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DHEA and Testosterone After Bilateral Adrenalectomy

Question: Since my adrenal glands were removed, my testosterone and DHEA levels are low. Is there value in taking replacement doses of either one of these?

Answer: Although it is not part of the standard of care to treat women or men with primary adrenal insufficiency (and bilateral adrenalectomy is such a state) with adrenal androgens, it makes sense to mimic nature and provide such steroids at replacement amounts. Because DHEA is converted by the body to both testosterone and estrogen, taking DHEA would be like taking small amounts of each of these hormones. The first studies on this issue have just started to be published and the appropriate doses of DHEA are currently being defined, as are the potential benefits of such replacement. Adrenal androgens may be more important in women than in men because normally the adrenals produce about half of the daily androgen requirement of a young adult woman. Taken in excess, DHEA can cause undesirable side effects, thus if replacement proves beneficial, this should be managed by your physician.

By Dr. George Chrousos MD (July, 1998)

 

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