DHEA- Helpful or Harmful

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January 3rd, 2011, 02:30 PM
nuthinbutpink

DHEA- Helpful or Harmful

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!
January 3rd, 2011, 02:44 PM
grits

Good question. Tagging along...
January 4th, 2011, 04:06 PM
sassafras

great question! Looking forward to Dr. P's response
January 5th, 2011, 03:09 AM
Dr. Potter

Quote:

Originally Posted by 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!

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.
January 7th, 2011, 09:23 AM
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?
January 14th, 2011, 12:32 AM
Dr. Potter

Quote:

Originally Posted by 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.
November 15th, 2011, 10:18 AM
atomic sagebrush

Dr. P, do you really think it's possible that DHEA will be banned?? Should we start stockpiling it?
November 15th, 2011, 11:38 AM
Zivic-Bubac

Quote:

Originally Posted by atomic sagebrush

Should we start stockpiling it?

LOL!
I'm from Europe and I got DHEA in Fitness & Body Building shop.
November 16th, 2011, 12:27 PM
Dr. Potter

Quote:

Originally Posted by atomic sagebrush

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.
November 16th, 2011, 12:30 PM
Dr. Potter

Quote:

Originally Posted by Zivic-Bubac

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.
December 21st, 2011, 10:08 PM
glory

Just adding to this, it is only available in Australia via script and then you have to get it specially made up at a compounding pharmacy.
January 16th, 2012, 03:56 PM
Princess of Pink

Quote:

Originally Posted by glory

Just adding to this, it is only available in Australia via script and then you have to get it specially made up at a compounding pharmacy.

Thats not true...

DHEA 6X (Pretorius) - Vitamin Warehouse
January 16th, 2012, 04:14 PM
michaela

Quote:

Originally Posted by Princess of Pink

Thats not true...

DHEA 6X (Pretorius) - Vitamin Warehouse

That is homeopathic which is much different than the stuff we have here in the states or what you would get via a script. Basically homeopathic is like taking a bucket of water and then adding a drop of DHEA into it. Then split that bucket of water up into hundreds of different bottles.
January 17th, 2012, 03:55 AM
glory

Princess to be honest I haven't googled it, but from what my Aussie RE said it can only be got on prescription in Australia. If you find anything online, then I would say it will not be the same quality as what you need for IVF.

What you have found, like Michaela said is a homeopathic preparation, this is NOT DHEA, homeopathics do not work like vitamins, but work to stimulate a certain reaction, in this case I am assuming the adrenals, this is not what we are talking abou in terms of DHEA and while this preparation may be helpful as with any vitamins or supplements it should be given by a qualified homeopath, as if you are not lacking with homeopathics, the preparation will do absolutely nothing.

I personally love homeopathics but would not use this preparation when talking in what RE's mention as DHEA.
January 25th, 2012, 03:30 AM
Dr. Potter

Quote:

Originally Posted by glory

Princess to be honest I haven't googled it, but from what my Aussie RE said it can only be got on prescription in Australia. If you find anything online, then I would say it will not be the same quality as what you need for IVF.

What you have found, like Michaela said is a homeopathic preparation, this is NOT DHEA, homeopathics do not work like vitamins, but work to stimulate a certain reaction, in this case I am assuming the adrenals, this is not what we are talking abou in terms of DHEA and while this preparation may be helpful as with any vitamins or supplements it should be given by a qualified homeopath, as if you are not lacking with homeopathics, the preparation will do absolutely nothing.

I personally love homeopathics but would not use this preparation when talking in what RE's mention as DHEA.

Hard to put much stock in homeopathic hormones. Hormones work by receptor binding. The more receptors bound the more response.