Androsterone and Etiocholanolone are DHEA metabolites via Androstenedione and the 5α- and 5β-reductase pathways. These androgens allow assessment of 5α-reductase activity. Normal metabolites may be a better indicator of androgen status in a patient with low DHEA and/or testosterone.
A higher Androsterone level and low to normal Etiocholanolone level would indicate that the preferred pathway is 5a. The 5a pathway is more androgenic.
Causes of low Androsterone levels:
- Declines as DHEA declines
- adrenal insufficiency
- anorexia nervosa
If Androsterone is elevated and Etiocholanalone is relatively low, the metabolism will tend to favor towards the alpha metabolism pathway. Alpha metabolites are more androgenic and beta metabolites are less androgenic.
When testosterone pushes towards DHT it has to go down the 5-alpha metabolite pathway. This can be the case in a female with, for example, PCOS. In this situation there is typically an insulin issue which pushes towards 5-alpha. When testosterone gets into the cellular space (ex. hair follicle or skin) it will shift towards DHT (via the 5-alpha pathway). DHT happens to be 3-times more potent than testosterone. In these women symptoms of high androgen, such as thinning scalp hair, facial hair growth or acne can often show.
- Androsterone is a DHEA metabolite via the 5α-reductase pathway.
- 5α-metabolism makes androgens more potent, most notably 5α-DHT is the most potent testosterone metabolite.
High levels are often seen in PCOS or over-supplementation.
- Acne, mild.
- decrease or increase in sexual desire or drive.
- hair loss or thinning of hair.
- increase in pubic hair growth.
- infection, pain, redness, or other irritation at site of injection.
- stomach pain.
- trouble in sleeping.
Other causes of high Androsterone levels:
- DHEA, pregnenalone supplementation
- Androgen producing gonadal tumors
- Congenital adrenal hyperplasia
- Adult onset adrenal hyperplasia
- Serious illness/ shock - burns, etc.
If both Androsterone AND Etiocholanolone are high there is most likely too much DHEA producted. If this is the case refer to the "Total DHEA Production" biomarker for more information.
If the metabolic preference is towards that 5-alpha metabolic pathway (Androsterone = high), we can look at the following supplements that are natural 5-alpha blockers. Please discuss any supplement routine with your doctor first:
- saw palmetto
- stinging nettle
- EGCG from green tea
- reishi mushroom
- pygeum africanum
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