Dr. Amy Nett: Okay, so here we’re talking about a woman with high DHEA and you’re asking about DHEA and PCOS. So one of the defining features of PCOS, or polycystic ovarian syndrome, is high androgens. DHEA is considered an androgen. So again just defining PCOS, high androgens. The etiology of the high androgens is not entirely clear. PCOS again, it’s the syndrome where we often see insulin resistance, metabolic dysfunction, high androgens, high luteinizing hormone, and you may see polycystic ovaries which are actually harder to diagnose than might be thought. So that’s just part of the defining characteristic of polycystic ovarian syndrome.
I don’t know that the etiology is clear, but I generally do try to lower the testosterone or the androgens in my patients because it decreases symptoms. A lot of these women are coming and saying, “I have facial hair, I have acne.” And they have some of these more quote “male” characteristics. So I do try to balance hormones while I’m working on identifying underlying causes of inflammation. So I treat PCOS just like I would any other inflammatory condition. I’m looking at gut, I’m looking at thyroid, I’m trying to figure out what could be causing inflammation hormonal imbalance. So in PCOS while you’re working on the gut, while you’re working on methylation, these other pieces, I would try to balance hormones. So depending on the specific hormone profile, if you want to lower androgens, I often use inositol. So I find inositol, I do about four grams daily, and I normally do it in divided doses. So two grams twice daily of inositol. And we’ve talked about this before actually.
Some people use ovasitol and I might be mispronouncing that. It’s like o-v-a-s-i-t-o-l I think, Ovasitol and it’s a mix of myo- and d-chiro-inositol, I believe. And so it’s more of a, considered a physiologic ratio of those types of inositol. Other people will just use inositol powder, a lot less expensive. And I actually have a fair amount of success with just using the inositol powder like either Designs for Health or Pure Encapsulations have that inositol powder. So that’s what I generally do to lower androgens if it’s PCOS. You might also need to look at the other hormones.
If there’s low progesterone, I might sometimes put Baytex or chaste tree berry on board to help raise progesterone at all. So it depends on what’s going on with the rest of the hormones, but inositol might help lower those androgens. Okay, let’s see.