Help determining proper pregnenolone dosage and frequency

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Even though when you see this diagram it only makes sense to infer that supplementing pregnenolone and DHEA may increase testosterone, the fact is that, for that to happen, the enzymes responsible for synthesis of downstream hormones may be affected by several factors.

View attachment 46686

Sex Hormone Cascade from Pregnenolone to Testosterone​

The synthesis of sex hormones, including testosterone, follows a complex cascade starting from cholesterol. Here is a detailed overview of the pathway from pregnenolone to testosterone:

1. Conversion of Cholesterol to Pregnenolone

The process begins in the mitochondria, where cholesterol is converted into pregnenolone by the enzyme cholesterol side-chain cleavage enzyme (CYP11A1). This step is crucial as pregnenolone serves as the precursor for all steroid hormones.

2. Conversion of Pregnenolone to 17α-Hydroxypregnenolone

Pregnenolone is then converted into 17α-hydroxypregnenolone by the enzyme 17α-hydroxylase (CYP17A1). This enzyme is found in the adrenal glands and gonads.

3. Conversion to Dehydroepiandrosterone (DHEA)

The same enzyme, CYP17A1, also possesses 17,20-lyase activity, which converts 17α-hydroxypregnenolone into dehydroepiandrosterone (DHEA).

4. Conversion of DHEA to Androstenedione

DHEA is then converted into androstenedione by the enzyme 3β-hydroxysteroid dehydrogenase (HSD3B2). This conversion is a critical step as androstenedione is a direct precursor to testosterone.

5. Conversion of Androstenedione to Testosterone

Finally, androstenedione is converted into testosterone by the enzyme 17β-hydroxysteroid dehydrogenase type 3 (HSD17B3). This enzyme facilitates the reduction of androstenedione to testosterone, completing the cascade.

Enzymatic Pathway Summary

Step

Substrate

Enzyme

Product

1

Cholesterol

CYP11A1

Pregnenolone

2

Pregnenolone

CYP17A1

17α-Hydroxypregnenolone

3

17α-Hydroxypregnenolone

CYP17A1 (17,20-lyase)

DHEA

4

DHEA

HSD3B2

Androstenedione

5

Androstenedione

HSD17B3

Testosterone


Physiological Significance

This cascade is essential for the production of testosterone, a critical androgen responsible for male sexual development, reproductive function, and various other physiological processes. Disruptions in any step of this pathway can lead to hormonal imbalances and associated health issues.Understanding this pathway is crucial for medical research and treatment strategies involving hormone replacement therapy, fertility treatments, and managing conditions related to hormonal imbalances.

Factors that Affect Downstream Conversion

Several factors can affect the activity of enzymes that convert sex hormones into downstream ones. These factors include:

1. Hormonal Regulation

  • Feedback Mechanisms: Hormones can regulate enzyme activity through feedback loops. For example, high levels of end products like testosterone can inhibit upstream enzymes to maintain balance.
  • Other Hormones: Hormones like follicle-stimulating hormone (FSH) and luteinizing hormone (LH) can activate or inhibit enzymes like aromatase, which converts androgens to estrogens.

2. Genetic Factors

  • Gene Expression: Variations in the genes encoding steroidogenic enzymes can affect their expression levels and activity. Polymorphisms in the CYP17A1 gene, for example, can change how much 17α-hydroxylase is made, which in turn changes pregnenolone into other hormones.
  • Mutations: Mutations in genes like HSD17B3 can lead to deficiencies in enzymes responsible for converting androstenedione to testosterone, resulting in hormonal imbalances.

3. Local Tissue Factors

  • Tissue-Specific Expression: The expression of enzymes like aromatase can vary between tissues, affecting local hormone levels. For example, aromatase is highly expressed in adipose tissue, influencing local estrogen production.
  • Cellular Environment: The redox state, pH, and availability of cofactors (e.g., NADPH) in the cellular environment can influence enzyme activity. For example, oxidative stress can inhibit steroidogenic enzymes by altering the redox balance.

4. Age and Developmental Stage

  • Aging: The efficiency of steroidogenic enzymes can decline with age, affecting hormone production. For instance, aging can reduce the activity of enzymes in Leydig cells, leading to lower testosterone levels.
  • Developmental Changes: Hormone production and enzyme activity can vary during different life stages, such as puberty, pregnancy, and menopause.

5. Environmental Factors

  • Endocrine Disruptors: Exposure to environmental chemicals like bisphenol A (BPA) and phthalates can disrupt the activity of steroidogenic enzymes, leading to altered hormone levels.
  • Diet and Lifestyle: Nutritional status and lifestyle factors such as stress and physical activity can influence hormone production and enzyme activity.

6. Disease States

  • Cancer: Enzymes like 17β-hydroxysteroid dehydrogenases (HSD17B1 and HSD17B2) can change how they are expressed and work in diseases like breast cancer. This can affect hormone levels in the area and the progression of the disease.
  • Metabolic Disorders: Conditions such as obesity and diabetes can affect the activity of steroidogenic enzymes, leading to imbalances in hormone levels.
Understanding these factors is crucial for developing targeted therapies and managing conditions related to hormonal imbalances.
Thank you, Nelson.
 
Defy Medical TRT clinic doctor
Only Preg at 50 mg per night. HCG 500 IU twice per week. TRT 50 mg testosterone enanthate twice per week.

Have you felt a better response from 500 IU versus 250IU? I’ve been doing 250 IU twice weekly for a while but been contemplating going up? Just worried about higher E2.

And do you feel like you’re getting enough DHEA conversion from the Pregnenolone? I would love to just take pregnenolone if I could! I currently take 30 mg Preg and 25 mg DHEA. Unfortunately whenever I start taking Pregnenolone, I feel better emotionally and mentally but then my libido tanks…..

And I’m surprised your Test dose is so low?

What do these doses keep your total and free at?
 
I am up to 100 mg twice per day. Two things I have noticed: deeper sleep and more fluidity in my speech. Watching closely to rule out the "placebo effect" that usually happens when we all start something new.

My pregnenolone on 100mg per day increased from almost undetectable to 95 ng/dL using a sensitive assay. I am hoping 200 mg may double that.

The "normal" range of pregnenolone in men is 10-200 ng/dL.
Were you taking HCG as well? And if so, how much was your dose?
 
Only Preg at 50 mg per night. HCG 500 IU twice per week. TRT 50 mg testosterone enanthate twice per week.
I've just taken 50mg pregnenolone before bed for the first time and actually slept worse. I felt more awake and alert like I wasn't tired, the opposite of what I was hoping to achieve.

Could this just be a symptom of addressing a deficiency for the first time, or is this a typical outcome for some people?
 
I've just taken 50mg pregnenolone before bed for the first time and actually slept worse. I felt more awake and alert like I wasn't tired, the opposite of what I was hoping to achieve.

Could this just be a symptom of addressing a deficiency for the first time, or is this a typical outcome for some people?
It is very difficult to predict anyone's response to any hormone treatment. Have you tried taking it during the day?
 
Beyond Testosterone Book by Nelson Vergel
It is very difficult to predict anyone's response to any hormone treatment. Have you tried taking it during the day?
Not yet, this was my first dose ever on the advice of Defy.

I'm trying to decide whether to try some in the morning today or just stay the course and do what was recommended by my provider.

If it brought on more energy and wakefulness, I'd certainly be interested in that during waking hours.
 
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