should cortisone always be combined with DHEA?

The Hertoghe doctors say you need to take DHEA with hydrocortisone or Medrol (unless you also suffer from PCOS). The reason is that DHEA will prevent cortisone from "eating up" too much tissue. Therefore, you are handed a prescription for DHEA along with your prescription for cortisone. Last year, my DHEA-S levels were out of range (372 ug/dL; ref 56-283). Just for comparison: DHEA-S before taking supplements: 152, so not really low.

I have since weaned off both Medrol and DHEA, but this has made me wonder. I have been reading a lot about the benefits and side effects of DHEA, and it seems excess DHEA can have quite serious side effects. This in turn makes me wonder if it's a good sign that a so called hormone specialist renews your prescription for DHEA, even though your levels are out of range (and I always go to the lab 24 h after taking hormones)? Is DHEA really that important in case of cortisone supplementation; if that was indeed the case, should not all patients taking cortisone (including those taking much larger doses for rheumatoid arthritis, for instance) be taking DHEA? However, I've never heard of anyone else taking DHEA along with HC/Medrol.

Recently, I have begun wondering if it's worth it...paying a fortune in doctor's fees, labs and drugs not covered by health insurance, if you are not even sure your doctor knows what s/he is doing...after all, it does seem rather irresponsible to me to prescribe hormones to a patient with out-of-range levels...?

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  • Dalle prescribed DHEA for me, along with HC. But he said my DHEA levels were very low, didn't say anything about needing to take the two together. However, my DHEA all converted to testosterone, and I was covered in acne, so had to stop taking it, although I continued with the HC, and my DHEA level continued to be low. So, I've no idea, really. Sorry. :)

  • Ok, no problem! Thanks for your input! Interesting to hear you were also put on HC and DHEA by a so called Hertoghe doctor, even though he did not mention a connection between the two...but Hertoghe himself writes in his book "The hormone solution" (both English and French version) that it is vital to combine the two hormones in order to stop HC from "eating up" tissue...are you still taking HC? If not, how long did you stay on it before weaning off it?

    Interesting also to hear that your DHEA converted to testosterone...I have read that pregnenolone can convert to any of the sex hormones, but I had no idea the same was true for DHEA....that just proves that you always learn something every time you visit this forum:-)

  • DHEA is really a good supplement to take if you are on immunosupressants or have a AI disease. It is really strange that the rheumies treating RA do not perscribe it to their patients. The truth seems to be that the rheumies seldom perscribe any supplements at all! Even if there are an abundance of supplements that would be of great benefit.😡

  • Yes, I don't doubt DHEA is good for many people, but was wondering if you should continue taking it if your DHEA-S levels are out of range 24 h after taking it...? I have never taken more than 20 mg of DHEA daily, so I was a bit surprised to see my levels so elevated...I'm in my late 40s, so I assume my hormone levels are no longer optimal by themselves. Add to that being hypoT (Hashi's) since my late 20s, and I'd expect my DHEA levels to benefit from supplements...I don't know if there are any recommendations concerning optimal DHEA levels (midrange, close to upper normal range etc)?

  • Can't remember exactly, it was over ten years ago. But, about two years on HC. Not very long on DHEA.

    Dalle writes in his book 'The Hormone Revolution' :

    'one of the particularities of steroid hormones, such as testosterone, dhea and estrogens, is the ability to convert into other steroid hormones. Dhea, for example, can transform into testosterone and estrogen, and testosterone into estrogen with an enzyme called aromatase, in men as well as women.'

  • Thanks:-)

  • Also, it seems DHEA is called the "anti-stress hormone" as it reduces/counterbalances cortisol. So, isn't it a bit illogical to prescribe HC or Medrol for adrenal fatigue (suboptimal cortisol levels), only to add DHEA...?

  • Here is something very interesting to read.

    raypeat.com/articles/articl...

  • Yes, yes, indeed, very interesting!!! I was wondering about what it says at the end; that about 4 mg of DHEA daily should be enough to restore DHEA levels to youthful levels...it's obvious that, on 20 mg daily, my DHEA-S levels ended up out of range. However, I have not been able to find any capsules containing less than 15 mg of DHEA...unless DHEA creams are easier to dose...I have to look into that.

    When I say I have been unable to find less than 15 mg capsules, I mean in Europe. I am not sure if it's legal to import DHEA where I live, which is why I'd prefer to order it from a another EU country. 5 mg capsules may be available in the US, but I am not sure I'd like to order hormones from there. Not that I doubt the quality of their products, quite the opposite, but I always prefer to order hormones from EU countries.

    Thanks again, really interesting article and it explains why 20 mg of DHEA daily may have been too much for me, especially since my levels before supplementation were midrange so not disastrous in any way...!

  • Yes, I've been taking too much too I think. It was interesting also that pregenenolone would be a safer alternative. I certainly do not want to increase estrogen levels when having an AI disease!

  • When I say I have been unable to find capsules containing less than 15 mg of DHEA, I meant in Europe. I am not sure if it's legal to import DHEA where I live, which is why I'd prefer to order it from a another EU country. 5 mg capsules may be available in the US.

  • This article also talks about the importance of not overdosing DHEA (end of article); it states that 5-10 mg daily is considered a safe dose, whereas most hormone doctors (at least in Belgium, which is the country I know best) seem to prescribe 20-25 mg daily...

    hormoneresearch.blogspot.lu...

    I have really learned a lot today and, sadly enough, not because I pay a so called hormone doctor a lot of money...:-( That makes me even more grateful there are forums such as HU, where patients can ask questions, get answers and learn from each others' experiences...invaluable, IMHO.

  • I don't know. But I have DHEA on prescription without cortisone.

  • But you have been diagnosed with DHEA deficiency, right...? My DHEA levels have always come back in range on labs (booth blood and 24 h urine analyses); yet, I ended up on 20 mg of DHEA per day, although some sources claim you should not need more than 5 mg daily to restore DHEA levels to youthful levels...so it's all pretty confusing. But thanks for your input, much appreciated:-)

  • My DHEA was just in range, but I had low (but in range) cortisol and low testosterone. I couldn't take testosterone directly (got total 'roid rage), but DHEA seems to convert mosly into testosterone without the "Hulk SMASH!" problems. I have 12.5 DHEA a day. It was dropped to 10 but symtoms came back so they upped it again and I felt better. You probably don't absorb all you take, and you can't tell exactly which pathway it'll be used by.

  • Interesting! Maybe I should try 10 mg of DHEA daily (available from the UK I just found out), and see if that makes a difference. I was also told last summer that my testosterone levels were low and I was given a prescription for Testim (Ferring), but then read that it should never be used by women, even though I was told to use 1/8 of a tube daily (a man is usually prescribed a whole 5 mg tube daily). So I hesitated for a while, then decided not to take it, at least not yet. It seems the only testosterone product intended for women was taken off the market a few years ago, meaning we now need to use those intended for men, using only a fraction of what a man would use.

    Thanks a lot for your useful input:-)

  • Some women do fine on testosterone. But I get 'roid rage and end up smashing anything that doesn't work as I feel it should (a sort of red mist descends and I can't stop) - crockery, the cooker, the back door ... much too expensive and very tiring!

  • DHEA is very important for adrenal support especially for patients that are hypo . But taking DHEA in low dose of 2-5mg is all that's needed .There is no reason for over dosing it only causes unneeded side affects . Physiological doses are beneficial only .

  • Thanks:-) I was surprised the so called Hertoghe doctors in Belgium seem to prescribe at least 20-30 mg of DHEA daily...if you or anyone else know/s where to order 5 mg of DHEA, please PM me. So far, I have been unable to find less than 15 mg per dose...

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