Dehydroepiandrosterone + Folic Acid

Usage

• This combination is primarily used as a supplement to address potential deficiencies in both dehydroepiandrosterone (DHEA) and folic acid. DHEA is prescribed for conditions like adrenal insufficiency, hypoactive sexual desire disorder in women, and depression. Folic acid is crucial for cell growth and development, especially during pregnancy, and is used to prevent neural tube defects in developing fetuses and treat folic acid deficiency anemia. It’s important to note that while both are available over-the-counter, they should be taken under the guidance of a healthcare professional. The combined usage is not FDA-approved for any specific condition.

• Pharmacological Classification: DHEA can be classified as an endogenous hormone precursor/androgen. Folic acid is classified as a water-soluble vitamin, specifically a B vitamin.

• Mechanism of Action: DHEA acts as a precursor to androgens and estrogens, influencing various physiological processes, including sexual function, mood, and bone health. Folic acid is essential for DNA synthesis, cell division, and red blood cell production.

Alternate Names

• Dehydroepiandrosterone (DHEA): prasterone
• Folic Acid: folate, vitamin B9, pteroylmonoglutamic acid
• There are various brand names under which DHEA and folic acid, alone or in combination, are marketed.

How It Works

• Pharmacodynamics (DHEA): DHEA is converted in the body to androgens and estrogens, influencing a wide range of physiological processes. Its effects depend on individual hormone levels and conversion rates.
• Pharmacokinetics (DHEA): DHEA is readily absorbed orally. It’s metabolized in the liver and other tissues. Elimination occurs primarily through the kidneys.
• Pharmacodynamics (Folic Acid): Folic acid is converted to its active form, tetrahydrofolic acid, which is essential for one-carbon transfer reactions in various metabolic pathways.
• Pharmacokinetics (Folic Acid): Folic acid is well-absorbed from the gastrointestinal tract. It’s metabolized in the liver and excreted primarily in the urine.
• Specific receptor binding, enzyme inhibition, or neurotransmitter modulation details are complex and depend on the downstream metabolites of DHEA.

Dosage

Dosing of this combination isn’t standardized. Dosages are usually based on individual components.

Standard Dosage

Adults (DHEA): DHEA dosage varies widely depending on the condition being treated, typically ranging from 25 mg to 450 mg daily, sometimes divided into multiple doses.

Adults (Folic Acid): For preventing neural tube defects, 400 mcg daily. For treating folic acid deficiency anemia, doses can range up to 5 mg daily.

Children: DHEA is generally not recommended for children. Folic acid dosage for children depends on age and health status.

Special Cases: DHEA dosage should be carefully considered and adjusted in elderly patients and those with renal or hepatic impairment. Folic acid dosage may need adjustment in patients with renal impairment.

Clinical Use Cases

The combination of DHEA and folic acid is not typically used in clinical settings such as intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.

Dosage Adjustments

Dose adjustments for both DHEA and folic acid may be necessary based on individual patient factors, including renal or hepatic dysfunction and other health conditions.

Side Effects

Common Side Effects (DHEA): Acne, oily skin, hirsutism, hair loss, deepened voice, increased aggression, insomnia.

Rare but Serious Side Effects (DHEA): Liver damage, changes in cholesterol levels, increased risk of hormone-sensitive cancers.

Common Side Effects (Folic Acid): Generally well-tolerated, but high doses can cause abdominal discomfort, nausea, and flatulence.

Rare but Serious Side Effects (Folic Acid): Allergic reactions (rash, itching, swelling). Masking of vitamin B12 deficiency.

Contraindications

DHEA: Hormone-sensitive cancers (breast, prostate, ovarian), severe liver disease, pregnancy, breastfeeding.

Folic Acid: Hypersensitivity to folic acid. Untreated vitamin B12 deficiency.

Drug Interactions

DHEA: May interact with insulin, anticoagulants, anticonvulsants, and other medications metabolized by the liver.

Folic Acid: May interact with certain anticonvulsants and medications used to treat cancer or rheumatoid arthritis.

Pregnancy and Breastfeeding

DHEA is contraindicated during pregnancy and breastfeeding. Folic acid is recommended during pregnancy for neural tube defect prevention. Its safety during breastfeeding is generally considered good.

Drug Profile Summary

See above sections.

Popular Combinations

DHEA is sometimes combined with other hormones in bioidentical hormone replacement therapy. Folic acid is often included in prenatal vitamins along with other essential nutrients. The combination of DHEA and folic acid itself is not a commonly used or recommended practice.

Precautions

See above sections.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Dehydroepiandrosterone + Folic Acid?

A: There’s no officially recommended combined dosage. Dosage needs to be evaluated based on individual deficiencies and clinical considerations for each component.

Q2: Can DHEA be taken during pregnancy?

A: No, DHEA is contraindicated during pregnancy.

Q3: What are the common side effects of DHEA?

A: Acne, oily skin, hirsutism, and changes in mood.

Q4: How does folic acid help during pregnancy?

A: It’s crucial for preventing neural tube defects in the developing fetus.

Q5: Who should not take DHEA?

A: Individuals with hormone-sensitive cancers, severe liver disease, or those who are pregnant or breastfeeding.

Q6: What is the role of folic acid in the body?

A: Essential for DNA synthesis, cell division, and red blood cell production.

Q7: Can DHEA improve athletic performance?

A: While some athletes use DHEA hoping to enhance performance, there’s limited scientific evidence to support its efficacy and it’s prohibited by many sports organizations.

Q8: Are there any long-term risks associated with DHEA use?

A: Potential long-term risks of high-dose or prolonged DHEA use may include liver damage and increased risk of some cancers. More research is needed in this area.

Q9: How does folic acid interact with other medications?

A: Folic acid may interact with certain anticonvulsants, methotrexate, and some other medications.