DHEA- Helpful or Harmful

[nuthinbutpink]

Hi Dr Potter. I have a question. Lots of us take supplements especially after a failed cycle or due to poor pretesting and prognosis.

There are a number of supplements I have seen discussed on the boards but DHEA in particular seems to be one that has come up a bit more lately and one that is not just the same as good ole Vitamin C.

Regarding DHEA, some of us have taken it, including me, and have had wonderful results. I ended up with my DS. I saw my day 3 FSH go from 10 to 6 the month I cycled and my AMH went from .75 to 2. I took it for a long time- 8 or so months, 75mg per day.

BUT, the research that is available on it, mainly the CHR ongoing study in NY doesn't even seem like it understands how it works but they do see results in older patients with DOR.

Getting to my question, regarding supplements, is too much of a good thing too much sometimes and can we hurt our chances by taking them? Not just DHEA but any others too. Thanks!

[grits]

Good question. Tagging along...

[sassafras]

great question! Looking forward to Dr. P's response

[Dr. Potter]

Hi Dr Potter. I have a question. Lots of us take supplements especially after a failed cycle or due to poor pretesting and prognosis.

There are a number of supplements I have seen discussed on the boards but DHEA in particular seems to be one that has come up a bit more lately and one that is not just the same as good ole Vitamin C.

Regarding DHEA, some of us have taken it, including me, and have had wonderful results. I ended up with my DS. I saw my day 3 FSH go from 10 to 6 the month I cycled and my AMH went from .75 to 2. I took it for a long time- 8 or so months, 75mg per day.

BUT, the research that is available on it, mainly the CHR ongoing study in NY doesn't even seem like it understands how it works but they do see results in older patients with DOR.

Getting to my question, regarding supplements, is too much of a good thing too much sometimes and can we hurt our chances by taking them? Not just DHEA but any others too. Thanks!

DHEA is an androgen steroid hormone that is converted to testosterone and then to either estradiol or dihydrotestosterone. Its use in IVF patients is controversial. It probably has the same effect in DOR patients as estrogen priming. It is very difficult to conduct meaningful research for this or any other agent that might help DOR because no one will agree to participate in a double-blinded randomized clinical trial. In such a trial, women with DOR would be randomly assigned to either receive DHEA or placebo and neither the patient nor the investigator would be aware of which substance the patient is receiving until after the cycle result is obtained. In nature, DHEA is secreted primarily by the adrenal gland and its secretion decreases steadily with age. There have been many advocates of DHEA replacement as part of an anti-aging regimen, particularly in men. DHEA is thought to promote an increase in lean body mass and improve libido and sexual function. One notable advocate of DHEA's use in this manner was the late Sam Yen from UCSD, one of the preeminent reproductive endocrinologists of the 20th century. Dr. Yen did not advocate DHEA for use in fertility patients though. The downside of DHEA is acne acne and birth defects if taken by pregnant women. The positive is that it is cheap and may help women with DOR. DHEA is a reasonable consideration in women with decreased ovarian reserve when other more traditional and proven methods have failed.

[Dreaming]

Thank you for your response Dr Potter. Do you ever recommend your patients take DHEA in preparation for a cycle? Would you favour an estrogen priming protocol instead? If estrogen priming fails would you then suggest DHEA or would that indicate DHEA is unlikely to help? Apart from ache could taking it on the run-up to a cycle have a detrimental effect to a cycle?

[Dr. Potter]

DHEA is an androgen steroid hormone that is converted to testosterone and then to either estradiol or dihydrotestosterone. Its use in IVF patients is controversial. It probably has the same effect in DOR patients as estrogen priming. It is very difficult to conduct meaningful research for this or any other agent that might help DOR because no one will agree to participate in a double-blinded randomized clinical trial. In such a trial, women with DOR would be randomly assigned to either receive DHEA or placebo and neither the patient nor the investigator would be aware of which substance the patient is receiving until after the cycle result is obtained. In nature, DHEA is secreted primarily by the adrenal gland and its secretion decreases steadily with age. There have been many advocates of DHEA replacement as part of an anti-aging regimen, particularly in men. DHEA is thought to promote an increase in lean body mass and improve libido and sexual function. One notable advocate of DHEA's use in this manner was the late Sam Yen from UCSD, one of the preeminent reproductive endocrinologists of the 20th century. Dr. Yen did not advocate DHEA for use in fertility patients though. The downside of DHEA is acne acne and birth defects if taken by pregnant women. The positive is that it is cheap and may help women with DOR. DHEA is a reasonable consideration in women with decreased ovarian reserve when other more traditional and proven methods have failed.

I do use estrogen priming more in my practice. DHEA is a controlled substance in many jurisdictions and can be hard to get. It is very likely that DHEA will be taken off shelves in the US in the near future. I know that they were very close to doing it last year. It may even be unavailable in some states at this point. Aside from the acne and increased lean muscle mass, there is no down side that I am aware of if it is stopped when you become pregnant.

[atomic sagebrush]

Dr. P, do you really think it's possible that DHEA will be banned?? Should we start stockpiling it?

[Zivic-Bubac]

Should we start stockpiling it?

LOL!
I'm from Europe and I got DHEA in Fitness & Body Building shop.

[Dr. Potter]

Dr. P, do you really think it's possible that DHEA will be banned?? Should we start stockpiling it?

The FDA is looking very hard at it. You should have some warning.

[Dr. Potter]

LOL!
I'm from Europe and I got DHEA in Fitness & Body Building shop.

That is where we get it in the US too, the FDA is still looking at calling it a drug. It does not mean that people won't have access to it, it means that it will be a controlled substance and require a prescription.