Can DHEA be prescribed by GP: Hi all my DHEA is... - Thyroid UK

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Can DHEA be prescribed by GP

DizzyD profile image
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Hi all my DHEA is very low and in the past private endo prescribed DHEA at a cost of £68 x60. I tried to buy same brand online but it cannot be sold in UK but there are supplement DHEA on the market which I assume is not the same as prescribed DHEA.

Can DHEA be prescribed by my GP? Does anyone get DHEA from GP

Kind regards

Have a rewarding day

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DizzyD
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helvella profile image
helvellaAdministratorThyroid UK

If DHEA is offered for sale on genuine UK websites, the vendors are putting themselves in legal jeopardy. It is a Controlled Drug in the UK - even possession (without it being prescribed for you) is illegal.

However, some sites appear to be UK sites but actually operate from other countries. And DHEA is legal in many other countries.

Buying it for yourself is illegal. This is only meant to make sure you are aware of its status.

The British National Formulary only lists pessaries:

bnf.nice.org.uk/drug/praste...

DizzyD profile image
DizzyD in reply to helvella

Thank you helvella.

babycometrue profile image
babycometrue in reply to helvella

I have been told to take DHEA for IVF but also have underactive thyroid. Just opened the main place and so many dhea for sale

helvella profile image
helvellaAdministratorThyroid UK in reply to babycometrue

Yes - there is lots listed for sale - almost all from outside the UK. Even if it appears to be in the UK.

Carys21 profile image
Carys21

I've been following this thread and thought I would do my own research on whether you can buy DHEA legally as I bought 2 bottles of it online last year not even knowing I was potentially committing a crime. I found a reply from the MHRA to TPAUK concerning importing medicines into the UK from 2014. "There are no formal restrictions on an individual importing medicines into the UK provided they are strictly for use by that person or a member of their immediate family. Consequently, we do not issue any form of licence, certificate or authorisation to aid personal importation. We consider personal use to involve the use of the products by an individual or their immediate family or household; under such importation an individual must not sell or supply imported medicines onward as this would be considered placing the product onto the market.

Up to a 3 month supply of a medicine is considered to be an acceptable quantity for personal use, HM Revenue and Customs can prevent importation if large quantities are being imported and/or they have suspicions that the product is not being imported for personal use. There is more information on the HM Revenue and Customs website at the link below: hmrc.gov.uk/

Individuals are advised to investigate whether the product(s) to be imported would be categorised as controlled substances in the UK. Controlled drugs are regulated by the Home Office under the Misuse of Drugs Act, and can require a licence to allow their entry into the UK. The Home Office have published a list (although not exhaustive) of controlled substances on their website and individuals are advised to contact them directly for clarification on whether a Home Office licence is required for importation into the UK: gov.uk/government/public…le... I could not see DHEA on the list. I remember reading an article in The Mail from Dr Michael Mosely a couple of years ago where he said it was perfectly legal in the UK to buy DHEA for personal use, and he had actually bought it from the states himself for personal use. So as I read it you can legally buy small quantities of DHEA supplements for personal use - whether it gets confiscated by customs is another matter, as happened here: hammadbaig.co.uk/post/refus... In this case even the court couldn't decide whether an offence had been committed or not, and bounced it back on customs to revisit their decision. I think the grey area is that it is classed as a prescription drug in the UK but it is also classed as a controlled class C substance (although not listed) So there you have it, clear as mud. My head hurts and I'm going to lie down.😵

humanbean profile image
humanbean in reply to Carys21

There are no formal restrictions on an individual importing medicines into the UK provided they are strictly for use by that person or a member of their immediate family.

I'm absolutely certain that the information you've posted does not apply to controlled drugs.

For example, people can't import anabolic steroids into the UK for their personal use, and for some unknown reason Customs and Excise or the UK government has classified DHEA as an anabolic steroid.

The list of controlled drugs in the UK can be found here :

gov.uk/government/publicati...

You can find DHEA in that list under the name "Prasterone (Dehydroepiandrosterone DHEA)" and it is classified as a Class C drug.

Carys21 profile image
Carys21 in reply to humanbean

Yes, I see that now but what did you make of the court case where they ruled Refusal to Restore Mis-described Dehydroepiandosterone (DHEA) / Prasterone held unreasonable? I couldn't find a follow up on it so I don't know what happened in the end.

helvella profile image
helvellaAdministratorThyroid UK in reply to Carys21

The tribunal decision was that Border Force had to review in the context of human rights. But that is short of deciding the decision was outright unreasonable.

IT IS DIRECTED THAT

(1) The Border Force shall carry out a further review of Ms Perkins’ review decision of 8 March 2017 in accordance with the views contained in this decision, giving full reasons for its decision.

(2) In carrying out such further review the Border Force shall consider the applicability of Article 14 of the European Convention on Human Rights and shall bear in mind the appellant’s Convention rights.

(3) The Border Force act proportionately, in accordance with the appellant’s Convention Rights and in particular A1P1, bearing in mind the guidance given by the Supreme Court and the Court of Appeal set out in the Smouha decision referred to in footnote 7 above, and the views expressed by this Tribunal.

(4) The appellant shall be entitled for the purposes of this further review to produce any further information (including medical information) which he considers appropriate – such information to be produced within 30 days of the date of the release of this decision.

(5) The further review by the Border Force shall be completed and issued within 60 days of the date of the release of this decision.

(6) The parties shall be at liberty to apply to the Tribunal for an extension of the above time limits.

86. Finally, in accordance with Rule 14, The Tribunal Procedure (First-tier Tribunal)(Tax Chamber) Rules 2009, the Tribunal orders that the name or address of the appellant shall not be published in any manner that is likely to lead to members of the public identifying the appellant. It is necessary for this decision give details of the medical condition of the appellant that would ordinarily remain confidential. The appellant is a private individual and this order to withhold his name and address is made in order to respect his right to a private and family life.

87. This document contains full findings of fact and reasons for the decision. Any party dissatisfied with this decision has a right to apply for permission to appeal against it pursuant to Rule 39 of the Tribunal Procedure (First-tier Tribunal) (Tax Chamber) Rules 2009. The application must be received by this Tribunal not later than 56 days after this decision is sent to that party. The parties are referred to “Guidance to accompany a Decision from the First-tier Tribunal (Tax Chamber)” which accompanies and forms part of this decision notice.

bailii.org/uk/cases/UKFTT/T...

humanbean profile image
humanbean in reply to Carys21

what did you make of the court case where they ruled Refusal to Restore Mis-described Dehydroepiandosterone (DHEA) / Prasterone held unreasonable?

Based on the fact that it can be bought over the counter without prescription in the USA, and it can be prescribed in the UK, and that the human body makes it as part of its normal functioning, it suggests to me that the UK decision to make DHEA a controlled drug was wrong, and an over-stretch of the government's power, or Customs and Excise power, who ever was responsible.

But I have done very little reading on the subject of DHEA and really know almost nothing about it.

helvella profile image
helvellaAdministratorThyroid UK in reply to humanbean

I have come to the conclusion, rather more by guesswork than analysis and evidence, that it is largely due to its potential use in relation to sport. Which seems an unsatisfactory basis for such a decision.

Carys21 profile image
Carys21 in reply to humanbean

Yup, agree with that, a lot of faff for something that I believe is made from wild yams. I've read up a lot on it and it does seem to be helpful for older women, if one doesn't want to take HRT.

DizzyD profile image
DizzyD in reply to Carys21

Lol no wonder your head hurts after researching DHEA and also writing such an informative lengthy post on your findings which is so helpful. Wondering why Dr Mosley bought DHEA from the US and not from a UK site???

In all honesty I suspect that DHEA sold on UK sites is not genuine DHEA (prices far to low) while the one initially prescribed to me (from US) by private endo was £68 x 60 caps which is produced in a reliable laboratory.

Considering all the priceless information you have put forward Carys21, which I really appreciate, I am going to try and purchase DHEA (same brand endo prescribed) from US. If I remember correctly, the company would not sell to public in the UK but they would sell product to a medical professional person!!!

Enjoy your well deserved rest.....you certainly deserve it.

Thank you most sincerly

Carys21 profile image
Carys21 in reply to DizzyD

Yes, Mosely bought them to try out when he was developing his fast diet and wanted to make sure he had the right ones. I wish I could find the article again, it was after reading it I decided to buy some as he seemed clear that it was ok for personal use.

SeasideSusie profile image
SeasideSusieRemembering in reply to DizzyD

DizzyD

Wondering why Dr Mosley bought DHEA from the US and not from a UK site???

I am no so sure that you can actually buy it from a UK site, in fact I don't think you can without a prescription.

There is one company that sells DHEA and other products that are prescription only here (Melatonin is one, also DHEA) that to all intents and purposes appears to be a UK site, it has .com/UK in it's web address (some might be alerted by that, not everyone will).

Everything is in UK £, reasonable postage, free over a certain amount, 6-8 days delivery. They tell you they have warehouses "worldwide to ensure your order is processed and despatched quickly" (again that might alert some). If you want to contact them their email address is "support-uk@....".

Nothing really to make you suspect they're not in the UK.

I bought something off them.

Delivery took far longer than expected. After 3 weeks I contacted them. I was told it wasn't deemed lost until 30 days had passed so contact them again then. In the meantime I bought from elsewhere as I needed the item. Eventually just after the 30 days had passed the item turned up. I saw that it was posted from the US. I contacted them to say it was no longer needed so I wanted to arrange a return. They were fine with me returning it but it had to be at my expense and to the US. Goodness knows what that would have cost so I didn't return it. Lesson learned!

Carys21 profile image
Carys21

You might also find this useful, I found it on Dr Sarah Myhill's site. "I used to treat DHEA deficiency with DHEA. However, I believe pregnenolone is more physiological because it is upstream of all adrenal hormones including progesterone and cortisol.

Cholesterol is the raw material from which steroid hormones are made in the body. The next biochemical step is pregnenolone- this is the mother and grandmother of all steroid hormones. Starting off with pregnenolone means that all steroid hormones can be naturally synthesised in the correct physiological balance.

In theory this should greatly simplify the business of prescribing and monitoring hormones because the body can do its own natural balancing act. Please see Wikipedia entry on Pregnenolone

A physiological dose of pregnenolone is 50mg. My office can supply Pregnenolone, 50mg, 60 caps. It is better absorbed under the tongue. This works because sublingual doses bypass the liver - the so-called "first pass effect".

This advice applies equally to men as it does to women. If you are taking DHEA now or if a future Adrenal Stress Profile (ASP) result shows low levels of DHEA, my advice is that you should consider taking/swapping to pregnenolone. If you do the ASP test through my practice, then I will recommend pregnenolone if indicated by the results. In addition to CFS sufferers, post menopausal women and those aged over 50 may also benefit from this therapy. For those 'transferring' from DHEA to pregnenolone, the conversion rate is approximately 1:2, so that if you are currently taking 5 mg daily of DHEA then you should transfer to 10 mg daily of pregnenolone." Bearing in mind pregnenolone is available to legally buy in the UK it might be worth a try on it's own. I wouldn't take her recommendation of 50mg though, I think I would stick with 10mg for myself.

humanbean profile image
humanbean in reply to Carys21

"I used to treat DHEA deficiency with DHEA. However, I believe pregnenolone is more physiological because it is upstream of all adrenal hormones including progesterone and cortisol.

This is something that has always baffled me about biochemistry and hormones. Suppose a substance like cholesterol is a pre-cursor of ten hormones. See the very simplified picture in this (very short) thread :

healthunlocked.com/thyroidu...

I have issues with high cortisol. If I took pregnenolone how do I know that my cortisol won't just get even higher? My body hasn't done a brilliant job of getting my cortisol levels right so far so giving my body more of one of the precursors of cortisol sounds like a bad move to me. But I'm saying that from a position of almost total ignorance.

Carys21 profile image
Carys21 in reply to humanbean

I found Brownsteins book the miracle of natural hormones very good for a simple explanation on how they work, he reckoned DHEA lowered cortisol so he would give them both together - I believe it lowers it by breaking it down

humanbean profile image
humanbean in reply to Carys21

Interesting, thanks.

Carys21 profile image
Carys21 in reply to humanbean

pubmed.ncbi.nlm.nih.gov/125...

humanbean profile image
humanbean in reply to Carys21

Ooh, interesting. I have been taking Holy Basil for its cortisol-reducing properties for several years, although my dose gradually dropped throughout that time. I can't test my saliva cortisol any more - I produce so little saliva now that I wouldn't be able to produce a sample. If I'd known about DHEA reducing cortisol I could have got a much faster response than I got with my Holy Basil. I'm not taking it every day now, but I do still take the occasional capsule when I feel some of the symptoms I associate with high cortisol.

radd profile image
radd in reply to humanbean

hb,

Regarding your link, it is common when cortisol rises that DHEA lowers but the cause is now thought to be other factors involving conversion rather than certain areas of diminished available pregnenolone (previously known as 'pregnenolone steal').

This is because the pregnenolone conversion from cholesterol is thought to occur within the mitochondria of every adrenal cortex cell type, so should be able to supply all downstream hormones as long as the conversion conditions are met.

Although prenenolone is the mother hormone (underneath cholesterol) it splits into three regions within the adrenal cortex:

- Zona Glomerulosa makes mineralocorticoids (ie aldosterone)

- Zona Fasciculata makes glucorticoids (ie cortisol)

- Zona Reticular makes androgens (ie DHEA)

(And then the medulla which is separate makes catecholamines, ie adrenaline).

There are different cell-specific enzymes & concentrations to synthesis the varying steroid hormones & no known mechanism that could transfer pregnenolone between the mitochondria of one cell to another, and especially not between the different zones. The newer figures (graphs) now demonstrate three headings of cholesterol with three lots of pregnenolone converting to all downstream hormones in three separate columns.

Conversion is effected by enzyme availability and concentrations, but also external signals coming from outside the adrenal gland. Think of the HPA Axis and because many steroids such as DHEA are neuro-active, meaning they will activate or inhibit neurotransmitter systems and vice versa, its not just about the usage but also our emotional wellbeing, etc. .

This is similar to the negative effects of say depression on DIO1's abilities to convert thyroid hormone. And there is also research showing Zona Reticular to down-regulate DHEA production under bodily inflammatory conditions, again similar to the effect bodily inflammation in the form of elevated thyroid antibodies can have on thyroid deiodinases.

Therefore supplementing pregnenolone is not always guaranteed to replace insufficient levels of DHEA unless the root cause of the deficiency is addressed alongside.

Also a hormone elevation may be because the opposing is deficient and not necessarily because it is higher than normal levels. DHEA naturally declines with age faster than cortisol, but because of our crappy history with hormones and wellbeing, our natural declines are skewed, and supplementing pregnenolone is something I would consider when my HRT is eventually withdrawn.

humanbean profile image
humanbean in reply to radd

I think I'm going to have to read that a few times, although I think I got the gist of it. :)

Thank you. 👍

Carys21 profile image
Carys21 in reply to radd

Thanks for that useful info, I'm 63 and I never did HRT and I am trying pregnenalone again at a slightly higher dose this time, I did 5mg DHEA and 5mg of pregnenalone a while back but didn't notice anything, so I have added another 5mg of the latter and my evening pulse has decreased to match my morning pulse which I think is a good sign, also feel a bit calmer too!

DizzyD profile image
DizzyD in reply to Carys21

Oh good grief after reading all of these posts which I don't fully understand at all, I have reached the conclusion that I have made a big mistake taking DHEA, regardless of it being initially prescribed (50 mcg daily) by a private endo to treat my very low (nearly out of range) dhea.

Also at that time (seeing private endo) my morning cortisol was very low, noon cortisol level was out of range evening / night cortisol quite high (which he refused to treat) so why did he prescribe DHEA when clearly going by what you knowledgeable people have written: DHEA lowers cortisol ? This would have been fine for the high cortisol period but what about the low periods?

At the time, he also put me on a trial of NDT which I was pleased about but at the back of my mind I was really worried that the trial of NDT would not go that well because my cortisol levels were so out of sync. I failed the trial miserably. Could the DHEA lower my cortisol levels so much that I was bound to fail NDT trial?

Would love some feedback as in all My ignorance I started dosing with 25mcg DHEA three weeks ago (purchased online) not knowing that it was lowering my cortisol. Stopped taking it three days ago before I read these replys to this post which wrote quite sometime ago.

When the pupil is ready the teacher will appear!!! I am a pupil

humanbean profile image
humanbean in reply to DizzyD

If it makes you feel better and doesn't cause any new symptoms, I would carry on with it in your shoes.

DizzyD profile image
DizzyD in reply to humanbean

Hi Humanbean I felt better on the DHEA during the day and evening...more energy, no anxiety, clearer thought process etc but downside is I was waking up constantly through the night which was getting progressively worse. I read somewhere, that DHEA causes insomnia so I stopped taking it 3 days ago. Sleeping better but now less energy, slight anxiety, can't think straight....grrr and dreaded fatigue. Tomorrow I going to take half capsule and see how that goes.

Sincere thanks humanbean.

humanbean profile image
humanbean in reply to DizzyD

Would there be any mileage in trying to alter the timing of when you take the DHEA rather than reducing your dose?

I have no idea if there is an optimal time for taking DHEA.

Carys21 profile image
Carys21 in reply to DizzyD

paulrobinsonthyroid.com/hig...

DizzyD profile image
DizzyD in reply to Carys21

Thank you for the link really is an eye opener. In the process of contacting Paul for one to one counselling which is what I need hopefully to try and sort my cortisol issue and progress further with T3 or NDT. Priceless! Sincere thanks.

Carys21 profile image
Carys21 in reply to DizzyD

Glad it was useful, let us know how you get on 🙂

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