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Are High DHEA And ACTH Levels Associated With Hashimoto's Disease?

Posted on Wed, 8 Jul 2015

Question: hello, i wanted to know what causes dhea to go up and down. 10 yrs ago, my dhea and acth were highly elevated and docs did all the tests on adrenal glands and everything came back normal, however ten years later and was diagnosed with hashimotos disease and still my dhea levels are high one minute and normal next. havent had acth checked since then but have had cortisol levels checked and also normal. one doc said pcos while others tell me they dont know. im just worried and want some advice on what it could be. ive also just had an mri done and cat Scan and brain looks great. its been 10 yrs and i just dont feel right. coukd this all be from hashimotos? any advice? thank you. also my endo said that i prob had hashimotos.,then but it doesn't show till later stages. thank you

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Reason for hormone tests

Detailed Answer:
Good day,
Noted your concern.
Why was the DHEA and ACTH checked ?
Hashimoto's disease is auto immune thyroid disease and rarely in such patients, they can develop auto immune adrenal gland destruction. In that case, ACTH can go up, but DHEA will come down.

If in the last 10 years, your cortisol is normal, not to bother.
ACTH is produced in the pituitary gland and can go up even in stress.
Infact, there is no need to recheck these if there is no clinical indication.

How are your latest thyroid function tests ? Are you on thyroxine ( thyroid horone) replacement?
How are your periods? Any excess hair growth over body or suggestion of male hormone excess? Doctors often check DHEA when they find a woman with irregular periods and excess body hair or clitoral enlargement/ increased libido.
DHEA is an adrenal and ovarian androgen ( secreted at both places) and excess secretion can cause above mentioned problems.
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (28 minutes later)

they were checked years ago cause of irregular menstral cycles and back then they said i didnt fit the profile for pcos and they did a 24 hour urine test and a stimulating test for the adrenals and those were normal. this last year,ive gained weight with diet and excersise wich ive always been active and then was diagnosed with hashimotos. since ive gotten older periods come every month and sometimes there early and sometimes late but i always something have one. i do get extra hair on chin, and stomach wich upsets me a lot. i pluck a lot. so recently had mri and ct scan to rule out masses and also a whole look at brain and pituitary. have had cortisol checked a couple times and normal but dhea goes up and down. my endo finally thinks its coming from ovaries but just worried that its not cause I've really never been told as to why these levels are up and down. actually had my acth levels checked today again since 10yrs ago. anymore advice would be great and thank you for your time.

Answered by Dr. Binu Parameswaran Pillai (6 hours later)

Brief Answer:
What is the actual DHEA result

Detailed Answer:
Thank you for the reply. I would like to know your DHEA levels. In polycystic ovaries, some times there can be functional ovarian hyperandrogenism ( FAH) and DHEA levels can be high. This can cause further deterioration in ovulation and also may cause hair growth like what you mentioned. You may need to maintain a healthy weight and involve in regular physical activity. That will help . Besides, you may also need to use oral contraceptiive pills to reduce androgen levels.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (17 hours later)

my dhea levels the last time they were checked was 500 and then checked again were normal. they go up and down it seems. i am on synthroid and currently taking 112mg. i believe my tsh was 1.26 the last time was checked but back in XXXXXXX it was 8.6 so finally got it down. i just wanted to know, can hashimotos cause whatevers going on with my dhea? i guess if pcos is confirmed, could the hashimotos be to blame? again thanks for all your advice.

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
DHEA or DHEA-S ?

Detailed Answer:
Uncontrolled hypothyroidism ( due to Hashimotos) can cause secondary PCOS. But your TSH of 1.26 seems perfect.
Are you sure it was DHEA, not DHEA-S which was checked?
DHEA is from ovary and adrenal ( could be from both) where as DHEA-S is from adrenal gland exlusively.

If it is DHEA-S, then 500 is not a big value,. A value above 800 is alarming.

Hashimotos has no direct relationship with DHEA

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (17 hours later)

it was just dhea. i appreciate all the advice and thank you so much for your time. i hope i can feel better soon and get these issues figured out.

Answered by Dr. Binu Parameswaran Pillai (3 hours later)

Brief Answer:
Exercise well, balanced diet and stay healthy

Detailed Answer:
Since your DHEA levels are normal at times ( not constantly elevated), please do not go behind that. Besides, you had all other investigations including MRI and they turned out normal. Endocrine system is complex and it is best not to repeat tests unless it is really clinically indicated.

If your periods are reguar and hair growth is minimal on body, you can use anti androgen measures like Spironolactone or Finasteride. If the periods are irregular and if hairgrowth is excessive, then you may need oral contraceptive pills ( example, XXXXXXX or Diane) for regulating periods and to reduce hair growth. Do not pluck hairs as it will leave scars and ca cause infections. A spa will be able to help you by mechanical hair removal safely.

Discuss with your endocrinologist on next visit. Use thyroid medication daily and keep TSH in normal range. Exercise regularly and be in healthy weight range. In most cases, that alone will be sufficient in regulating your adrenal/ovarian androgens.

REgards
Binu

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar