17 - Ketosteroids Total (FMV urine, menopause)

Higher level of Total 17-Ketosteroids may be associated with:

- DHEA, androstenedione, or testosterone supplementation

- High protein- or high calorie diet

- PCOS (especially with obesity) and/or hirsutism and/or acne

- Low sex-hormone binding globulin (e.g., from hyperinsulinemia or hypothyroidism)

- Aromatase inhibitors

- Congenital adrenal hyperplasia

- Tumors of adrenals, ovaries, or testes

TREATMENT OPTIONS to decrease Total 17-Ketosteroids:

- Improve insulin sensitivity.

- Correct thyroid imbalances.

Lower level of Total 17-Ketosteroids may be associated with:

- Acute or chronic stress (check Total 17-Hydroxy-corticosteroids)

- Aging, DHEA deficiency

- Excessive conversion of androgens to estrogens (see “Aromatase activity” below)

- High estrogen level or estrogen replacement including oral contraceptives (can increase sex-hormone binding globulin, which reduces the amount of bioavailable androgens)

- Smoking, chronic alcohol ingestion

- Diabetes mellitus

- Ketoconazole, metformin, troglitazone

TREATMENT OPTIONS to increase Total 17-Ketosteroids:

- Stress management (see section for Total 17-Hydroxy-corticosteroids)

- Increase dietary protein.

- Address aromatase imbalances.

- Consider supplementation with DHEA (15-100 mg/day) or other androgens.

ANDROGENS such as DHEA, testosterone, and androstenedione tend to be extensively metabolized into downstream androgen compounds. As a result, the levels of testosterone along with “Total 17-ketosteroids” (DHEA plus metabolites) should be used to assess androgen status and/or efficacy of androgen replacement.