T Nation

Wife with Low T & Low DHEA


#1


My wife is 38yrs. old and has no energy, no sex drive, tired all the time even after sleeping all night, tender or sensitive breast, feelings of depression, moody as hell.

Dr. Has her on Celexa for depression, but I really don't think that is the problem.

After being on TRT replacement myself and reading over the forums here for the last 3 months I decided to go have some labs run on her from life ext.

Here results are attached.

I am thinking she needs to raise DHEA to get her T up.
I welcome all comments.

Thanks Everyone!


#2

The report does not say what day or phase she was in at the time of the draw so it’s not obvious if the hormone levels are high or low.

She won’t want to hear this word, but read up on “perimenopause” and “estrogen dominance.”

Be careful with DHEA supplementation. Women are much more sensitive to it than men and the monthly cycle makes dosing far more complex than it is for us. Instead, research Progesterone treatment. Some have gone as far as to say it should be used by all women over 40. Pro-Gest cream is a popular, high quality brand available via Amazon. Check out the reviews, where many women describe symptoms and results. They are almost entirely positive.


#3

Sorry, she was in the Follicular Phase.


#4

What day of her cycle were the labs done. Should have been near day 18.

Not knowing the above…

She may have low estrogen and then we would want to consider causes.

  • what drugs? OTC and Rx
  • OBC? [oral birth control]
  • periods normal?
  • 28 day cycle
    –variable

Read the “thyroid basics” sticky

  • report body temperatures
  • report iodine in vitamins and use of iodized salt
  • dry skin in summer time?
  • brittle nails and hair?
  • feels cold easily
  • time line for above changes
  • would be good to have TSH, fT3, fT4, must do if temperatures low
  • if above and temperatures are low
    – test rT3, associated with adrenal fatigue, blocks T3

Introduce:

  • B complex multi vits and minerals with iodine
  • fish oil caps
  • 5000iu vit-D3, take with oily meal, avoid high fiber
  • DHEA 25mg, take with oily meal, avoid high fiber
  • If BP a problem, 50 mg ubiquinol, a form of CoQ10

Low DHEA can be from low pregnenolone which indicates some of the activity in the ovaries.

DHEA is made from pregnenolone in the adrenals. One also has to consider that the adrenals are problem. Start with an AM cortisol test. And this leads into a consideration of adrenal fatigue.

Also test LH/FSH. But we need to know what day of cycle is best.

Read the advice or new guys sticky and note some issues that may cross over.

Does she have ovarian cysts? -common
Enlarged uterus? -not rare
Thickened endometrial lining? -not rare
Painful periods
PMS

If a doctor treats the above using OBC to provide progesterone receptor action with progestins, this can really make things worse.

Your descriptions fit female estrogen dominance that can happen with normal or low E levels if progesterone is low. In females, progesterone levels and DHEA levels start to fall by mid 30’s or sooner. Get on the WWW and find ‘KAL progesterone cream’ which is 2% progesterone and OTC, no Rx needed. Please do not use a different brand. I have observed absorption problems VS KAL. Progesterone can address all of the issued that you describe, including the ovarian cysts and endrometrial lining, as well as fibroids.

She can try 25mg DHEA, but do labs later. Some will create too much T and get facial hair problems. DHEA will not convert to progesterone, so DHEA cannot help with that.

If on OBC, consider a inter uterine device.

If you can straighten out hormone issues, total cholesterol may resolve to some extent. Do not start a statin drug at this time as it could make things worse.

Any changes in blood pressure?

Acne?

Progesterone cream should resolve may of these problems. However, there seems to be other issues that may involve adrenal fatigue and other issues. Thyroid may also be a factor.


#5

Thanks KSman.

I can tell you that she has not taken any form of Birth Control now for over a year.
Her periods are pretty much right on time every month like clockwork.
Only drug she takes is the Celexa that the Dr. gave her for Depression. I really don’t think depression is the problem so much as her hormones being out of balance.
Her blood pressure is always ok.
She has been making comments the last few weeks about Acne, so I would say that is an issue.
Oh, and she does have fibroids.

I started her on Fish Oil and D3 last week from Life Extension.
Ordered DHEA and Kal Progesterone cream today from Amazon.
Also Ordered Life Extensions Complete Vitamin B Complex for her.

Think we should get this started this week and retest at the beginning of Feb. after her period ends.
She usually starts on the 20th of each month and it doesn’t seem to last more than 7 days.
Also plan to include Thyroid tests.

Sound like a solid plan?

I really appreciate your insight on this KSman.


#6

Like I said, estrogen dominance + progesterone therapy. (Just kidding, KSman.)

I spent some time earlier this year researching very similar symptoms for my wife. I quickly discovered that women are just as f’ed as men when it comes to how MD’s treat matters of ageing. Worse, in fact, because standard medical practice tends towards treating women as if their entire condition is a disease and cutting out the troublesome parts.

BrianG8, what you are doing is both valiant and risky. It’s important to proceed with caution and here is my advice: Go slowly, very slowly. At the start we are not yet able to help our women feel good, we are only trying to help them feel less bad. Moving too fast without testing the waters runs a great risk of making her feel worse, at which time you may be told that "you and your internet friends can go "…

The theory of estrogen dominance and application of trandermal progesterone treatment appears to have originated with Dr. John R. Lee MD in the mid 1990’s. I have not read his books but they appear to be the source of, or at least the inspiration for, most of what’s out there on reasonable treatment of women’s health. As I write this I put his “Hormone Balance Made Simple” in my Amazon cart.

I want to offer a second opinion to BrianG8 based on what I have managed to pick up while trying to help my wife. Premenopausal women tend to be very,very sensitive to low level hormones such as Pregnenolone and DHEA. 25mg DHEA is an unusually high starting dose for a premenopausal women. Progesterone is a very low risk initial treatment and may accomplish most if not all of the needed rebalance but when DHEA is used, typical starting dose is 2.5mg or 5.0 run for a full monthly cycle. Only if there are no undesirable side effects after a full month (to be clear: Finish this month’s cycle then run through all of next month’s cycle) should the dose be increased, and then only by a similarly small (by male standards) increment.

KSman, the Emerita Pro-Gest product is world-famous and has a huge following. Proper form and dosage for Progesterone, impeccable ingredient list. The KAL product looks good too but the ingredient list includes chemical substances that may be undesirable to some. Interestingly, it appears that both brands are controlled by the same group. Regardless, I would submit that with careful research, there are at least a few high quality progesterone creams available that will deliver the desired results.


#7

[quote]torrential wrote:
Moving too fast without testing the waters runs a great risk of making her feel worse, at which time you may be told that "you and your internet friends can go "…

[/quote]

Point Taken. Don’t want that. Just want my Wife to feel more like herself again.
Go Low and Slow - Retest - Adjust as needed - Retest again.

Think I got it.


#8

Morning Temp. before she got out of bed was 92.8
This is her completely wrapped in blankets and covers.

I’m putting this here for tracking.

Thanks!


#9

Brian, if her problem also involves low iodine, you would share the same dietary implications. Check your temps too. Temp of 92.3 sounds fatal. Concerned that the thermometer is bad or how it is been used.

Keep testing. Not my comments on use of oral thermometer in the sticky. Look for 98.6 this afternoon.

I have seek KAL work well. Have seen other products lead to return of symptoms. So I assume that the other products do not absorb as well.

Have wondered if the way guys cannot absorb transdermal T if hypothyroid, has a parallel for absorption of female hormones.

Testing. Because hormone levels from one woman to the next are so variable and because hormones are changing every day, lab results are not particularly useful. Noting a woman’s build and history provides clues and how she feels and reacts is more important. Many doctors look for a woman to learn to read her body and make changes to the amount of hormones applied.

The first woman that I worked with here was in her late 30’s and had fibroids. Her doctors wanted to do an hysterectomy. Got her started on KAL and that provided some relief. She soon was calling the shots and later got on Rx progesterone and she actually expelled her fibroids as her thick endrometrial lining normalized. She also used anastrozole for a while and that would have really changed the progesterone:estrogen ratio. How significant that was would be guess work. She was taller and I would guess by her build that she had always been a lower E type. Yes, women are really on their own.


#10

Checked her temp again an hour ago and it was at 98.2 - I am thinking that this morning it was taken out of her mouth before it was done taking the temp. Will check again in the morning.


#11

Recommended reading: http://www.amazon.com/Natural-Hormone-Balance-Women-Exuberance/dp/0743406664

“natural hormone balance for women”

https://www.uzzireissmd.com/book_naturalhormone.html