dr. phuli's blog

DHEA: Four Letters You Want to Know

Wednesday, July 10th, 2013

DHEA is the most abundant hormone in your body, yet few women have ever heard of it. Fewer can pronounce its twenty-two lettered scientific name, Dehydroepiandrosterone.

Think of DHEA as your battery, your reserve fuel. Without DHEA you have trouble activating your thyroid hormone. You can take all the Synthroid, (the most commonly prescribed thyroid medication), in the world, but without enough DHEA your body may not feel any beneficial thyroid effects.

DHEA is made by your adrenal glands. Young men and women have a lot but as we levels fall. When you are busy, chronically stressed and not taking time to refuel, DHEA levels fall faster than normal.

Most doctors just accept low levels as “typical aging,” but do you want to age typically?

DHEA helps an “over 50 woman” regulate cortisol, and make serotonin, estrogen, and testosterone. If your DHEA is low you are at risk for immune problems like frequent colds or autoimmune disease. Low DHEA can also result in bone loss, depression, sexual dysfunction, fatigue, dementia and even heart disease.

Could low DHEA be why you can’t lose weight, can’t sleep at night, or stay awake after lunch?

Ask your doctor to measure DHEA-S in your blood. (DHEA-S is the stable form of DHEA) Most labs can do this and most insurance companies will cover testing.

When your doctor tells you “it’s normal,” ask for the number. You want to keep your DHEA-S level above 150, some suggest aiming as high as 200

DHEA is available in most health food stores, but most doses recommended are too high for most women. Most women need only 2 to 10 mg/day (a typical male dose is 25 to 50 mg/day). If your level goes too high you could develop pimples, facial hair or hair thinning. The 7-keto form of DHEA is less likely to cause these side effects, and is readily available over the counter.

Start with a low dose, say 5 mg in the morning, on an empty stomach. Use it for a few weeks. You should notice more energy and a better sense of well-being. If not, increase to 10 or 15 mg.

I recommend taking breaks. Use it for a couple of months, then break for a couple of weeks. DHEA can also be used vaginally. Your doctor can write a script for DHEA vaginal suppositories and any compounding pharmacy can make it for you. Most women notice 25 to 50 mg inserted 2 to 3 times per week enhances orgasm and improve vaginal dryness. Think of it as female Viagra.

Don’t be afraid of DHEA. It is an important adrenal hormone, sadly overlooked as we age.

10 Comments  |  Permalink  |  Posted in Adrenal Hormones


There are 10 Comments

  1. Katrina  |  July 10th, 2013

    Hi Phuli,

    Can you take DHEA while using .75 Synthroid?


  2. Phuli Cohan  |  July 12th, 2013

    Katrina » Yes, its often used with thyroid medication. In fact I often have patients take it first thing in the morning with thyroid, on an empty stomach.

  3. Mercedes  |  July 11th, 2013

    Hello Phuli!
    we met at the SY family retreat in PA a few years back
    I wish I could see you regarding hormone testing and guidance
    are you in practice at all in or near NYC?
    warmly sending blessings
    Mecedes Garcia

  4. Phuli Cohan  |  July 12th, 2013

    Mercedes » Hi Mercedes- I remember you well! I am doing very limited consults since recovering from Lyme.

  5. Michelle Komer  |  July 11th, 2013

    I have used DHEA transdermally in the past and had some of the negative side effects you listed. I would like to try it again, and am wondering about the liver handling it well if taken internally?

  6. Phuli Cohan  |  July 12th, 2013

    Michelle Komer » Using the keto form reduces side effects. Also limiting the dose- start very low, say 5 mg. If you had palpitations, take a compounded slow release form. Some women need Saw Palmetto with it to avoid hair loss. Also, taking it with breaks every couple of months can help. Good luck!

  7. Elizabeth  |  May 8th, 2014

    Hi !!!
    My Dr write a Rx for suppositories dhea 7 keto 3.25 mg once a day for 15 days plus 3 refills. My question is Can I take DHEA over the counter too or is going to be too much?


  8. Phuli Cohan  |  June 22nd, 2014

    Elizabeth » Sorry your doctor will have to advise you as I don’t know your levels. Hopefully the doctor prescribing can advise you.

  9. Jen  |  September 26th, 2014

    I believe DHEA is a fat-soluble vitamin, so why would you have people take it on an empty stomach? Wouldn’t it be better absorbed with food? The directions instruct you to take DHEA with food. I have just started taking Synthroid as I am curious about this.

  10. Phuli Cohan  |  August 22nd, 2015

    Jen » There’s a lot of debate and controversy surrounding DHEA supplementation. The take home message is take it with a doctor monitoring your levels and breakdown and like all things take breaks from therapy. Taking it with food can reduce absorption as stomach acid can interfere with absorption. I generally recommend it on an empty stomach for this reason. Many feel that it should only be given by skin, vagina or rectally. I generally use low dose oral in women and follow blood or urine testing. The real test is how you feel! You should notice a difference, i.e. more energy, sex drive, and sense of well being.


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