Anti-androgenic Drugs Increase Cortisol And Cause NAFLD

haidut

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I discussed this in my first show with Danny Roddy. Namely, the crucial role the enzyme 5-AR plays in inactivating glucocorticoids and how detrimental it is to inhibit this enzyme with drugs like Finasteride. High PUFA diet also inhibits 5-AR by a magnitude comparable to Finasteride. DHEA is one of the most potent activators of 5-AR, is a glucocorticoid "receptor" antagonist, and is an inhibitor of 11b-HSD1. So, taking DHEA recudes de-novo cortisol synthesis, blocks cortisol's effects and increases cortisol deactivation by enhancing 5-AR activity. Adding to that the nice boost in DHT that taking DHEA causes makes DHEA one of the most important factors in restraining the stress response (and even aging) and its negative effects on health.

http://www.ncbi.nlm.nih.gov/pubmed/25974403

"...Glucocorticoids and androgens have both been implicated in the pathogenesis of nonalcoholic fatty liver disease (NAFLD); androgen deficiency in males, androgen excess in females, and glucocorticoid excess in both sexes are associated with NAFLD. Glucocorticoid and androgen action are regulated at a prereceptor level by the enzyme 5α-reductase type 2 (SRD5A2), which inactivates glucocorticoids to their dihydrometabolites and converts T to DHT. We have therefore explored the role of androgens and glucocorticoids and their metabolism by SRD5A2 upon lipid homeostasis in human hepatocytes. In both primary human hepatocytes and human hepatoma cell lines, glucocorticoids decreased de novo lipogenesis in a dose-dependent manner. Whereas androgen treatment (T and DHT) increased lipogenesis in cell lines and in primary cultures of human hepatocytes from female donors, it was without effect in primary hepatocyte cultures from men. SRD5A2 overexpression reduced the effects of cortisol to suppress lipogenesis and this effect was lost following transfection with an inactive mutant construct. Conversely, pharmacological inhibition using the 5α-reductase inhibitors finasteride and dutasteride augmented cortisol action. We have demonstrated that manipulation of SRD5A2 activity can regulate lipogenesis in human hepatocytes in vitro. This may have significant clinical implications for those patients prescribed 5α-reductase inhibitors, in particular augmenting the actions of glucocorticoids to modulate hepatic lipid flux."
 

Vinero

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Nice find. Ray has also said that androgens block cortisol effects. He said
the heart muscle contains a lot of androgens like testosterone so that the heart is not eaten up/damaged by cortisol during stress.
 
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haidut

haidut

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Vinero said:
post 107625 Nice find. Ray has also said that androgens block cortisol effects. He said
the heart muscle contains a lot of androgens like testosterone so that the heart is not eaten up/damaged by cortisol during stress.

Yep, and I would emphasize boosting DHT even more than T. DHT is actually anti-estrogenic unlike testosterone which can turn into estrogen even more easily then DHEA under the wrong conditions. It would be very interesting to see an analysis of the DHT contents of tissues other than gonads and prostate. I bet in healthy people DHT is high in the brain, heart and liver and in the liver. The study above said 5-AR is highly expressed in the liver where DHT probably protects the liver from both cortisol and estrogen.
 
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tomisonbottom

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I discussed this in my first show with Danny Roddy. Namely, the crucial role the enzyme 5-AR plays in inactivating glucocorticoids and how detrimental it is to inhibit this enzyme with drugs like Finasteride. High PUFA diet also inhibits 5-AR by a magnitude comparable to Finasteride. DHEA is one of the most potent activators of 5-AR, is a glucocorticoid "receptor" antagonist, and is an inhibitor of 11b-HSD1. So, taking DHEA recudes de-novo cortisol synthesis, blocks cortisol's effects and increases cortisol deactivation by enhancing 5-AR activity. Adding to that the nice boost in DHT that taking DHEA causes makes DHEA one of the most important factors in restraining the stress response (and even aging) and its negative effects on health.

5α-Reductase Type 2 Regulates Glucocorticoid Action and Metabolic Phenotype in Human Hepatocytes. - PubMed - NCBI

"...Glucocorticoids and androgens have both been implicated in the pathogenesis of nonalcoholic fatty liver disease (NAFLD); androgen deficiency in males, androgen excess in females, and glucocorticoid excess in both sexes are associated with NAFLD. Glucocorticoid and androgen action are regulated at a prereceptor level by the enzyme 5α-reductase type 2 (SRD5A2), which inactivates glucocorticoids to their dihydrometabolites and converts T to DHT. We have therefore explored the role of androgens and glucocorticoids and their metabolism by SRD5A2 upon lipid homeostasis in human hepatocytes. In both primary human hepatocytes and human hepatoma cell lines, glucocorticoids decreased de novo lipogenesis in a dose-dependent manner. Whereas androgen treatment (T and DHT) increased lipogenesis in cell lines and in primary cultures of human hepatocytes from female donors, it was without effect in primary hepatocyte cultures from men. SRD5A2 overexpression reduced the effects of cortisol to suppress lipogenesis and this effect was lost following transfection with an inactive mutant construct. Conversely, pharmacological inhibition using the 5α-reductase inhibitors finasteride and dutasteride augmented cortisol action. We have demonstrated that manipulation of SRD5A2 activity can regulate lipogenesis in human hepatocytes in vitro. This may have significant clinical implications for those patients prescribed 5α-reductase inhibitors, in particular augmenting the actions of glucocorticoids to modulate hepatic lipid flux."

Do you have thoughts on spironolactone at all?

It is an aldosterone antagonist, and helps you retain potassium so it seems a bit peat friendly in that sense, but some places I have read also said it increases estrogen.
It's also recommended for transgender women, which makes me wary because I believe it's for the purpose of increasing estrogen in that scenario too.

I'm interested in the mechanism, because years ago I took it and it was the first and only time my skin was cleared successfully by anything I'd ever taken before.
I don't have symptoms of excess aldosterone as far as I'm aware, but for some reason it helped me a lot.
 
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