THE PREGNENOLONE STEAL

In this article I’m going to discuss a common mechanism that explains how stress can lead to hormonal imbalances and the signs and symptoms that accompany them. First I’ll go through the physiological steps that take place and then explain how this leads to common signs and symptoms of hormonal imbalance. Stick with me.

As you may know, the hormone pregnenolone which is derived from cholesterol is the pre-cursor to many other hormones. That is, it gets converted into other hormones such as progesterone and DHEA, which then further get converted into more downstream hormones. These include the likes of androstenedione, testosterone, estrogens, cortisol, and aldosterone, to name the more commonly spoken of ones.

Whether pregnenolone converts (more so) into progesterone or DHEA will in turn determine how much of the above-mentioned downstream hormones get formed (i.e.: estrogen, testosterone, androstenedione, etc.). When pregnenolone converts into progesterone, that progesterone will eventually convert into androstenedione, cortisol and aldosterone. When pregnenolone converts into DHEA, the DHEA will eventually convert into testosterone and estrogen. Obviously, there can be many complications in these conversions, but that’s beyond the scope of this article. I’m going to focus on one common malady related to these conversions as it relates to stress. Follow this link for a graphic of what I’m referring to about hormone conversions.

A quick review: pregnenolone converts to progesterone and/or DHEA. Progesterone converts to androstenedione, cortisol, and/or aldosterone. And DHEA converts to estrogens and testosterone.

The common malady I’m referring to is known as the “pregnenolone steal”. This occurs when a person is in an acute or chronic stress response. This stress can be coming from inside the body like an infection, faulty digestion, food sensitivities, blood sugar imbalances, toxin overload and more. Or the stress can be from the outside (mental/emotional), such as poor family dynamics, a “bad” relationship, overly-demanding boss, financial woes, traffic, loud noises, hectic schedules, etc..

Whenever stress is present, the body produces the stress hormone cortisol, if it’s capable… This is a normal, healthy response to stress and is necessary for the body to adapt to that stress. The problem arises when stress (of any form) becomes chronic and long-lasting. Because the body uses cortisol to attempt to adapt to this stress, it begins to produce more and more, on a regular basis.

How does the body manage to do this? It does this by preferentially shunting (or “stealing”) pregnenolone towards the production of cortisol. That is, it shunts it towards progesterone instead of DHEA. Additionally, progesterone will then get converted into cortisol at the expense of androstenedione and possibly aldosterone.

So why does this matter and how does it affect your health and overall hormonal balance? Remember, DHEA converts into estrogens and testosterone. If those are spared in order to produce cortisol, you’ll get all the symptoms associated with low estrogen and testosterone. If it’s estrogen that is spared, you may experience hot flashes, depression, irregular periods, PMS and PMDD, pain and inflammation, vaginal dryness, poor memory, poor concentration, weight-gain, hair loss or thinning, and more. If it’s testosterone that gets spared, you may experience a loss of libido, erectile dysfunction, decreased energy, reduced muscle mass, heart disease, increased body fat, depression, lack of drive and motivation, and more.

So how do we unwind this vicious cycle of increased cortisol and decreased estrogen and testosterone production? You can certainly take testosterone and estrogen replacement therapy! Well, that may resolve the signs and symptoms, but usually not for long. And in fact, over the long run, it can eventually exacerbate the signs and symptoms of low testosterone and estrogen due to “wearing out” those hormones’ receptor sites. (To understand that concept better you can follow this link to my most read and commented on article.) Even bio-identical hormones can become a problem and leave you worse off from where you started.

So, the obvious answer is to eliminate or severely reduce the stressor. And remember, that stressor can be something coming from the inside like an infection, food sensitivity reaction, blood sugar imbalance, toxic overload, and/or more. Not all stressors are as obvious as mental/emotional ones. Also, even the internal stressors (like food sensitivities) can go unnoticed and not cause overt symptoms.

Lastly, let’s not forget the complications associated with large amounts of cortisol flooding your body. These include altered and/or decreased immune system function (possibly linked to infections and allergies), collagen loss (think wrinkles), decreased muscle synthesis, increased abdominal fat, bone breakdown, decreased intestinal immunity (possibly leading to GI infections), damage to the lining of the intestines (or leaky gut syndrome), increased stomach acid secretion (think heartburn and ulcers), hippoacampus destruction (leading to problems with circadian rhythm, memory, and causing a feed-forward vicious stress cycle), increased blood pressure, thyroid hormone imbalances, “shutdown” of the reproductive system (possibly leading to miscarriage or infertility), and more.

Remember, however, cortisol is important for normal body function, and you couldn’t live without it. It only becomes a problem when it’s increasingly produced because of a chronic stressor, or a repeated acute stressor.

Additionally, low cortisol is also not normal and not a good situation to find yourself in. That may result from chronic stress that leads to adrenal gland “failure”, and is a topic for another article. Remember, it’s all about balance.

So don’t blame the firemen (cortisol) for being at the burning building (the symptom-ridden body), blame that darn space heater (the stressors) that caused the fire. Well, now that I think of it, don’t blame anything or anyone, that’s a stress in itself.

I hope this information helps you to understand the root of your issues and brings you to hormonal balance.

Dr. Rob D’Aquila – NYC Chiropractor – Diplomate and Board-certified teacher of the International College of Applied Kinesiology