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Proper Use of Hormone Precursors
Dr. Joseph J Collins, RN, ND
Hormone precursors such as pregnenolone, DHEA and 7-KETO-DHEA may be used if the body is not able to adequately respond to lifestyle, diet, nutritional support, proper essential fatty acids (omega-3 oils) and proper herbal therapies (the Hormone Specific Formulations).
In truth, it is not a good idea to use pregnenolone, DHEA and 7-KETO-DHEA until the body is healthy enough to use them properly. Before considering the use of pregnenolone, DHEA and 7-KETO-DHEA make sure that the patient has consistently adhered to recommendations in the Foundations of Hormone Health and the proper use of Hormone Specific Formulations.

Supplements that are typically called “hormone precursors” include pregnenolone, DHEA and 7-KETO-DHEA. Pregnenolone is primarily made by the adrenal glands, as well as the gonads (ovaries and testicles), and to a lesser extent by other tissues such as the liver. Ideally, we want to have the adrenal glands and gonads healthy enough for the body to make its own pregnenolone. However, sometimes it cannot, so supplementation may be appropriate – if used properly.
DHEA is also made primarily by the adrenal glands; so again, support of adrenal health is our first choice. Since DHEA has so many beneficial properties, supplementation is appropriate. 7-KETO-DHEA is a DHEA metabolite that has beneficial properties as well, such as increasing thermogenesis (fat burning) activity.

Actually, “precursor” may not be the most accurate way to describe them (but we a stuck with that label and have to work with it). 7-KETO-DHEA (3-acetyl-7-oxo-dehydroepiandrosterone), also called 7-KETO, is actually a metabolite of DHEA. Studies indicate that 7-KETO-DHEA does not convert into other steroid hormones in the body and does not affect estrogen, testosterone or progesterone levels in the body. However, it does enhance the actions of testosterone by having an androgenic effect. So, 7-Keto may best be considered a testosterone agonist ( "agonist" works with - "antagonist" works against). In fact, pregnenolone, DHEA and 7-KETO-DHEA are all actually hormones in and of themselves. They can each affect the health of tissues throughout the body. They really don’t have to become something else (such as testosterone or estrogens) to affect the body.

Unlike 7-KETO-DHEA, both pregnenolone and DHEA can potentially become other hormones – the operative word being “potentially” – there is no guarantee what they will become, or what hormone levels will increase. Both pregnenolone and DHEA may help increase testosterone, but may also increase estrogens, such as estradiol and estrone. Even though they are each commonly referred to as “hormone precursors”, these supplements may or may not be converted to more potent hormones such as testosterone or estrone, or estradiol. They may just stay pregnenolone or DHEA. This may not be a problem because even if they are not converted, they still have actions of their own. For example, if DHEA (an important hormone from the adrenal glands) levels are low, we want to increase DHEA, and really do not want it to become something else.

If increased estrogens and testosterone levels are both desired, then DHEA may still be a good choice. But the only way to be sure is to do lab tests to see which hormones increase. If you do not want to increase estrogens, it is also a good idea to use DIM Enhanced when using DHEA, since  DIM Enhanced promotes more rapid detoxification of estrogens and clearance and removal of estrogens from the body.

Pregnenolone may also increase progesterone, but it may also increase DHEA, testosterone and estrogens. So it is always important to monitor hormone levels when taking DHEA or pregnenolone. It is best to test progesterone, estrogen and testosterone levels before and after starting DHEA or pregnenolone to see which hormone levels are changing. It is also best to start with the Foundations of Hormone Health and the Hormone Specific Formulations for two to three months before trying hormone precursors such as pregnenolone, DHEA, or 7-KETO-DHEA so that hormone metabolism pathways are at their best health. Sometimes pregnenolone, DHEA and 7-KETO-DHEA are used with bioidentical hormone replacement therapies (BHRT) to get better results.

DHEA dosages for men may start at one DHEA (25 mg) each AM. The dosage may be increased to one or even two of the DHEA 50 mg capsules if indicated (by lab tests), but keep in mind that the higher the dosage of DHEA, the more likely that it will become estrogens. Using TestoGain will encourage the body to convert more DHEA to testosterone. In men, it is very important that DHEA, estrogen and testosterone levels all be monitored before and after starting DHEA, to make sure the estrogens do not become elevated. DHEA is more likely to become estrogens in men with excessive body weight or liver disease. So, it is really a good idea to be on  DIM Enhanced  before adding DHEA, because  DIM Enhanced  promotes more rapid detoxification and clearance of estrogens.

DHEA dosage for women should start at DHEA 5 Sublingual (which can also be swallowed) each AM. It may be increased to one or even two of the DHEA 10 mg capsules up to 20 mg for short periods of time. However, in some women, if more than 5 to 10 mg is given for too long the androgenic effects (acne, oily skin, hair growth) may start to be a problem. In women, it is very important that DHEA, estrogen, progesterone and testosterone levels all be monitored before and after starting DHEA, to make sure the hormones do not become imbalanced. If the DHEA is being used to help raise testosterone and/or estrogen, then women may consider using TestoGain and/or EstroMend as indicated.

Pregnenolone dosage for both men and women can be 2 ½ mg to 25 mg a day, but typically, it is best to keep it at or below 10 mg. If higher dosages are indicated, based on laboratory tests, it is best to start with a low dosage and work it up slowly over time. High dosages can make a person irritable or anxious, or cause headaches or heart palpitations. Each person reacts differently to dosages so increase slowly – it does not take much. Women can take ProgestoMend with Pregenenolone to encourage the body to convert more pregenolone to progesterone.

7-KETO-DHEA dosage can be as 7-KETO (100 mg) a day. This is a significant dosage, but not as high as the 200 mg dosage that was shown to be safe in males during a 4 week study. As noted, lifestyle, diet, nutritional support, essential fatty acids and Hormone Specific Formulations should first be addressed before trying  7-KETO. The ability of 7-KETO-DHEA to stimulate the metabolism may be too much if the body does not have optimal nutrition including fatty acids – and enough magnesium (to keep the heart calm with the increased metabolism). Since 7-KETO-DHEA has androgenic (masculinizing) properties in and of itself women should lower the dosage or stop if acne or oily skin develop.

Summary of Proper Use of Hormone Precursors
Many people are able to achieve optimal hormone health with hormone precursors if they have made healthy lifestyle, diet, nutritional support and essential fatty acids choices, and use the appropriate Hormone Specific Formulations™, and appropriate dosages of DHEA, pregnenolone and/or 7-Keto-DHEA.
In some patients Bio-identical Hormone Replacement Therapy (BHRT) may be required. The ideal time to consider BHRT is discussed in the next, final article of this series: "Applying the Hormone Health Guidelines."
Many people are able to acheive A significant Prescription bioidentical hormone replacement therapies should be considered if, lifestyle, diet, nutritional support, essential fatty acids, Hormone Specific Formulations, and precursors are unable to restore optimal hormone function. If BHRT is used, please see the series of articles on Bio-identical Hormone Replacement Therapy.

Next: Applying the Hormone Health Guidelines

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