Selwyn and colleagues describe graded aerobic exercise as a simple, cheap, effective, and available treatment for fibromyalgia. It has been suggested that because dehydroepiandrosterone (DHEA) levels have been found to below in the condition and raised by exercise, DHEA supplements can be used. However, DHEA supplements may increase the risk of breast cancer in postmenopausal women.
DHEA
DHEA stands for dehydroepiandrosterone. This steroid occurs naturally in your body, where it’s produced primarily by the adrenal glands. Your body uses DHEA to make some hormones, including estrogen and testosterone. Because of that, it’s sometimes called “the mother hormone.” Your DHEA levels naturally drop as you age, and this is considered a key marker in determining biological age. DHEA is considered an antioxidant, which means that it has a protective effect on your tissues and reverses damage due to oxidation, which is believed to be a component of aging. In women, DHEA levels may increase during times of stress. It may also play a role in your immunity.
DHEA is notoriously low in fibromyalgia patients
DHEA is notoriously low in many fibromyalgia patients. Chronic stress initially causes the adrenals to release extra amounts of stress hormone cortisol. Continuous stress raises cortisol to abnormally high levels. Then the adrenal glands get to where they can’t keep up with the demand for more cortisol. As the cortisol levels continue to become depleted from ongoing stress the body attempts to counter this by releasing more DHEA.
Eventually they can’t produce enough cortisol or DHEA. This is where most of my patients find themselves in-low DHEA levels from years of stress. Aging makes holding on to DHEA even tougher. Even in healthy individuals, DHEA levels begin to drop after the age of 30. By age 70, they are at about 20% of their peak levels.
Benefits of DHEA supplements
DHEA supplements are taken for multiple reasons, including:
>>treating some symptoms of fibromyalgia and chronic fatigue syndrome
>>slowing or reversing the aging process
>>improving mental function in the elderly
>>improving athletic performance (DHEA is banned by many athletic organizations, including the Olympic Committee)
>>treating sexual dysfunction
>>preventing clogged arteries
>>treating infertility
>>improving diabetes and metabolic syndrome
>>treating several autoimmune diseases, psychological, and neurological conditions, including depression, schizophrenia, Alzheimer’s, Parkinson’s, lupus, Sjogren’s, osteoporosis, multiple sclerosis, and more
Stress and DHEA
DHEA helps prevent the destruction of tryptophan (5HTP), which increases the production of serotonin. This helps provide added protection from chronic stress. Serotonin is one of the most important stress coping chemicals. This happy hormone increases or moods, reduces pain (increases pain threshold), and is responsible for stimulating the production of the sleep hormone melatonin.
If you’ve read a book, Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome, you know the importance of 5HTP and serotonin. And I spend quite a bit of time discussing the merits of DHEA for reversing anxiety and depression in my book, Treating and Beating Anxiety and Depression with Orthomolecular Medicine. DHEA is one the most effective antianxiety therapies available and much safer than benzodiazepine drugs. Studies continue to show low DHEA to be a biological indicator of stress, aging, and age-related diseases including neurosis, depression, peptic ulcer, IBS, and others.
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DHEA for Fibromyalgia
We’re steadily accumulating evidence of the potential role of DHEA deficiency and supplementation in people with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS). A small study published in 2012 suggested that DHEA levels may be low in post-menopausal women with fibromyalgia and that lower levels were linked with reduced pain threshold and tolerance and several measures of illness severity.
However, studies have been inconsistent as to whether FMS involves low DHEA levels. A 2014 study suggested that DHEA levels are not linked to pain intensity or other signs and symptoms of the condition. ME/CFS may be tied to decreased levels of DHEA as well, according to a 2009 study that showed low levels of DHEA and several other antioxidants.
Other research published the same year also showed low DHEA levels along with and an abnormal ratio between DHEA and the stress hormone cortisol. Again, though, research is mixed. A 2010 study found no abnormalities in DHEA levels in people with this disease. Depression rates are high in both FMS and ME/CFS and a 2014 systematic review said DHEA showed promise in treating depression, especially when it’s mild or resistant to other forms of treatment.
Clinical trials
108 consecutive female FM patients, mean age 48.87 years treated in a private community-based rheumatology practice were evaluated. All fulfilled ACR 1990 and 2010 FM criteria. All complained of fatigue and decreased stamina. Blood samples were obtained on the initial visit and sent to a reference lab for measurement of dehydroepiandrosterone sulfate (DHEA-S) levels.
Conclusion
Of the 108 FM patients tested, 83 (77%) had low-for-age DHEA-S levels. 6 had no detectable DHEA-S. The levels ranged from 0 to 679 mcg/dl, with 75 having levels under 100mcg/dl. The mean DHEA-S level for the 108 patients was 96.8 mcg/dl, much lower than the expected level of 150 mcg/dl. DHEA deficiency is a common co-morbidity in FM and levels should be measured especially if fatigue and decreased stamina are prominent symptoms.
DHEA Dosage
The recommended dosage of oral DHEA supplementation varies widely based on what it’s being taken for. For FMS and ME/CFS, it ranges from 50 mg to 500 mg daily. This dosage hasn’t been studied for long-term use. Be sure to talk to your doctor about what dosage may be appropriate for you.
You may also want to check with your pharmacist, as DHEA can have negative interactions with multiple medications, including antidepressants and other drugs that alter serotonin levels or function. Serotonin syndrome is a possibility.
DHEA may change the way your liver processes drugs, so be sure to ask your doctor and pharmacist about whether this increases risks of problems from your other medications. The higher the dosage, the higher the likelihood of side effects
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