DHEA therapy has provided benefit in autoimmune disease. IN this study they review the previous articles and physiology behind DHEA's proposed benefit in autoimmune disease.
SHBG decreases in response to androgens, and in the presence of hypothyroidism, and insulin resistance.
Plasma SHBG levels tend to increase with increasing age
The apparent metabolic clearance rate of testosterone is decreased in elderly as compared to younger men
Testosterone circulates predominantly bound to the plasma proteins SHBG and albumin, with high and low affinity respectively
Testosterone is secreted in a pulsatile fashion
Current clinical guidelines suggest at least two measurements
In adult men, there is a well-documented diurnal variation (particularly in younger subjects) in testosterone levels, which are highest in the early morning and progressively decline throughout the day to a nadir in the evening
In older men, the diurnal variation is blunted
it is standard practice for samples to be obtained between 0800 and 1100 h.
Testosterone and DHEA decline, whereas LH, FSH, and SHBG rise
DHT remains constant despite the decline of its precursor testosterone
Longitudinal studies show an average annual decline of 1–2% total testosterone levels, with decline in free testosterone more rapid because of increases in SHBG with aging
Massachusetts Male Aging Study (MMAS) data show DHEA, DHEAS, and Ae declining at 2–3% per year
DHT showed no cross-sectional age trend
Androstanediol glucuronide (AAG) declined cross-sectionally with age in the MMAS sample, at 0.6% per year
The EMAS data show that, consistent with the longitudinal findings of MMAS (Figure 1), the core hormonal pattern with increasing age is suggestive of incipient primary testicular dysfunction with maintained total testosterone and progressively blunted free testosterone associated with higher LH
This author proves the point in the review of these two studies, that TT may remain constant in aging men, however, FT drops.
obesity impairs hypothalamic/pituitary function
Androgen deprivation in men with prostate cancer has been associated with increased insulin resistance, worse glycemic control, and a significant increase in risk of incident diabetes
Low serum testosterone is associated with the development of metabolic syndrome 116, 117 and type 2 diabetes. 118 SHBG has been inversely correlated with type 2 diabetes
Improvement in insulin sensitivity with testosterone treatment has been reported in healthy 121 and diabetic 122 adult men
In studies conducted in men with central adiposity, testosterone has been shown to inhibit lipoprotein lipase activity in abdominal adipose tissue leading to decreased triglyceride uptake in central fat depots. 123
salivary testosterone and DHEA using LC-MS/MS accuracy exceeds 98.5%. Compare that with historical 50% resolution of pain with a hysterectomy. There is no perfect test, but if accuracy exceeds 98%, you have reliable test.
Another study supports saliva hormone testing. This study involved 2,722 individuals and tested estradiol, progesterone, DHEA and testosterone in men and women. All of these are sex hormones. Someone needs to tell the insurance companies that the overwhelming evidence supports saliva hormone testing. But, that would mean they are even interested in the science.
good review of sex hormones and LUPUS; whether it is causative or not, sex hormones trends exist in LUPUS i.e. low DHEA in both sexes, low progesterone in women, and low Testosterone in women>men.
Only abstract available. Resveratrol found to reduce total Testosterone by 23% and DHEAS by 22% in women with PCOS; a decrease in insulin by 32% and improved insulin sensitivity was also noted.
3 year study finds improvement in classic menopausal symptoms for women in perimenopause and menopause with improvement in other parameters: fasting glucose, cholesterol, MMP-9, CRP, fibrinogen and other clotting factors. This study used bioidentical Bi-est, progesterone, and in some DHEA and Testosterone.
Very interesting study finds that a single value assessment of androgens, DHEAS, prolactin, IGF-1 and IGFBP-3 can be used to assess 3 year average in pre-menopause women. Estrogen and progesterone need to be assessed through the cycle.