Thursday, May 19, 2011

Stopping the DHEA For Now

Ever since coming off the Pred, I decided to just keep going with the HC too. If I can get off of this then in a few weeks I can get the appropriate testing done for late onset congenital adrenal hyperplasia (LOCAH) as well as looking into getting a stim test done.

For those who do not know what LOCAH is, basically your body has enzymes which are needed to convert your hormones into cortisol and aldosterone. You can look at this hormone pathway chart on this page to see every step takes an enzyme. 

If you are deficient or missing one of those enzymes, then the step before it gets "backed up" and you are unable to create enough cortisol or aldosterone in the body. Your body starts dumping this extra hormone into DHEA and you grow extra hair on your body. Some have it so severe, the hair growth is very thick, their periods stop and some women (if they have it at a young age) have weird changes to their genitals due to the androgens. If I have this, mine is not severe as I did not have the really thick hair growth, but I am definitely more hairier than most women.  

This testing I should have had done in the beginning. My natural doctor conveniently had no idea what he was doing when he said my 17 OH progesterone was normal even though it was slightly elevated during my follicular stage of my cycle.This should NEVER be elevated and I should have immediately been referred to an endo. A slight elevation means serious issues needs ruled out. There is no way around this and this doctor failed.

"A substantial proportion of women with hirsutism have mild defects in adrenal steroidogenesis, revealed by an ACTH stimulation test, that are indicative of late-onset (nonclassic) congenital adrenal hyperplasia. Measurements of basal steroid levels are not helpful in differentiating among the causes of increased androgen production in such patients and may be misleading. (N Engl J Med 1990; 323:849–54.)"

"Four patients (two in group 2 and two in group 4) as well as three normal women had elevated basal plasma 17-hydroxyprogesterone levels. Thus, three of five patients considered to have 21-hydroxylase deficiency would not have been identified if only basal plasma 17-hydroxyprogesterone levels had been measured."

If you read that whole study, you find out even women with normal basal levels of DHEA and 17-OH progesterone were found to have mild forms of LOCAH and that a stim test is absolutely critical. My natural doctor is completely out of his mind when he said my levels needed to be in the 300's to be suspect. I would have been considered elevated even though it was only a few points above.

In those with elevated 17 OH Progesterone, it means the problem lies with the P450c21 enzyme. This is the most common form of LOCAH. LOCAH is sometimes misdiagnosed as PCOS too. If you have PCOS you should immediately get tested. 

Why Have I Come Back To This?

Since lowering my HC, I am getting hairier. This could be happening because ACTH is starting to rise again which is then stimulating all of those pathways. If I am deficient in one of those enzymes, the "backing up" process is starting to occur and thus hair growth. The other day I was looking in the mirror and I was shocked at how dark my side burns are getting. It is actually noticeable now! Even my husband said something to me and he did not know how to approach the conversation without hurting my feelings. He says my upper lips is growing fast too and I have been complaining about how oily my hair has been (it gets dirty in 10 hours) and I have been breaking out like crazy too. I have another weird symptom but would rather not go into that right now. :)

So no more DHEA for me. I do not think DHEA alone is causing this in me. I think it is from me lowering my HC dose to 10mg/daily. I am doing ok for now on that dose, but the mornings are getting harder for me. I no longer wake up feeling rested and I could go right back to bed if I wanted. I will try to fight through this for as long as I can. This time I am really determined. I have no nausea so that is excellent.

I'll let you know how all of this goes. I hope I am overreacting! haha

I haven't chelated since the last hive incident. We are out of pills, so just waiting to get some more. The good news is that we are both (my husband is also chelating with DMPS) seeing improvements already. It is very slight, but it is more than I can DMSA ever did for me.

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