DHEA supplement benefits and side effects, dosage, danger,
how much to take
Role in hormone replacement therapy and libido boost for a man and woman
November 11 2017 by Ray Sahelian, M.D., author of DHEA: A Practical Guide, Mind Boosters, and Natural Sex Boosters
You MUST read this article regarding DHEA side effects, risks and danger before you buy a supplement
Do not buy dosages more than 10 mg per pill
is a hormone made by the adrenal glands located just above the kidneys.
Scientists have known about it since 1934 but it became available to the public
without a prescription in 1995, shortly thereafter pregnenolone became available. More than 150 hormones are made by the adrenal glands.
However, the most abundant is DHEA. Humans are thought to make between 10 and 15
mg a day. These numbers are lower in women by about 10 to 20 %. After it is made
by these glands it goes into the bloodstream and from then on it travels all
over the body and goes into our cells where it is converted into male hormones,
known as androgens, and female hormones, known as estrogens. Small amounts are also made in
the brain by neurons (brain cells). Many doctors prescribe this hormone supplement to their patients in
high dosages without realizing the risks and dangers it can cause.
I do not feel comfortable with the high dosages of DHEA, pregnenolone and 7-keto DHEA supplements sold over the counter. They are most commonly sold as 10, 25, 50 and even 100 mg per capsule or tablet. I think a maximum of 5 mg is acceptable when used occasionally. Hormones are powerful substances. They can be very helpful if used appropriately but can cause harm if misused.
Buy DHEA supplement 5 mg per each pill - Purity and potency guaranteed
DO NOT EXCEED more than 5 mg a day on a long term basis. Blood and saliva testing are not reliable ways to determine how much DHEA you should take because blood levels do not give a clear view on how this hormone is interacting within cells in the brain, skin, hair, liver, breast, prostate, and other tissues and organs. You may consider other non-hormonal options to improve your health. For instance, for sexual health and libido improvement, consider a popular and effective male and female herbal sexual enhancement product such as Passion Rx yohimbe. For mental health, there are various brain supplements including Mind Power Rx. To improve muscle tissue, consider creatine powder. For more energy and a sense of wellbeing, try MultiVit Rx or the natural antidepressants 5HTP, St. John's wort or SAM-e. If there are no other good options, and if you really do need to take a DHEA supplement, use the smallest amount that works in order to prevent unpleasant reactions. Take frequent breaks which I call 'hormone holidays.'
Buy DHEA supplement or subscribe for Free to a newsletter on the topics of natural hormone therapy benefits and risks
Alternatives to DHEA pills:
Passion Rx with Yohimbe for enhanced sexuality in men and women
Eyesight Rx for improved visual acuity, day and night vision, works within hours or days
Mind Power Rx for better mental focus
Diet Rx for appetite suppression
MultiVit Rx for more energy all day long
Joint Power Rx for healthy joints as we age
Prostate Power Rx for a healthy prostate gland
|Serving Size: 1 capsule|
|Amount per capsule||% Daily Value|
|DHEA (dehydroepiandrosterone)||5 mg||*|
|* Daily Value not established.|
DO NOT TRUST ANYONE - no matter what his or her credentials - including professors at academic centers - Who says a DHEA supplement is safe in high doses when taken for prolonged periods.
How to boost sexuality in men and women without hormones
or pharmaceutical ED medications
This natural libido enhancer provides results that are commonly are noticed within 2 or 3 days. This blend of many herbal extracts improves libido and sexual thoughts, erectile function, orgasms, climaxes and stamina. The potent herbal extracts in in this all natural herbal sexual enhancer include ashwagandha, catuaba, choline, cnidium, horny goat weed herb, maca, muira puama, passion flower, rhodiola, tongkat ali, tribulus extract and yohimbe bark. Passion Rx does not have DHEA, pregnenolone, testosterone, androstenedione, progesterone, or other hormones.
and medical uses, who can be helped?
Before puberty blood DHEA levels both in males and females is very low. However it rapidly increases at puberty and starting in late 20s or early 30s levels begin to decrease with age.
A DHEA supplement may benefit those who have adrenal deficiency and low levels. The benefit from a supplement (in men and women who are deficient) include improved sense of wellbeing, more alertness and stamina, and enhanced sexual interest and libido. Blood levels of all the steroid hormones that derive from DHEA metabolism are often increased when people take this hormone pill. This may lead to both beneficial and harmful effects. The overall benefit from a supplement must be balanced against potential side effects. Mid to late fifties is the time that some people start noticing benefits from taking this hormone. Others may never need to use hormone replacement therapy.
DHEA side effects,
Review of safety and adverse events,
concerns with safety
Individuals with normal levels of this hormone in their bloodstream who take high doses are likely get DHEA side effects. Some of these effects can linger several days after stopping the hormone, but much depends on the dosage used, a person's unique metabolism, and how long the product has been taken.
Email received in 2016:
Dear Dr. Sahelian, I wish I read and followed all of your warnings regarding dhea many years ago. I was a bodybuilder and yoga instructor and I am experiencing many health problem which I believe are related to too much dhea in addition to other supplements. I'm upset that I did not take dhea more seriously.
Adverse effects of DHEA supplementation include:
Acne and pimples
Acne can occur due to increase levels of androgens. There are those who are very prone to acne eruptions and they could have pimples develop within a day or two. I know others who have taken this androgen hormone for months and years without any skin problems.
Blood pressure elevation
Some users have reported hypertension with use.
I started taking DHEA about 2 months ago at 20 mg per day. On Christmas day my blood pressure shot up higher than it has ever been at 177/80. However, that was nothing compared to what happened 2 weeks ago when I woke up at 4 am with a headache and a blood pressure of 226/99, which has been the peak. My blood pressure is now averaging 175/80. Before this all happened it was averaging 135/70. I am a 71 year old male.
Email - My friend is 42 and took DHEA 25mg for about 2 months. Her breasts have started to swell painfully. She already needs a bigger bra size.
Cancer, tumor formation
High dosing for prolonged periods - many years - could theoretically increase the risk for certain cancers such as breast cancer and prostate cancer. It is well-known that excess exposure to many types of hormones, such as androgens, progesterone and estrogens, increases the risk for certain types of cancer.
Hair loss side effects, thinning hair is a
concern in men and women, hair falling out
Any androgenic steroid, such as DHEA, testosterone and androstenedione can cause the side effect of hair loss or thinning in susceptible individuals. DHEA is likely to raise levels of testosterone and dihydrotestosterone (DHT) in the hair follicles. Too much DHT will lead to hair loss. The temporary (2 to 3 month) use of finasteride [Propecia 1 mg or Proscar 5 mg] could stop the hair loss and possibly regrow part or all of the loss. It is difficult to predict how long a person would need to take finasteride. Even if DHEA supplementation does not significantly increase levels of testosterone in the bloodstream, it is still quite possible, and perhaps likely, that it enters hair follicles, and is converted to testosterone, and on to DHT locally, thus contributing to hair loss. The study of hormones is called endocrinology, and there is increasing attention to the study of hormones inside tissues and cells. This is called intracrinology.
I took some DHEA for 2
weeks at 25mg. I am a 31 year old female. My period has become
scant and early and my hair is thinning rapidly. I have already stopped it. I find I can almost control it with curcumin, soy, saw palmetto,
evening primrose oil, NAC and taurine. Is it possible that the hair will
continue to fall out even after cessation of supplementation?
In all likelihood the hair loss should stop after cessation of the hormone supplement. It is difficult to know how long the process will take to reverse.
A doctor prescribed 25 mg daily of DHEA for my wife. She stopped taking it after 3 months when her menstrual cycle became irregular. Her hair is also coming out. If we had researched it better ahead of time she would never have agreed to take it.
My hair loss has recovered. I felt it important to share with your female readers that I did recover completely from DHEA induced hair loss. I am a woman who began taking 50mg at 35yrs of age. I took it for approx. one year. Within 24 hours of stopping I experienced withdrawal symptoms just like those of withdrawal from benzodiazepines. These severe symptoms lasted 6 months, tapered at a year, and were not completely gone for 2 years. It has now been 5 years and I am finally feeling good again, and yes...my hair is fine as well.
I started taking 25 mg DHEA in the interest of increasing the usefulness of my workouts/runs, increase my libido (which was waning). I was 41 when I was taking it (I am 43 now). The hormone addition did contribute to my workouts and a further decrease in BMI. I felt great. My libido had increased. My arms were cut -- but then they began getting veiny, like a male body builder's. My breasts shrunk, and my hair started falling out. Panic. I stopped taking it when my hair started coming out. Over time, things went back to "closer to normal."
I was given DHEA supplement for about 5 months from my doctor. Since I started taking it the first couple weeks were great, then I started losing hair, having mild acne, depression, fatigue, pms, not sleeping well, etc... I asked if I should be taken off, she said yes because my levels were high -- 321, I'm 34 year old female.
Heart rhythm problems,
cardiac arrhythmias, palpitations, PVCs
High dosages of pregnenolone and DHEA, generally more than 10 mg, cause heart palpitations and irregular beats in some users. In some people this can occur on dosages as low as 5 mg whereas others may take 25 mg or more to notice an arrhythmia. I believe that the highest dose of these hormones sold over the counter should be no more than 5 or 10 mg, even though they are often available at 10, 25, 50, and even at 100 mg. These hormones are much more powerful that people realize. Just because they are available over the counter does not mean they have been proven to be completely safe. The Oct 10, 1998 issue of the respected medical journal Annals of Internal Medicine published my letter to the editor regarding DHEA and cardiac arrhythmias. It was the first time such an association was made and published. See Ann Intern Med. 1998 Oct 1;129(7):588. Dehydroepiandrosterone and cardiac arrhythmia. Sahelian R, Borken S. Case Reports - Letter. The case report mentioned heart palpitations that occurred in Dr. Borken who was taking 25 mg of DHEA supplement daily. When he stopped the hormone supplement, the palpitations went away, when he resumed the supplement, the palpitations recurred. Heart rhythm almost always returns to normal after the supplement is stopped.
Testosterone replacement therapy is now known to increase the risk for heart attacks and it is possible the same could occur with high dose use of other androgenic hormones.
Here are examples of DHEA and pregnenolone cardiac side effects and testimonials we have received by email:
I have been taking DHEA 30mg daily for 5 years. 2 years ago i developed heart palpitations. Then i became angry, easily agitated, sleep problems appeared. 2 weeks ago i ordered pregnenolone 25mg, and adrenal cortex 250mg, wanting to address the adrenal exhaustion problem. On the 5th day of taking the new tablets, plus usual DHEA, i developed extreme dizziness, on 6th day was rushed to hospital by ambulance, placed in cardiac intensive care. ECG showed erratic heart rhythms, they thought my electrolytes were out of whack, and said the electrics of my heart was irregular. I have never had high blood pressure, always good cholesterol levels, not overweight, generally very healthy - they were confused because tests all came out normal, and said my symptoms were not typical. After reading your web sight, i now know the pregnenolone tablets were the straw that broke the camel's back. I am going to take plenty of hormone holidays. I am a 56 year old female from Australia.
I have been diagnosed with PVCs via several stress tests and Holter monitor. While they are uncomfortable, they are not bad enough to warrant medication. However, I started taking DHEA about 10 months ago because I read that it helped female libido. I am a 52-year-old female. It did seem to help, but then I gradually began to notice that my PVCs were much worse. It didn't dawn on me that it could be anything I was taking until I ran out of DHEA. I noticed almost immediately that my heart didn't flutter when I climbed the stairs.
I wrote to you a few months back regarding the heart flutters I thought were caused my my intake of 25mg of dhea daily. Once I stopped taking DHEA the flutters stopped within a matter of days! However, I have noticed since I have not been taking DHEA my all over well being is not as great and my libido has all but disappeared.
I had been taking 50mg of DHEA 4 days a week. A week or so prior to my episode of severe palpitations, I had felt neck and chest pains and discomfort during activity and during rest. I had felt my heart rate faster than the usual. The week after, I traveled to Northern VA to see my wife. We decided to go to the mall, and that night I started to feel as if I was going to faint, I felt I could not breathe properly, chest pains, shortness of breath, and numbness in my tip of my nose and toes. The worst feeling EVER! I was rushed to the Virginia Hospital Center where they ran every test possible and fortunately they found nothing wrong except my heart rate at rest was between 110 and 120. But BP was borderline. The ER attending doctor could not explain this horrific experience and therefore, prescribed 2mg of Ativan to relax me. Thereafter I saw my primary care physician who continue to treat me with Ativan. As stated, he was under the impression I had anxiety. After 8 months of this mystery, I finally have discovered that I have developed PVCs shown by my event monitor. I have now conquered the Ativan withdrawals and my PVCs have disappeared. I believe that DHEA caused this arrhythmia and the withdrawal from the Ativan also permitted for my palpitations. Please note that before this incident, I had been a competitive powerlifter who has always been in shape and who has eaten extremely well.
I have mitral valve prolapse and have been having major heart palpitations for the past few weeks. I thought my valve was going to need replaced. My doctor told me to discontinue caffeine products. The palpitations came on suddenly and could not have been from drinking caffeine. About 4 weeks ago my mother had recommended me to take DHEA because I was complaining to her about my low sex drive. I went to Wal-Mart and bought DHEA 50 mg that day. Since then I have been extremely moody, my hair has been coming out more easily than before, my eyes feel like they are about to explode from increased pressure, and I have frequent palpitations. I came across your website and I now know what has been wrong with me. I am discontinuing the pill TODAY and I will be calling my doctor to let him know about my findings. Maybe I can help him with future patients. I am so grateful that you put this information out there!
I'm a MD in the field of neurology and psychiatry in Amsterdam, Holland. I have been taking it for about one year now, in the dosage of 50 mg/day. Since a few weeks I was having complaints of palpitations which after examination appeared to be caused by supraventricular extrasystoles, 1-3 per minute, going on for about 3 weeks.
I am 56 year old physician assistant and can easily monitor blood levels in our office. I checked my DHEA sulfate in the morning and found them to be very low at 35 ng/dl. I began supplementation at 25 mg and found a marked improvement in my energy. Levels increased to 198. I increase the dose to 50 mg/day and found an even larger increase in energy and levels at 268. However, the 50 mgs caused marked insomnia, increased tachycardia and multiple PVCs.
Insomnia, sleep problems
I am 53 years male and due to low testosterone and dheas (check by blood test), I start taking 25 mg good quality supplement at night time, I had to change it to the morning, because it was causing me insomnia. Now after 3 years on and off taking it (taking only twice a week), I feel moody, low energy, blurry vision, the only benefit that I can see from it, losing some belly fat.
Intraocular pressure, glaucoma
Have you heard of DHEA causing high IOP (intraocular pressure) or possibly temporary glaucoma. I have been taking DHEA for about a year. I like the benefits it has provided both physically and mentally. However my last flight physical for the military showed me having high IOP in both eyes. Two days after I stopped taking DHEA my pressures where back to normal.
I have not heard of this side effect yet, and I have not seen it mentioned in the medical literature, however it is a possibility to consider. There's a lot we don't know about the long term effects of DHEA. If your IOP is increased again after restarting the DHEA and then returns to normal after stopping, then that would make it quite likely that in your case it was involved.
Menopause, vaginal dryness, female issues
Low dose DHEA at 10 mg could help reduce some menopausal symptoms and improve sex life. Climacteric, December 2011.
Regarding DHEA tablets for use as a vaginal suppository? I used a 10 mg tablet vaginally but think it is too strong as I am starting to get acne. I am using it to reverse vaginal dryness and vaginal atrophy (shrinking and loss of elasticity), as well as low libido. It has eliminated the libido and dryness problems. I have only been using it for 3 weeks. I am 68 years old.
Mental effects, mood changes, anger, restlessness,
Irritability and restlessness - sometimes low doses can actually help induce calmness but high amounts could induce jitteriness and anxiety with a panic feeling. Some people get angry, impatient and assertive.
I am a 50 year old man and on more than two occasions I have taken 25 mg DHEA over the period of a few weeks. At first I was happy with the results of increased libido, good workouts, but little by little I started to get more and more aggressive and very short tempered, In fact everything started to piss me off and then my back started to break out. So when I ran out It was some time before I started to use It again and the same results happened.
I am generally sensitive but recently started DHEA 12mg daily. I developed menstrual irregularities.
I currently take 15 mg for approximately 3 weeks and stop once the onset of my menstrual cycle appears. I have found that if I take the DHEA during my menstrual cycle I will continue to bleed for up to a week. I am 50 years old now and my periods have begun to subside significantly. Although I continue to have regular periods they are much lighter. It is clear though that taking the hormone will produce heavier periods and longer duration.
Pregnancy, women who are pregnant
I've been taking DHEA 25mg for almost 6 months now with no obvious negative side effects, possibly its contributed to a slightly quicker temper. I've just discovered that I'm pregnant. Should a woman supplementing at 25mg, who becomes pregnant, immediately stop it or would a lower dose of 5mg per day for a while be better?
I don't feel comfortable prescribing it to a woman who is pregnant at any dose.
I am a 47 year old male. I went to a vitamin store and it was suggested that I take DHEA to increase my testosterone which I was told would help increase my metabolism. I took one 20 mg capsule the first day and when I woke up the next morning my scalp and body skin were itchy. Not realizing these were side effects I took another 20 mg capsule and within one hour I was sweating heavily, my heart was racing, and I was very dizzy. And my scalp is more itchy than before. So these symptoms occurred within 24 hours.
Increased sweat odor is possible.
If you have been taking DHEA in high dosages for a long time and you wish to stop, it may be a good idea to lower the dosage over several days or weeks rather than stopping it cold in order to avoid potential withdrawal symptoms.
Your site is just about the only space on the internet where the pros and cons of DHEA are honestly discussed. I am a 27 year old healthy male. While physically healthy, I've struggled with mood and confidence problems. Running helps. I run around 7 miles almost every day. But running can only go so far. So, about 8 months ago I decided to give DHEA a try. I don't know why, exactly. I made a B in my college Chemistry course, and I know next to nothing about human anatomy, endocrinology, etc... I just saw it on the grocery store shelf, read a little online, found out it was a precursor to testosterone (which is makes men manly, right?), and read that some studies have indicated it's effective in fighting depression. Anyway, I've been taking 25 mg daily, more or less, for 8 months. Man, you wouldn't believe the enthusiasm I developed for distance running. I felt zippier than ever. I steadily increased my distance and pace, culminating in two half marathons. Personality wise, I felt more assertive than ever. I seemed less plagued by self-doubt, regret, and social anxiety. In short, I had a positive experience with the supplement for quite a while. Then, about a month ago, 7 months after starting the DHEA regimen, I started getting random heart flutters or palpitations. They wouldn't last very long, just a second or two. Some days I wouldn't have any. Some days I'd have two or three. I quit cold turkey about 2 weeks ago. Soon after I quit, my body utterly rebelled. I started getting lower back pain, right around the kidneys, which I associated with the adrenal glands (but I don't really know). My mood dropped off a cliff. Energy levels plummeted. This past weekend I was sleeping around 12 hours out of every 24. After a two day rest, I went out for what was supposed to be a long run, but after 4 miles I just couldn't go any farther. As I was walking back to my car my legs seized up in violent cramps; I had to painfully limp back to my car. The cramps lasted for hours. Since then the cramps have stopped and the back pain has lessened, and I do feel like I'm returning to some kind of stasis; but I had to go through a sort of purgatory. I will never take that stuff again. The idea that withdrawing a non-nutritive chemical from daily ingestion could cause me to feel like that--well, it's repulsive and nasty. I think there's an important message that just doesn't get across to the average consumer. This stuff is serious. It's for real. This isn't a multivitamin. If you must take it, be careful! Personally, I don't think this stuff should be sold OTC. I think there should be a doctor between the pills and the consumer.
I'm a premenopausal 45 yr old woman and
just thought Id let you know that early on even when I bought 25 mg 6 yrs ago I
only took 12 mg daily because I just didnt like the way I felt taking 25 mg. Ive
had very good success with it 12mg. I had gone through an adrenal ordeal after a
nervous breakdown of sorts and my Dr only noted afterward that my testosterone
levels were almost non existent, but just insisted that I go on an anti
depressant! I felt like I would die! No energy, very depressed and NO libido at
all! Well Thank God I found an online site that spoke of the need for DHEA
supplementation among other things and I have been so much better since Ive
started taking it daily! It must be the right dose for me cause Ive noticed no
hair loss, acne, irritability or anything but I recently ran out, (I live in
Canada and cannot buy it over the counter here like there in the US) Since I ran
out Ive been achy and weak, tired easier, sleep not as well at night, NO libido
and my legs ache so much at night! Im glad to read about the man on your site
who had similar withdrawal side effects after going off DHEA! Another weird
thing...when I ran out I started experiencing hot flashes like crazy! Could the
DHEA have been maybe masking the effects of menopause? I will go back on it
again...maybe its not for everyone but low doses for me are the answer...just
for the record it has really helped me!
It is possible that it could be masking the symptoms of menopause.
What do you think of testing for blood or saliva DHEA
Unless your doctor suspects you have a serious medical condition due to low levels of hormones, I do not recommend you get a routine blood test. Sometimes more harm than good is done by such testing and the resulting inappropriate treatment. There is no reason to test if you have mild fatigue or other mild symptoms.
It is very difficult to determine the appropriate dosage of DHEA supplements based on testing. At this point I do not recommend blood or saliva DHEA testing unless there is a strong medical suspicion that your severe symptoms are due to low hormone levels. The interpretation of DHEA saliva testing is difficult and different labs may have different ways of testing DHEA making interpretation even more complicated (and test levels could easily vary throughout the day). Even a difference of two or three hours can lead to marked variations. For instance, if your blood test one day was at 9 am and a couple of months later you had it done at 11 am, the circadian blood level changes that normally occur throughout the day can give you a different number. If you really want to know your levels in a more consistent manner, have a test at about the same time, for instance 9 am, each time, or early afternoon at 2 pm each time. Pregnenolone and DHEA levels normally peak around 6 to 9 am in the morning and are at their lowest around midnight.
I do not see the reason to test for DHEA levels if the hormone supplement is used occasionally. If a person plans to use it as hormone replacement in low doses, such as 1 to 3 mg, again I do not see the need to test for the levels.
One reason why I am not a proponent of testing is that there are no accepted standards of how much to take, if any, based on a testing. If you show a particular blood level to 20 doctors, you are likely to get 20 different responses on what the dosage supplementation should be since there are no accepted guidelines on how much to supplement based on a given blood level.
Hormone testing is overdone and should be limited to cases where there are clear clinical indications that a hormone deficiency or excess is present. Most people who want to begin androgen replacement therapy just for overall enhancement don't need to have a blood test done if thy only plan to take 1 or 2 mg a day. In those cases where hormone level testing has been done due to suspicion of potential endocrine problems, if the DHEA level is very low, then it may mean that the patient would benefit taking 5 to 10 mg. However these cases are infrequent compared to the vast majority of those who want to take a supplement in low amounts for believed (rightly or wrongly) health enhancement.
My blood test revealed a very low DHEA level. I am a 50 year old female dealing with the onset of menopause. I began taking 25 mg tablets two months ago. I gradually began developing symptoms, especially acne and increased facial and body hair. Finally, I realized the cause and stopped taking it last week.
As a postmenopausal woman, I took DHEA cream
in a combo formula with pregnenolone for a month and then monitored the results with a saliva
test. I was as surprised as could be to find out DHEA rose to maximum for me but did not
convert at all into estradiol nor testosterone.
I would like to know, in your experience, whether different forms of DHEA -- cream, pills, sublinguals, etc --
metabolize differently and give different results.
When taking hormone supplements it is very difficult to know exactly what is happening in the tissues of the body. Blood or saliva tests may not show conversions that go on when DHEA enters a particular tissue, for instance skin, breast, brain, etc, and converts there to other hormones. I find blood and saliva tests of limited value. Hormone replacement is a very difficult and complex issue with no clear answers. If I can make any generalizations they would be to use the lowest effective dose, err on the side of taking less not more, and to take breaks from use. Different forms of ingestion, pills, cream, injection, sublinguals, etc. metabolize differently.
What is its role in the human body?
DHEA is converted in the body to androgens (such as testosterone) and estrogens, thus influencing practically every organ and tissue in the body, including the brain. However, the physiological role of this hormone has been studied for over three decades and still eludes final clarification. What we know is that DHEA is secreted by the adrenal cortex, and it exerts its action either indirectly in peripheral tissues after its conversion to androgens and estrogens, or directly as a neurosteroid through the interaction with neuronal receptors. Pregnenolone converts into DHEA and progesterone. DHEA does not convert into progesterone, rather it converts into estrogen and testosterone.
Where does it come from? How
is it made?
DHEA supplements are made commercially from a plant of the Dioscorea family [wild yams] found in abundance in Mexico. Extracts of this plant contain a steroidal saponin called diosgenin which may be converted in a laboratory by a series of 6 to 8 chemical reactions into DHEA. In the human body, this hormone is made from cholesterol. A few years ago I purchased a dozen DHEA products on the market and sent them to a laboratory to be tested. They all were accurate and true to their label.
Do supplements suppress the adrenal gland's natural
The production of many hormones is controlled by a "feedback loop," which means that when hormone levels get too high, the body is told to make less, and when hormone levels are too low, the body is told to make more. Cortisol, testosterone, and estrogen are all regulated by this feedback. In other words, if a person takes cortisol, or a similar derivative such as prednisone, it will shut off the body's natural production. DHEA appears to be one of the exceptions. There doesn't seem to be a feedback mechanism. In other words, DHEA supplements are not likely to stop the body's own production.
Research and feedback from users indicate the following potential benefits:
Arlt W, Callies F, Allolio B. DHEA replacement in women with adrenal insufficiency--pharmacokinetics, bioconversion and clinical effects on well-being, sexuality and cognition. Endocr Res. 2000 Nov.
May help reverse bone loss and some of the emotional disturbances associated with anorexia nervosa.
I have a daughter and very good friend who suffer from severe asthma. In and out of hospitals, regularly. Seven years ago my friend began taking 25 - 50mg of DHEA for other reasons. We were discussing an asthma attack my daughter had just encountered when my friend said she had not had one for seven years. She had just mentioned taking DHEA for seven years. I suggested that my daughter take the supplement. Her hospitalizations and use of a nebulizer have subsided. She only needs a nebulizer treatment when she gets a severe cold. I recommended the supplement to three other asthmatics and they have had the same results.
DHEA in this case may be acting as a steroid hormone similar to cortisol. I'm not so comfortable using it for this purpose for prolonged periods.
Athletic benefit, strength, body metabolism
I am an 18 year old "extreme" athlete. I recently started taking 100 mg DHEA in the mornings along with a well balanced diet. In just three days I had noticed a huge difference in my aggression and strength. Out of all of the supplements I have taken, DHEA shows significant results... fast!! Everybody says don't do it because you're so young, but with results this good I don't see why I should stop.
There are short term benefits to taking large doses of DHEA which you have noticed, but sooner or later side effects will appear, such as thinning of hair, or acne, or potentially more serious medical problems.
J Clin Endocrinol Metab. 2013. Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo-controlled trials. The present meta-analysis of intervention studies shows that DHEA supplementation in elderly men can induce a small but significant positive effect on body composition that is strictly dependent on DHEA conversion into its bioactive metabolites such as androgens or estrogens.
Crohn's disease treatment
In a small study, it was found to be beneficial in patients with Crohn's disease and ulcerative colitis. Andus T, et al. Patients with refractory Crohn's disease or ulcerative colitis respond to dehydroepiandrosterone: a pilot study. Aliment Pharmacol Ther. 2003 Feb.
Eyesight and vision
I am just starting to experiment with DHEA trying 25 mg a day. I noticed right away that my vision and colors had become noticeably clearer and brighter. Is this a good indication that a person is lacking it in the body?
A. DHEA and pregnenolone can sometimes enhance color perception and vision, however this does not mean you are lacking in the hormones. The visual improvement would likely occur even in individuals who have normal levels but perhaps slightly more so in someone who is deficient.
This hormone supplement may be a popular choice for people with fibromyalgia, but it is unlikely to be helpful. Fibromyalgia is a syndrome marked by widespread aches and pains, fatigue and sleep problems, among other symptoms. There are no medications specifically approved for the condition. Instead, medical treatment usually involves a combination of approaches, such as painkillers, antidepressants and exercise therapy. DHEA at 50 mg a day for 3 months was given to 52 women, mostly in their 50s and 60s, who had been diagnosed with fibromyalgia. Overall, the women reported no clear improvement in pain, fatigue, depression and anxiety, and physical and mental function -- with either the supplement or the placebo. Journal of Rheumatology, July 5, 2005.
The administration of DHEA in patients with advanced HIV infection results in improved mental function Piketty C, et al. Double-blind placebo-controlled trial of oral DHEA in patients with advanced HIV disease. Clin Endocrinol (Oxf). 2001.
Hormone replacement therapy
I have been using an estradiol patch for several years. Recently I began taking 5 mg a day of DHEA. I feel very good on this, more energetic, better mood and more focused in thinking. I am wondering if I should see about decreasing the estradiol dose since I gather DHEA supplies some estrogen as it breaks down. Is there any way to estimate how much estrogen 5 mg DHEA as a capsule supplies?
It's difficult to estimate the conversion into estrogen since every person has a different metabolism. I do think the dose of estrogen should be reduced when adding DHEA. How much to reduce is difficult to know but it's better to err on the side of taking less than more.
Will DHEA interfere with my regular dosage of hormone
replacement therapy with Premarin and progestin?
Yes, it is converted to both estrogen and testosterone and your dose of estrogen and progesterone may need to be reduced if your doctor plans to add it.
It is an effective addition to the conventional treatment of those who suffer from hypopituitarism, a condition in which the pituitary gland fails to secrete a variety of pituitary hormones into the circulation.
Is there any data or studies out that show that liver damage can result from DHEA usage?
Some studies in rodents and fish have shown large doses (equivalent by weight in humans to a few hundred mg per day) causes harm to the liver. It is extremely unlikely that 5 mg a day causes liver damage.
May be helpful in women with lupus (systemic lupus erythematosus) although adverse effects may limit its use. Chang DM, et al. Dehydroepiandrosterone treatment of women with mild-to-moderate systemic lupus erythematosus: a multicenter randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2002 Nov.
Osteoporosis, thinning bones
DHEA is helpful in older men and women with osteoporosis.
Prostate gland influence,
Pharmacokinetics of dehydroepiandrosterone and its metabolites after long-term daily oral administration to healthy young men.
Acacio BD, Stanczyk FZ, Mullin P et al. Fertil Steril. 20044.
Fourteen healthy men, ages 18-42 years. Daily oral administration of placebo, 50 mg or 200 mg DHEA for 6 months. Quantification of DHEA, DHEA sulfate, androstenedione, T, dihydrotestosterone (DHT), and 5alpha-androstane-3alpha-17beta-diol glucuronide (ADG). Physical examination, semen analysis, serum LH, FSH, prostate-specific antigen, and general chemistries were done. Baseline DHEAS, and ADG levels increased significantly from day 1 to months 3 and 6 in the treatment groups but not in the placebo group. Clinical parameters were not affected. Although the pharmacokinetics and its metabolites are not altered, sustained baseline elevation of ADG, a distal DHT metabolite, raises concerns about the potential negative impact of DHEA supplementation on the prostate gland.
Can it cause difficulty urinating?
Thus far we have not heard of difficulty urinating being related to the use of this hormone but it is possible if it causes an enlarged prostate.
I am a nutritionist in suburbs of
Philadelphia. I have CFS for 5 years. I am happy to see in your writings and books that
you take a conservative approach to dosage of natural hormones. I am 59 and have
prostatitis for 1 year. I keep it under control with many of the latest
nutrients for prostate. My doctor prescribed 50mg and my psa shot up to 4 from
2.5. I stopped it and now it is down to 2.5 again. My latest results on
saliva testing show normal DHEA, estradiol and testosterone, but results from another lab
show below normal DHEA.
There's still much to be learned about interpreting results from saliva and blood tests as it relates to DHEA levels. Unless you are clearly and significantly deficient, it is better you not take or take a very small amount.
Why would dhea cause an
increase danger or prostate enlargement and hair loss if in fact testosterone levels
decline in aging males and increase the probability of these conditions occurring anyway.
This is a very good question and I don't have all the answers. Different tissues in the body including hair, skin, prostate, brain, have different levels of enzymes that convert different steroid hormones and the decline or shift in these enzymes varies within different tissues and among different individuals.
Have you heard of it slowing down psoriasis or psoriatic arthritis? If so, would there be any interactions with methotrexate or indomethacin?
A 1995 study found lower DHEA levels in those with psoriasis. (Clin Exp Rheumatol 1995 May-Jun.) I suspect, though, if DHEA is helpful, it is only a minor part in the overall therapy of psoriasis. I am not aware of any studies evaluating its interaction with methotrexate and indomethacin.
According to limited studies, DHEA provides, at most, only a slight added benefit when given to patients with rheumatoid arthritis. Rheum Dis Clin North Am 2000 May.
Sexual enhancement, increase
drive and libido
Libido enhancement and improved erectile function can occur in a man or woman, but caution is advised.
effects on sexual arousal in postmenopausal women.
J Womens Health Gend Based Med. 2002 March. Hackbert L, Heiman JR. University of Washington, Seattle, USA.
Sixteen sexually functional postmenopausal women participated in a randomized, double-blind, crossover protocol in which oral administration of 300 mg or placebo occurred 60 minutes before the presentation of an erotic video segment. The concentration of DHEAS increased 2-5-fold following administration in all 16 women. Subjective ratings showed significantly greater mental and physical sexual arousal to the erotic video.
DHEA has totally ruined my life. Yes, at first it gave me energy, the reason I started taking it, and it did actually give me a feeling of well-being. However, after about a year I began to lose good judgment, became too sexual for my own good or anyone else's for that matter, had a total personality change, became aggressive, and fearless. No one, including my doctor, suspected that these were due to it. The results ruined my marriage and other people's lives, caused me to lose my good reputation, all of my assets, my business, and my health. I have been on psychiatric medicines ever since not really knowing what was wrong, have relocated to another town in shame and guilt and continue to go through life in survival mode. Some watched in amazement as I turned before their very eyes into someone they didn't know at all.
What explains the fact that DHEA can initially
cause increased libido, but then that effect wears off in a couple of weeks?
This may happen in some people. I am not sure why, there could be some feedback loop that suppresses some hormone release, hence occasional use of DHEA for libido enhancement is preferable.
I am 74 years old and writing from Paris, France. After reading about DHEA in your book, I had a friend from the USA send a parcel of DHEA 10 mg, 300 capsules. I took one every day for 6 months and thanks to you I feel very well and I'm in a good mood. The most important phenomena are the increasing libido feelings. Unfortunately my dear wife doesn't participate any more and I am alone but the feeling is good. I want to send you all my gratitude and faithful thanks.
I am 44 and a testicular cancer survivor (back when I was 33). About the time I turned 43, my libido declined like a light switch had been turned off. I am using 25 mg DHEA supplements but I am using a pill cutter to split them into 4 roughly 6 mg pieces. I started taking them and the next day my libido surged back and the response has been consistently strong and immediate when I take them. My good mood returns after a couple days of taking the DHEA supplements.
Skin health in the elderly
J Steroid Biochem Mol Biol. 2017. Potential prevention by oral DHEA of superficial tears in elderly atrophic skin. Oral DHEA improves skin hydration and sebum production as well as bone mineral density in older patients while limiting progression of their skin atrophy. Topical DHEA cream stimulates local collagen production. Trials should be undertaken to examine their potential for preventing tears in fragile aging skin.
I started taking DHEA at 25mg. After just two days I had a presumed heart flutter that last just a second or two where I wasn't sure exactly what it was. A second heart flutter occurred a day later that lasted about 15 seconds and felt like a large butterfly with rather strong wings fluttering in my upper chest. No dizziness or lightheadedness. I do seem to feel quite a bit better and rather hate to stop, but don't want to compromise my heart health either! I am a 44 year old female and take 125mg of Unithroid for last 3 years but otherwise am healthy.
Q. You recommend no more than 5 mg. Is it safe to use a hydration suppository (13 mg DHEA) for vaginal dryness?
A. I have not seen studies regarding how much is absorbed from the vagina, but I suspect most would be and hence I do not think it would be safe to use it at these dosages for prolonged periods.
What about medical consultation?
Even though vitamins, herbs, and certain hormones, are available over-the-counter, it is advisable that consumers discuss with their health care provider any supplements they are taking. Unfortunately, many physicians are not familiar with the benefits and risks of supplements and consumers are often left on their own to find reliable information regarding natural supplements.
Does misuse cause death or severe harm?
Thus far, even though DHEA has been sold over-the-counter since the mid 1990s, and hundreds of thousands of individuals, or perhaps more, are estimated to have taken it, there have not been any reports in the medical literature indicating that DHEA has caused fatalities. But I have come across one email from an older gentleman whose wife died of heart rhythm problems after a few months of taking more than 50 mg daily of DHEA and pregnenolone.
Summary and bottom line, final review
DHEA is made from cholesterol and is a natural hormone that has been available over-the- counter since the mid 1990s. No fatalities have been recorded in the medical literature regarding the use of this hormone by the general public. There is little justification for DHEA supplementation in healthy elderly subjects, except perhaps in tiny doses of 1 or 2 mg, perhaps up to 5 mg in some people. Thus far studies have failed to prove for beneficial effects of DHEA on muscle function, bone metabolism or cognition. However, more research with DHEA may provide the answers we currently lack. There is a lot of information regarding hormone, nutrition, medicine, and health matters on the internet, and it is up to consumers to decide which website's information they trust. It would certainly be safer if there were times when one stops taking these hormones. You could call this 'cycling' or I call it taking 'hormone holidays.' There are many ways to do this. You could take these hormones every other day, five days on, two days off, take them for a week and off a week or take them for three weeks and off a week.
The dosage needs to be individualized to each person's needs. This is based on regular evaluations of a basic physical exam, including blood pressure, heart rate, examination of hair and skin, evaluation of routine blood studies, and monitoring of mood, sleep patterns, energy levels, and motivation. Women need to have regular breast exams and Pap tests. Men need to have their prostate exam. Although blood or saliva DHEA levels are important to monitor, in the end, the important point to keep in mind is what kind of influence DHEA or other hormones are having on our brain, organs and tissues. It's possible that taking too much of these hormones could actually shorten lifespan. DHEA and pregnenolone are not like vitamin C. More is not necessarily better. There's a smaller range to play with. I get uncomfortable when I hear of doctors prescribing 25 or 50 mg a day to their patients.
In my opinion, based on its reported benefits, side effects, and safety profile, I believe
its important that the public should continue to have access to it as a dietary
supplement. However it is recommended that consumers discuss with their health care
provider before undertaking any regular use of this hormone. It is also recommended that
the natural health industry itself put forward that dietary supplement companies
voluntarily sell and recommend only low dosages of this hormone, such as 5 mg.
Since 5 mg pills of DHEA are difficult to find, those who plan to take this hormone under medical supervision could open a capsule of 25 mg and take only a small portion, or take a portion of a tablet. Since DHEA can increase alertness, morning use is best; although each individual is unique and some prefer mid-day or even bedtime dosing. Bedtime dose should be very low in order not to disturb sleep.
Is DHEA the only adrenal hormone?
More than 150 hormones are known to be synthesized by the adrenal glands. However, the most abundant hormone made by the adrenal glands is DHEA. After DHEA is made by these glands it goes into the bloodstream, and from then on it travels all over the body and goes into our cells, where it is converted into male hormones, known as androgens, or female hormones, known as estrogens. Whether DHEA gets converted predominantly into androgens or estrogens depends on a person's medical condition, age, genetics, and sex. Every person has a unique biochemistry. In males the testicles also make androgens, while in females, before menopause, the ovaries also make estrogens. So the body has developed at least two organs where sex steroids are made. After menopause, the ovaries no longer make estrogens.
Will natural yam extract pills increase my DHEA levels?
Most of the DHEA sold now in vitamin stores or through mail order firms is produced in a laboratory from diosgenin. However, some vitamin companies do sell extracts of wild yams in pill form, without first processing it into DHEA. Some even promote these yam-extract products as "DHEA precursor complexes."
DHEA is made commercially from a plant of the dioscorea family [wild yams] found in abundance in Mexico. Extracts of this plant contain a steroidal saponin called diosgenin which may be converted in a laboratory by a series of 6 to 8 chemical reactions into DHEA. A comparable series of reactions is not known to exist in nature and certainly not in humans. Consequently it is highly unlikely, perhaps impossible is a better word, that the ingestion of extracts of the dioscorea plant will lead to the formation, by metabolic transformation of the relevant plant constituent, to either pregnenolone or DHEA.
Herbs, vitamins, supplements to increase levels of
Q. I wonder how one can increase DHEA naturally with herbal and natural methods, without hormones. I read that maybe tribulus terrestris can, or tongkat ali, or fenugreek. I wonder if you know herbs and other ways to raise DHEA naturally.
A. I am not aware of any studies that indicate the specific use of vitamins, herbs, or other supplements lead to a consistent rise in levels over prolonged periods. The best way to balance DHEA levels is to eat healthy, exercise moderately, lead a low stress life, and to sleep deep each night.
Cause of high DHEA levels
Very high levels may be caused by Cushing's disease or syndrome, an overproduction in the adrenal glands or the ovaries. Women with PCOS could have high levels. However, most of the time, an isolated high level on a blood or saliva test may not be significant and it is worthwhile to have the levels tested in a few weeks since levels fluctuate and a one time reading of a high DHEA may not mean anything. Also, it is important, before any therapy is initiated, to have a repeat test by another laboratory since the measurement of this hormone can vary between different labs. Body hair growth, acne, menstrual changes, etc. are some of the consequences of excess DHEA. If a person has a high level but no other symptoms, I do not seen any reason to treat. I prefer treating the whole person, not an isolated blood study result.
I recommend a medical evaluation to find out why this is happening, sometimes a tumor or cysts can be the cause of this excessive production. Steps can be taken to resolve this problem if the source of the overproduction is found. I'm not aware of any natural supplements that lower levels. Perhaps weight loss can decrease the levels of this hormone in some individuals.
Use with natural supplements
at the same time
I live in Italy and my doctor prescribe me 20 mg alternated 3 days a week with pregnenolone 25 mg. I'm 41 yo. My doctor suggest me to take some anti-aromatase supplement like chrysin. But i reed that chrysin is a fake promise: it has anti-aromatase effect. So suggest to my doctor that i can take DIM (with Bioperine). He said ok. I am not sure and before to begin a hormonal therapy I'd like to the right thing: which anti-aromatase can i take? I'm your fan.
I am not aware of any research that indicate the use of chrysin or DIM supplements can counter some of the side effects of these hormones. I think your doctor may benefit from reading the cautions that I discuss regarding the use and dosage of these hormones.
My husband has just had some saliva tests done which showed his DHEA level to be very high (88ng/ml compared with a norm for his age (53) of 3-10). He is not taking a DHEA supplement. He has many of the symptoms of high DHEA - acne, palpitations etc. Are there any known risks with a high natural level?
First, I am not convinced saliva tests for DHEA are completely accurate since different labs may have different ways of doing them, and I suspect saliva levels may not reflect accurately levels in various cells in the body where it really counts. Second, there are other causes for acne and heart rhythm irregularities, not just DHEA. If it is true that someone has high levels of androgens, it is possible that over time this could increase the risk for androgen sensitive tumors such as prostate cancer or other problems like hair loss or enlarged prostate. Before accepting these high levels to be true, it would be best to have the DHEA level tested by another health care provider at another lab, and this time by blood. And then repeat the blood study a couple of more times over a period of several weeks or months.
I cringe when I see/hear people taking 50-100mg and even more per day. Even at 5 mg DHEA, it can trigger a very aggressive / explosive feeling in me that I don't like. Verbal, not physical. I lose my temper very easy even on 5mg dhea. It's almost embarrassing to me going through this. Temper can be awful. Every time I come off it, that temper subsides within 2-3 days, completely gone within a week. I think everyone should be aware of this. DHEA can ruin lives if people do not understand it. There is alot of good with DHEA but there are drawbacks, some major, as stated above. Two other potential drawbacks for me (and others). DHEA actually seems to be addicting. I have now started / stopped DHEA for 8 periods (being on for a few weeks each time). Each time I start out swearing I'll only take 5mg every other day and by the end of the month, I'll be taking 5-10mg each day, one time even going up to 30mg a day. I also have a hard time stopping it even knowing it's building up and my moods are going haywire. I've often read about the mood elevation of DHEA. BUT, I notice it's not steady (for me). I can go up and down, sometimes way down, quite often when taking this hormone supplement. Again, I've read this from others also. I think we need to be fair/realistic when touting any med or supplement. Bottom line: There can be major drawbacks / side effects when taking even small doses of DHEA
first started taking it my libido was better then great. Now its seems to have disappeared
to the point of like when you are on an antidepressant. I am 50.
Perhaps there is a feedback loop that somehow decreases the sex boosting effect of dhea. It's just a guess.
Q. I have taken two separate saliva tests to check my DHEA level --
both before and after starting daily supplementation -- and found it to be low both times.
The two different labs I used both advise to collect the saliva samples in the morning
prior to the next usage. The normal ranges of DHEA levels for different age
groups on the back of the test results reflect levels found 8-12 hours after
last usage. I take my DHEA supplement in the morning. Should they be taken at
night if one is to take a morning saliva test, and, if so, how long does one
need to supplement at night prior to taking a morning saliva test in order to
get an accurate reading.
A. The whole issue of DHEA testing, accuracy of lab results, interpretation of results, and clinical significance of these results is still a murky issue with no definitive guidelines or medical consensus. Blood or saliva levels don't completely tell us what's going on inside cells and how much of these hormones are in the cells and tissues of hair, skin, brain, liver, other organs, etc. Since there are a number of unanswered questions medicine still has to resolve, the best approach is to take low doses of DHEA (if you plan to take it at all) and not put an overemphasis on saliva or blood testing. It's quite likely that if you take a DHEA pill in the morning, unless it is a very high dose, it would be practically out of your system by next morning when you are having your saliva test. If you take the DHEA the night before, even a few hours difference on the timing could make a difference in your saliva levels. Basically, for the time being, blood or saliva levels of DHEA are a way to know if you are deficient, and help give a clue as to whether or not to take the hormone.
You may also wish to reevaluate why you are taking DHEA in the first place. Are there other non-hormone supplements that could help you achieve your desired goals (energy, mood, sex drive, vitality, memory, etc.) and would have fewer side effects? Perhaps you could take some of these supplements and thus lower your dose of DHEA. In chapter 2 of Mind Boosters (an engine alone does not run a car) I mention that it is better to use a few different supplements together in small dosages as opposed to one or two in higher amounts.
I took 25 mg of dhea for 3 weeks. I found myself getting irritable and had fluttering in the chest. I stopped taking the hormone supplement, and within a week i began alot of strange symptoms: anxiousness, perspiration, clamminess about the neck, and extremities, panic attacks, tingling out the head and both arms. What is the half-life of supplementation once halted, and are there any known side-effects associated with cessation of the hormone?
The half life of DHEA is less than a day. It likely caused the irritability and fluttering of the chest, but I'm not eager to blame it for your symptoms that started a week later. I do recommend a medical evaluation to rule out a cardiac or other condition that accounted for your symptoms. I believe 25 mg is a high dose. I am often criticized by some individuals in the vitamin industry for my low dosage recommendations for hormones and supplements, and your case of fluttering in the chest (which I have come across often) confirms my position on keeping my dosage recommendations on the low side.
I am a 40 yearl old female; extremely healthy all my life. My mother experienced menopause at 40, shortly after having me. Now it seems it is my turn! Never being sick in my life, I new something must be awry with my hormones. I am currently undergoing bio-identical hormone pellet therapy from a M.D. team and I am satisfied so far because a complete blood work up revealed my levels were all in the lower 1-5% of the desired 'bell curve'. I've felt the first relief in nearly two years. Anyway, my doctors have also suggested I take their DHEA and pregnenolone for certain reasons. I know the former causes me to feel anxious to outright aggressive and mean; in even doses as low a 5mg. I've asked to avoid taking it, but they strongly encouraged me to at least take the pregnenolone to help keep my very low progesterone levels elevated as well as for brain-support and breast-cancer preventative measures. Dosage 25 mg /day 3 x week. I am also on oral progesterone up to 200 mg/day as well as the creams from Life-Flo. Earlier I had read your website about the cautions regarding dosage, and when I learned pregnenolone can also convert into DHEA, I immediately did not want to take it.
There are doctors who prescribe high dosages of these hormones without realizing the risks they pose.
I am glad that you say to use only 5 mg. You've probably seen that WebMD recommends 25-50 mg for many things. I guess they are thinking in terms of drugs.
Acute dehydroepiandrosterone effects on sexual arousal in postmenopausal women. J Womens Health Gend Based Med. 2002.
The effect of dehydroepiandrosterone on recognition memory decision processes and discrimination in postmenopausal women. Psychon Bull Rev. 2003.
Low dose DHEA affects behavior in hypopituitary androgen-deficient women: a placebo-controlled trial. J Clin Endocrinol Metab. 2002.
Replacement of DHEA in adrenal failure: no benefit for subjective health status and sexuality in a 9-month, randomized, parallel group clinical trial. J Clin Endocrinol Metab. 2003.
Other products online:
Enzymatic Therapy, Youthful You, DHEA, 5 mg, 60 Veggie Caps
Life Extension, DHEA, 25 mg, 100 Dissolve in Mouth Tablets - only use a small portion of a tablet.