Posted by Larry Hoover on April 7, 2003, at 15:04:21
In reply to Re: Cortisol and DHEA Balance » Larry Hoover, posted by Ron Hill on April 7, 2003, at 13:46:12
> Hi Larry,
>
> Thank you for your response.
>
> > In essence, I've been working one month on, one month off.
>
> Given your posting frequency lately, I assume you are currently off. When do you go back on?The end of this month. There's a very close match-up with the calendar.
> > The month off has been characterized by profound fatigue, cognitive and memory problems, irritabliity, mood decline.
>
> Have you ever had your cortisol levels measured?Yes, and DHEA, and DHEA/S. My blood had "normal" levels, but the question remains, what should be termed normal? If peoples' experience with thyroid hormone measurement is any indication, the normal range (an entire order of magnitude! for TSH) is not normal at all.
> As an aside, some of johnj's symptoms are somewhat similar to yours. Maybe there is a CFS component to John's dx (as you have alluded to in prior posts to John). In John's case, however, his "CFS-like" symptoms seem to be caused by the TCA he is taking.Well, I'd be concerned about the logical fallacy "post hoc, ergo propter hoc", i.e. after this, therefore because of this. Coincidence, in other words. You cannot exclude coincidental correlation by any logical means. The TCA could be a red herring.
> > Ya, I know. Hormones are potent. Hormones are tricky. Still, 50 mg of DHEA isn't going to do too much adverse, even if you didn't need it.
>
> YIKES! 50 mg?! I was thinking about 5 mg! In his book titled "Mind Boosters", Ray Sahelian, M.D. urges individuals to use the least amount possible and to take breaks from use. But Larry my real question for you was do you have an opinion regarding the idea that there may be some efficacy in using DHEA supplementation to bring cortisol in balance (as implied in the previously posted article)?
>
> Thanks Larry!
>
> -- RonI have trouble with mechanistic explanations. I'm more comfortable with empiricism. What do people feel like when they take DHEA? I don't need to know why. I'm interested in whether.
I've never seen DHEA in 5 mg doses, but that doesn't mean it isn't out there. DHEA supplementation studies have used up to 500 mg/day. The following studies used more than 50.
Surprisingly, I had trouble finding appropriate abstracts. Recently published studies had no abstract available.
Biol Psychiatry 1999 Jun 15;45(12):1533-41Comment in:
Biol Psychiatry. 1999 Jun 15;45(12):1531-2.
Dehydroepiandrosterone treatment of midlife dysthymia.Bloch M, Schmidt PJ, Danaceau MA, Adams LF, Rubinow DR.
Behavioral Endocrinology Branch, National Institute of Mental Health, Bethesda, MD 20892-1276, USA.
BACKGROUND: This study evaluated the efficacy of the adrenal androgen, dehydroepiandrosterone, in the treatment of midlife-onset dysthymia. METHODS: A double-blind, randomized crossover treatment study was performed as follows: 3 weeks on 90 mg dehydroepiandrosterone, 3 weeks on 450 mg dehydroepiandrosterone, and 6 weeks on placebo. Outcome measures consisted of the following. Cross-sectional self-ratings included the Beck Depression Inventory, and visual analogue symptom scales. Cross-sectional objective ratings included the Hamilton Depression Rating Scale, the Cornell Dysthymia Scale and a cognitive test battery. Seventeen men and women aged 45 to 63 years with midlife-onset dysthymia participated in this study. Response to dehydroepiandrosterone or placebo was defined as a 50% reduction from baseline in either the Hamilton Depression Rating Scale or the Beck Depression Inventory. RESULTS: In 15 patients who completed the study, a robust effect of dehydroepiandrosterone on mood was observed compared with placebo. Sixty percent of the patients responded to dehydroepiandrosterone at the end of the 6-week treatment period compared with 20% on placebo. A significant response was seen after 3 weeks of treatment on 90 mg per day. The symptoms that improved most significantly were anhedonia, loss of energy, lack of motivation, emotional "numbness," sadness, inability to cope, and worry. Dehydroepiandrosterone showed no specific effects on cognitive function or sleep disturbance, although a type II error could not be ruled out. CONCLUSIONS: This pilot study suggests that dehydroepiandrosterone is an effective treatment for midlife-onset dysthymia.
Biol Psychiatry 1997 Feb 1;41(3):311-8
Dehydroepiandrosterone (DHEA) treatment of depression.Wolkowitz OM, Reus VI, Roberts E, Manfredi F, Chan T, Raum WJ, Ormiston S, Johnson R, Canick J, Brizendine L, Weingartner H.
Department of Psychiatry, University of California, San Francisco, School of Medicine 94143-0984, USA.
Dehydroepiandrosterone (DHEA) and its sulfate, DHEA-S, are plentiful adrenal steroid hormones that decrease with aging and may have significant neuropsychiatric effects. In this study, six middle-aged and elderly patients with major depression and low basal plasma DHEA f1p4or DHEA-S levels were openly administered DHEA (30-90 mg/d x 4 weeks) in doses sufficient to achieve circulating plasma levels observed in younger healthy individuals. Depression ratings, as well as aspects of memory performance significantly improved. One treatment-resistant patient received extended treatment with DHEA for 6 months: her depression ratings improved 48-72% and her semantic memory performance improved 63%. These measures returned to baseline after treatment ended. In both studies, improvements in depression ratings and memory performance were directly related to increases in plasma levels of DHEA and DHEA-S and to increases in their ratios with plasma cortisol levels. These preliminary data suggest DHEA may have antidepressant and promemory effects and should encourage double-blind trials in depressed patients.
Am J Psychiatry 1999 Apr;156(4):646-9
Double-blind treatment of major depression with dehydroepiandrosterone.Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L, Roberts E.
Department of Psychiatry, University of California Medical Center, San Francisco, USA. owenw@itsa.ucsf.edu
OBJECTIVE: This study was designed to assess possible antidepressant effects of dehydroepiandrosterone (DHEA), an abundant adrenocortical hormone in humans. METHOD: Twenty-two patients with major depression, either medication-free or on stabilized antidepressant regimens, received either DHEA (maximum dose = 90 mg/day) or placebo for 6 weeks in a double-blind manner and were rated at baseline and at the end of the 6 weeks with the Hamilton Depression Rating Scale. Patients previously stabilized with antidepressants had the study medication added to that regimen; others received DHEA or placebo alone. RESULTS: DHEA was associated with a significantly greater decrease in Hamilton depression scale ratings than was placebo. Five of the 11 patients treated with DHEA, compared with none of the 11 given placebo, showed a 50% decrease or greater in depressive symptoms. CONCLUSIONS: These results suggest that DHEA treatment may have significant antidepressant effects in some patients with major depression. Further, larger-scale trials are warranted.
poster:Larry Hoover
thread:215282
URL: http://www.dr-bob.org/babble/20030407/msgs/217068.html