Extremly High Levels of DHEA

[LisaCurry]

I have been having real extreme anxiety attacks for the past few years that has me home bound. I am a 27 year old female. My chiropractor gave me a neurotransmitter test to see my levels. Almost all my levels are out of the norm. Because of my anxiety I can't leave my house to get clarification on the results. My DHEA level was 1717.3 pg/ml where the norm should be between 200-400. Estradiol was 3.6 norm is 0.5-5.0 pg/ml. Estrone was 3.5 norm is 0.5-3.5 pg/ml. Progesterone 0.133 norm is <0.100. Testosterone was 41.8 norm is 15-35. Cortisol was 14.4 at 8 AM norm is 7.0-10, at 11:15 AM was 2.7 norm is 3.0-6.0, at 5:15 PM it was 1.9 norm is 2.0-4.0, and at 10 PM it was 1.5 where norm is <1.5. Norepinephrine was 30.5 norm is 35-50. Serotonin was 101.8 norm is 150-200. 5-H1AA was 1860.2 norm is 3,500-6,000. Glycine was 197.1 norm is 200-400. Can someone please explain this to me. I need to know if any of these results can be whats causing my anxiety problem. Can someone tell me what needs to be done? Thanks.

[Jeffrey Junig MD PhD]

A couple things... first, there is no connection between levels of the chemicals you are describing and 'neurotransmitter levels'. I'm not sure where the sample was taken... blood? Urine? Spinal fluid? Brain tissue? Hopefully not the latter! I suspect you are talking about blood levels-- urine levels would be even more worthless, although blood levels alone are worthless. It is not difficult for any cell in the body to make many of the substances that you listed; some are specifically from gonadal tissue (testes or ovaries), and some from the adrenal gland, and some from pretty much everywhere (glycine). Some of these compounds have dual functions, including a role as neurotransmitter in the brain... but getting blood levels tells you absolutely nothing about the brain levels. The 'blood brain barrier' separates the brain fluids from the blood...but that isn't even the issue! You have tons of circulating serotonin, norepinephrine, glycine, etc... but it doesn't even come from the brain--it is made all over the place, particularly the sympathetic ganglia and the adrenal gland.

I have heard the layperson's talk about 'depleting neurotransmitters'- say during addiction, etc... but it is all nonsense. Yes, in Parkinson's there is a depletion of dopamine, not from the inability to make it, but because of the destruction of cells that contain dopamine. And yes, meds that block breakdown of acetylcholine will reduce the progression of Alzheimer's for a few months, but again, this is a case of massive cell death throughout the brain-- nothing at all like the situation in people without that specific disease.

But beyond all of this... we do check levels of some of the chemicals you describe- not to treat psychiatric illness, but for endocrine conditions. But your numbers are all off! Here is a pretty good source for normal lab values: http://www.aids.org/factSheets/120-Normal-Laboratory-Values.html

Note, though that for DHEA for example the results are in the standard format of nanograms per deciliter (ng/dl). Taking your value of 1717 pg/ml and converting it, you get a value of 170 ng/dl, which is in the normal range-- if anything on the low normal side of things. Most of your listed 'normal ranges' are not at all accurate; Testosterone varies by 10-fold or more in normal individuals, for example. And glycine levels have nothing to do with anything!

I fear that you have a chiropractor who has learned something from a course that he took in Arizona-- he learned how to make some extra money by billing for bogus lab tests in trusting individuals! That guy deserves the boot!

[Faye Lang, RN, MSW]

Hello Lisa,

You have had a detailed answer to your question about your abnormal levels of various tests from Dr. Junig. I will add to his response by pointing out that you seem able to go out to see your chiropractor, so there is a way for you to go out for further physical examination to see if there is a specific problem going on. It's not clear where your testing was done, or by whom. However, if those levels are accurate, it is essential that you see a physician - particularly an endocrinologist, if possible. While it's unklikely, we do not want to overlook possible tumors of the pituitary, adrenal or even thyroid glands. Most are benign, but can cause the high level of discomfort that you are experiencing. It's not that anxiety is causing the high levels - it would be more likely that the high levels are causing anxiety. Please see a physician as soon as you can to rule out a major disease.

Faye RN, MSW

[LisaCurry]

Thanks for the replies. I have since seen a physician and it has been determined that the anxiety was caused by the high hormone levels from having a baby. They said it is like post partum, just effects me differently than it can effect others. My baby is now a year old and my levels have dropped quite a bit and I am now having fewer attacks. I do not have them daily like I was and I feel good enough to leave the house during evening times. Mornings are always the worst. I was told that within a few months my levels should be back to normal and I should not have so many or so intense attacks. Thanks again.

[Beverly H.]

There certainly can be medical conditions that cause or contribute to panic attacks or episodes of extreme anxiety. Are you currently taking any medications? If you are taking an antidepressant (SSRI such as Zoloft or Lexapro) your dose may be too high or the medication may need to be changed. Otherwise, an endocrinologist would most likely be your best bet for further analysis of any physical cause for your symptoms. Unfortunately, you say you cannot leave your home due to the anxiety. Perhaps if you were to consult a physician via telephone, you would feel more secure about scheduling an appoinment. Your primary care physician may be willing to prescribe a small amount of anti-anxiety medication that would enable you to make a visit to the doctor, perhaps if you take along a trusted friend. Good luck.

Beverly H.