DHEA. See

DHEA. See Dehydroepiandrosterone (DHEA) DHS34 gene, 1272 DHS-like gene (DHSL20), 1272 DHT, 2413... 

Adrenal androgens also have a complex metabolic fate DHEA-S is formed in the adrenal cortex or by sulfokinases in the liver and kidney from DHEA and excreted by the kidney. DHEA and DHEA-S can be metabolized by 7a-and 16a-hydroxylases. 17p-Reduction of both compounds forms A -5-androstenediol and its sulfate. Androstenedione can be metabolized to androsterone after 3a- and 5a-reduction. 5P-Reduction results in the formation of etiocholanolone (see Eigure 51-7). These metabolites are conjugated to glucuronides and sulfates, which are then excreted in the urine. 

Boys with 17fi-hydroxysteroid dehydrogenase deficiency fail to form testosterone from androstenedione, androstenediol fi om DHEA, or estradiol from estrone in a normal manner (see Figure 53-4). At puberty, plasma concentrations of testosterone and DHT are low, and plasma androstenedione and estrone are elevated in those individuals. ... 

Elevated plasma concentrations of 17-hydroxypreg-nenolone, DHEA, and DHEAS are found in patients with 3 -hydroxysteroid dehydrogenase deficiency (see Chapter 51). Plasma concentrations of 17-hydroxyprogesterone may be elevated due to peripheral conversion of 17-hydroxy pregnenolone. The ratio of 17-hydroxypreg-nenolone to 17-hydroxyprogesterone is strikingly elevated in these patients. 

The skin tension is better and the yellow discoloration caused by actinic damage has been reduced. The daily care routine also consists here in Actilift (DMAE cream) and DHEA-Phyto see Chapters 2 and 3 for more information on these two products. When retightening is indicated. Easy Phytic can be applied in a single layer every morning for several days, depending on how the skin reacts. The results are surprisingly quick, and the skin soon tightens visibly (see Chapter 11). 

The wisest patients go to see their doctor before the clinical signs of aging appear and seek advice on how to prevent skin aging. The preventive treatments that might be suggested to these patients are straightforward and superficial procedures that do not disrupt their social lives too much. They may simply be prescribed cosmeceuticals DHEA-Phyto , Actihft (dimethylaminoethanol (DMAE) cream), Renutriv ACE Lipoic Complex (an antioxidant) or Vit E... 

See Chapter 3. DHEA-Phyto cream (in the morning) and Renutriv ACE Lipoic Complex (in the evening) are particularly effective on the hands. 

The adrenal cortex, the zona reticularis in particular, daily secretes substantial amounts of DHEA and DHEAS, equaling or exceeding the amount of cortisol. Table 32-1 shows approximate blood levels of the important corticosteroids. Most of the DHEA and all of the DHEAS come from the adrenals. Negligible amounts of testosterone, dihydrotestosterone (DHT), and estradiol are secreted by the cortex however, DHEA and, to a lesser extent, DHEAS undergo conversion to estradiol in skeletal muscle and adipose tissue they also can be converted to testosterone. The adrenal cortex accounts for about two-thirds of the urinary 17-ketosteroids, which are a measure of androgen production. This steroidogenic versatility makes the adrenal cortex an important factor in certain disease states (see below). 

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