HORMONES!! Although many individuals have fears and concerns about hormone replacement, no one’s life would be the same without them. For hormones influence not only whether one becomes a male or a female, but hormones controls almost every aspect of daily life: from whether one shaves, gets fat, becomes chronically fatigued, has blood pressure problems, contracts chronic illnesses, or suffers from depression. Medical breakthroughs in the last fifty years have allowed doctors to analyze hormones present in blood samples, determine their important actions, and then to replace these hormones with bio-identical medication as a means to improve the individuals well-being. Recently, one such hormone released from the adrenal gland, has been found to have so many important functions that it has been named the "anti-aging" hormone. Noted by the initials, D.H.E.A., dehydroepiandrosterone has become the focus of research world-wide. In fact, an international medical meeting in June, 1995, focused on what is now recognized about its actions. Low levels of D.H.E.A. have been commonly identified in a number of yet, unmanageable medical conditions including obesity, cancer, arthritis, and heart disease. Secondly, when taken orally, D.H.E.A. is well absorbed and relatively free of side-effects. And although it is an adrenal hormone, it does not appear to cause osteoporosis, weight gain or depression. In fact, it may aid in reversing the side-effects of these and other hormonal problems. D.H.E.A. is produced in large amounts during pregnancy and then again in the teens and twenties. Its maximal level is attained in the mid-twenties, only to drops in half by 50 years of age and then to less than 10% by the time an individual is 70. Produced in larger amounts than any other hormone, D.H.E.A. is converted into the male hormone testosterone and the female hormone estrogen. Today it is also known that D.H.E.A. is necessary for the action of almost every cell in the body. D.H.E.A. controls the energy production within the cell; and the addition of D.H.E.A. may be likened to putting high-test fuel in a automobile’s engine. Researchers suggest that low D.H.E.A. levels may be found in men and women with cardiovascular disease (myocardial infarction), cerebral vascular accidents (strokes), osteoporosis (broken bones), hypercholesterolemia (high cholesterol), diabetes ("sugar"), obesity, cancer, Alzheimer’s disease (senile dementia), chronic fatigue and disturbances of the immune system (including multiple sclerosis, lupus, and fibromyalgia).

Animal Studies
Animal studies already completed confirm the benefit of supplementary D.H.E.A. This research demonstrates that D.H.E.A. can prevent the damage to the blood vessel walls that precedes cardiovascular disease. D.H.E.A. also thwarts the development of skin cancer, breast cancer, prostate cancer, diabetes and certain immune diseases like lupus as illustrated in other animal studies. In addition, D.H.E.A. prevents obesity in aged rats and increases their life expectancy by 30 to 50 percent. Since studies with D.H.E.A. have been successful in prolonging life and retarding disease in rats, will these effects carry through in humans? In the United States, DHEA is sold as a supplement over-the-counter.  If the FDA finds no problem with it, why not measured your blood levels and supplement accordingly? Just to see the differenced one hormone from the life-pyramid can do for you remaining the healthy, youthful thinking and acting YOU!

Human Studies
More than 3000 medical articles have been written about D.H.E.A. in the last 5-6 years! Many of these evaluate the difference in the amounts of D.H.E.A. between healthy and sick individuals. As confirmed at the series of international meeting, D.H.E.A. may hold a key to understanding many diseases. Studies in human subjects substantiate the benefits of D.H.E.A.. SSC Yen reported(1) in a 1994 study of "advancing age" (age over 50) an improvement of physical and psychological well-being in both genders and the absence of side-effects when on D.H.E.A. supplements compared to a placebo (empty pill). Other studies note that those on D.H.E.A. slept better, awoke refreshed, had greater endurance to perform activities, and may have had an improved sex life. Mortola and Yen(2) proved the safety of D.H.E.A. in doses up to 1600 mg daily. Still other researchers demonstrated safety in amounts 10 times higher. Recently, McGuire(3) at Stanford University found that 200 mg of D.H.E.A. relieved some of the severe symptoms associated with lupus erythematosis, including arthritis, steroid use, renal damage and fatigue with minimal side-effects.

Dr. Lichten’s Blood Studies
Rather than empirically add D.H.E.A., many of my colleagues and I feel it is mandatory to measure blood levels of this hormone to determine what is normal. Monitoring the blood levels of D.H.E.A. is necessary since the best results should occur when D.H.E.A. levels are brought back into the "normal" range. The "normal" range, however, will vary by age, by individual, and by laboratory. Therefore, before being able to determine if one individual value is "normal" or "low", there has to be an established standard to measure that value against. One of the most complete studies to date was published by Orentrich in 1984.(4) His recorded values shows that there exists a statistically restricted range of normal values based on the individuals' age and sex. In order to reconfirm this narrow range of blood values, Dr. Lichten focused his attention on a group of senior Olympic athletes. Since these elderly individuals maintain excellent health, their blood values are expected to be a more uniform measure of "normal" for their age groups. In a preliminary review of men and women over 65, the healthiest individuals had as expected, what would be considered elevated blood levels of D.H.E.A, testosterone and IGF-1( measure of growth hormone)! The values were normal for a 30-35 year old!!  That can be your normal as well!
We have subsequent studied a population of younger women with various complaints of fatigue, weight gain, headache, depression and "feeling stressed." Preliminary evaluation of those undergoing serum sampling of D.H.E.A. show them to be two standard deviations below the expected "average" D.H.E.A. level. Or, looking at it on the aging continuum, these individuals appear to have the blood levels of women 20 years older! After normalization of their D.H.E.A. blood levels, usually to the levels of very healthy 20-30 years old, our patients almost routinely report relief from their suffering with chronic complaints of fatigue, insomnia, and headache. Both depression relief and weight loss have improved, but not as consistently as the other complaints related to exhaustion. The correlation between "normal" blood levels and "normal" energy in these individuals seems readily apparent.

IF YOU SUFFER WITH CHRONIC FATIGUE you may be able to get relief with DHEA over-the-counter supplementation!

Read our article on CHRONIC FATIGUE!

D.H.E.A. and Aging
One of the primary changes felt with aging is fatigue. Whenever there is a loss of energy in the late afternoon, a decrease in productivity at work, an inability to exercise due to exhaustion or a feeling of unrest after a fitful night’s sleep, with  aging comes listlessness. As such, a sense of frustration may occur along with becoming short tempered, being unable to concentrate and growing intolerant to change. And D.H.E.A. seems to be a key to understanding this fatigue that occurs with aging. For D.H.E.A. is necessary for the production of energy as it drives the energy producing parts of the cells. D.H.E.A. is also vital to burning fat. That is why along with fatigue, elderly individuals often gain weight and store the fat thus gained in the abdominal region. Additional fat deposits are also found around the heart and in the blood vessels causing arteriosclerosis. Then, with the supplementation of D.H.E.A. that is lost in the aging process, one may find his or her energy level be potentially improved. And with subsequent renewed energy, exercise and a change in life style, potentially the risk of some of these diseases may be lowered. In the medical literature and our practice, select patient population with chronic complaints of fatigue, headache, obesity, and depression, show low D.H.E.A. blood levels measured as DHEA-S (DHEA sulfate is stable in the blood stream while DHEA is consumed rapidly). Could this information explain why these patients are relatively unable to function? It may further illustrate what a lack of energy from one corner of the life--pyramid does to the body’s systems: it weakens the immune system and the ability to fight infection. A biochemical explanation for such finding may show that the lack of efficient cellular energy production may be a cause for the vast array of choleric conditions. As such, further research may find that many illnesses thought to be psychosomatic are, in fact, precipitated by a state of D.H.E.A. deficiency.

D.H.E.A. may be a link into understanding some of the processes that affect both aging and disease states.(5)

D.H.E.A. and Osteoporosis
Labie in 1998 [6] showed that DHEA significantly increased bone mineral density in post-menopausal women. He found increased in plasma osteoclacin and decrease in bone absorption (decrease in urinary hydroxyproline excretion).
Labrie noted that DHEA is necessary for tissue specific c-DNA action. "It is estimated that 30-50% of total androgens in men are synthesized in peripheral intracrine tissues (fat) from inactive adrenal precursors while, in women, peripheral estrogen formation is even more important. The best estimate being 75% of all estrogen/testosterone for women in their 40's and 100% after menopause build the body's necessary sex hormone from adrenal precursors (DHEA) for tissue use of estrogen and testosterone.[6]

Availability of D.H.E.A.
Interestingly, D.H.E.A. is available in here, Europe and the Far East. In Europe, D.H.E.A. has been used for hormonal replacement for twenty years. In Japan, D.H.E.A. is given prior to delivery to soften the cervix and allow for an easier vaginal childbirth, avoiding Cesarean section deliveries. In fact, Americans have traveled to European clinics in search of D.H.E.A. and its "anti-aging" properties. One researcher in Philadelphia, Pennsylvania has patented a modified 7-Keto- D.H.E.A. hormone and brought it to the market. However, it is associated with less acne. Our approach is to use a slow-release compounded DHEA with increased purity and micronized formation which allows for lymphatic absorption with 50% of the hormone bypassing the first pass to the liver. If acne persists, spirolactone is used as it is quite helpful; otherwise, try reducing the dosing.

Hopefully, the ongoing studies, clinical trials and personal testimonies  will confirm the benefit of replacing D.H.E.A. for both the relief of symptoms of fatigue and possibly as a "preventative" treatment for advancing age.
D.H.E.A. is available from compounding pharmacists and in the United States over-the-counter at many health food stores and pharmacies. Costs vary depending on dosage. Typical treatment is: DHEA 25-50 mg taken twice daily starting at a cost of pennies per day.
We found that the blood levels or bio-availability vary from product to product. The micronized pharmaceutical grade products produce up to 200% more usable DHEA-sulfate over a 6 hour period than the over-the-counter products tested. Results of course, vary from product to product and individual to individual.

To Learn More About:

1. D.H.E.A., Exhaustion, Fatigue of Aging and Headache
2. D.H.E.A. and Treatment for Chronic Fatigue
3. Our Research with Hormones and Disease

References

1. Yen SSC, Morales AJ. Effects of Replacement Dose of Dehydroepiandrosterone in Men and Women of Advancing Age. Journal of Clinical Endocrinology & Metabolism. 1994; 78: 1360-1367.
2. Mortola JF, Yen SSC. The Effects of Oral Dehydroepiandrosterone on Endocrine- Metabolic Parameters in Postmenopausal Women. Journal of Clinical Endocrinology & Metabolism. 1990; 71: 696- 704.
3. VanVollenhover RF, McGuire JL. An Open Study of DHEA in Systemic Lupus Erythematosis. Arthritis & Rheumatism. 1994; 37(9): 1305-10.
4. Orentreich N. Age Changes and Sex Differences in Serum Dehydroepiandrosterone Sulfate Concentrations throughout Adulthood. Journal of Clinical Endocrinology & Metabolism. 1984; 59: 551-555.
5. Nestler JE. DHEA: A Coming of Age. Annuals NY Academy of Science, 1995;774:ix-xi. December 29, 1995 printing of June, 1995 D.H.E.A. Symposium.
6. Labrie F, Belanger A, et al. DHEA and the intracrine formatoin of androgens and estrogens in perioheral target tissues: its role during aging. Steroids 1998 May-Jun; 63(5-6):322-8.

The information in this newsletter does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice.

The information in this newsletter does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice.