Dehydroepiandrosterone + L-Methyl Folate + Vitamin D3

Usage

This combination is primarily prescribed for female infertility, particularly in women undergoing in-vitro fertilization (IVF). It aims to improve ovarian function, egg quality, and pregnancy rates. It may also be used as a nutritional supplement to address deficiencies in these components.

• Pharmacological Classification: This combination includes an endogenous steroid hormone (DHEA), a B vitamin (L-methylfolate), and a fat-soluble vitamin (Vitamin D3). It could be categorized under endocrine agents, vitamin supplements, or fertility agents, depending on the specific use case.

• Mechanism of Action: DHEA acts as a precursor to both estrogen and testosterone, potentially improving ovarian reserve and egg quality. L-methylfolate, the active form of folic acid, is essential for DNA synthesis, cell division, and fetal development, reducing the risk of neural tube defects. Vitamin D3 supports calcium absorption and bone health, and may also play a role in ovarian function and reproductive health.

Alternate Names

There isn’t a universally recognized alternate name for this specific combination. However, the individual components are known by various names:

• Dehydroepiandrosterone (DHEA): Prasterone, androstenolone.
• L-Methylfolate: (6S)-5-methyltetrahydrofolate, 5-MTHF, levomefolic acid, metafolin.
• Vitamin D3: Cholecalciferol.

Brand Names: Examples of brand names include Ovigyn D3, Dheagyn Plus, Coedhea Plus. (Note: Brand names can vary by region.)

How It Works

• Pharmacodynamics: DHEA influences the production of androgens and estrogens, thus impacting reproductive function. L-methylfolate participates in one-carbon metabolism, vital for DNA synthesis, amino acid production, and various metabolic processes. Vitamin D3 regulates calcium and phosphate homeostasis, affecting bone mineralization and potentially reproductive hormone levels.

• Pharmacokinetics:

  • DHEA: Administered orally. Metabolized in the liver and other tissues. Excreted primarily in urine.
  • L-Methylfolate: Administered orally. Converted to other folate forms as needed. Excreted in urine.
  • Vitamin D3: Administered orally. Metabolized in the liver and kidneys to its active form, calcitriol. Excreted in bile and urine.

• Mode of Action: DHEA interacts with steroid hormone receptors, influencing the production of sex hormones. L-methylfolate acts as a cofactor in enzymatic reactions involved in nucleotide synthesis. Vitamin D3 binds to the vitamin D receptor, modulating gene expression related to calcium and phosphate transport.

Dosage

Dosage is highly individualized based on patient needs, the specific product formulation, and medical history. Always consult a physician for personalized dosing instructions.

Standard Dosage

Sources do not provide consistent standard dosage recommendations for this combination. A doctor must determine the appropriate dose on a case-by-case basis.

Adults:

Dosage must be determined and prescribed by a physician.

Children:

This combination is generally not recommended for children without explicit medical direction.

Special Cases:

Dosage adjustments may be required for elderly patients, those with renal or hepatic impairment, and patients with comorbid conditions. A doctor should supervise these adjustments.

Clinical Use Cases

The provided sources do not detail specific dosages for scenarios like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.

Dosage Adjustments

Dose adjustments are based on patient-specific factors, including renal and hepatic function, metabolic disorders, and concomitant medications.

Side Effects

Common Side Effects

Oily skin, acne, hair loss, mood swings, irritability, headaches, fatigue, changes in menstrual cycle, nausea, bloating, flatulence, abdominal cramps, sleep disturbances.

Rare but Serious Side Effects

Allergic reactions, signs of virilization (in women), abnormal liver function tests, changes in blood cholesterol levels.

Long-Term Effects

Increased risk of hormone-sensitive cancers (breast, ovarian, uterine, prostate) with prolonged high-dose DHEA use.

Adverse Drug Reactions (ADR)

Severe allergic reactions, hypercalcemia (with high doses of vitamin D3), worsening of mood disorders (with DHEA).

Contraindications

• Hypersensitivity to any component of the combination.
• Hormone-sensitive cancers (breast, ovarian, uterine, prostate).
• Undiagnosed vaginal bleeding.
• Pregnancy and breastfeeding.

Drug Interactions

• Tamoxifen
• Triazolam
• Antidepressants
• Anticoagulants
• Magnesium oxide
• Lamotrigine
• Medications for hypertension, heart failure, or cholesterol
• Alcohol

Pregnancy and Breastfeeding

Contraindicated. DHEA can affect fetal androgen levels, and components of the combination may be present in breast milk.

Drug Profile Summary

• Mechanism of Action: See “How It Works” section.
• Side Effects: See “Side Effects” section.
• Contraindications: See “Contraindications” section.
• Drug Interactions: See “Drug Interactions” section.
• Pregnancy & Breastfeeding: Contraindicated.
• Dosage: Determined by physician.
• Monitoring Parameters: Hormone levels (androgens, estrogens), blood sugar, cholesterol, liver and kidney function (especially for long-term use).

Popular Combinations

This specific combination itself is commonly prescribed for female infertility. Other medications may be added at the doctor’s discretion based on the patient’s specific needs.

Precautions

• Pre-screening for allergies, hormone-sensitive conditions, liver/kidney disease, and metabolic disorders.
• Monitor patients with diabetes or a history of mental health issues.
• Avoid alcohol.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Dehydroepiandrosterone + L-Methyl Folate + Vitamin D3?

A: There is no universally standard dosage. A healthcare provider must determine the appropriate dose based on individual patient needs and the specific product being used.

Q2: Can this combination be used during pregnancy?

A: No, it’s contraindicated during pregnancy and breastfeeding.

Q3: What are the common side effects?

A: Common side effects may include acne, oily skin, hair changes, mood swings, and gastrointestinal issues.

Q4: Are there any serious side effects?

A: Although rare, serious side effects can occur, including allergic reactions, signs of virilization in women, and liver function abnormalities.

Q5: Does this combination interact with other medications?

A: Yes, it can interact with several medications, including tamoxifen, certain antidepressants, and anticoagulants. Consult a physician about potential interactions.

Q6: Should any specific monitoring be done while taking this combination?

A: Monitoring may include hormone levels, blood sugar, cholesterol, and liver and kidney function, particularly with long-term use.

Q7: What is the primary use of this combination?

A: It’s primarily used to support female fertility, especially in women undergoing IVF.

Q8: Are there any lifestyle recommendations while on this medication?

A: Avoiding alcohol is often advised while taking this medication. Maintain a healthy diet and discuss any other lifestyle modifications with your physician.

Q9: What if I miss a dose?

A: Contact your healthcare provider for guidance on missed doses. Do not double the next dose without consultation.

Q10: Is this combination safe for long-term use?

A: Long-term, high-dose DHEA use is associated with potential risks, such as an increased risk of hormone-sensitive cancers. Therefore, long-term use should be carefully evaluated and monitored by a physician.