In light of the risks associated with off-label use of hormones and supplements in patients without an established endocrine disorder and the lack of rigorous assessment of the safety and efficacy of dietary supplements, the AACE position statement recommends proper training for physicians to interpret laboratory test results in a more comprehensive way and to provide them with sufficient skills to be able to discuss with their patients the potential risks and benefits associated with off-label use of adrenal supplements. 1 Recommendations for Healthcare Professionals Furthermore, the use of these supplements may delay the diagnosis and treatment of medical issues and can also worsen pre-existing medical conditions. The potential complications of unsupervised and unknown exposure to steroid hormones include development of iatrogenic Cushing syndrome and a risk for adrenal insufficiency if these supplements are discontinued abruptly. However, a systematic review of DHEA supplementation in postmenopausal women did not support an improvement in wellbeing with DHEA supplement use. Supplements containing DHEA are often marketed to support adrenal health and increase energy. 1ĭehydroepiandrosterone (DHEA) is another endogenous precursor steroid that is mainly produced by the adrenal cortex. While there are claims that pregnenolone is an effective anti-aging treatment, there are no studies to support its use for adrenal insufficiency or deficiency. Pregnenolone is an endogenous steroid and precursor in the biosynthesis of steroid hormones, including androgens, estrogens, and glucocorticoids. Authors of a 2018 study that assessed whether 12 dietary supplements marketed for adrenal fatigue or adrenal support contained active hormones reported that pregnenolone was the most common hidden steroid in the samples (42%), followed by budesonide (25%), androstenedione (17%), 17-hydroxyprogesterone (8%), cortisol (8%), and cortisone (8%). Although they are frequently marketed as completely safe and hormone free, many of these supplements do contain unknown amounts of active hormones. Adrenal supplements are used widely to treat patients who self-diagnose adrenal fatigue.
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