As many of you know I have been doing alot of research and reading about Dhea because I feel Liam needs to have Dhea replacement therapy because he has no capacity to produce it since he has no adrenal cortex.  Dhea is known to be important in skeletal growth, immune response to bacterial infections, pyschological well being, memory and cognative function.

However, the recent posts about surgery, Mary's post below about her son and Aimee's post have caused a light to go on here.  This is pure speculation and just comes from my research, reading and understanding as I see it.

Dhea and therefore androgen production come in three important stages.  Most of you are probably aware that before birth we have a fetal cortex.  During pregnancy the  fetal cortex produces large amonts of Dheas and this is used to produce placental estrogens.  The degree the fetal cortex is overstimulated will then result in the different levels of genital ambiguity.  After birth the fetal cortex shrivels away and the Dheas levels fall off with its disappearence to very low levels.  This is consistant with many stories on the board where parents have said that clitoral reduction seems to take place or kids grow into their genitals.  It seems that the medical community is aware and active at this stage because the problem is visual and can be identified.

The next stage is where my interest lies.  Between 6-8 what has been dubbed andrearche begins.  I think I am correct in summarising this as the cycle of Dhea production throught our lives.  Dheas and other androgen production kick in and begin to rise from 6-8 and this is seen to coincide with skeletal development.  Mary's son and if I remember correctly Carol's son started having problems at around this age.  Is this just a coincidence?

The onset of puberty sees the activation of the hypothalmic-pituatary-gonadal axis take place and the body gets another increase in Dheas, androgens and many other hormones to boot.  If I remember correctly Aimee and other have alluded to problems of control and other changes during teenage years.  This is consistant with recent research that shows that oestrogens and other androgens have a negative affect on cortisol levels.

This may be old news to endo's but from the posts we see there is little evidence of endo's being extra careful at these cross over points which could be the reason for some kids being more difficult to control.  As I said earlier this is just how my brain has digested all this information and I have no idea if it has any validity or value to anyone.  Just a few thoughts that seem to have a link...  I will be interested to see what some of you think because I have been working from the opposite spectrum to you who have CAHyperplasia kids vs Liam and a few others who have CAHypoplasia kids

 

ShaunP.