tlcrowe

http://www.endocrinology.org/sfe/end...t/end07708.pdf


I found it while searching for any info on DHEA/DHEAS and their role in
PCOS.

What I found curious was the little hormone flow chart that is shown and how it depicts DHEA converting to androstenedione to testosterone to DHT...If it is in fact the DHEA that is converted to androgens, than why is it more crucial to test for DHEAS in PCOS?

I found the following excerpt especially interesting, or at least what parts of it I can understand...

Only desulphated DHEA is biologically active and can
be converted towards androgens. It has previously been
assumed that DHEA and DHEAS interconvert freely and
continuously, DHEAS being activated to DHEA by steroid
sulphatase, and DHEA inactivated to DHEAS by DHEA
sulphotransferase (SULT2A1). So DHEAS is usually seen as a
circulating storage pool for continuous DHEA regeneration.
However, while DHEA administration yields rapid
generation of active androgens, we showed that
administration of DHEAS did not lead to an increase in
either DHEA or downstream androgens. This suggests
that SULT2A1 activity, i.e. the inactivation of DHEA to
DHEAS, appears to be the rate-limiting step regulating
the DHEA-DHEAS equilibrium, determining DHEA
bioavailability.


Any insights?

Thermophile

a couple of things I noticed
-the general assumption is/has been DHEA can be easily converted to DHEAS and DHEAS can easily be converted to DHEA. this article suggests that converting DHEA to DHEAS may be more of a one-way street than originally thought
-normal DHEAS but elevated androstenedione may be a result of the impaired sult2a1 enzyme rather than proof that the ovaries are making too much androgens (this seems to be the authors main line of research). I think they're suggesting that the increased androgens could be from excess DHEA from the adrenals that isn't equally partitioned between DHEAS and androstenedione.
-DHEAS may be tested more often for practical reasons-chemically it may be easier/cheaper to detect the sulfated version of the hormone

tlcrowe

I get that his focus was on the adrenals, that's what attracted me to the article. Plus, until this, I could not find a single piece of reading that could link PCOS with NORMAL DHEAS.

I was really intrigued over the mention of the sult2a1 pathway dysfunction. I figured it may be able to explain why DHEA levels could be elevated while DHEAS was still normal and how even that type of "imbalance" could be indicative of PCOS.

__________________

Thermophile

generally if you don't already know a lot of the backstory, it's hard understand what researchers are talking about in editorial overview type articles. Endocrinology is clearly not my thing.

Have you looked at these papers? They should have a lot more details and background info into that pathway

http://jcem.endojournals.org/cgi/con...ract/94/9/3558
http://jcem.endojournals.org/cgi/con...act/91/10/4085
http://jcem.endojournals.org/cgi/con...act/88/12/5907

tlcrowe

Wow. Thank you for the links. The 1st study was really helpful, I looked up inhibitors of the 5 alpha reductase action and Finasteride came up. I know from previous reads here that Finasteride was a popular anti-androgen, so it all comes full circle and makes sense now. =)



Any ideas how to present all this new-found information to my endo without him being a condescending jerk and dismissing my "knowledge" as inferior to his?

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ecgorder

Great article! I feel the same way tlcrowe, everytime I take something new I learned about PCOS to my RE he acts as though I am brusing his ego.

I am now on the search for a new RE after a year of nothing!

tlcrowe

Good luck with the new Doctor!!

It's safe to say I decided not to see mine any longer. Hmmph.


If you liked that article and don't mind a long read...this one was really informative as well. It was just about how all-encompassing PCOS can be with it's insulin issues and adrenal issues and androgens and wacky variations and so on and so on...

http://www.infertilityphysician.com/androgen/pcos.html

__________________

Pink Nails

Good thread guys. This stuff is so confusing.

__________________
5'3" 112 lbs - small yet battle the belly bulge every day
32 years old - DH 33
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Married since April 2009
ttc#1 since Septermber 2009

Diagnosed with PCOS in 2002. Some cysts and high DHEAS. Was on BCP for 7 years (I adore yasmin). Now I am on no medication becasue I want ttc.

I recently started taking vitamins: A, D, B Complex, Folic Acid and Fish Oil

I also aim for a very low sugar and almost no simple carb diet. I run a couple times a week.

Colleen87

I read a couple of the links and it seems that if your testosterone is high then everything else must be high too? Since the testosterone is the final product then if it is high then all of its precursors are high as well. Like me for example, My DHEAS is slightly high...so then my DHEA must be high as well. But everything in my case is "slightly" high...

__________________
Colleen(22)

-LSH :FSH 1:1
-Testosterone 70ish
-DHEAS 332

Symptoms
-Acne & oily hair/skin
-Dark skin patches
-Tiredness
-Belly fat (and I am a thin cyster!)
-No periods right now as I am breastfeeding
-No sex drive

Thermophile

I don't think that all the precursers will necessarly be high just because testerone is high. There are several pathways in several parts of your body that can make testerone (or do something else with the precursers) so high testerone could be the result of a shift in the ratio of testerone being produced in (for example) ovaries rather than the other hormone that the ovaries could channel those precursers towards.

__________________
me 31 dh 48
married 2003
no kids no pets but we have a kickass garden

Dx 10/2009
pulled the goalie 6/2009

500 mg Met
prenatal vit