T Nation

Why Take DHEA? Is It Necessary?

I have heard much conflicting info on if we need to take DHEA on TRT. I tried 25 mg DHEA every day and it did increase my FT quite a bit. but my doctor said no need to take DHEA cause we get all the T from the testosterone injections. is there any benefit to DHEA? seems like all it does is either convert to estrogen or Testosterone, correct?

I’m not entirely convinced DHEA increased your Free T when you consider there is a daily variability in Free T levels, so when you see as an increase I see as a natural daily fluctuation.

If you are truly deficient, then yes. DHEA when taken by a women increases testosterone, in men it increases estrogen.

Well total T and free T are two different things. You can have high total T but still have low free T so your doctor is off on his logic with that comment. I’ve been on TRT for over 6 yrs and even though my Total T was good my free T was always extreme low range of normal. My doc had me start taking 50 mg DHEA and 100 mg pregnenolone a day and my next blood test had me in the high range of normal for free T for the first time ever.

First test your DHEA-S levels. Some people have pretty good levels without taking it. Also most DHEA supplements are total scam, one doctor have tested a lot of them in lab. Nutricology is one of the few brands with guaranteeed quality

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my question is , if on testosterone and manipulating it so my FT is high, no benefit to taking DHEA. right? cause all DHEA does is either increase estrogen or testosterone? any other benefits?

you could have simply increased your testosterone to achieve higher free T.

If low, I like to increase DHEA to higher in range levels. The most dramatic benefits reported to me are improvements in cognition, focus, concentration, relieving “brain fog”. It has recently been determined to function as a neurotransmitter.

Clinically substantiated uses of DHEA include replacement for:
• Low DHEA levels
• Chronic disease
• Adrenal exhaustion or corticosteroid therapy
• Systemic Lupus Erythematosus
• Improving bone density
• Improving depression & mood disorders
• Enhancing immune response by activating T‐cells
• Improving well‐being
• Decreasing cardiovascular risk
• Improving erectile dysfunction
• Anyone over 40

DHEA raises testosterone levels in women slightly, yet not in men, while raising estradiol slightly in men. DHEA has never been shown to reverse the aging process as claimed by some, nevertheless, I believe DHEA is important for preventive medicine.

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What is your opinion on why a lot of men feel bad on DHEA and experience crashed libido?

I have not seen that at all, I have no male patients who have discontinued DHEA except for those deciding to move to OTC sourcing. We use pharmaceutical grade and it costs a little more.

When your Total T is high range normal and free T is low range normal it would take quite a bit more T to get free T back into mid-high normal range. Plus you’d possibly be ignoring another issue. Also, unfortunately doctors tend look at total T and convincing them you want to get your total T to 1500 so you can have more free T would present most patients with quite a challenge.

As the theory goes, when you start TRT, the negative feedback on the hypothalamus/pituitary decreases LH secretion. That much is pretty much universally agreed upon. However, testosterone is near the end of a long cascade of hormones that the testicles and adrenals produce, beginning with pregnenolone (and DHEA is not far behind).

There are those that believe that these intermediary hormones are important to body functioning, particularly the brain. That is why they support supplementation with these early hormones to “back fill” the hormone cascade that is missing once we start TRT. I have not researched this well enough to believe one way or the other, but my first TRT doc, who is well known in the TRT world, got me started on 50mg pregnenolone and 25mg DHEA per day. He is one of these believers in back filling. Since I am on a very stable and effective TRT protocol, and the supplements are relatively inexpensive and easy to take, I found no reason to discontinue taking them.

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What do you think about nutricology Ive heard from doctors they are close to pharma grade?

Ive talked to a lot of guys experiencing issues from even small doses like 10-25mg

I have no experience with Nutricology. I did look them up and it is micronized plus one of the more expensive OTC brands. I think the price is pretty close to pharmaceutical grade. It’s easy to check potency with a blood test.

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My Dr said same. No need to take dhea if you on testosterone.

I tried it anyway. Did not feel right.

My levels last checked were low normal. Unless it goes low I am not going to try again.

Is there an optimal level of DHEA for males?

Thanks.

DHEA is mainly an adrenal hormone and a neurosteroid. If you are using TRT to treat symptoms like low libido and low energy, then DHEA supplementation could (could!) be a good adjunct, indipendently of his androgen like effects and TRT, but you do not need DHEA to treat any imbalance caused by TRT (and maybe TRT can even increase DHEA).
DHEA has cortisol inhibiting properties and at low dosages it preferentially converts to DHT, without causing issues with T and estrogens. By low dosages I mean <=15mg, so the 25mg usually suggested is too high (even if this and higher dosages can be used as a short term pre-workout pro-hormone, but this is another story). The important thing is that you monitor blood levels as you are doing with testosterone.

If you are worried about correcting deficiencies caused by TRT, do not focalized on DHEA, but on Pregnenolone. There are such clues to hypothesize a decrease in Pregnenolone with TRT, and pregnenolone is the precursor of allopregnanolone (pregnenolone --> progesterone --> allopregnanolone), another neurosteroid with anxiolitic, antidepressant, neuroprotectant and anti-stress properties. It is conceivable that some side effects that exogenous steroids has on behavior can be caused by decrease in allopregnanolone. I think that 50mg are enough to restore physiological levels, but I always suggest testing. It is safely used even at high dosages (and I think is much safer than DHEA, even if you exceed you dosage), but I do not see this necessity, exept if you have some neurological problem.

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My lab references for DHEA-S are 120-520 micgr/dl for a 30 years old male.
Your levels will rise by 300 micgr/dl every 15mg of DHEA injested (according to this http://www.itmonline.org/arts/dhea.htm).

So for example, given my results of 250 micgr/dl I expect them to be 450 micgr/dl using 10mg of DHEA, 500 using 12,5mg and 550 using 15mg. At such a low dosage it is only converted to DHT, without increasing T and estradiol

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I take them to 450-500 mcg/dL.

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Wow! I thought I was doing decent at 255 (RR 44-331 ug/dL). So I assume I could benefit from supplementation of say 25mg/day?

Your DHEA-S level is like mine at 250ug/dL. I’d been wondering if I might be low and had actually never had that test before so I checked it two weeks back. Thanks for the link and info!