Pregnenolone in Men

An important hormone often forgotten in TRT

Pregnenolone is a hormone that is often forgotten in men, but has important roles in neuron function and neuroprotection (affecting memory, cognition, alertness, and mood), is an upstream precursor to testosterone (see graphic), and has regulatory effects on stress/cortisol and inflammation (helpful for symptoms of arthritis). It also helps maintain libido, and can have mild positive effects on lipid levels.

As the below graphic shows, in order to produce *all* of our other steroid hormones, first cholesterol has to be converted to pregnenolone.

From there, pregnenolone is either converted to progesterone or DHEA (either of which can be converted to androstenedione).

Because testosterone replacement therapy (TRT) suppresses LH and FSH (discussed previously in Male Sex Hormones, Part 2), over time some patients on TRT will develop low pregnenolone levels as these pathways are not adequately stimulated.

Because of this, it is reasonable to consider checking a baseline pregnenoline level prior to starting TRT, and then checking levels every 3-6 months after starting/while on TRT.

Symptoms of pregnenolone deficiency