Hormone Replacement Therapy for Adrenal Fatigue: Pregnenolone and DHEA

Hormone testing can show whether you need hormone replacement as part of your treatment for adrenal fatigue. Because of the complex nature of adrenal gland physiology, too low or too high of a dose of hormones can be counterproductive. Here are a few facets of hormone replacement that you need to be aware of:

  • Everyone's hormonal needs are different, so the treatment needs to be personalized.

  • When you begin hormone treatment, your healthcare practitioner will likely follow your hormone levels to see whether your dosing needs to be adjusted periodically.

  • Increasing the dose of one hormone can alter the levels of other hormones. For example, DHEA supplementation can change the levels of testosterone and/or estradiol in some people. Everything can affect everything else, so be aware of possible side effects with hormone supplementation.

  • Even though your hormonal profile may suggest that hormone replacement is necessary, your personal health situation may prevent the use of hormone replacement. For example, prostate cancer precludes testosterone replacement in men.

Do not take random doses of hormones yourself. Hormone replacement should be done under the guidance of a qualified health professional.

Basics of pregnenolone for adrenal fatigue

Pregnenolone is called a precursor hormone. It helps make other adrenal hormones (such as DHEA and testosterone), and it also acts on its own.

If your pregnenolone levels are low, your healthcare provider may talk to you about supplementing. Most healthcare practitioners prefer an oral form of this hormone, which is taken daily. The benefits of taking pregnenolone can include the following:

  • Improvement in cognition and memory

  • Increase in energy and overall improved sense of well-being

  • Improvement in sleep quality

The potential side effects of taking pregnenolone are related to the hormones your body may convert it into. Possible side effects include the following:

  • Arrhythmia (palpitations or abnormal heart rhythms): In some people, pregnenolone supplementation may cause an irregular heartbeat. This may be related to the fact that the body can change pregnenolone into DHEA, which at high doses may increase the risk of developing an abnormal heart rhythm.

  • Insomnia: In some people, pregnenolone may cause insomnia, especially at higher doses. Insomnia is thought to be related to the pregnenolone itself.

  • Headaches: Some people complain of headaches when taking this medication over a long period of time or when starting at higher doses.

Getting the pregnenolone dose right is very important, because low doses decrease the risk of side effects. A typical starting dose of pregnenolone is 5 to 10 milligrams once a day. The dosage is slowly increased, based on your hormone levels.

Basics of DHEA for adrenal fatigue

Many personalized hormonal treatment plans involve a prescription for dehydroepiandrosterone (DHEA) because levels of this hormone may be low in someone with adrenal fatigue. Your body converts DHEA to testosterone and estradiol.

The benefits of DHEA supplementation can include the following:

  • Improved sleep quality

  • Possible help in treating depression

DHEA is prescribed most commonly in an oral form. Starting doses are approximately 5 milligrams once a day, usually taken in the morning.

If you're prescribed DHEA, you can increase the absorption by taking it with an oil (olive oil or the omega oils, for example). Do not increase the absorption without first speaking with your healthcare provider.

Now, about those side effects. . . . Be aware of the potential risks of taking DHEA:

  • Abnormal heart rhythms: Abnormal heart rhythms may happen, especially at higher doses.

  • Increased blood pressure and elevated cholesterol levels: Be sure to monitor your blood pressure and follow your cholesterol levels.

  • Insomnia: In some people, DHEA supplementation can worsen sleep problems, including insomnia.

  • Facial hair: DHEA can increase the levels of estradiol and/or testosterone. If you're a woman and you find yourself growing facial hair while taking DHEA, you may need to stop using the supplement and obtain a repeat DHEA-S level; your practitioner will likely need to adjust your dosage.

  • Hair loss: Excessive use of DHEA can cause hair loss. Given that the hormone may cause the growth of facial hair, this is hardly fair, but it's the truth.

The treatment of adrenal fatigue isn't about hormonal supplementation alone; it's the incorporation of hormonal supplementation into a complete adrenal recovery program. Here are some natural ways to improve DHEA levels:

  • Reducing stress can increase hormone levels.

  • Exercise — along with a diet that's mostly plants, low in carbohydrates, low in omega-6 fatty acids, and high in omega-3 fish oils — can also increase DHEA levels.

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