2. DHT makes? - ANSWER androstanediol, another androgen
measure levels by urine- elevated if PCOS, hirsutism, visceral obesity and post
menopause women with breast cancer
3. What enzyme converts testosterone to androstanediol? - ANSWER 5
alpha reductase high levels of 5 alpha reductase are associated with insulin
resistance, obesity, high protein diets, sodium restriction, licorice,
hyperthyroidism and DHEA supplementation
4. Low levels of 5 alpha reductase - ANSWER vegetarians
progesterone users
EGCG
flaxseed ligans
Proscar/Propecia
intake of saw palmetto, pygeum and stinging nettles
6. SHBG is a carrier protein for? - ANSWER testosterone
DHT
,estradiol E2
7. High SHBG levels? - ANSWER less E2 and T available for the body to use
8. Low SHBG? - ANSWER more E2 and T available to use
may be marker for low thyroid function
9. DHEA is made by? - ANSWER adrenal glands and some made by brain and
skin
DHEA makes estrogen and testosterone
10. When does DHEA production decline? - ANSWER late twenties
11. How does stress affect DHEA levels? - ANSWER initially increases DHEA
and if patient remains stressed, DHEA levels become low
12.1 DHEA recommended daily dosing - ANSWER Most common dosage is 2.5
mg to 30 mg PO SR (need healthy GI tract)
Can be used PO or transdermally
Women are more sensitive and commonly need less than men
Use a hormone holiday if menopausal
Use keto DHEA if the patient has a normal or elevated testosterone
13. DHEA level commonly normalizes in a younger patient as cortisol normalizes-
fix cause of problem= long term stress - ANSWER do not supplement DHEA
,14. When is DHEA contraindicated? - ANSWER breast/ovarian/uterine cancer
history
causes of elevated DHEA levels? long term stress, adrenal tumor, too high of
DHEA dose
therapeutic benefits of DHEA - ANSWER stress
weight loss
hypercholesterolemia
hypertriglyceridemia
insomnia
, insuline resistance/diabetes
sexual dysfunction
coronary heart disease
cognition
osteopenia/osteoporosis
depression
RA
AS
lupus
insomnia
menopause
DHEA in males - ANSWER Recommended daily dosage: 10-100 mg PO SR.
may be used PO or transdermally
Contraindicated in prostate cancer
severity of insulin resistance - ANSWER If FBS high-normal (over 85 mg/dL)
the risk of the patient dying of cardiovascular disease is increased by 40%. Also
increased risk of vascular death. May account for a 6 to 10% decrease in the
volume of the hippocampus and amygdala.
Insulin resistance is a risk factor for cognitive decline.
symptoms of insulin resistance - ANSWER fuzzy brain, infertility, irregular
menstrual cycles, irritability, loose bowel movements alternating with
constipation, water retention, weight gain
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