תוסף DHEA

דיון מתוך פורום  גיל המעבר וטיפול הורמונלי חילופי

09/06/2004 | 15:59 | מאת: חנה

בעבר ציינתי שכאשר אני מנסה להפסיק HRT- כרגע חצי ליויאל נפגמת לי השינה (אין לי הזעות) אך אני מצליחה לישון כ- 5 שעות ביממה דבר שממש מחליש אותי ופוגע במערכת החיסונית שלי . שאלתי: האם יש לך מידע על התוסף DHEA האם הוא יכול לענות על בעית השינה? האם לידיעתך בטוח יותר מ hrt אני מצרפת מחקר: Long-term low-dose dehydroepiandrosterone oral supplementation in early and late postmenopausal women modulates endocrine parameters and synthesis of neuroactive steroids. Genazzani AD, Stomati M, Bernardi F, Pieri M, Rovati L, Genazzani AR. Department of Obstetrics and Gynecology, University of Modena, Modena, Italy. [email protected] OBJECTIVE: To evaluate the effects of a low-dose DHEA supplementation on hormonal parameters in early and late postmenopausal women. DESIGN: Prospective case study. SETTING: Postmenopausal women in a clinical research environment. PATIENT(S): Twenty postmenopausal women were divided in two groups according to age (50-55 and 60-65 years). INTERVENTION(S): All patients underwent hormonal evaluation before and at 3, 6, 9, and 12 months of therapy (25 mg/d of DHEA orally). Pelvic ultrasound examination and Kupperman score were performed before and after 3, 6, and 12 months of therapy. MAIN OUTCOME MEASURE(S): Plasma DHEA, DHEAS, estrone (E1), E2, P, androstenedione (A), T, dihydrotestosterone, 17alpha-hydroxyprogesterone (17-OHP), cortisol (F), allopregnanolone, beta-endorphin, sexual hormone-binding globulin (SHBG), LH, FSH, growth hormone (GH), and insulin-like growth factor-1 (IGF-1) concentrations. RESULT(S): The levels of all the steroids that derive from DHEA metabolism increased in plasma with DHEA administration. Also neurosteroids (namely allopregnanolone) and endorphin showed increased plasma levels, whereas both gonadotropins were significantly reduced. Endometrial thickness did not change throughout the study period. CONCLUSION(S): Administration of low doses (25 mg) of DHEA positively modulates several endocrine parameters in early and late postmenopausal women, inducing the increase of the androgenic, estrogenic, and progestogenic milieu and reducing the climateric symptoms, similarly to estroprogestin replacement therapy. These data suggest that DHEA supplementation is a more effective replacement therapy than a simple "dietary supplement."

09/06/2004 | 16:16 | מאת: חנה

Postmenopausal levels of oestrogen, androgen, and SHBG and breast cancer: long-term results of a prospective study. Zeleniuch-Jacquotte A, Shore RE, Koenig KL, Akhmedkhanov A, Afanasyeva Y, Kato I, Kim MY, Rinaldi S, Kaaks R, Toniolo P. Department of Environmental Medicine, New York University School of Medicine, 650 First Avenue, New York, NY 10016, USA. [email protected] We assessed the association of sex hormone levels with breast cancer risk in a case-control study nested within the cohort of 7054 New York University (NYU) Women's Health Study participants who were postmenopausal at entry. The study includes 297 cases diagnosed between 6 months and 12.7 years after enrollment and 563 controls. Multivariate odds ratios (ORs) (95% confidence interval (CI)) for breast cancer for the highest quintile of each hormone and sex-hormone binding globulin (SHBG) relative to the lowest were as follows: 2.49 (1.47-4.21), P(trend)=0.003 for oestradiol; 3.24 (1.87-5.58), P(trend)<0.001 for oestrone; 2.37 (1.39-4.04), P(trend)=0.002 for testosterone; 2.07 (1.28-3.33), P(trend)<0.001 for androstenedione; 1.74 (1.05-2.89), P(trend)<0.001 for dehydroepiandrosterone sulphate (DHEAS); and 0.51 (0.31-0.82), P(trend)<0.001 for SHBG. Analyses limited to the 191 cases who had donated blood five to 12.7 years prior to diagnosis showed results in the same direction as overall analyses, although the tests for trend did not reach statistical significance for DHEAS and SHBG. The rates of change per year in hormone and SHBG levels, calculated for 95 cases and their matched controls who had given a second blood donation within 5 years of diagnosis, were of small magnitude and overall not different in cases and controls. The association of androgens with risk did not persist after adjustment for oestrone (1.08, 95% CI=0.92-1.26 for testosterone; 1.15, 95% CI=0.95-1.39 for androstenedione and 1.06, 95% CI=0.90-1.26 for DHEAS), the oestrogen most strongly associated with risk in our study. Our results support the hypothesis that the associations of circulating oestrogens with breast cancer risk are more likely due to an effect of circulating hormones on the development of cancer than to elevations induced by the tumour. They also suggest that the contribution of androgens to risk is largely through their role as substrates for oestrogen production.

חנה שלום ותודה על שאלתך המעניינת. אני בהחלט מכיר את החומר ומשתמש בו לעיתים. אין מספיק מחקרים מבוקרים לגבי תופעות הלואי אם כי יש לא מעט כאלו המצביעים על יעילות במידה זאת או אחרת. המחקר השני שציינת אינו קשור כ"כ אם כי הוא מראה את המנגנון דרכו החומר יעיל ואף עשוי להזיק. החומר מעלה את רמת הורמוני המין, כולל אסטרוגן ולכן יעיל לגלי חום אך האם מעלה את הסיכון?? התרופה אינה נמכרת רוטינית בארץ אם כי ישנם בתי מרקחת המכינים אותה לפי מרשם רופא. בארה"ב ניתן להשיגה בבתי טבע כתוסף מזון, אמיתי או לא? לסיכום: החומר ידוע, משתמשים או אולם חשוב להתיעץ עם רופא מומחה בתחום האנדוקרינולוגיה. כל טוב דר' זלוצובר

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