Nutritional Endocrinology Practitioner Training (NEPT)
Clinical Pearl

October 8th, 2017

When Testosterone and DHEA Supplementation may  NOT a good idea: Exploring Aromatase and 5-Alpha Reductase

What are your thoughts when a male client tells you that his doctor prescribed testosterone – bio-identical –  because his blood test was low?

Sounds reasonable and pretty harmless , UNLESS…

His aromatase and 5-alpha reductase activity are in excess.

Aromatase converts estrogen to testosterone, and 5-alpha reductase converts testosterone to DHT (di-hydro testosterone), a potent and potentially carcinogenic form of testosterone.

In the presence of excess aromatase, males can become estrogen dominant – putting them at risk of hormonal cancers and moobs.  That’s right, male boobs, common in older men, is often a sign of excess aromatase activity.

I bet you’ll never see those jiggly breasted men at the beach the same again.

DHT elevation can lead to prostate issues.  

So what’s the solution?  Aromatase inhibitors and 5-alpha reductase inhibitors.

There are pharmaceutical versions of both, but there are also natural ones too – herbs, foods adn nutrients.

Here’s a chart i LOVE!  Its from the DUTCH test.  At first glance it might seem overwhelming, but trust me – it will become your friend.  You can pretty much look up any step in the steroid pathways and see what co-factors promote eahc step.  I’ve pointed to aromatase and 5-alpha reductase.

We’ll be going into much more detail about this is an upcoming Mastery module, and we visit it on many lab and case study calls.

Below the picture Iv’e given you a table of aromatase and 5-alpha reductase inhibitors.  There are overlaps.

Happy hormone sleuthing!!

Aromatase Inhibitors	5-alpha Reductase Inhibitors
Nettles Zinc Damiana Grape seed extract EGCG (from green tea) Collards Cacao Isoflavones and  flavonoids Cruciferous vegetables Nuts and seeds Coconut ‘Garlic and onions Herbs such as oregano, thyme, rosemary, sage and turmeric	Nettles Zinc Pygeum Saw palmetto EGCG (from green tea) Progesterone Asthaxanthin Reishi Cactus flower Alkaline diet

 

In addition to the inhibitors, you need to look at factors that increase the activity of these enzymes, most notably excess insulin, anti-fungal medications, alcohol, a variety of medications and excess adipose tissue.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074486/

http://drjockers.com/the-7-best-aromatase-inhibiting-foods-and-herbs/

http://www.greenmedinfo.com/pharmacological-action/5-alpha-reductase-inhibitor

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1502352/