Carrie Lam, MD and Jeremy Lam, MD, host the Dr. Lam Show, where they show their passion for Integrative and Functional Medicine and share nutritional education to empower people to take control of their health. This pair of siblings started LAM CLINIC, where they're able to provide whole-person healing not only in person but also through telemedicine all over the world.
The Right Way to Supplement with DHEA and Pregnenolone
•Dr. Lam
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Using hormone supplements can be tricky. It’s too easy to overuse or use them incorrectly, resulting in side effects and even a worsening of your overall condition. But here’s how to use DHEA and Pregnenolone supplements correctly and in a way that supports your adrenal function.
1:40 - Pregnenolone the Grandmother of Hormones 4:00 - How Cortisol and Stress affects Lab results 6:30 - How to Supplement DHEA and Pregnenolone correctly 9:00 - How your adrenals make Cortisol and DHEA 10:50 - What to do for Low DHEA 12:40 - Side effects of DHEA 14:40 - High DHEA Causes
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Do you know what hormone supplements you should take? You can go into your local pharmacy and you'll see shelves full of them. Supplements are a big business. But that doesn't help you work out what's right for you. This is an important decision because it will help you overcome deficiencies and problems associated with hormone imbalance. And if you get the supplements wrong, the consequences could range from annoying to devastating. Hi, everyone, this is the Dr. Lam show. We're here to share with you the most effective integrated strategies for good health. We want to empower you to take control of your health one step at a time. So if you find this information helpful, please subscribe, leave us a review so that we can have more people see us and reach a wider audience. I'm Dr. Carrie Lam. And my specialties are an anti aging, family lifestyle and regenerative medicine and I love nutrition.
Dr. Jeremy Lam, MD:
And Hi, I'm Dr. Jeremy Lam, I'm an expert in chronic diseases and also how to combine preventative, conventional, as well as integrative medicine practices to achieve better health. Today we're going to talk about hormone supplements, particularly pregnenolone and DHEA. You'll learn what they are the best ones for certain complaints and symptoms, and how to make sure you're getting the right supplements and the right amounts. So let's talk about hormone supplements starting with the mother of all hormones, pregnenolone. That comes from your adrenals. It starts from taking cholesterol, vitamin C and vitamin D five, making pregnenolone. And that does a lot of miraculous things in your adrenals. So Dr. Carrie, what does pregnenolone become after that?
Dr. Carrie Lam, MD:
Pregnenolone then can cascade down to all your other hormones. So that's why they call it the mother or I like to call it the grandmother all hormones, the mother will be pregnenolone becomes progesterone. Then progesterone can become 17 hydroxyprogesterone and decide to become cortisol or aldosterone or your other hormones like DGA, which we'll talk about later. And also, the sex hormones like estradiol and testosterone. The adrenal have so many different paths, but it all begins with pregnenolone.
Dr. Jeremy Lam, MD:
It's very important again, in creating all your reproductive hormones is that actually starts with pregnenolone. And you know, your body is amazing because of its autoregulation process. This feedback loop and it happens the hormone circuits and the thyroid, the pituitary and hypothalamus. We all have feedback loops, because our body needs to tell itself when to produce lot and when not to. And so this feedback loop, pregnenolone and the adrenals is a very fine line that is regulated automatically, and you don't want to upset it. Oftentimes people see low pregnenolone levels by their laboratory tests and so the automatic mechanism is just to really jump with supplementing with more pregnenolone because that makes sense. This is often a common mistake, because pregnenolone can be low because it's being shunted away to make more downstream hormones. Now, Dr. Carrie, why don't you explain this concept to us?
Dr. Carrie Lam, MD:
Right, so let's say your body is under stress, and it wants to make more cortisol to deal with that stress. As cortisol is anti inflammatory, your adrenals will start producing cortisols instead of pregnenolone. So therefore, the grandmother starts to make the mother and the mother makes the child which would be cortisol. Because you are using most of your resources to make cortisol your pregnenolone on the labs could look like it's low and so your reserve would be low. However, this is a normal mechanism. If pregnenolone is low, you don't want to oversupply the pregnenolone because it's like an overflowing cup of water. It can flow down into all the other hormones like DHEA, testosterone or estrogen. If you have more DHEA, and it becomes testosterone, women might experience more acne, irritable, hair loss, aggression. Men can also be a little more aggressive when they have too much DHEA or testosterone. And so when you try to upset the cycle by manipulating the hormones by taking them, you're kind of forcing certain paths to become more dominant, which is not the body's best way to self regulate.
Dr. Jeremy Lam, MD:
So your body has its mechanisms in place and it will tell which pathways and mechanisms to shut off and which ones not to. That way, you don't have hirsutism, hair loss or gain, or pimples, and yet you get the rise in cortisol. This requires a holistic nutrition approach to give the body the raw materials, and then the body will then decide what to do inst ad of feeding it. Because when you feed it today could be ight tomorrow, it could be wr ng, you know. When you're under tress, you can eat more, and wh n you're not under stress, you can need less. And so the more ou micromanage the more diffi ult it is for your body to re ain its composure. Some peopl who need DHEA and pregnenolone and then you have to monitor very carefully the right dose and the right delivery s stem. The delivery sy tem can make a big difference, like sublingual is faster, tra sdermal is slower. Both h ve its advantages, because somet mes you don't want too fa t over release and sometimes ou do. You have to understand all the mechanisms that is invol ed, understand the bigger pict re or blueprint of wh t you're trying to accomplish. Once you know what to give, h w to give, when to giv
Dr. Carrie Lam, MD:
And also I gave pregnenolone right now, will my adrenals want to produce its own hormones. Because if you get pregnenolone sometimes the feedback loop to your brain can
Dr. Jeremy Lam, MD:
Now you've probably heard a little about prevent hormone release. And therefore your brain inhibits your pituitary from producing hormones and therefore it slows it even more down. So you have to be careful that you're getting the right amount of nutrients. First, I like to see the the five that we talked about the good cholesterol before you just supplement someone with DHEA or pregnenolone. And now you kno about the importance o pregnenolone as well as how har it can be to balance. W recommend that you don't try t supplement or this hormone b yourself. It's key to find a expert who can help you do th supplements in a stepwis fashion. And if you have an questions, you can talk to ou team at Lam clinic 714709 100 call our office for free phon call. And our staff have firs hand knowledge and knowledg when it comes to hormones an adrenal fatigue to help you mak the safest and most effective personalized choices the DHEA, so let's talk about cortisol and DHEA and why they're so important.
Dr. Carrie Lam, MD:
First, the pathophysiology of how adrenals make cortisol and DHEA. We already touched on pregnenolone being the mother of all hormones, needing cholesterol, then cholesterol becomes pregnanolone with the help of vitamin C and vitamin D five, then pregnenolone becomes aldosterone, or cortisol or DHEA and other reproductive hormones. So your body can decide to make one, two or all three, Or your body can be in a lot of stress and need more cortisol than DHEA, so you need products that are more cortisol based and less DHEA. Conversely, what can happen Dr. Jeremy?
Dr. Jeremy Lam, MD:
If your body needs more estrogen and testosterone then it will produce more DHEA and less cortisol. So how does this relate to someone with adrenal fatigue and their lives? It's all about auto balancing that's very critical and we have to respect the body and how it does this feedback loop again. The body knows when to shunt towards more cortisol and when towards more DHEA. This mechanism is regulated and if we micromanage it, we can put some of the feedback loops into dysregulation mode. Now, a lot of people come in with a low cortisol curve from four point salivary cortisol, and it's a flatline. We've classically called these people with adrenal fatigue and event stages and they also have low DHEA.
Dr. Carrie Lam, MD:
So when you see a low DHEA, practitioners like to put patients on DHEA and when you try to artificially bump up the DHEA you have to know what it becomes. DHEA can lead to more testosterone production, and testosterone is an anabolic hormone. A lot of people do use it for muscle building or helping libido and increasing energy. But the problem is that if you're trying to only increase energy and not increased the cortisol, it can backfire because cortisol is helping with inflammation and reduce stress. And so you have to really remember the balance between the DHEA and cortisol. You want to increase cortisol, then might be better to think about the whole pregnenolone pathway that we talked about before rather than doing DHEA, because once it becomes DHEA, it does not become cortisol. It makes testosterone and estradiol. So your adrenals can decide to make either DHEA or cortisol. If you supplement with DHEA, again, same feedback loop can go back to your brain and it does not produce the reproductive hormones testosterone and estradiol. So you got to be very careful when you start DHEA on yourself or practitioners starting on you, because you have to know what the side effects are. Dr. Jeremy what are some side effects of DHEA?
Dr. Jeremy Lam, MD:
In women it can be drastic hair loss because of the testosterone effect. You can also get severe acne. In men, it can be hair loss and voice change as possible a side effect. It's dose dependent and how sensitive your body is. People who are sensitive can have an exaggerated response or an opposite reaction. So even if you have low DHEA, you have to be careful with supplementation. Even if you have adrenal fatigue and your body is quite congested, you can still have the opposite reaction.
Dr. Carrie Lam, MD:
DHEA can be tested in the blood serum but it's very hard to find free DHEA, because most of the time when it's in the blood, it's already bound. So, many of the blood tests actually are are looking for DHEA sulfate of DHEAS in the blood. This is what your doctor is most likely order to see how your DHEA levels are. If you wanted to get a free DHEA level, it would be best to get it through the saliva test, which you can also along with all other hormones and cortisol. This would give you the free hormones that are active and not just the hormones bound by protein. So what does it mean when you have high levels of DHEA in your saliva?
Dr. Jeremy Lam, MD:
If you have high DHEA, that means that your body is putting out more DHEA. The question is why is your body putting more DHEA? You get a signal from the brain to put a more out because either your HPA axis is on overdrive, or you have a problem with converting the DHEA to another downstream hormone, resulting in the backup and rise in DHEA. So you can have multiple reasons for high DHEA. It has to be correlated with what is going on with your symptoms. Listening to what the body's telling us to make good sense out of it. Otherwise, people can make a lot of mistakes by thinking while the DHEA is high, so let's bring it down. Or it is too low so need going up. If you have a problem with DHEA, it's important to address the underlying problem, either it's shunted to make other hormones or over supplementation, or adrenal fatigue. If you have adrenal fatigue you have to be careful when supplementing with DHEA, Dr Carrie?
Dr. Carrie Lam, MD:
If you find that your saliva test is showing a low DHEA then always compare your DHEA with cortisol. High DHEA can be from the causes that you mentioned like over supplementing or if you have low DHEA, then check your cortisol levels. If the cortisol is low, and low DHEA, then maybe your adrenals are tired of producing hormones. However, if your DHEA is low or cortisol is high, that means it's shunting. You adrenals are trying to produce less DHEA and the reproductive hormones and have more cortisol. So that might be an earlier stage of Adrenal Fatigue. It's important to correlate what is going on with each person and what stage they're in. With a good practitioner you can see your levels and correlate with your symptoms. Again, it is important to just not supplement someone with DHEA or pregnenolone unless you know the root cause. Because these adrenal hormones are very important to function you don't want to reduce your own feedback to your brain and stop producing adrenal hormones. So never just jump into supplementing, always get expert help and care for your body and make sure it's personalized. And so if you feel like you want help from Lam Clinic, we invite you to call our office at 714-709-8000. We hope you really enjoyed this podcast today and learn something about DHEA and pregnenolone and the right way to supplement. Please subscribe to this podcast if you find useful. Remember, we're here to empower you to take control of your health, on the Dr. Lam show.
