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  1. #1
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    Default Rare case: HIGH DHEA-S

    What is the most usual cause of elevated DHEA-S? My DHEA-S has been elevated for decades, and I've yet to hear a suggestion about possible causes from any of my doctors.

    My ACTH is normal, if not too low, so what gives?


    DHEA-S: 537 [110-370] (HIGH)
    Pregnenelone: 13 [13-208] (TOO LOW)
    ACTH: 12 [6-50] (RELATIVELY LOW)
    Cortisol, total: 11.8 [1.8-13.6] (ELEVATED? AFTERNOON, 4 PM)
    Cortisol, free: 0.44 [0.04-0.45] (ELEVATED? AFTERNOON, 4 PM)
    Testosterone, total: 382 [241-827] (LOW FOR AGE)

    - The elevated DHEA-S is not compensatory to the low T. Increasing T increases DHEA-S even more.
    - Testicles are 100% functional. HCG and Clomid stimulation tests work like magic to increase testosterone. My body can easily make its own T, it just does not want to!
    - I have very low SHBG (< 15) no matter how high T or E become. Something above is suppressing it.

  2. #2
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    Life EXtension links low SHBG to insulin resistance and cardiovascular disease: http://www.lef.org/magazine/mag2011/...earch&key=SHBG
    "The high insulin levels found in people stricken with metabolic syndrome have also been shown to suppress SHBG, creating a vicious cycle of abnormal SHBG activity.34,35"
    "Low SHBG is also associated with elevated triglycerides and low-density lipoprotein (LDL).40"
    "In men, low SHBG indicated an increased risk of death from cardiovascular disease.35 In both men and women, low SHBG levels are strongly correlated with obesity.41"

    "SHBG is an important regulator of your testosterone and estrogen levels, responsible for distributing sex hormones throughout your body—yet few doctors test for it. SHBG abnormalities are associated with multiple killer diseases of aging in both sexes, including cardiovascular disease (especially in women), cancer, type 2 diabetes, metabolic syndrome, sleep apnea, and osteoporosis."

    As to how to fix they are not so helpful (suggesting testosterone replacement).
    But what they said above is a clue all by itself for see here: http://www.lef.org/protocols/appendi...eference range
    "Another study showed that administration of thyroid hormone lowered cholesterol in patients with TSH ranges of 2.0–4.0 but had no cholesterol-lowering effect in patients whose TSH value was in the 0.2–1.9 range (Michalopoulou G et al 1998). It also showed that in people with elevated cholesterol, TSH values of 2.0 or greater could indicate that a thyroid deficiency is the culprit, causing excess production of cholesterol, whereas TSH levels at or below 1.99 would indicate normal thyroid hormone status."

    So, check your TSH and I'll bet you it is >1.9 which means you are hypothyroid (ignore the meaningless 'standard reference range' which has NO BEARING on whether or not your thyroid is healthy). So then the problem becomes one of treating the thyroid and seeing if it fixes all of the above. because if the thyroid is not working effectively it will lead to weight gain, metabolic syndrome, elevated cholesterol, and these are all associated with low SHBG so MAYBE correcting these symptoms can fix the SHBG.

    My best guess.
    Rydra

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    Quote Originally Posted by rydra_wong View Post
    Life EXtension links low SHBG to insulin resistance and cardiovascular disease: http://www.lef.org/magazine/mag2011/...earch&key=SHBG
    "The high insulin levels found in people stricken with metabolic syndrome have also been shown to suppress SHBG, creating a vicious cycle of abnormal SHBG activity.34,35"
    "Low SHBG is also associated with elevated triglycerides and low-density lipoprotein (LDL).40"
    "In men, low SHBG indicated an increased risk of death from cardiovascular disease.35 In both men and women, low SHBG levels are strongly correlated with obesity.41"

    "SHBG is an important regulator of your testosterone and estrogen levels, responsible for distributing sex hormones throughout your body—yet few doctors test for it. SHBG abnormalities are associated with multiple killer diseases of aging in both sexes, including cardiovascular disease (especially in women), cancer, type 2 diabetes, metabolic syndrome, sleep apnea, and osteoporosis."

    As to how to fix they are not so helpful (suggesting testosterone replacement).
    But what they said above is a clue all by itself for see here: http://www.lef.org/protocols/appendi...eference range
    "Another study showed that administration of thyroid hormone lowered cholesterol in patients with TSH ranges of 2.0–4.0 but had no cholesterol-lowering effect in patients whose TSH value was in the 0.2–1.9 range (Michalopoulou G et al 1998). It also showed that in people with elevated cholesterol, TSH values of 2.0 or greater could indicate that a thyroid deficiency is the culprit, causing excess production of cholesterol, whereas TSH levels at or below 1.99 would indicate normal thyroid hormone status."

    So, check your TSH and I'll bet you it is >1.9 which means you are hypothyroid (ignore the meaningless 'standard reference range' which has NO BEARING on whether or not your thyroid is healthy). So then the problem becomes one of treating the thyroid and seeing if it fixes all of the above. because if the thyroid is not working effectively it will lead to weight gain, metabolic syndrome, elevated cholesterol, and these are all associated with low SHBG so MAYBE correcting these symptoms can fix the SHBG.

    My best guess.
    Rydra
    Rydra,

    I do have TSH 1.8-5.8. It fluctuates between these numbers. I have tried T3-only treatment at 5-20mcg, but I couldn't feel any subjective effects and thus I gave up the treatment. I simply didn't feel safe messing with T3, particularly while my body temperature is normal. At those small doses of T3, my temperature kept hitting 99 and above. My T3 and T4 are at the top of the range, but so is my RT3. I've been told I have "thyroid resistance," but the AACE doesn't agree that Wilson's Syndrome, or "thyroid resistance" is legitimate.

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    TSH >1.9 means hypothyroid. So sounds like MOST of the range you specified is hypothyroid. The "normal" range is NOT based on science or the health of the thyroid. Th elab just throws out the 5% worst values and gives you the "range". Science has shown that your cholesterol will rise at TSH >1.9, among other things, and that it is normalised when your TSH is brought down to 1.9 or below.

    I have never had thyroid resistance. The 2 things I would do TOP OF THE LIST for it are take selenium 400 mcg and take anti-oxidants like C and E (make sure to get gamma tocopherol, not just d-alpha). Selenium is the antioxidant needed by the thyroid. I take 200 mcg but if you have a problem you can take up to 400 mcg. Beyond that, you should search a good site on thryoid like www.stopthethyroidmadness.org. You should look up what nutrients are required by the thryoid and make sure you get them. Do you get enough iodine? Selenium? copper? zinc? tyrosine? iron? (I am sure there are other things). I don't think you need a drug, you just need to steadily supply the nutrients the thyroid needs. And prevent auto-immune with anti-oxidants.

  5. #5
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    Quote Originally Posted by vestpocket View Post
    What is the most usual cause of elevated DHEA-S?
    maybe ACTH deficiency does? have you ever tried to ask for the CRH stimulation test in order to get the measure of your own ACTH releasing higher peaks?
    Even if ACTH of yours stays within the correct range it may be too low anyway. Also cortisol of yours stays relatively too high. Ask your docs to consider the possibility that could be an ACTH deficiency and ask to be put under the CRH stimulation test. Imho acth of yours is low.

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    Hi vestpocket, the low pregnenolone can be a sign of pregnenolone steal, this happens when you have bad adrenals, but i cannot explain the high DHEA-S.

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