T3 happens within cells © 2010 Meridian Valley Laboratory 47

  48. Thyroid © 2010 Meridian Valley Laboratory

  49. SODIUM / POTASSIUMRATIO © 2010 Meridian Valley Laboratory

  50. Sodium/Potassium Ratio • Reflection of Dietary intake • Important in prevention of • Hypertension • Heart Attack • Stroke • Ideal ratio = 1.5 © 2010 Meridian Valley Laboratory 50

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