DHEA

DHEA: Overview

Alternative Names: Dehydroepiandosterone.

DHEA is a hormone produced by the adrenal glands.  It peaks at approximately age 25 and then declines.  In the prime of life (age 20 to 25), men produce about 31mg of DHEA (Dihydroendoendosterone) daily and women about 19mg daily.  DHEA production slowly declines over the years and by the age of 75, DHEA production can decrease by 80-90%. DHEA and its activated sulfated form DHEA-S, have become popular supplement ingredients in the past several years.  Proponents of DHEA use often argue that since DHEA levels decrease with age, supplementing DHEA will reduce many age-related disorders.  In essence, they argue:

"The day DHEA begins to decline is the day that an individual "starts dying".  Studies have shown that when it falls to very low levels, the end is close for most individuals.  The lower one's DHEA, the less one's expected longevity.  The more above 150 that levels are, the longer a person is expected to live.  It should improve not only the quantity of one's life, but the quality as well."

Source

DHEA comes form natural sources such as the Mexican yam (Dioscorea).  Pharmaceutical grade products are readily available in pharmacies and health food stores without prescription, supplied in 5, 25, 50, and 75mg sizes.

Function; Why it is Recommended

The body converts DHEA into testosterone or estrogen.

There have been many studies done and some of the research shows that this DHEA may be an anti-aging product, and if used in physiologic doses, can retard this natural process of aging.  In over 2,500 medical references regarding this substance, there are some excellent articles in the prevention of cancer, arteriosclerosis, autoimmune diseases such as lupus, chronic fatigue syndrome, Alzheimer's disease, hypercholesterolemia, depression and osteoporosis.  It also helps sexual function and causes weight loss in the overweight patient and has been touted to reduce the sugar lowering mediations in diabetes.  Under extreme stress, one needs more DHEA.

It is claimed that maintaining correct DHEA levels can produce:

  • Energy
  • Youthfulness
  • Increased metabolism to burn fat
  • Increased sex drive
  • Improved memory
  • Reduced tendency to depression
However, evidence does exist to the contrary.  Several studies like the following have not shown an obvious benefit.  Four months of supplementation with DHEA (50mg per day) had no effect on serum lipids, bone markers, body composition, exercise capacity, sexuality or mood scores in a double blind cross-over study of 22 healthy men (50-69 years old) with age-related physiological decline of DHEA production.  [J Clin Endocrinol Metab 2001;86(10): pp.4686-92]

While there are some studies that have shown DHEA to have an effect on incidence of heart disease, and may help therapeutically with systemic lupus erythematosus (SLE, lupus); it is not recommended as a supplement for everyone (because of its ability to raise testosterone and estrogen levels, a possible problem for those at increased risk of prostate or breast cancers).

Instructions

DHEA is the hormone precursor for testosterone and estrogens.  When DHEA levels are low, but the sex hormones are normal or elevated, a different form of DHEA should be used.  7-keto DHEA has DHEA activity but is reported to not increase sex hormone levels.

Caution is advised against using higher doses of DHEA (greater than 50mg) because of possible short- and long-term side-effects, including acne and increased facial hair (the primary short-term side-effects.)

Some recommend 25 to 100mg per day, taken first thing in the morning with or without food.  At the time of writing, DHEA can be taken with any other drug or supplement.

DHEA should be used only under the supervision of a qualified individual who understands the complex nature of adrenal hormones and can test for DHEA, cortisol, and other relevant markers of adrenal health.

Side-Effects; Counter-Indicators and Warnings

DHEA metabolizes to testosterone and estrogen, so the side-effect is that regular DHEA could cause slight acne, facial hair and lower the voice when taken in high doses, and might increase the risk of prostate and breast cancer.  Keto-DHEA may be a safer version in that it is not converted to sex hormones.

There may a possible link between elevated DHEA levels and prostate, breast and ovarian cancer risk.  While younger women with breast cancer may have low levels of DHEA, postmenopausal women with breast cancer appear to have high levels of DHEA, which has researchers concerned.  Until more is known, it would be prudent for people with breast or prostate cancer or a family history of these conditions to avoid supplementing with DHEA, or monitor their levels.

DHEA can help with the following:

Aging

DHEA often helps with Parkinsons Disease Parkinson's Disease

C.A.  Hackethal, M.D.  has reported excellent success in treating Parkinson's Disease by use of replacement therapy of DHEA.  Apparently the bad side-effects of L-Dopa are avoided, and the Parkinsonian victim is restored to appropriate functioning.

Autoimmune

DHEA often helps with Chronic Thyroiditis Chronic Thyroiditis

Some doctors report finding that a high percentage of patients with autoimmune disorders, such as thyroiditis, are also deficient in DHEA, and should be tested.

Circulation

DHEA may help with Coronary Disease / Heart Attack Coronary Disease / Heart Attack

A landmark study in 1986 of 242 men aged 50-79 and based on 12 years of research stated that a small supplementation of DHEA corresponded to a 48% reduction in death from heart disease and a 36% reduction in death from any cause, other than accidents.  Indirect evidence does suggest that DHEA supplements might reduce the risk of heart disease, especially in men, but this is far from proven.

Not recommended for
DHEA is sometimes not recommended for Arrhythmias/Dysrhythmias Arrhythmias/Dysrhythmias

Ray Sahelian, MD has reported arrhythmias of different types in individuals using as little as 50mg DHEA or 25mg Pregnenolone.  [TLDP Feb 1998, p.119]

Hormones

DHEA often helps with Hypopituitarism Hypopituitarism

Six months of treatment with DHEA (at 30mg per day if over 45 years of age and 20mg per day if under 45 years of age) induced androgen effects on skin and axillary and pubic hair in a study of 38 women with androgen deficiency due to hypopituitarism.  Improved alertness, stamina and initiative was also reported.  [J Clin Endocrinol Metab 2002;87(5): pp.2046-2052]

DHEA may help with Low DHEA Level Low DHEA Level

The optimal dosage range for DHEA varies considerably between individuals.  Men and women should consider taking a total of 15 to 75mg per day in one to three divided doses.  Many human studies use a daily dose of 50mg.  DHEA can be taken with or without food, though some believe that fat helps DHEA to assimilate better.  DHEA can be taken in a cream form along with other hormones.

Mainly because DHEA levels naturally decrease with age, this hormone has been widely used as a kind of "fountain of youth".  However, there is no real evidence that it is helpful against aging in general.  Seven studies have found that DHEA supplementation does not improve mood or increase the general sense of well-being in older individuals.  In addition, although some reports suggest that declining DHEA levels cause impaired mental function in the elderly, large studies have not found a connection between the two.

Not recommended for

Immunity

DHEA may help with Immune System Imbalance (TH2 Dominance) Immune System Imbalance (TH2 Dominance)

DHEA increases TH1 cytokines which help balance the immune system.

Lab Values

DHEA often helps with Low T-Helper (CD4) Cell Level Low T-Helper (CD4) Cell Level

One study has found that DHEA therapy (75mg per day) increased CD4 and CD8 cell counts in the majority of HIV patients.  [Hasheev, D, et al.  Intl AIDS Conference Abstract no PB0322, 1994]

Mental

DHEA often helps with Depression Depression

DHEA is a plentiful adrenal steroid hormone whose quantity decreases with age and may have significant psychiatric effects.  In one study, six middle-aged and elderly patients with major depression and low plasma DHEA or DHEA-S levels were openly administered DHEA (30-90mg per day for 4 weeks) in doses sufficient to achieve circulating plasma levels observed in younger healthy individuals.  Depression ratings as well as aspects of memory performance significantly improved. 

One treatment-resistant patient received extended treatment with DHEA for 6 months: her depression ratings improved 48-72% and her semantic memory performance improved 63%.  These measures returned to baseline after treatment ended.  Improvements in depression ratings and memory performance were directly related to increases in plasma levels of DHEA and DHEA-S and to increases in their ratios with plasma cortisol levels.  [Biol Psychiatry, 1997 Feb; 41:3, pp.311-8]

Another study evaluated the efficacy of very high doses of DHEA (450mg) in the treatment of midlife-onset dysthymia.  In 15 patients who completed the study, a robust effect of DHEA on mood was observed compared with placebos.  60% of the patients responded to DHEA at the end of the 6-week treatment period compared with 20% on placebo.  A significant response was seen after 3 weeks of treatment on 90mg per day.  The symptoms that improved most significantly were anhedonia (failure to experience pleasure), loss of energy, lack of motivation, emotional "numbness", sadness, inability to cope, and worry.  [Biol Psychiatry 1999 Jun 15; 45(12): pp.1533-41]

In a study conducted by S.  S.  C.  Yen and associates at the University of California, San Diego, researchers found that 50mg a day of DHEA administered for 6-months restored levels of DHEA in both men and women.  This DHEA replacement was associated with an increase in perceived physical and psychological well-being for both men (67%) and women (84%).

Another study at UCSD was conducted in which researchers considered the association between levels of DHEA and depression.  Nine different hormones (including DHEA) were measured in 699 older women.  Out of all of these hormones, only low levels of DHEA were linked with depression. 

In studies conducted at Cambridge University in England, researchers discovered that children with major depression have abnormally low levels of DHEA accompanied by abnormally high levels of cortisol.

University of California San Francisco At the University of California, San Francisco, DHEA was given to people with depression to determine its antidepressant effects.  After 6 weeks, psychological tests indicated that about half the participants responded to DHEA therapy, with an overall enhancement of mood scores by over 30%.

In another study conducted by the Department of Psychiatry at UCSF, DHEA was administered to six middle-aged and elderly patients with major depression.  In patients who received extended treatment with DHEA for six months, depression ratings improved 48-72%.

In a study conducted by researchers at the National Institute of Mental Health, middle-aged people with dysthymia (a chronic, low-grade depression) were given 90mg of DHEA a day for 3 weeks.  This study concluded that this amount significantly alleviated the participants' depression.

DHEA is the only hormone besides cortisol and serotonin that has consistently been linked to depression.  But unlike cortisol, where high levels increase depression, high levels of DHEA actually alleviate depression.

Researchers have different theories about how DHEA alleviates depression.  DHEA and can cross the blood-brain barrier and interact with the brain directly.  DHEA can affect serotonin, GABA receptors, and other brain factors.  It might modulate the serotonin-signaling pathway.  In addition, DHEA is the precursor for estrogen and testosterone, which also enhance mood.

DHEA also has antistress effects that may be part of its antidepressant action.  Research shows that cortisol, the stress hormone, is elevated in cases of major depression.  DHEA counteracts cortisol.  Calmness is also associated with higher levels of DHEA.

DHEA may help with Poor Memory Poor Memory

In a study of six middle-aged and elderly patients with major depression and low plasma DHEA levels, memory performance and depression improved significantly when DHEA was supplemented sufficiently to raise their plasma DHEA to levels found in healthy younger people [Biol Psychiatry, 1997 Feb, 41:3, pp.311-8].  Other, larger studies have not supported this claim.

Metabolic

DHEA may help with Problems Caused By Being Overweight Problems Caused By Being Overweight

7-Keto DHEA supplements, at a dose of 200mg per day in adults 25 to 55 years of age has been shown in a double-blind trial to enhance weight loss, aid in the reduction of body fat and effect thyroid hormone levels.  This two-month study also demonstrated that 7-Keto does not significantly affect blood sugar, testosterone, estradiol, liver or kidney function.

How much DHEA we maintain may be involved in determining how fat is actually stored in the body.  In another study, DHEA was given to five male, normal weight subjects at a dose of 1600mg per day, divided into 4 doses.  After 28 days, with diet and physical activity remaining normal, 4 of the 5 exhibited a mean body fat decrease of 31% with no overall weight change.  This meant that their fat loss was balanced by a gain in muscle mass characteristic of youth.  At the same time, their LDL levels fell by 7.5% to confer protection against cardiovascular disease. 

7-Keto DHEA does not become converted to sex hormones as does DHEA.  The choice of whether to use DHEA or 7-Keto DHEA will be influenced by your sex and adrenal hormone status.  Laboratory testing is required to determine this.

Musculo-Skeletal

DHEA may help with Rheumatoid Arthritis Rheumatoid Arthritis

The incidence of osteoporosis is elevated in women with rheumatoid arthritisDHEA levels correlated significantly with, and were predictive of, bone mineral density, even after corticosteroid therapy was taken into account.  Raising DHEA levels by supplementation in these women should reduce the risk of osteoporosis.  [Gaby, AR.  Holistic Medicine.  Spring, 1993: p.22]

Dr. Hackethal has observed some rheumatoid patients taking DHEA become well even when C-reactive protein and Rh- factor are positive.

DHEA can help prevent the following:

Tumors, Malignant

KEY

May be useful: may help with; may help prevent
May be useful:
may help with; may help prevent
Moderately useful: often helps with
Moderately useful:
often helps with
Caution: is sometimes not recommended for
Caution:
is sometimes not recommended for
Should be avoided: is NOT recommended for
Should be avoided:
is NOT recommended for