What Are the Differences between DHEA and DHA for Reproductive Health?
Preparing for a healthy pregnancy
One question that comes up often about DHEA is this: “Is DHEA the same as DHA?” The short answer is no – DHA, short for docosahexaenoic acid, is an omega-3 fatty acid, while DHEA, short for dehydroepiandrosterone, is a hormone.
Adding to the confusion from the similar-sounding acronyms, both are recommended in the reproductive and prenatal health context as supplements, because they both play different but important roles. In this article, we delve into the roles of DHA, primarily focusing on reproductive and prenatal health.
What is DHA?
DHA is one type of omega-3 polyunsaturated fatty acids – a “healthy fat.” DHA is the main building block of our nervous system, including the brain, cerebral cortex and retina, as well as our skin – it’s the most abundant omega-3 fatty acids in our brain, with as much as half of the plasma membrane of our neurons consisting of DHA.
Supporting a wide range of signaling between cells and through cell membranes, DHA is considered essential for the health of our nervous system. Human body can synthesize a small amount of this essential fatty acid from another omega-3 fatty acids, such as eicosapentaenoic acid (EPA). However, for a vast majority of DHA that our body needs, we rely on dietary sources, primarily salmon and other seafood.
What are DHA’s role in reproductive and prenatal health?
DHA has been the subject of numerous studies since since at least the 1980s. In addition to its better-known roles in our cardiovascular health, and neural and cognitive health in babies and adults, recent studies have suggested that DHA may have a supporting role in the reproductive and prenatal health.
One caveat to keep in mind: Many studies on DHA and other omega-3 fatty acids have been observational studies that link higher intake of fish and seafood to better health outcomes. While this type of studies is easier to conduct than a randomized controlled trials, the study design makes it difficult to confirm that it’s the DHA that makes the difference and not any other factors – such as generally healthier behaviors of people who eat more fish, or another nutrient in seafood that scientists didn’t look into, for example.
DHA and reproductive processes
A 2016 study, published in the journal Nutrients, compared the fertility outcomes of 46 women based on how much omega-3 and omega-6 fatty acids were present in their diet. The researchers found that women whose diet contained higher levels of omega-3 fatty acids were more likely to get pregnant than women whose diet was low on these healthy fats.
More recently in 2018, researchers from Harvard University’s T. H. Chan School of Public Health investigated the serum levels of omega-3 and omega-6 fatty acids in women trying to get pregnant. They reported an 8% increase in pregnancy and live birth rates for every 1% increase in the concentration of omega-3 fatty acid in the blood.
Furthermore, some studies have suggested that DHA may help support pregnancy to term. While systematic reviews have found evidence to be inconclusive, many doctors recommend pregnant women and those planning to get pregnant to up their DHA intake, either through incorporating more seafood to their diet, taking an omega-3 supplement or both.
DHA and baby’s neural and cognitive development
There has been some direct and indirect evidence to suggest that DHA may support the baby’s neural and cognitive development. Some studies like this one in the journal Pediatrics found that mother’s DHA intake during pregnancy may impact the baby’s intellectual development well after birth.
Epidemiological studies like this one have positively linked the fish intake during pregnancy to the baby’s early cognitive development, suggesting that DHA, abundant in many fish, may be a reason for the observed benefit of eating fish.
What is DHEA - briefly?
While DHA is a fatty acid, DHEA is a weak male hormone (androgen) that exists naturally in both men and women. It’s an intermediary step in a process called steroidogenesis, where male and female hormones like testosterone and estrogens are synthesized from cholesterol. Although it may sound counter-intuitive, reproductive health specialists have been using 25 to 75 mg/day of DHEA to support women’s reproductive health for nearly two decades.
DHEA levels decline with age, and this decline accelerates after women hit their mid- to late 30s. Scientists think that DHEA, once converted into testosterone, may help support the ovarian health in women over 35 pre-conception.
Should I take DHEA or DHA?
So, should you consider taking a DHEA or DHA supplement on your journey? The answer may be one or both, but it depends on a few factors, including your age, diet and where you are on the journey.
When getting ready for a baby
- Aim for 1.1 grams of omega-3 per day. Eating 6-8 oz of seafood 3 times a week can get you there, or you can take a DHA or an omega-3 supplement instead.
- If you are over 35, ask your doctor if a DHEA supplement is right for you to support your ovarian health. (Sadly, there is no natural food source of DHEA.)
- Get started on a high-quality prenatal vitamins, so your body can lay the foundation for a healthy pregnancy. Look for a brand that supplies a good amount of these nutrients that you are most likely to be low on, particularly the brain-building choline and folate.
- Aim for 1.4 grams of omega-3 per day. The recommendation is higher than pre-pregnancy in order to supply enough DHA/EPA to the developing baby. Eating 8-12 oz of seafood each week will get you there.
- Consider taking an omega-3 supplement. Doctors may recommend taking an omega-3 supplement to pregnant women instead of increasing fish intake, because omega-3 supplements typically don’t contain mercury, which is a concern in some species of seafood. Here’s FDA’s handy list of safer and riskier fish species, in terms of mercury content.
- Stop taking DHEA, if you supplemented before pregnancy. Your body produces more DHEA during pregnancy, so you won’t need the supplement.
- Continue taking your prenatal vitamins to support the baby’s healthy development, as well as your own health and wellbeing.
- Aim for 1.3 grams fo omega-3 per day to support the early cognitive development of the baby through breastmilk.
- Stay on your prenatal vitamins.
Should your prenatal vitamins contain DHA?
You might wonder if you should look for prenatal vitamins that contain DHA. In theory, yes, but there is one thing to watch out for: Some ingredients in prenatal vitamins can accelerate the oxidation process of DHA.
Oxidation essentially degrades the quality of DHA, so if you select a prenatal vitamin blend that comes with DHA, make sure it’s separate from other prenatal ingredients. Because this oxidation effect may not be completely mitigated by separating the capsules if they are sitting in the same container for an extended period of time, it may also be a good idea to purchase prenatal vitamins and DHA separately.
What are the good sources of DHA?
Seafood is the most common sources of DHA. For example, a 4-oz portion of salmon has 1.65 grams of DHA, more than what you need in a day during pregnancy. Seafood is also a good source of another major type of omega-3, EPA.
If you are vegetarian or vegan, nuts and seeds like flaxseed, chia seeds and walnuts, are a great source of alpha-linolenic acid (ALA), a plant-derived type of omega-3. However, the conversion of ALA into DHA and EPA in our bodies is rather inefficient, and vegetarians and vegans may benefit from taking omega-3 supplements. There are plant-derived omega-3 supplements, such as those made with algal oil, which has been shown to be equivalent to DHA from salmon.
As always, talk to your doctor or registered dietitian – they are in the best position to determine if any lifestyle change or supplement is a good fit for your particular situation. If you – or your healthcare team – have any questions, please reach out. We are with you.
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