| Name | Dehydroepiandrosterone (DHEA) and Pregnenolone—typically compounded and used together for hormone optimization and adrenal support. |
| Uses | Elective use in adults experiencing hormone imbalance symptoms such as fatigue, low libido, cognitive decline, or mood changes. Also supports adrenal function. Not indicated for acute adrenal insufficiency or endocrine disorders requiring specialist care. |
| Route Of Administration | Oral capsule or sublingual troche. Topical/transdermal formulations may also be available depending on compounding pharmacy. |
| Frequency Of Use | Once daily; maximum of 1 prescription refill per 3-month interval unless otherwise indicated. Reassess every 3–6 months. |
| Concentration(s) | DHEA: commonly 5–25 mg per capsule; Pregnenolone: commonly 10–50 mg per capsule. Compounded strengths may vary. |
| Maximum Dosage (Day, Wk) | DHEA max: 25 mg/day; Pregnenolone max: 50 mg/day. Weekly max equals daily dose × 7. Begin with lowest effective dose. |
| Contraindications | Absolute: Hormone-sensitive cancers (breast, prostate), active liver disease, seizure disorder (for pregnenolone), pregnancy/lactation. Relative: uncontrolled thyroid disease, psychiatric instability, and polycystic ovarian syndrome (DHEA may worsen acne or hair growth). |
| Possible Side Effects | DHEA: acne, hair growth, irritability, oily skin. Pregnenolone: headaches, anxiety, sleep disturbance. Rare: mood swings, hormone-sensitive tissue stimulation. |
| Compatibility With Other Treatments/Drugs | May be used with estrogen, progesterone, thyroid medications, or adrenal support supplements. Avoid use with high-dose corticosteroids, anabolic steroids, or anti-seizure drugs unless under specialist care. |
| Allergies | Allergic reactions to any base or excipient (e.g., coconut oil, soy). Rare true allergy to DHEA or pregnenolone itself. |
| Administration Time | Oral or sublingual: takes effect within 1–2 weeks. Topical: variable absorption. Consistency is key. Take at the same time daily. |
| Dosing/Settings | DHEA: 5–25 mg daily. Pregnenolone: 10–50 mg daily. Start low and titrate every 1–2 months based on symptom relief and labs. |
| Test Spot Requirement | Not required. For sensitive individuals, consider a reduced initial dose and observe for 48 hours before full regimen. |
| Pre-Treatment Guidelines | Avoid caffeine, alcohol, and other hormone therapies 24 hours before starting. Recommend baseline labs including DHEA-S, pregnenolone, CMP, CBC, and thyroid panel. |
| Provider Clearance Guidelines | Proceed if over 18, low-risk profile, with symptoms suggestive of adrenal or hormone deficiency. Defer if contraindications are found in GFE or medical history. |
| Pre-Treatment Screening Workflow | Confirm no history of cancer, seizures, psychiatric instability, or active liver disease. Check age, symptoms, and recent labs. Defer if unclear or symptoms exceed scope of wellness clinic. |
| What To Do If Adverse Reaction Occurs | 1) Stop treatment. 2) Evaluate airway/breathing. 3) For severe anxiety, insomnia, or mood changes, reduce dose or discontinue. 4) For serious symptoms (e.g., seizure, allergic reaction), call 911. Document in chart and notify medical director. |
| Clinic Implementation Guidelines | Front desk: Ensure intake and consent completed. Provider: Review GFE, history, and labs. Supplies: Medication log, lab checklist. Document dose and rationale. |
| Photographic Documentation Protocol | Not applicable. No photo documentation required for internal hormone therapy unless combined with cosmetic procedures. |
| Post-Treatment Care | Daily administration at the same time. Follow up in 3 months for symptom check and optional labs. Advise on possible transient side effects. |
| Additional Documentation Requirements | Signed informed consent, medication log, GFE exam, lab attestation if applicable. Document all doses, changes, and adverse events in EMR. |