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Thyroid Disorders Prevention

The best prototype of primordial prevention of thyroid disease is adequate iodine nutrition for prevention of iodine deficiency, which is the most preventable cause of mental retardation. Approximately 1.6 billion people worldwide are at risk of iodine deficiency disorders (IDD).

Соотношение кортизол/ДГЭА-С


A complex interaction between cortisol and dehydroepiandrosterone-sulphate (DHEA-S) is crucial in the stress system balance. In particular, significantly higher or lower cortisol/DHEA(S) ratios have been associated with depression1 and aggression2. In general, DHEA-S levels affect various body systems, as well as prevent aging (Chahal and Drake 2007). That is why the Cortisol DHEA ratio is a very informational indicator, which, along with other indicators calculated in Healsens, provides important information about human health. Thus, using the ratio of cortisol / DHEA-S, you can assess body responses to exercise or evaluate mental health. Another benefit is that you can check your cortisol and DHEA-S levels at home.

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 4 March 2021.

How Cortisol and DHEA Sulfate Affect the Body

Let’s start by looking at how cortisol and DHEA-S affect overall health. Dehydroepiandrosterone (DHEA) and cortisol are produced in the adrenal glands and are both derived from pregnenolone. So, DHEA and DHEA-S production reaches its peak at the age of 20–30 and then declines progressively with age. When it comes to cortisol levels, while some studies show that cortisol increases with age3, others do not support this observation4. However, everyone agrees that the reduction in DHEA-S entails disruption of various physiological systems.

Stress Level

As mentioned above, DHEA and DHEA-S play a protective role during acute stress as an antagonist to the action of the stress hormone cortisol56. In turn, cortisol also helps to effectively manage stress. Let’s see how this happens.

About 15 minutes after a stressful situation, cortisol levels rise and remain elevated for several hours. This marks the onset of stage 1. During this stage, there are elevations in cortisol with no corresponding changes in DHEA. Subsequently, glucose is mobilized, non-essential organ systems are suppressed, and inflammation is reduced. All of these physiological responses collectively enable the body to effectively cope with stress.

However, in cases of chronic stress, this adaptive reaction can take a catastrophic turn: cortisol loses its ability to function normally. This transition ushers in stage 2. In this latter stage, the persistence of stress leads to a sustained peak in cortisol levels, matched by a corresponding elevation of DHEA.


It becomes increasingly challenging to maintain appropriate blood sugar levels, to allow for adequate rest, to achieve high-quality sleep, and to achieve a harmonious balance among other hormones. This signals the arrival of stage 3, wherein stress persists and becomes chronic. During this stage, cortisol levels decrease, while DHEA remains elevated. In the absence of timely intervention, prolonged adrenal hyperstimulation can result in adrenal exhaustion. This condition is eventually manifested by a decline in both cortisol and DHEA, a phase often denoted as adrenal exhaustion or stage 4. Ultimately, this process may culminate in adrenal failure.

Thus, the optimal ratio between salivary cortisol and DHEA is approximately 5:1 to 6:1, serving as an indicator of a normal state of adaptation to stress7.

When the body’s ability to maintain its normal stress adaptation is compromised, a process known as stress maladjustment can ensue. This phenomenon is now recognized as a chronic stress response, often identified by terms like pregnenolone steal, cortisol escape, or an elevated cortisol to DHEA ratio. The longer one remains in a state of chronic stress, the more pervasive its negative impact becomes on various aspects of physical well-being.

As a result, individuals grappling with depression or heightened anxiety levels (measured at 0.24 ± 0.03 in the healthy group compared to 0.41 ± 0.12 in the group of individuals with severe anxiety)8, along with those dealing with post-traumatic stress disorder, exhibit disruptions in the cortisol to DHEA ratio9. Nevertheless, it’s worth noting that certain studies have demonstrated the potential of DHEA treatment to mitigate the adverse health effects associated with stress.

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Musculoskeletal disorders

We have already mentioned that cortisol dysfunction entails disorders of the musculoskeletal system10. Thus, the higher the cortisol / DHEA-S ratio, the more serious the risk of this problem.

Moreover, multiple regression analysis showed that the independent risk factor for sarcopenia was a serum cortisol/DHEA-S ratio ≥ 0.211. Sarcopenia is a type of muscle loss that occurs with aging and/or immobility.

Immunity and Cortisol DHEA Ratio

In addition, an increase in the cortisol / DHEA-S ratio with age (Phillips et al. 2007) is associated with immune dysfunction and the risk of infection in the elderly due to the fact that DHEA-S enhances immunity. However, cortisol has an inverse immunosuppressive effect (Buford and Willoughby 2005). It is also worth adding that DHEA-S is known for its antioxidant properties12.

Metabolic Syndrome

Various studies have shown that both cortisol and DHEAS are related to metabolic syndrome13, and type 2 diabetes14. While high cortisol concentrations are associated with an increased risk of metabolic syndrome, high DHEA-S levels appear to be protective. By far, the strongest associations were observed for the cortisol / DHEA-S ratio. According to observations, the higher the coefficient, the greater the risk of metabolic syndrome. This ratio is also strongly associated with four of the five components of metabolic syndrome.

Alzheimer’s Disease

The cortisol / DHEA-S ratio may also be crucial in Alzheimer’s disease. For example, some studies have found a link between the cortisol / DHEA-C ratio and a decrease in hippocampal volume15. It is worth saying that a decrease in the volume of the hippocampus is one of the early diagnostic signs of Alzheimer’s disease.

This finding has been confirmed by other studies, observing the relationship between cortisol / DHEA-S and hippocampal atrophy (HA)1617. For example, such a direct relationship was observed in patients with Cushing’s syndrome18. Moreover, HC volume partially recovered following treatment-induced cortisol decrease. However, not all studies support this association within normal cortisol levels in healthy people19.

To sum up, the ratio of cortisol / DHEA sulfate can reflect:

  • psychological health (high level of anxiety, depression, etc.).
  • more favorable hormonal profile which implies higher levels of DHEA sulfate and a lower cortisol / DHEA-S ratio.
  • increased risk of sarcopenia.
  • increased risk of metabolic syndrome and type 2 diabetes.
  • mortality in general, which is strongly associated with the cortisol / DHEA-S ratio

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 4 March 2021.

Assessing Exercises

DHEA (Aldred et al. 2009; Cumming et al. 1986) and DHEA-S (Tremblay et al. 2004) have been shown to increase in response to active exercise. Measuring the ratio of cortisol to DHEA-S can help determine the intensity of physical activity. A higher level of cortisol and/or a lower level of DHEA-S may indicate significant physical stress. This can be valuable information for assessing whether the workout is sufficiently intense or if a lighter approach is needed to prevent overtraining. However, resistance training showed a stronger increase compared to endurance training (Tremblay et al. 2004). It’s also worth noting that trained and untrained people can cause different hormonal responses to exercise. So, untrained people experienced more significant increases in DHEA and cortisol levels2021. Such result was observed in both young people and people over 60 years old22.

How to define intensity of exercise?

For this purpose, the researchers used heart rate (HR) indicators. So the exercise was stopped as soon as the participants had reached 75% of their maximum HR. You can also determine maximum HR by the Tanaka formula:

208 − (age × 0.7)

So, for a 65-year-old person, the maximum heart rate will be 162 beats per minute. Consequently, 75% of this figure will be 121 bpm. Healthwise, muximum loads are not advisable. Therefore, it is recommended to use between 50% and 80% of the maximum.

Research has shown that 16 weeks of regular exercise decreased cortisol/ DHEA ratio by nearly 30%. In addition, athletes with the highest performance levels and the greatest amount of training had the lowest ratio. So,

Healthy Cortisol/DHEA-S Ratio

1 : 5 – 1 : 6

1:6 corresponds to 0.167 & 1:5 corresponds to 0.2

Adrenal/DHEA Restoration

High Adrenal/DHEA-S Ratio

Taking this into account, DHEA supplementation may be considered. Research confirms that it has a significant effect on the concentration of cortisol. For example, even a single morning dose of 200 mg DHEA can lower cortisol concentrations23. Moreover, in women, such a decrease was more pronounced.

An earlier study in healthy people came to the same result24. By the way, researchers also found that taking DHEA (300 mg) did not improve memory. However, supplementation is rational only in cases of decreased DHEA-S levels. In addition, it is important to monitor the sex steroid hormones as well as DHEA-S, because both deficiency and excess of DHEA can lead to negative symptoms.

In addition to DHEA supplements, your doctor may recommend pregnenolone25 and seriphos (phosphatidylserine)26. Seriphos was developed to aid in lowering cortisol. Besides, it contains key nutrients for stress resiliency. As for about pregnenolone, it is a steroid hormone. It plays a key role in the production of other steroid hormones, such as progesterone, DHEA, and estrogen.

Research also shows that fish oil supplements2728 and an Asian herbal medicine called ashwagandha both help to reduce cortisol levels29.

Calculated Cortisol/DHEA-S Ratio in Healsens App

Clinical Note

Improving adrenal function (augmenting DHEA and pregnenolone) can significantly enhance thyroid function, thereby reducing the amount of thyroid medication necessary. If this possibility is taken into account, it is suggested that any patient on thyroid should be closely monitored and lower dosages of pregnenolone and DHEA should be initially considered.

Low Adrenal/DHEA-S Ratio

So, as discussed in previous chapters, exercise has a positive effect on DHEA and cortisol levels. Besides, your doctor may recommend taking licorice extract. This is because licorice helps the adrenal glands prevent the breakdown of cortisol. In some cases, cortisol supplementation may be required.

Either with increased and decreased cortisol / DHEA-S ratio, an adrenal support program is recommended. So, try to balance your intake of protein, healthy fats, and carbohydrates. It will also be very beneficial to increase your vegetable intake to get the required amount of vitamins and minerals. To this end, foods high in vitamin C, B-5, B-6 and magnesium will assist in maintaining adrenal health.

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Source: ©️2019 Healsens B.V. All right reserve


thyroid gland hormones


All hormones in our body must work in concert to maintain optimal health. Thyroid gland hormones play a major role in regulating this work. In today’s article, we will discuss which symptoms can tell us that not everything is in order with our thyroid hormones. We will also take a closer look at the three ways to check the functioning of the thyroid gland.

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 17 February 2020.

If we look into history, we will see that thyroidology itself (the study of the thyroid gland) is a relatively new field of endocrinology. In spite of this fact, however, as early as in 1600 BC Chinese writers described the treatment of thyroid goiter (an enlarged thyroid gland) with burnt seaweed1. However, the goiter itself was not specifically associated with the thyroid gland. It was only in 1656 that Thomas Wharton first gave the thyroid the name that is still in use today.

How thyroid gland hormones affect health

Thyroid hormone is the main regulator of hormonal levels. Many people do not realize that they have a dysfunction of the thyroid gland even though it is a disorder, every tenth2 of which, leads to many adverse health changes.

In this case we are talking about already diagnosed problems. However, according to the American Thyroid Association, up to 60 percent of people with thyroid disease go undiagnosed3. And an undiagnosed illness can put patients at risk of getting some serious illnesses. How do thyroid hormones affect our body?



Thyroid gland hormones have a permissive effect on catecholamines. Catecholamines are a group of similar hormones produced by the adrenal medulla. Those, in turn, increase the expression of beta-receptors to increase heart rate, stroke volume, cardiac output, and contractility4. Often, people with hypothyroidism have very high cholesterol levels (350 and higher), and a bunch of other risk factors leading to a cardiovascular disease5.


Thyroid hormones are responsible for thermoregulation, which is why people with reduced thyroid function (hypothyroidism) often complain that they are constantly cold. This happens due to increased available energy in the body, as well as increased appetite, heart rate, and the amount of oxygen delivered to various parts of the body.


These hormones also help control the basal metabolic rate (the rate at which calories are burned). So fatigue and excess weight are also signs of hypothyroidism. On average, an underactive thyroid gland can add 5 to 15 kg of weight. But most of that extra weight will come from water and salt. In addition, decreased thyroid function can cause constipation6, memory problems, and lethargy.

An overactive thyroid gland (hyperthyroidism) is characterized by the opposite signs: having difficulty gaining weight, feeling hot, having frequent bowel movements, feeling nervous, and having a rapid heart rate. Other functions controlled by thyroid hormones include metabolism of fats, proteins and carbohydrates, as well as protein synthesis.

Relation to other hormones

There is also an interrealtion between thyroid function and control over other hormone levels. So, deviation of the thyroid hormone level from the norm can adversely affect the work of the adrenal glands. For instance, сertain human autoimmune conditions can destroy both the thyroid gland and adrenal cortex resulting in combined hormone deficiencies7. Moreover, dysfunction of the thyroid gland negatively affects the levels of sex hormones. Hyper- and hypothyroid men have increased rates of sexual dysfunction, including erectile dysfunction (ED). But the good news is that treatment of thyroid disorder at least partially reverses sexual dysfunction8. Thyroid hormone also affects fertility, ovulation, and menstruation9.

What hormones does the thyroid gland produce? In the following, we will discuss three tests for testing thyroid function – thyroid stimulating hormone (TSH), free T3, and free T4. You will probably want to make these tests part of your early diagnosis program and get them done regularly.

Thyroid stimulating hormone (TSH)

Thyroid stimulating hormone is a hormone that stimulates the thyroid gland. It is also known as TSH and is a glycoprotein hormone produced by the anterior pituitary gland. It is the main stimulus for the production of thyroid hormones. The TSH screening test is the first line test for suspected thyroid disease.

According to the American Thyroid Association, TSH levels are typically between 0.4 and 4.0 milliunits per liter (mU / L). However, these ranges will vary among laboratories and the upper limit can be raised from 4 to 5. If your level is higher than this, you are most likely to have an underactive thyroid gland. However, some studies show that this range should actually lie within 0.45–2.5 mIU / L. This is because TSH below the upper limit of the normal reference range poses an additional risk of progression to overt hypothyroidism over time1011.

So, high TSH levels indicate that your thyroid gland is not producing enough thyroid hormones. This condition is called hypothyroidism, which we wrote about above. Low TSH levels, on the other hand, may mean that your thyroid is producing too much hormone, the condition is called hyperthyroidism. Hyperthyroidism can be caused by Graves’ disease. This is a condition when your body’s immune system attacks the thyroid gland. It can also be a result of too much iodine in your body.

T3 (triiodothyronine) and T4 (thyroxine)

T3 (triiodothyronine) and T4 (thyroxine) are the two key thyroid hormones that are produced by the thyroid gland. The main product of thyroid secretion is T4, while T3 is secreted only in small amounts12. However, the activity of T3 is three to four times higher than that of T4. Nonetheless, both hormones play a vital role. Both T3 and T4 contain iodine. And it is iodine that is one of the main building blocks of both hormones. So let’s talk about tests that help measure the content of these hormones in the body.

Triiodothyronine (T3)

So, T3 thyroid hormone is the most active of the two main hormones. Normal levels of total T3 (free and bound) in the blood are between 75 and 195 ng / dL. The normal level of free T3 in the blood is 0.2-0.5 ng / dL.

If your results show high levels of total T3 or free T3, this could mean that you have hyperthyroidism. High T3 levels can lead to unpleasant symptoms such as rapid heart beat, insomnia and anxiety. High T3 levels also can harm the heart and the bones.

Low T3 levels may mean you have hypothyroidism. Typically, the T3 test results are often compared to the T4 and TSH test results. This helps to more accurately diagnose thyroid disease and understand whether the disease is primary or secondary. Primary hypothyroidism is most common; it is associated with thyroid disease and high thyroid-stimulating hormone (TSH) levels. Secondary hypothyroidism is less common; it is associated with a disease of the pituitary gland or hypothalamus. The TSH level will be low.

So, if we talk about the role of triiodothyronine, then it regulates the rate of oxygen consumption by tissues, and also stimulates protein synthesis, gluconeogenesis and glycogenolysis (which leads to an increase in the concentration of glucose in the blood). It is also responsible for lipolysis and intestinal motor function. In addition, triiodothyronine enhances catabolism and excretion of cholesterol with bile, promotes the synthesis of vitamin A and the absorption of vitamin B12 in the intestine, bone growth, and the production of sex hormones.

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Thyroxine (T4)

A normal total T4 level in adults ranges from 5.0 to 12.0μg/dL. As for free T4, the normal range in adults is 0.8 to 1.8 nanograms per deciliter (ng / dL) or 12 to 30 pmol / L. In general, high thyroxine T4 levels (as well as total T4, free T4, or free T4 index) may indicate an overactive thyroid gland (hyperthyroidism). A low level may indicate an underactive thyroid gland (hypothyroidism).

Just like in situation with T3, doctors don’t only look at your T4 level, but also at your TSH level to diagnose hypothyroidism. So, if TSH> 4.0 / mU/L, and the T4 level is low, then this is hypothyroidism. However, if your TSH is higher than  4.0 mU / L and your T4 level is normal, then your doctor will most likely suggest testing your serum thyroid peroxidase antibodies (anti-TPO). If these antibodies are present, it may indicate an autoimmune thyroid disorder, which is a risk factor for hypothyroidism13. In this case you will be advised to take a TSH test at least once a year.

Higher T4 or lower TSH levels are known to be associated with an increased risk of dementia14.

In addition to the two hormones described above, there is another hormone produced by the thyroid gland. It is called calcitonin. Calcitonin is produced by C cells and is involved in calcium and bone metabolism.

The role of the pituitary gland

In conclusion, we’d like to say a few words on how the pituitary gland affects the production of thyroid hormones. Sometimes our body needs more thyroid hormones, and sometimes fewer. For example, when we grow up, feel cold or are pregnant, the thyroid gland, to produce the right amount of hormones, needs help of another gland: the pituitary gland. The pituitary gland tells the thyroid gland whether it needs to release more hormones or fewer hormones into the bloodstream. Also, a certain amount of thyroid hormones are needed to transport proteins in the blood. If the body needs more hormones, T3 and T4 can be released from blood proteins and do their job.

👉Thus, there is no uniform recommendation on the need for screening for thyroid hormones!15

☝️For example, the American Thyroid Association recommends TSH screening for all adults over 35, with retests every 5 years. However, AACE recommends routine screening for TSH in elderly patients regardless of their age. But the USPSTF still discourages routine thyroid screening in non-pregnant adults.

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

Drastically reduce the time to detect chronic diseases & inspire healthy habits


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Source: ©️2019 Healsens B.V. All right reserve


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