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cortisol

DHEA Deemed ‘Effective Hormonal Replacement Treatment’ for Women – (09-10-01)

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DHEA Deemed ‘Effective Hormonal Replacement Treatment’ for Women

Getting the idea? As mentioned numerous times, I am against using hormones in the body as a first resort to replace hormones that are low. In peri and postmenopausal women, balancing adrenal steroidogenisis should be the first plan of attack. This along can increase DHEA levels without exogenous administration. This lets the body find its own level instead of modulating it from outside. If this is unsuccessful, than a trial of DHEA is warranted (can also be used if adrenocortical testing indicates adrenal exhaustion with no DHEA or cortisol being produced). The author comes to a dangerous conclusion at the end of the article, suggesting that DHEA should be moved from the supplement category to hormone replacement; this would take DHEA off the health food shelves.

Fertil Steril 2001;76:241-248 Treatment with dehydroepiandrosterone (DHEA) is similar to that with estrogen-progestin replacement therapy in its effects on several endocrine parameters in postmenopausal women, Italian physicians report. Dr. Alessandro D. Genazzani, now with the University of Modena, and associates from the University of Pisa treated 31 women with oral DHEA 50 mg daily for 6 months. The subjects were grouped according to age and body mass index. Hormone evaluations and a growth hormone releasing hormone (GHRH) test were performed before and after the trial. “Oral DHEA treatment annulled the differences observed between early and late postmenopause, including those strictly related to excess body weight,” the physicians write in the August issue of Fertility and Sterility. Plasma levels of steroids that derived from DHEA metabolism increased, as did osteocalcin, growth hormone (GH), and insulin-like growth factor 1 (IGF-1). Levels of luteinizing hormone and follicle stimulating hormone decreased. DHEA treatment was similar in its effect on the GHRH-GH-IGF-1 axis as treatment with estrogen-progestin, Dr. Genazzani’s group concludes. They recommend that DHEA be considered not just a diet supplement but an effective hormone replacement treatment.

Dehydroepiandrosterone Sulfate, Mortality in Elderly Men and Women – (09-10-01)

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Dehydroepiandrosterone Sulfate, Mortality in Elderly Men and Women

Well..doesn’t adrenal cortical function seem to be a hot topic lately?? As a quick review, the adrenal cortex produces aldosterone (regulates BP), cortisol (the stress hormone) and DHEA (precursor to estrogen and testosterone). Low levels of DHEA indicate adrenal stress and improper function. Whether this is a result of the adrenals shunting towards cortisol production or whether the adrenal cortex is failing can be determined with adrenocortical testing using salivary levels.

JCEM — Abstracts: Trivedi and Khaw 86 (9): 4171

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Resistance to Glucocorticoid Feedback in Obesity – (09-10-01)

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Resistance to Glucocorticoid Feedback in Obesity

Once again we see how important the adrenal glands are to our health. This study basically status that the adrenal cortex is shutting down in obese patients. The pituitary is trying to prod the adrenals to work but cannot get the adrenals to produce enough cortisol (and by inference I’m sure DHEA levels would also be low). Checking adrenal status is looking more and more to be an essential part of any workup on a patient with a multitude of chronic diseases.

JCEM — Abstracts: Jessop et al. 86 (9): 4109

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Phytoestrogens Alter Adrenocortical Function – (11-19-01)

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Phytoestrogens Alter Adrenocortical Function

This study finds that the genistein and daidzein (both found in soy) lower cortisol levels and increase DHEA levels, essentially reversing the pregnonolone steal. The pregnonlone steel occurs when precursers in the adrenal cortex get shunted over to cortisol production instead of DHEA in times of chronic or extreme stress.

JCEM — Abstracts: Mesiano et al. 84 (7): 2443

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Identification of Leptin in Human Saliva – (11-19-01)

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Identification of Leptin in Human Saliva

I had a patient the other day go to her ob/gyn office and see the nurse practitioner. This patient had shown a high DHEAs and low cortisol level on salivary panels. When she mentioned this to the NP, the NP said that DHEA was not a “medical test.” I’m still somewhat confused by the response of the NP, but what scares me is that DHEA is a major precursor to sex steroid hormones and this NP knew nothing about it. She did, however, recommend the pill for this patients’ symptoms; ironically, insulin resistance appears to be a major factor in this patient’s condition and BCP is known to adversely effect insulin resistance. The moral of this story? Salivary hormone profiles are valid, noninvasive diagnostic testing that is supported in the medical literature.

JCEM — Abstracts: Gröschl et al. 86 (11): 5234

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DHEA May Be Effective Treatment for Female Sexual Dysfunction – (06-21-01)

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DHEA May Be Effective Treatment for Female Sexual Dysfunction

In using salivary analysis to check for hormone levels (saliva checks for the free forms of hormones, not the ineffective protein bound forms that most bloodwork checks for…) as an assay for adrenal gland function, cortisol and DHEA levels are checked. In patients under chronic stress, the body will actually steal the building blocks to make more cortisol, leaving none to make DHEA. Now, considering that DHEA is the precursor to testosterone and estrogen, this creates a problem. This article shows benefits of using DHEA in women with sexual dysfunction. Personally, I would check adrenal function first. By addressing this problem, DHEA levels can rise without ever administering DHEA itself.

96th annual meeting of the American Urological Association Dehydroepiandosterone (DHEA) may serve as an effective treatment for women with androgen deficiency syndrome leading to sexual dysfunction, according to a study released at the 96th annual meeting of the American Urological Association in Anaheim, California.Irwin Goldstein, MD, and colleagues from Boston University School of Medicine administered DHEA to 32 patients. After 6-12 months of receiving 50 mg of DHEA daily, all of the women reported improved scores both on the Female Sexual Function Index and the Sexual Distress Scale.Use of the adrenal androgen steroid as therapy for sexual dysfunction remains controversial, however, because there is a lack of specific criteria for diagnosis of female androgen deficiency syndrome.Until now, women with sexual dysfunction and a serum-free testosterone concentration in the lower third of the normal range have been considered for androgen replacement therapy. The syndrome is associated with loss of libido, low motivation, and fatigue, most often occurring in women who have undergone oophorectomy or are postmenopausal. A lack of objective measures for gauging symptoms such as blunted motivation, however, as well as low assay sensitivity in the lower concentrations of androgen seen in women after iatrogenic menopause have hampered clinicians’s abilities to reach consensus on the definition and classification of the syndrome.

Lack of Sleep May Increase Risk of Type 2 Diabetes – (07-09-01)

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Lack of Sleep May Increase Risk of Type 2 Diabetes

Two things that are absolutely essential for any other natural therapy to work for any condition is exercise and sleep. The results of this article should not be surprising. Poor sleep or lack of sleep is a stress on the body and the body responds by producing cortisol, the stress hormone. Cortisol is known to increase insulin resistance…thus predisposing to diabetes. There are many ways to get a better night’s sleep…valerian root, hops, passionflower are just a few of the herbs known to have a sedative effect and help with sleep. Exercise, a mattress that’s right for you and maintaining a healthy sleep schedule are also part of the program.

American Diabetes Association’s annual meeting A chronic lack of sleep may cause far more serious problems than a tendency to nod off the next day, researchers warn. Their study results, presented here Monday at the American Diabetes Association’s annual meeting, show that people who do not get enough sleep on a regular basis may become less sensitive to insulin. In fact, chronic sleep deprivation — 6.5 hours or less of sleep a night — had the same effect on insulin resistance as aging, says co-investigator Bryce A. Mander, a research assistant at the University of Chicago in Illinois. “Just like poor diet, sedentary lifestyle, chronic stress and aging, sleep loss is a…risk factor” for type 2 diabetes, Mander said. In the study, led by Dr. Eve Van Cauter of the University of Chicago, healthy adults who averaged 316 minutes of sleep a night — about 5.2 hours — over 8 consecutive nights secreted 50% more insulin than those who averaged 477 minutes of sleep a night, or about 8 hours. As a result, “short sleepers” were 40% less sensitive to insulin. The researchers suggest that sleep deprivation, which is becoming commonplace in industrialized countries, may play a role in the current epidemic of type 2 diabetes. Mander cited a poll by the National (US) Sleep Foundation documenting a steady decline in the number of hours Americans sleep each night. In 1975, the average American slept 7.5 hours, down from 9 hours in 1910. Today, adults sleep about 7 hours a night, he said.

Adrenalectomy Improves Diabetes in Mice – (07-01-02)

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Adrenalectomy Improves Diabetes in Mice

It is well accepted that chronic stress resulting in the overproduction of cortisol (on of the body’s stress hormones…) alters insulin sensitivity in a negative fashion. This animal study builds on this foundation. Remember that chronic stress has deleterious effects on just about every aspect of human physiology. However, if your endocrinologist comes after you with a knife, better run for the hills–not only do you avoid the scars, but exercise is a wonderful way to manage chronically elevated cortisol…

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