PREGNENOLONE, LC/MS

Pregnenolone is a precursor to many critical steroid hormones in our bodies including:

• Progesterone
• DHEA
• Corticosteroids
• Estrogens
• Androgens (male hormones such as testosterone)

Pregnenolone as a supplement:

Pregnenolone can be valuable as an alternative treatment for improving memory and alertness, while reducing stress, depression and fatigue. Although the current research is inconclusive there are also claims that the hormone helps to prevent cancer, obesity, arthritis, multiple sclerosis, premenstrual syndrome and menopause. Pregnenolone levels decline more than 60% as we age. Chemically modified or synthetic pregnenolone supplements are taken to counteract some of the typical signs of aging and increase the levels of DHEA and other steroid hormones, including testosterone, in the body. High levels can cause adverse side effects such as aggression, irritability, insomnia, and the growth of body or facial hair in women. Pregnant women should not take pregnenolone.

Pregnenolone and congenital adrenal hyperplasia (CAH)

High pregnenolone levels may be caused by an inherited condition called congenital adrenal hyperplasia (CAH). CAH causes a deficiency or dysfunction in the enzymes required to convert pregnenolone into steroid hormones. This can cause a deficiency of cortisol and an overabundance of male hormones or androgens. The pregnenolone test is often used in suspected cases of CAH for infants whose external sex organs are not clearly defined or for teens who do not develop secondary sexual characteristics or who has delayed puberty. If there is an enzyme deficiency in the steroid hormone process the levels of pregnenolone may be elevated. This can help to determine which enzyme is deficient or defective.

What is congenital adrenal hyperplasia (CAH)?

CAH is a group of inherited disorders associated with deficiencies in the enzymes required for the production of the steroid hormones.

In congenital adrenal hyperplasia, one or more of the enzymes is deficient or dysfunctional and inadequate amounts of one or more final products are produced.

With CAH, the enzyme deficiency can cause a decrease in cortisol and/or aldosterone and, in some cases, an increase or decrease in androgens. Deficient androgens can cause male newborns to be born with external sex organs that are not clearly male or female (ambiguous genitalia) and can affect the development of secondary sexual characteristics of both males and females at puberty.

What are the causes of CAH?

Congenital adrenal hyperplasia (CAH) is caused by inherited defects in steroid biosynthesis. The resulting hormone imbalances can lead to life-threatening, salt-wasting crisis in the newborn period and incorrect gender assignment of virilized females.

What are the various Pregnenolone reference values?

CHILDREN

Males

• 0-6 years: not established
• 7-9 years: <206 ng/dL
• 10-12 years: <152 ng/dL
• 13-15 years: 18-197 ng/dL
• 16-17 years: 17-228 ng/dL

Tanner Stages

• Stage I: <157 ng/dL
• Stage II: <144 ng/dL
• Stage III: <215 ng/dL
• Stage IV-V: 19-201 ng/dL

Females

• 0-6 years: not established
• 7-9 years: <151 ng/dL
• 10-12 years: 19-220 ng/dL
• 13-15 years: 22-210 ng/dL
• 16-17 years: 22-229 ng/dL

Tanner Stages

• Stage I: <172 ng/dL
• Stage II: 22-229 ng/dL
• Stage III: 34-215 ng/dL
• Stage IV-V: 26-235 ng/dL

ADULTS

or =18 years: 33-248 ng/dL

References:

• https://www.ncbi.nlm.nih.gov/pubmed/26433186
• https://www.ncbi.nlm.nih.gov/pubmed/25030803
• https://www.ncbi.nlm.nih.gov/pubmed/12918023
• https://www.ncbi.nlm.nih.gov/pubmed/8395958 
• https://www.ncbi.nlm.nih.gov/pubmed/20070787
• https://www.ncbi.nlm.nih.gov/pubmed/20493557 
• https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.12150 
• https://www.ncbi.nlm.nih.gov/pubmed/20493557 
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008321