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.



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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

Some thoughts I have about the causality vs. correlation. Those studies that show correlation with increased mortality /disease with sleep times longer than 9 hours per day could suggest that people with deseases sleep longer because of the disease?  Not that longer sleep periods them selfs are the cause of the disease and early death but a sign of troubles in health which need more time for the body to trying to recuperate?

I personally sleep between  7 - 9 hour per day if I can rest up to my taste, but if I'm stressed I sleep less and if I'm sick I sleep more.

(Sorry for possible spelling mistakes, I'm not native english speaker.)

WBR:
JVAS

Anon--

Excellent point.

In fact, I wonder if greater sleep need is, for many, a red flag for hypothyroidism, in addition to other conditions.

Brain study shows differences in night owls, early risers
Last Updated: Tuesday, June 23, 2009 | 5:36 PM MT  
CBC News  

Scientists at the University of Alberta have found there are significant differences in the way our brains function, depending on whether we are early risers or night owls.

Using magnetic resonance imaging-guided brain stimulation, neuroscientists tested muscle torque and the excitability of pathways through the spinal cord and brain.

"We found that the brains of morning people are more excitable in the morning and evening people are completely opposite," neurophysiology researcher David Collins said Tuesday.

"The evening people ... it's almost a perfect storm of excitability in the central nervous system, where the brain is maximal in the evening and the spinal cord is maximal in the evening.... They generate the most force in the evenings," he said.

David Collins, neurophysiology researcher at the University of Alberta (CBC) "Morning people ... their brains are most excitable in the morning, but their spinal cords are most excitable in the evening," Collins said.  

The results may suggest that morning people are performing below their maximum possible level at all times of the day because of this, he said.
Morning person may be steadier

If you could change morning people into evening people, maybe their performance would be best in the evening, he suggested. This doesn't mean it's necessarily better to be an evening person, he said.

"A morning person may be a more consistent, steady plodder over the course of the day," Collins said.

Kaitlin Cleveley, a sports performance researcher at the U of A, likes to begin work around 10 p.m. and go until 3 a.m.

"Anything that starts in the morning is absolutely brutal for me to try and get up and try and function," she said. This study brings new perspective to training, she said.

"It's about trying to peak the athlete.... It can help to set up a sleep program, and it can help to reduce jet lag and sort of help you to determine you know 'When should I book the flight?, When should I get there?'" Cleveley said.

The research has lots of applications, including understanding mental and physical peaks and how people can maximize performance, she said.

Initially the research was to determine if brain function changes over the day, Collins said.

The study evolved with some early findings around two subjects in the study. One proved to be an extreme morning person, the other an extreme evening person, he said.

How does napping fit into this?  Does napping count in the "hours per night" or is it separate?  Any statistics on mortality and napping?

A lot of cultures have an afternoon siesta but Americans tend to frown on napping.

A close family member just underwent double bypass surgery in the past few weeks (doing well now, though it took a blood transfusion to get over a 2 day slump while in the hospital), after more than a year of symptoms with exertion,  poor stress test results, a lot of career stress recently, etc.  None of us were told though until just before the recent angiogram.   I always viewed this situation as a "when", not an "if", because I had a different view than the AHA's, but it's always "too soon", even if expected.

The angiogram revealed multiple sites of stenosis in locations not suitable for stents, so double bypass was performed.

Aside from family history (her father died of CVD at age 50), there were other risk factors, so she faithfully followed most of the AHA guidelines since at least the 80s - regular chol panels (high results), statins, HRT, low fat/high chol, reduced saturated fat, reduced fat dairy, lean meats, lots o' carbs (even lots of whole grains), etc.  

But obviously, this didn't work (I think it's a recipe for a bypass), because  CVD happened anyway despite all this adherence to  "prevention" (I use that word loosely in this context).  

Other risk factors include tendency toward "apple" shape, "strong explosive" personality (sort of Type A), and as I suspected, diabetes (though that was concealed from the family until just before the surgery).  On top of that ...(drum roll)...

and pertinent to this post - 25+ years of working the third shift as a nurse in L & D.  She was *chronically* and noticeably sleep-deficient (very often apparent, even over the phone), not to mention also Vitamin D deficient (her calcium supplement only added a tiny amount).  The coronary calcium scan wasn't done until last year, when there was marked plaque and shortness of breath & fatigue symptoms.  Of course no program such as Track Your Plaque was suggested or undertaken.  It was fate, right? - the family history - nothing could be done to override that, right? Note: if you are reading this with a sarcastic tone, that's about right .

Talk about an AHA failure to prevent. Everything I've  I shared about about the AHA's misguided approach to prevention, low carb and grain restriction to manage BG and diabetes, and all the other ways to prevent CVD fell on deaf ears.  Still does.  Still keeping my fingers crossed that the bypass arteries don't clog up.