DHEA 25/50mg (Take 1 Cap PO QAM)

Route: Oral capsule, taken by mouth.

• Administer one capsule each morning (QAM), with or without food, consistent with the prescriber's instructions.
• Morning administration aligns with the endogenous diurnal peak of DHEA (early morning) and supports physiologic-pattern supplementation.
• Swallow capsule whole with adequate fluid; do not open or chew unless instructed.

Dosing is individualized by the prescribing clinician. Common reference dosing for DHEA supplementation:

• Typical oral doses: 25–50 mg once daily in the morning.
• Lower doses (e.g., 25 mg/day) are typically initiated and titrated based on serum DHEA-S, testosterone, and estradiol levels.
• Doses above 50 mg/day are not generally recommended due to risk of androgenic and estrogenic side effects.
• Response monitoring and dose adjustments are at the prescriber's discretion based on laboratory and clinical response.

• DHEA: Produced predominantly in the zona reticularis of the adrenal cortex under ACTH stimulation, DHEA is converted peripherally by 3β-HSD and 17β-HSD enzymes to androstenedione, testosterone, and dihydrotestosterone (DHT) in target tissues (skin, gonads, adipose). It also undergoes aromatization to estrone and estradiol. DHEA directly binds androgen receptors (weak agonist), estrogen receptors ERα and ERβ (low affinity), and neurosteroid receptors (NMDA, σ1, GABA-A), and acts as an uncompetitive inhibitor of glucose-6-phosphate dehydrogenase (G6PDH), modulating immune and inflammatory pathways. Serum DHEA and its sulfated form DHEA-S decline substantially with age, contributing to reduced androgen and estrogen precursor pools.

Clinical Context: Oral DHEA is prescribed in the context of documented adrenal insufficiency, age-related DHEA-S decline, and relative hypoandrogenism in women (e.g., low libido, diminished energy, poor mood associated with low serum DHEA-S). It may be used as adjunct therapy in peri- or postmenopausal hormone protocols when low adrenal androgen precursor status is documented. DHEA-S (sulfated form) is the preferred serum marker for adrenal androgen production.

Monitoring:

• Serum DHEA-S, total testosterone, free testosterone, and estradiol at baseline and after 6–12 weeks of therapy.
• Clinical assessment for androgenic side effects: acne, oily skin, hirsutism (in women).
• Lipid panel: may affect HDL cholesterol, particularly at higher doses.
• Consider PSA monitoring in male patients.
• Use with caution in hormone-sensitive conditions (see Safety).

Contraindications:

• Known or suspected hormone-sensitive malignancies (breast, ovarian, endometrial, prostate cancer) — DHEA may stimulate hormone-responsive tumors.
• Pregnancy and lactation — DHEA's androgenic metabolites may cause fetal virilization.
• Active or uncontrolled polycystic ovarian syndrome (PCOS) without appropriate clinical oversight.

Warnings & Precautions:

• Androgenic effects (acne, hirsutism, voice changes) in women at higher doses or with androgenic sensitivity.
• Estrogenic effects: may exacerbate endometriosis, uterine fibroids, or estrogen-sensitive conditions through peripheral conversion.
• Hepatic considerations: oral DHEA undergoes first-pass hepatic metabolism; monitor liver function in patients with pre-existing hepatic disease.
• Not recommended in patients with adrenal hyperplasia or conditions with pre-existing androgen excess.

Drug Interactions:

• Anticoagulants (warfarin): DHEA may affect warfarin metabolism — monitor INR.
• Insulin/antidiabetic agents: DHEA may improve insulin sensitivity; monitor glucose.
• Hormone therapies: additive estrogenic or androgenic effects possible.

Common Side Effects: Acne, oily skin, mild hirsutism (in women), hair thinning, insomnia, headache, and mood changes. Side effects are generally dose-dependent and reversible with dose reduction.

Store at controlled room temperature (20–25°C / 68–77°F). Protect from moisture, heat, and light. Keep tightly sealed in original container. Store out of reach of children. Use before the beyond-use date assigned by Genesis Compounding. Do not use if capsule appears discolored or damaged.

Why is DHEA taken in the morning?

Endogenous DHEA secretion follows a diurnal rhythm with a morning peak. Oral morning dosing mimics this physiologic pattern and may optimize efficacy while minimizing disruption to the sleep cycle, as DHEA can have mildly stimulating effects.

What lab tests should be monitored while on this medication?

Prescribers typically monitor serum DHEA-S, testosterone (total and free), and estradiol at baseline and at 6–12 weeks after initiating therapy. Additional monitoring may include lipids, liver function, and PSA (in men) depending on clinical context.

Is this FDA-approved?

DHEA is available as an over-the-counter supplement in the U.S. but is not FDA-approved as a prescription drug for most indications (except vaginal prasterone/Intrarosa®). This preparation is compounded by Genesis Compounding as a prescription-only, patient-specific product at clinically relevant doses with pharmaceutical-grade excipients, and is not FDA-approved as a compounded preparation.

Can DHEA be used in men?

Oral DHEA has been studied in men with documented DHEA-S deficiency and adrenal insufficiency. In men, DHEA may also be converted to testosterone. Prescribers should monitor androgenic and estrogenic parameters and assess prostate health (PSA) as appropriate.

How does the 25mg dose differ from the 50mg dose?

The strength selected is individualized by the prescriber based on baseline serum DHEA-S levels, clinical symptoms, and patient sex/age. Lower doses (25 mg) are typically initiated to assess tolerability and response before considering escalation to 50 mg if clinically indicated and serum monitoring supports it.