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Over the last few weeks, I’ve covered progesterone, estrogen, and DHEA. Today I will outline some key considerations on evaluation of and treatment with pregnenolone.
An outline of today's email:
- Pregnenolone FYI
- Pregnenolone “Nevers”
- Prescribing Tips
1: Pregnenolone FYI
- Pregnenolone is made from cholesterol, and if total cholesterol is under 140, the body cannot adequately make pregnenolone. It is the precursor ("mother hormone") to DHEA, cortisol, progesterone, testosterone, and estrogen.
- As with anything, if pregnenolone is low (especially in someone under the age of 65, since this decreases with age), look for the cause (e.g. hypothyroidism, pituitary tumor, etc)!
- If under 50 on labs, it is difficult to maintain memory
- Consider evaluating levels of this in anyone with fatigue, insomnia, pain, and "brain" symptoms (especially depression, trouble managing response to stress, cognitive changes...)
2: Pregnenolone “Nevers”
- Never (or be very cautious) with use in those with seizures (it may be a tool in lowering seizure frequency, but too much can also trigger seizures)
- Never prescribe pregnenolone to someone with a history of breast cancer (no way to determine which pathway it will go down, and not enough research)
3: Pregnenolone Prescribing Tips
- Common dose for repletion is 10-50mg. However, research studies have used 500-800mg of pregnenolone to treat various conditions like schizophrenia, MDD, and some autoimmune conditions. Don't use these high doses unless you know what symptoms are associated with high levels of pregnenolone.
- Have a patient take pregnenolone in the morning at first, since it can be stimulating.
- The brand I see the most symptomatic response from is Douglas Labs dissolving tabs.
- My personal belief is that if we are prescribing this, there should be a symptomatic response (and that we aren't just treating lab levels). Does the patient have more energy, better memory/cognition/mood, etc within 6-8 weeks of use?
Thank you for reading! Next newsletter topic: Testosterone in women.
Best in health,
Meg
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