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Supplements

DHEA

What Is It?
Health Benefits
Forms
General Dosage Information
Guidelines for Use
General Interaction
Possible Side Effects
Cautions
References
Evidence Based Rating Scale


What Is It?

The steroid Hormone DHEA (dehydroepiandrosterone) has been hyped as a supplement that will deliver the virtual fountain of youth, with extravagant claims that it can slow aging, melt away Fat, enhance memory, prevent osteoporosis, and increase libido. Naturally produced and released by the adrenal glands, DHEA is ultimately converted into estrogen (the female sex hormone) and androgen (the male sex hormone).

With age, DHEA levels in the body naturally decline. Researchers are presently investigating whether these lower levels can explain certain age-related ailments--and whether taking DHEA supplements will keep them at bay. Specifically, scientists are examining DHEA's power to protect against heart disease in older men, its ability to boost the immune system, and whether it can help in managing diabetes and easing lupus symptoms. The strongest evidence so far may be for DHEA's power to enhance the quality of life of older people, increasing their energy level and ability to handle stress.

Quality and potency of DHEA products vary. Because of its ability to dramatically shift hormone levels in the body, Whole Health MD recommends its use only under the guidance of a health care clinician. Further, we recommend blood levels guide dosage and treatment.

Health Benefits

DHEA has been associated with increased life expectancy and enhanced well-being. (1-3) DHEA deficiencies in older individuals have been associated with several medical conditions including breast cancer, cardiovascular disease, impaired memory and mental function, and osteoporosis. However, researchers are still examining whether DHEA supplements will reduce the risk or improve the outcome of these conditions.

DHEA is often used for weight loss, metabolic syndrome, and to increase immune function. It is also used for increasing strength, energy and muscle mass.

Specifically, DHEA supplements may help to:

  • Slow or prevent the effects of aging. Because the body’s production of DHEA decreases significantly with age, researchers believe DHEA supplements may slow or prevent age-related problems such as bone loss, skin health, and sexual drive in elderly adults, particularly women over 70. In a 2000 double-blind, placebo-controlled study in France, 280 healthy men and women between the ages of 60 to 79 were given 50 mg DHEA daily for a year. The women showed improvement in the reduction of bone loss and in increased libido. All of the patients, but particularly the women, reported improvement in skin condition including an increase in epidermal thickness, sebum production, skin hydration, and decreased facial skin pigmentation. (4) In female patients with adrenal insufficiency or androgen deficiency due to hypopituitarism, DHEA also has been shown to improve feelings of well-being, skin and hair, and sexuality. In a double-blind study of 24 women who received 50 mg DHEA or placebo daily, those treated with DHEA reported a significant increase in the frequency of sexual thoughts, sexual interest, and satisfaction for both the mental and physical aspects of sexuality. (5, 6)

  • Treat erectile dysfunction (ED). Men suffering from ED as a result of low serum DHEA-S (sulfite) levels, hypertension, or lack of etiology may benefit from DHEA supplementation. (However, DHEA has not been shown to help ED related to diabetes or neurological disorders.) The Massachusetts Male Aging Study, a community-based, random-sample observational survey of men 40 to 70 years old conducted from 1987 to 1989, was the first to show an inverse correlation between DHEA-S levels and the incidence of ED. (7) Further double-blind, placebo-controlled studies have found that men who take 50 mg DHEA daily over six months show improvement in sexual desire and in the ability to achieve and maintain an erection sufficient for sexual performance, orgasmic function, and overall sexual satisfaction, especially in men over 60. (8, 9, 10)

  • Treat osteoporosis. During menopause, the amount of DHEA produced by the ovaries declines by more than 60 percent. (11) DHEA has been found to be essential for the maintenance of bone mass in postmenopausal women. In a study of 105 women with Addison’s disease (caused by underactivity of the adrenal glands), measures of bone density and serum DHEA-S levels indicated women with low DHEA-S values were 40 times more likely to have osteoporosis than those with normal levels. (12) Taking 50 to 100 mg DHEA daily seems to improve bone mineral density (BMD) in older women and men with osteoporosis or osteopenia. (13, 14)

  • Treat depression. Preliminary research suggests taking DHEA supplements might improve symptoms of depression. As a neurosteroid, research suggests the DHEA hormone may play a vital role in regulation of neuronal excitability, giving it the potential to enhance mood. In a 1999 double-blind study of 22 patients with major depression who were treated with DHEA or placebo, five of the 11 patients treated with DHEA, compared with none of the 11 given placebo, showed a 50 percent decrease or greater in depressive symptoms. (15)

  • Treat lupus. DHEA is being intensively studied for the treatment of systemic lupus erythematosus (SLE), a chronic autoimmune disease that can be debilitating as the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage. The disease can affect the skin, joints, muscles, brain, kidney and nervous system. DHEA appears to decrease inflammatory cytokines such as IL-6 (responsible for stimulating antibody production), which may curb manifestations of lupus. (16, 17) Several studies have demonstrated efficacy in patients with SLE when treated with 50 to 200 mg DHEA daily. (18-22) A double-blind, placebo-controlled trial of women with SLE demonstrated the group receiving DHEA had a significant reduction in the number of disease flares and serious lupus-related adverse events, as well as improvement in the person’s global assessment. (21) DHEA also may lower the dose of the prescription steroid drug prednisone that a lupus patient needs to take. (23) It may also boost energy and relieve other symptoms. Because DHEA doses must be high in order to work, take it with the advice of a physician who is well versed in treating lupus with DHEA.

  • Improve symptoms of chronic fatigue syndrome (CFS). Preliminary clinical evidence suggests that the anti-inflammatory properties of DHEA might improve symptoms of chronic fatigue syndrome. (24)

  • Treat metabolic syndrome. Preliminary evidence indicates DHEA might decrease risk factors of metabolic syndrome in overweight elderly men and women. (25) The study recommended taking 50 mg daily for six months to significantly decrease weight, abdominal fat and insulin levels. While many athletes use DHEA to boost muscle mass and burn fat, little evidence exists to support these uses.

  • Treat rheumatoid arthritis. Decreased DHEA-S serum levels also are associated with rheumatoid arthritis (RA). The ability of DHEA to stimulate the inflammatory process may help patients with RA.  
  • Forms

  •  Capsules 
  •  Chewing gum
  •  Drops that dissolve under the tongue
  •  Topical creams

    General Dosage Information

  •  Men: up to 50 mg/day 
  •  Women: no more than 25 mg/day. (Up to 50 mg/day has been used for women with anorexia, adrenal insufficiency, and other conditions under medical supervision.)
  • Positive effects have been noted at dosages as low as 5 mg/day.

    Guidelines for Use

    The body produces DHEA primarily in the morning, so taking supplements early will follow the body’s natural rhythm.

    Unless otherwise prescribed, DHEA is not recommended for people under the age of 40, and should not be used in children.

    DHEA is not recommended during pregnancy or lactation.

    DHEA has been found to be effective for short-term use. Most studies have lasted from a few weeks to six months, but others have found DHEA supplements to be safe when taken for as long as a year or two. Longer studies are needed to confirm efficacy for long-term treatment.

    General Interaction

    Soy may decrease the effects of DHEA, particularly in premenopausal women.

    Premenopausal women who are vegetarians and lactovegetarians tend to have higher serum DHEA levels than non-vegetarians, so talk to your health care provider about your diet.

    Possible Side Effects

    DHEA can increase insulin resistance or sensitivity, so monitor glucose levels closely.

    DHEA is a potent estrogen receptor agonist and may, therefore, increase the risk of breast cancer and other hormone sensitive conditions. Patients with hormone sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, and uterine fibroids should avoid DHEA.

    DHEA may lower high-density lipoprotein (HDL), “good cholesterol,” levels in patients taking supplementation for at least three months.

    DHEA has been found to cause hypomania, mania, irritability, sexual inappropriateness and psychosis in some patients with suspected mood disorders. Those with a history of depression and bipolar disorder may be at an increased risk of psychiatric adverse events associated with DHEA. 

    Cautions

    Quality and potency of DHEA products vary. Because of its ability to dramatically shift hormone levels in the body, Whole Health MD recommends its use only under the guidance of a health care clinician. Further, we recommend blood levels guide dosage and treatment.

    Although DHEA is sold in Vitamin shops and health-food stores, keep in mind that it's a powerful hormone. Only use it under a doctor's supervision. Long-term effects remain to be determined. 

    Before starting to take DHEA supplements, have a blood test to determine your present level of this hormone. Only proceed if your level is low; healthy people under age 50 rarely need to take this supplement. Have another blood test three weeks after taking DHEA to determine if a satisfactory DHEA blood level has been reached. Once within the normal range, revert to a maintenance dose (typically 5 to 10 mg a week). 

    Certain cancers are affected by hormone levels in the body. Before taking DHEA, have your doctor check for hormone-related cancers such as prostate cancer and breast cancer. Don't use DHEA if you are at risk for either of these cancers. 

    High levels of DHEA can cause very oily skin, acne, increased facial hair in women, deepening of the voice, and mood swings. In one animal study, extremely high doses of this hormone were linked to the development of liver cancer. 

  • References 

    1. Holden C. Interest grows in anti-aging drug. Science. 1995;269:33.

    2. Lasley BL, Santoro N, Randolf JF, et al. The relationship of circulating dehydroepiandrosterone, testosterone, and estradiol to stages of the menopausal transition and ethnicity. J Clin Endocrinol Metab. 2002;87:3760-7.

    3. Dhatariya KK, Nair KS. Dehydroepiandrosterone: is there a role for replacement? Mayo Clin Proc. 2003;78:1257-73.

    4. Baulieu EE, Thomas G, Legrain S, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging. Contribution of the DHEAge study to a sociobiomedical issue. Proc Natl Acad Sci USA. 2000;97:4279-84.

    5. Arlt W, Callies F, van Vlijmen JC, et al. Dehydroepiandosterone replacement in women with adrenal insufficiency. N Engl J Med. 1999;341:1013-20.

    6. Johannsson G, Burman P, Wiren L, et al. Low dose dehydroepiandrosterone affects behavior in hypopituitary androgen-deficient women: a placebo-controlled trial. J Clin Endocrinol Metab. 2002;87:2046-52.

    7. Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994;151:54-61.

    8. Reiter WJ, Pycha A, Schatzl G, et al. Serum dehydroepiandrosterone sulfate concentrations in men with erectile dysfunction. Urology. 2000;55:755-758.

    9. Reiter WJ, Schatzl G, Mark I, et al. Dehydroepiandrosterone in the treatment of erectile dysfunction in patients with different organic etiologies. Urol Res. 2001;29:278-281.

    10. Reiter WJ, Pycha A, Schatzl G, et al. Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study. Urology. 1999;53:590-95.

    11. Monroe SE, Menon KM. Changes in reproductive hormone secretion during the climacteric and postmenopausal periods. Clin Obstet Gynecol. 1977;20:113-122.

    12. Szathmari M, Szucs J, Feher T, Hollo I. Dehydroepiandrosterone sulphate and bone mineral density. Osteoporos Int. 1994;4:84-88.

    13. Sun Y, Mao M, Sun L, et al. Treatment of osteoporosis in men using dehydroepiandrosterone sulfate. Chin Med J (Engl). 2002;115:402-4.

    14. Villareal DT, Holloszy JO, Kohrt WM. Effects of DHEA replacement on bone mineral density and body composition in elderly women and men. Clin Endocrinol (Oxf). 2000;53:561-8.

    15. Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L, Roberts E. Double-blind treatment of major depression with dehydroepiandrosterone. Am J Psychiatry. 1999 Apr;156(4):646-9.

    16. Straub RH, Konecna L, Hrach S, et al. Serum dehydroepiandrosterone (DHEA) and DHEA sulfate are negatively correlated with serum interleukin-6 (IL-6), and DHEA inhibits IL-6 secretion from mononuclear cells in man in vitro: possible link between endocrinosenescence and immunosenescence. J Clin Endocrinol Metab. 1998;83:2012-7.

    17. Linker-Israeli M, Deans JR, Wallace DJ, et al. Elevated levels of endogenous IL-6 in systemic lupus erythematosus. A putative role in pathogenesis. J Immunol. 1991;147:117-23.

    18. van Vollenhoven RF, Engleman EG, McGuire JL. An open study of dehydroepiandrosterone in systemic lupus erythematosus. Arthritis Rheum. 1994;37:1305-10.

    19. van Vollenhoven RF, Engleman EG, McGuire JL. Dehydroepiandrosterone in systemic lupus erythematosus. Results of a double-blind, placebo-controlled, randomized clinical trial. Arthritis Rheum. 1995;38:1826-31.

    20. van Vollenhoven RF, Park JL, Genovese MC, et al. A double-blind, placebo-controlled, clinical trial of dehydroepiandrosterone in severe systemic lupus erythematosus. Lupus. 1999;8:181-7.

    21. Chang DM, Lan JL, Lin HY, Luo SF. Dehydroepiandrosterone treatment of women with mild-to-moderate systemic lupus erythematosus: a multicenter randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2002;46:2924-7.

    22. Zhang L, Li B, Ma W, et al. Dehydroepiandrosterone (DHEA) and its sulfated derivative (DHEAS) regulate apoptosis during neuro-genesis by triggering the Akt signaling pathway in opposing ways. Brain Res Mol Brain Res. 2002;98:58-66.

    23. Petri MA, Lahita RG, van Vollenhoven RF, et al. Effects of prasterone on corticosteroid requirements of women with systemic lupus erythematosus: a double-blind, randomized, placebo-controlled trial. Arthritis Rheum. 2002;46:1820-9.

    24. Himmel PB, Seligman TM. A Pilot Study Employing Dehydroepiandrosterone (DHEA) in the Treatment of Chronic Fatigue Syndrome. [Abstract] J Clin Rheumatol. 1999;5:56-9.

    Villareal DT, Holloszy JO. Effect of DHEA on abdominal fat and insulin action in elderly women and men. JAMA. 2004;292:2243-8.

    25. Gordon CM, Grace E, Emans SJ, Goodman E, Crawford MH, Leboff MS. Changes in bone turnover markers and menstrual function after short-term oral DHEA in young women with anorexia nervosa. J Bone Miner Res. 1999 Jan;14(1):136-45.

    Evidence Based Rating Scale 

    The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements and therapies demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.

    Condition

    Rating

    Explanation

     A Warning  

     WholeHealthMD recommends use of this supplement only under the guidance of a licensed clinician.

     

     

     

     

    Andropause

     

     

     

     

      

     

    Several large, high-quality studies have shown efficacy in some forms of ED, especially in men over 60.

     

     

     

     Aging

     

    Date Published: 04/18/2005
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