I recently had this test as part of my blood work and have a level of 34, which is very low.  My doctor advised just as you have to start low and go slow watching how I feel.

This along with some other hormone supplementation has helped my overall well being and energy.  I can't remember when I had my last energy crash.  

As always, Thanks!

Interesting stuff, Dr Davis, regarding treating Lp(a) w/ DHEA.  

What are your thoughts on the efficacy of increasing/maintaining natural endogenous secretion via strength training and/or caloric restriction?

This is something I'm becoming more interested in as I creep closer to 40.

Hi, Mike--

I should have mentioned that I only suggest DHEA supplementation for these purposes in people age 40 and over.

Your idea of endogenous enhancement is the preferred, though relatively modest, route in younger people.

Thanks for reminding me.

I’m very interested in trying DHEA for this very reason. I’m am a 43 year old male in good health but who had very high cholesterol. I am currently using high strength fish oil and niacin along with cutting out most carbs from my diet. I have lost about 7 kilo since doing this and had some great plummets in my cholesterol. Problem is as I live in Australia we cannot get access to DHEA without paying obscene amounts of money via compounding pharmacies and doctor scripts as it’s a class 1 drug that is illegal. I know in the states you can get it as a nutritional supplement but Australia is backwards in this sense. Do you or any readers know of any sympathetic doctors who are interested in male health and would prescribe DHEA? It seems criminal that we cannot access the health benefits of this because of government bureaucracy.
Cheers from South Australia
Dave

Young people produce at least 12mg./day of DHEA; when we reach +/- age 30 our production of DHEA normally drops. I am led to believe that decline is +/- 2 mg./d. for every decade of our life past 30.

So, for an average patient of (say) 50 years supplementing daily with 10 mg. DHEA: the first 4 mg. is serves to "top up" the natural ageing deficit. The remaining 6 mg. is providing a 50% bonus level for the circulatory system to use thwarting Apo(a).

Sounds relatively safe intake. I'd like to hear if Apo(a)patients, who took it regularly in middle age, would be taking (say) +/- 15 mg. DHEA daily when they are in their 70's.

I am 58 years old and was recently tested and had levels of 4.510 ng/mL.  What levels do you recommend as targets for someone wishing to treat Lp(a)?

I have long been fascinated with DHEA but I read too many horror stories on Wikipedia and Consumerlabs.com about the dangers. Cancer, lowering of HDL, and aggressiveness are big turn offs. How do we balance these risks with the risk of heart disease?

-- Boris

http://curezone.com/forums/fm.asp?i=1448411#i

Problems with DHEA supplementation.

What do you think/know about magnesium oil's effect in raising levels of DHEA? I take oral magnesium in the form of Natural Calm (citrate i think) but three months ago I also started rubbing magnesium oil into my skin. I have read that this type of transdermal magnesium application raises DHEA levels. Any truth there, Dr.? Thanks

What is a good brand name DHEA, and can it be found in less than 50 mg tabs?

Thank you.

Anonymous,

I would recommend Life Extension brand of DHEA. I have had excellent results with Life Extension products over the years. They are a little more costly, but I believe the quality is top notch. Unfortunately however, the smallest dose of DHEA that LEF makes is 15mg.

Here is what Ray Sahelian, M.D. says about DHEA:

http://www.raysahelian.com/dhea.html

I myself had low levels of DHEA and low testosterone and I took DHEA (starting at 25mg and going all the way up to 75mg) and while my DHEA levels went up to the upper end of the reference range, my testosterone only increased by 9%-10%. I ended up discontinuing the DHEA because I couldn't get my testosterone levels up sufficiently and I was concerned about possible longer term side effects even though I didn't really experience any of the horror stories you read about online.

I don't have Lp(a) problems, but if I did, I would consider taking DHEA again in lower doses (15mg-25mg for me) however.

Hope this helps.

I've been taking the stuff since my mid-30s and found it to be great for general energy, mood and body composition. However, I've never been able to take more than 15 mg a day. That's low for a male, I know, but 25 or more and I get ferocious acne.

I was taking 10mg DHEA but have switched to 7-KETO (just 25mg a day at present). I believe that 7-KETO, as a naturally occurring metabolite reduces the risk of DHEA side effects, so was this a good idea?

(I am a 50-something female.)

Hi, Ben--

Sorry, no knowledge.

I did ask one of the manufacturers of topical magnesium preparations (creams, epsom salts) whether they had any data in humans showing effects on magnesium blood levels. They said they had not generated any nor were aware of any.


Several commenters--

The "horror stories" surrounding DHEA all refer to the higher, supraphysiologic doses I mentioned, not the low, physiologic replacement doses we use for Lp(a).

Also, this is about DHEA for Lp(a), not DHEA for youth preservation. Two different perspectives.

Q: I've been feeling really tired for a while now. My doctor checked my DHEA level which was very very low -- less than the level typical for an 80 yr. old woman and I am less than half of that! Could you please suggest some supplements for me? I know that there are DHEA supplements but these aren't available in Canada. Is there something else I can take? Thanks!





A: I have never been a fan of hormonal substitutes, including glandulars. With hormone replacements there is a great risk of atrophying the glands that normally produce the hormones. There are two reasons for this. One is a feedback mechanism in which if high hormone levels are perceived in the body the gland will be shut down to compensate. Secondly, glands are like muscles and must be worked to be kept healthy. Substituting for the glands makes them weak over time. I have seen some people claim that DHEA does not atrophy glands like other hormones, but rather leaves the adrenals producing the same level of hormones. Of course even if DHEA was not atrophying the glands and was leaving the glands to produce DHEA at the same level then the adrenals would still be producing at a diminished output. Therefore, the DHEA would do nothing to boost adrenal performance.



DHEA is classified as a weak androgen (male hormone). It is converted in to estrogen and testosterone, but not the balancing progesterone. This may lead to problems of elevated estrogen, including weight gain, thyroid dysfunction, problems with blood sugar, and problems with elevated testosterone, including increased body hair, and loss of scalp hair. There is also a lot of concern about the possibility of causing cancer or promoting existing cancers. There is not enough known about the actual long term effects of this hormone. Many of the studies on DHEA were done on rats, which do not have the same chemistry of humans. And the few human studies I have seen on DHEA were short term studies looking for improvement of certain symptoms, not side effects including the risk of adrenal atrophy. Overall I really think that DHEA supplements should be avoided!


DHEA is normally thought to decline due to age, though this is not necessarily the case. Primary production of DHEA occurs in the adrenal glands. Therefore adrenal function may directly affect DHEA levels. And the majority of the people are exposed daily to two of the biggest weakening factors for the adrenals, stress and stimulants. Stress can be physical, such as pain, or emotional. And both can be increased by reduced adrenal function since the adrenals produce the anti-inflammatories and anti-stress hormones for the body. Stimulants include caffeine, ephedrine, pseudoephedrine, and nicotine. Various pharmaceuticals can weaken adrenal function. The best known of these are steroids, such as Prednisone. Though anti-seizure medications, antifungals, cold medications, asthma medications, etc. can also cause adrenal weakness.


In short it is safer and more effective to build up your adrenal glands so they will produce their own DHEA at proper levels, rather than raising levels artificially to abnormally high levels. This is best addressed with vitamin C and pantothenic acid, the most important nutrients for proper adrenal function, and adaptogenic herbs. Adaptogenic herbs get their name from their ability to help people to adapt to stress by improving adrenal function.



Add To Favorites!

You have provided very nice information regarding testosterone supplements through your blog. Xenesis-T and Xenesis-EP for men and women a remedy for low Testosterone treatment, it will. It is the 100% natural supplement to overcome Testosterone problems.

At a dose of 50 mg daily, DHEA has not resulted in any decrease of HDL for me.

Adrenal genetic factors will not let everyone respond to "boosting". Of course, the same genetic quirks imply high dose DHEA (de-hydro-epi-andro-sterone)is not wise.

Worldwide +/- 1:1,000 develop late onset congenital adrenal hyper-plasia; among Hispanics 1.9%, Italians 0.3%, Slavs 1.6%,
Ashkenazi Jews 3.7% and caucasians generally 0.1%. Hirsutism (face hair) is an easy sign in women; adult acne for both genders.

A genetic enzyme 21-hydroxylase deficiency is the rate limiting factor in 95% of these cases. Then low amounts of cortisol are made. Signals for more, by cortico-tropins, "whips" the adrenal cortex; trying to get more cortisol output. But, the inability to synthesize cortisol makes all those building blocks go into production of androgens.

Additionally, there are 12 known genetic mutations of the gluco-dorticoid receptors. These make the body "resistant" to deal with the cortisol in circulation. Without de-activation (receptors a first step) into cortisone the cortisol level stays elevated.

In this situation both adrenals are, in a sense, overworking for no purpose. Progressively this leads to arterial hyper-tension down the way. So-called gluco-corticoid resistance, as a syndrome, develops in 10% of the elderly.

Point being that genetics, and the epigenetics of age, are some reasons why not everyone will respond to a "natural" plan. It also explains how different people respond to supplement dose of DHEA.

Paradoxically, genetics that mean patient can't be made to do what others can backs up Doc Davis' clinical DHEA use. If it is for combating high Lp(a) with small doses of DHEA.

I've never heard of topical magnesium supplements. It's awfully hard to imagine effective delivery of a cation/ionic salt through intact skin. Nor can I see any advantage in trying. Oral Magnesium supplements are readily absorbed and cheap. I'm also skeptical of claims that magnesium would optimize DHEA levels in most people. Magnesium is integral to the function of many enzymes, but unless it's the rate-limiting step in DHEA production and someone has a serious deficiency, I can't imagine how more magnesium would fix the issue. One CAN make a decent pharmacokinetic argument in favor of topical DHEA to minimize first-pass metabolism etc.

There's nothing like a warm bath with Epsom salt... I do believe magnesium is well absorbed through the skin, though I am ignorant of how it compares with oral supplementation. I get the same effects (deep sleep, vivid dreams) as with oral supplementation, only more pronounced with the bath.

My Lp(a) result was zero when I tested it a few years ago.

Was this inherited and will it likely always be absent? I can't find much if any info on nonexistent Lp(a).

I take 12.5 mg DHEA twice daily with no side effects - I just feel better. I am sure I was deficient - I plan on testing soon. I'm 43.

i tried 25mg and it drove me nuts. cut it down to 12.5mg and all of the crazy symptoms gone and i feel much better ocer all. wife tried 12.5mg and she felt bad. she cut it down to 6mg and she is fine too. thank you so much Dr. Davis

Thank you for your valuable post.  We have decided to share it with our global physician audience at PhysicianNexus.com:

http://physiciannexus.com/forum/topics/dhea-and-lpa
Jaerou Kim
Team Member
www.PhysicianNexus.com
Physicians Comparing Treatments Worldwide

Boris,

Based on 15 years of study and research, I would say (and truly without sarcasm) for you to stay away from Wikipedia (who get their info from google, FDA and American Medical Assoc) all of which are political agencies who DO NO ACTUAL RESEARCH THEMSELVES, but get their info from pharmacueitcal companies who HATE vitamins and nutritional supplements because they cannot patent them and make any money.

The horror stories that you have read at those sites are simply opinions of people who took as the gospel media soundbites on reported research and did not search out viable valid resources who study the actual research reports.

Dr. William Davis (of this site) is actually a very good resource for your valid health information.

Now stay away from those silly sites you cited and you can Live long and prosper.

Best of Health To You

Effective strength D3 is not available over the counter in the UK. UK readers have to buy from the USA.
http://tinyurl.com/8znjue
Iherb do Now foods 5000iu D3 in olive oil capsules very cheap.
Orders £18 or over are not only subject to Customs duty but our Post Office charges £8 extra to collect the tax.
Using Iherb $5 discount code such as WAB666 reduces the price of 360 to under the tax threshold. Leaving the daily cost including P&P to 5.25p daily

http://tinyurl.com/ch5262
May I also draw readers attention to this half hour video from Cedric Garland about Vitamin D status and cancer incidence and progression.
You will note Garland suggests 60ng 150nmol/l for lowest cancer incidence.

Is the vitamin D from cod liver oil effective?

Slightly off topic, but I just read that congress is going to vote on a bill to cut medicare coverage of vitamin D levels, so now we will have to rely on private insurance, or simply pay ourselves.

Jeanne shepard

By the way, I prefer not to be "anonymous" but the Google Blogger doesn't remember my password, and won't let me select a new one.

Some of the vitamin D experts warn against using cod liver oil. http://www.vitamindcouncil.org/newsletter/2008-december.shtml

One concern is too much vitamin A if you took enough of the cod liver oil to get the D you need. Another is that vitamin A and D compete with each other.

fritz
Read what Dr Cannell says about Cod liver oil here
http://tinyurl.com/dh9b6k

A typical 5ml tsp of CLO contains roughly 400iu. Most people require on average 5000iu/daily so the amount from CLO is insufficient.

Jeanne
Twice yearly $30, 25(OH)D blood spot tests, available by post from this source
www.grassrootshealth.org/daction/index.php

iHerb.com also has Country Life Vitamin D3 2500 IU (200 softgels).

Thanks for answering the questions about tablets so quickly, by the way.

For the benefit of UK readers, I'd like to second TedHutchinson's informative comment. I use the same product from the same supplier

It's worth noting that postage and packing cost from the US does not contribute to the value of the order for the purposes of taxes and extortionate 'fees'.

I don't understand why taking a vitamin D3 capsule will not raise level of 25(OH)D when consuming it with fat or meal containing fat. Should get the same results...

First, let me say that I really love your blog.  I learn so much every time I come here.

I do have a question for you.  What do you make of this site:

http://bacteriality.com/2007/09/15/vitamind/

On the surface, she appears to be a competent scientist, but she blames everything (and I do mean everything from macular degeneration to brain lesions) on too much Vitamin D and claims that the road to universal health should begin with driving one's Vitaman D levels to below 20 ng/mL.  A friend of mine just sent this to me in a panic.  Please let us know what you think.

Thanks so much!
Isabella

The Costco effect.  I had been wondering why so many people use the tablet form.  Just noticed yesterday that tablet is the form of Vitamin D that Costco carries.

All of the vitamin D capsules that I checked in Whole Foods yesterday were composed of some kind of frankenfood oil in them, most notably soybean oil.  Can anyone recommend any brands that use something better?  

(I have the same problem with my vitamin E complex, but I'm not convinced that I should be taking that anyway -- although it does seem to help the inevitable dry skin in winter here in Colorado.)

BTW, my husband and I got our levels tested thanks to your recommendations.  Mine were excellent (probably thanks to many months of good supplementation), but his need some work (despite some more moderate supplementation).  Thanks for the info!

Re: the http://bacteriality.com/2007/09/15/vitamind article...

Anonymous,

Dr. Davis wrote about this issue (more or less) last year: http://heartscanblog.blogspot.com/2008/03/marshall-protocol-and-other-fairy-tales.html

David

@ Diana Hsieh
Don't know if this is available where you are (I'm in Australia) but I use this brand of D3 for this very reason. It's in fish oil, of reasonable potency.

THOMPSON'S Vitamin D (1000mg) with Fish Oil (500mg) - 60 gelatin-free caps

http://www.thompsons.co.nz/afa.asp?idWebPage=8403&ID=163&SID=663632930&Type=Products

Product made in New Zealand. Hope this helps.

Diana,

Our family likes Carlson Vit D products.  They are definitely absorbable, because the whole family went from the low end fo the reference range to around 70-86 ng/ml in the past few months).

Mostly we use Solar D Gems in the 2000 or 4000iU capsules.  There is a bit of Norwegian CLO & EPA?DHA in them, and lemon flavor.  They chew up easily, too, but can also be swallowed.

The non-chewable capsules are much tinier and are made with sunflower oil, but even that is a very tiny amount in this very small capsule.

The Carlson D drops in the 2000iU/drop dose is made with coconut oil (though it is fractionated, to keep it liquid).  But it's only a drop.

I find very good prices at www.vitaminshoppe,com, usually for about 2-4 ¢ per each 1000iU (that's how I make price comparisons).  Plus Vitamin Shoppe has a frequent buyer program so purchases earn points toward fairly generous coupons (such as $5 off a $15+ purchase), and shipping is reasonable (sometimes free).  

Or I buy Carlson Vit D3 at the local store when they are on sale (stores that sell a lot of Carlson product often pass along "mfg discounts" or "special buys").

Isabella
Mark London  MRL@PSFC.MIT.EDU has provided a detailed scientific rebuttal of the Marshall Protocol here
http://tinyurl.com/cfod57
Is the MP Treatment for Sarcoidosis Helpful for Other Chronic Diseases?

MP’s Vitamin D Theories Are Not Supported by Lab Studies.
Updated July 2, 2008

Dr Davis has previously addressed this issue in the blog entitled
The Marshall Protocol and other fairy tales

Diana Hsieh
The capsules I suggested are dissolved in olive oil.
http://tinyurl.com/abbagz
Carlson 2000iu sunflower oil $12.22
http://tinyurl.com/abbagz
Carlson also do Solar Gems in Cod liver oil.
http://tinyurl.com/bclzom

Diana Hsieh,

I believe the NOW foods brand D3 formulations are suspended in olive oil.

Carlson's Vitamin D3, 2,000 IU is suspended in sunflower oil.

That being said, most of these D3 capsules are quite tiny, so I am not sure that they contain a huge amount of oil, unless you are taking more than 10,000 IU's daily (i.e., 5 capsules).

As to sources, iHerb is the best and most user friendly, and I won't even give you my $5. discount code, as previous poster did.  You can sign up for your own discount number at the iHerb website.

Hope that helps!

Diana,

I'm currently using Carlson 2000IU gelcaps which contain sunflower oil (omega-6, even if small quantities) and a few other more benign ingredients.

When these are exhausted I'm switching to Carlson D-drops in which D3 is dissolved into medium chain triglycerides (MCT).

Thanks everyone for the input.  I feel much better now and am off to take my gel-capped Vitamin D3.

All my best,
Isabella

When researching Carlson Solar Gems earlier I mentioned they contain Cod liver oil but no Vitamin A Content is listed on the Carlson's website.
So I emailed Carlson's to confirm the vitamin a content. They replied
total Vitamin A is below 2% of the daily value which is the threshold above which the FDA requires you to list the Vitamin A content.
As adult RDA for vitamin A is 700~900iu, below 2% of that is below 14~18iu. So there is really is no reason to avoid Solar Gems because of their potential Vitamin A content.

Dr. Davis,

Appreciate your elaborating the tablets vs. capsules point and thank you for continuing to take the time to write such informative posts!

"Heart disease was once thought to be less of a problem for women than for men. Research now indicates that heart disease is the No. 1 cause of death among women in the US, while confirming that women with an intact uterus have a lower incidence of heart disease because they benefit from the uterine advantage." Visit http://www.truthout.org/021609R for the full article.

Dr. Davis,
Are gelcaps with dried powdered form of vitamin d3 as effective as oil filled gelcaps?

Dr. Davis, "Americans Low on Vitamin D" - http://www.webmd.com/news/20090325/americans-low-on-vitamin-d

I've had great results from powdered gelcap from D-Max (5000 IU) from Nature's health Supply, but a bit less from NOW olive oil gelcaps (5000 IU). Just a hunch, because I have an autoimmune disease and I'm trying to work out my symptoms. So no 25(OH)D test here.

I'll try those Carlson's next.

Great blog by the way!

I just ordered some D3 to send to my 81 yo MIL and 46 yo SIL in London.  I'm quite sure they are going to very deficient (they just ordered the www.grassrootshealth.net home testing kit as it's a pain to get NHS to agree to test).  

I found Bio-Tech D3-5 (5000iU cholecalciferol capsules  - powder in a tiny gelatin capsule) offered on Drs. Eades's Protein Power website at a great price, 100 qty for $8.  Shipping via UPS was $6.45 to my location for up to 10 bottles.  That makes the price per 1000iu incredibly low.  I bought a year's supply (8 bottles) to mail to my in-laws, plus two bottles for me.  Note I was very surprised at the small size of the box, but it did contain the 10 bottles I ordered, but the capsules and bottles are small and light, which is nice when ordering so much at once and mailing it again.  Fast delivery, even with UPS ground service.

I just had another 25 (OH)D test drawn last week; I'll get the results tomorrow at my endo appt for my thyroid.  I was averaging 5000iU/day  supplementation with various Carlson D3 products, based on previous 25 (OH)D test results and supplementation levels.  So I'll switch to the Eades' Bio-Tech formula now and see how my 25 (OH)D is in late summer/early fall.

Anna,

I'd be very interested to hear a follow up from you when you retest after being on the Bio-Tech D3 for awhile. I'm of the mind that D3 in softgel form is more absorbable and hence more efficacious for raising and maintaining 25(OH)D levels, but I see many of the "big guns" (e.g. Cannell, Eades, etc.)promoting/selling the powdered Bio-Tech formula. Perhaps you could report back here with your results?

David

Dave,
Sure.  I'll be retesting  thru my endo in 6 mo.  But I might do a mail-in test via www.grassrootshealth.net before that.  

I'm guessing a gelatin capsule filled with a powder (might be an oily powder,too) is more absorbable than a hard tablet form.

Btw, I just got my lab result for 25(oh)d---a nice 68ng/mL (after months of 5000iU D3 carlson oil gelcaps and/or oil drops .  Also was an easier winter than i've had in years, which I think might be due to more sunlight and Vit D.

Thanks, Anna. 68 ng/ml-- Good for you! You know, all my life, I've had tough winters. I would always get very sluggish and depressed. I mean I would get really, really down. But ever since I've started the vitamin D, the winter blues are a thing of the past. This alone is probably the most noticeable effect I've ever had from taking any supplement. It's a very dramatic and welcomed change.

I will read from time to time for that.

http://allnutri.com/bid970/now+foods.aspx

That means D3 in Calcium tablets like Citrical is probably poorly absorbed  too, am I correct?

Yep.

I found this site using [url=http://google.com]google.com[/url] And i want to thank you for your work. You have done really very good site. Great work, great site! Thank you!

Sorry for offtopic

yoo... amazing thread!

GNC has Vit D drops.....do you feel this is good?

Oil-filled gelcaps are no more expensive than tablets (or perhaps a dollar more). Health food store employees and pharmacists don't know this. I have had many patients come to the office claiming they changed to tablets because that's all their health food store or pharmacy carried and the person behind the counter assured them it was the same. Blood level of vitamin D to confirm: right back down to the starting level or near it--little or no absorption.