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Dehydroepiandrosterone (DHEA) is the most abundant androgen (male steroid
hormone) secreted by the adrenal glands (small hormone producing glands which
sit on top of the kidneys), and to a lesser extent, by the ovaries and testes.
DHEA can also be converted into other steroid hormones, including testosterone
and estrogen. Considerable interest in DHEA has developed in recent years with
reports that it may play a role in the aging process. Circulating levels of DHEA
peak at age 25 and then steadily decline with age. DHEA levels in 70-year-old
individuals tend to be roughly 80 percent lower than those in young adults.
Some researchers consider DHEA a possible anti-aging hormone because DHEA
deficiencies in older individuals have been associated with a number of medical
conditions including breast cancer, cardiovascular disease, impaired memory and
mental function, and osteoporosis. In addition, population-based studies have
suggested that people with higher DHEA levels tend to live longer, healthier
lives than those with lower levels of DHEA. However, low levels of DHEA being
linked to certain diseases does not necessarily mean that DHEA supplements will
reduce the risk or improve the outcome of these conditions.
The United States Food and Drug Administration (FDA) removed DHEA supplements
from the market in 1985 due to false claims about health benefits. However,
since the passing of the US Dietary Supplement Health and Education Act of 1994,
DHEA has made its way back on the market and its popularity continues to grow.
Despite this growth and attention, support for the health claims, particularly
as tested on people, is lacking. Plus, given that DHEA products are sold as
dietary supplements, there is no control over their contents or the
manufacturing practices of the companies that make the supplements. One
independent evaluation found that the amount of DHEA in over the counter
products ranged from 0% to 150% of what the content stated on the label.
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DHEA for Aging
Given that DHEA levels decline with advancing age, some researchers have
investigated whether DHEA supplementation may slow or prevent age-related
declines in mental and physical function. Preliminary results from the DHEAge
study in France suggest that the hormone may slow bone loss, improve skin
health, and enhance sexual drive in aging adults, particularly women older than
70 years of age. Animal studies that have shown a boost in memory for older rats
taking DHEA supplements. Results from human studies, however, have been
conflicting. Some studies have shown that DHEA improves learning and memory in
those with low DHEA levels, but other studies have failed to detect any
significant cognitive effects from DHEA supplementation. Further studies are
needed to determine whether DHEA supplementation helps prevent or slow medical
conditions associated with the aging process.
DHEA for Adrenal Insufficiency
As mentioned earlier, DHEA is one of the hormones made in the adrenal glands.
When the adrenal glands do not make enough hormones, this is called adrenal
insufficiency. Women with this condition who were given DHEA supplements
reported improved sexuality and sense of well-being (including decreased
feelings of depression and anxiety). Only a doctor can determine if you have
adrenal insufficiency and if DHEA, along with other hormones, is needed. Adrenal
insufficiency can be a medical emergency, particularly when first diagnosed.
This is especially the case if your blood pressure is low, which can cause you
to experience dizziness or lightheadedness. Another reason to seek medical
attention right away in the case of adrenal insufficiency is swelling of the
ankles or legs.
DHEA for Impotence
Studies suggest that DHEA supplementation may help impotent men have and sustain
an erection.
DHEA for Osteoporosis
Studies have shown that DHEA cream applied to the inner thigh may boost bone
density in older women.
DHEA for Anorexia Nervosa
Women with anorexia nervosa are at increased risk for bone fractures and can
develop osteoporosis at a younger age than women without
eating disorders. It
has been observed that adolescents and young adults with anorexia nervosa tend
to have low levels of DHEA. Some studies suggest that DHEA may help protect
against bone loss in people who are anorexic.
DHEA for Athletic Performance
Although DHEA supplements are widely used by athletes and body builders to boost
muscle mass and burn fat, there is little evidence to support these claims.
There are no published studies of the long-term effects of taking DHEA,
particularly in the large doses used by athletes. Plus, the building blocks of
testosterone, including DHEA, may adversely affect cholesterol in male athletes
by lowering HDL ("good") cholesterol.
DHEA for Lupus
Lupus is an autoimmune disorder. Autoimmune diseases are a group of conditions
in which a person's antibodies attack a part of their own body because the
immune system believes the body part is foreign. Studies have shown that DHEA
helps regulate the immune system and may play a role in the prevention and/or
treatment of certain autoimmune diseases.
A recent review of scientific literature found that DHEA supplementation may
reduce the need for medications and the frequency of flare-ups, enhance mental
function, and boost bone mass in women with lupus. Further studies are needed to
determine whether DHEA is safe and effective for both men and women with this
condition, however.
HDHEA for IV
DHEA levels tend to be low in individuals infected with the human
immunodeficiency virus (HIV), and these levels decline even further as the
disease progresses. In one small study, DHEA supplementation improved mental
function in men and women infected with HIV. However, studies have yet to
demonstrate whether DHEA supplementation can improve immune function in people
with this condition.
DHEA for depression
In a preliminary study of individuals with major depression, DHEA significantly
improved symptoms of depression compared to placebo. However, results of this
study and others conducted to date on DHEA and depression are not conclusive.
The potential value of using DHEA for depression, therefore, remains unclear,
and the long-term effects of taking this supplement are unknown.
DHEA for Obesity
The results of studies using DHEA to treat overweight people have been
conflicting. While animal studies have found DHEA to be effective in reducing
body weight, studies of men and women showed that DHEA produced no change in
total body weight, although total body fat and LDL ("bad") cholesterol did
improve. These differences may be due to the fact that higher dosages were used
in the animal studies than in the human studies (such high doses would cause
intolerable side effects in people). Further studies are needed to determine
whether DHEA is an effective way to reduce body weight in
obese people. Until
the safety and effectiveness of DHEA is fully tested, it is best not to use this
supplement for weight loss.
DHEA for Menopause
DHEA has gained some popularity among peri-menopausal women. They often used the
supplement to alleviate symptoms of menopause including decreased sex drive,
diminished skin tone, and vaginal dryness. In one recent study, DHEA supplements
did raise levels of certain hormones in post-menopausal women. However, clinical
studies regarding the value of DHEA for improving menopause symptoms have had
conflicting results.
Those who believe in the use of DHEA claim that it relieves the menopausal
symptoms described above without increasing the risk of breast cancer or cancer
of the endometrium (lining to the uterus). The risk of each of these cancers may
be increased with regular, prescription hormone replacement therapy. There is no
proof, however, that DHEA does not stimulate these cancers as well. Women with
breast cancer tend to have low levels of this hormone in their bodies. But
replacement may lead to either inhibition or stimulation of growth of breast
cancer cells.
DHEA for Inflammatory Bowel Disease (IBD)
DHEA levels appear to be low in people with ulcerative colitis and Crohn's
disease. It is premature to say whether DHEA supplements have any impact,
positive or negative, on these two bowel diseases.
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DHEA is a hormone produced in the body and is not obtained through the diet.
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Most DHEA supplements are produced in laboratories from diosgenin, a plant
sterol extracted from Mexican wild yams. Some extracts from wild yams are
marketed as "natural DHEA." Advertisers claim that these "natural" extracts of
diosgenin are converted into DHEA by the body. However, it takes several
chemical reactions to convert diosgenin into DHEA, and there is no evidence that
the body can make this conversion. For this reason, it is best to look for
labels that list DHEA rather than diosgenin or wild yam extract. Also, it is
important to select products that state it is pharmaceutical grade.
One way to avoid purchasing a product with contaminated DHEA is to purchase
it through a professional healthcare provider.
DHEA is available in capsules, chewing gum, drops that are placed under the
tongue, and topical creams.
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How to Take It
DHEA is not recommended for people under the age of 40, unless DHEA levels
are known to be low (<130 mg/dL in women and <180 mg/dL in men).
Pediatric
DHEA supplements should not be used in children.
Adult
Dosages for men and women differ. Men can safely take up to 50 mg/day, but
women should generally not take more than 25 mg/day, although up to 50 mg has
been used for women with anorexia, adrenal insufficiency, and other medical
conditions under medical supervision. DHEA is produced by the body primarily in
the morning hours. Taking DHEA in the morning will mimic the natural rhythm of
DHEA production. Positive effects have been noted at dosages as low as 5 mg/day
and the lower the dose the better.
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Because of the potential for side effects and interactions with medications,
dietary supplements should be taken only under the supervision of a
knowledgeable healthcare provider.
DHEA is not recommended for people under 40 years of age, unless DHEA levels
are known to be low (less than 130 mg/dL in women and less than 180 mg/dL in
men). People taking DHEA should have their blood levels monitored every 6
months.
No studies have been conducted on the long-term safety of DHEA.
Because DHEA is a precursor of estrogen and testosterone, patients with
cancers affected by hormones (such as breast, prostate, ovarian, and testicular
cancer) should avoid this hormone supplement.
High doses of DHEA may inhibit the body's natural ability to make the hormone
and also may be toxic to liver cells. At least one case of hepatitis has been
reported.
DHEA increases the production of the male hormone testosterone, so women
should be aware of the risk of developing signs of masculinization (such as loss
of hair on the head, deepening of the voice, hair growth on the face, weight
gain around the waist, or acne), and men should be aware of the risks of excess
testosterone (such as shrinkage of the testicles, aggressive tendencies
including sexual aggression, male pattern baldness, and high blood pressure).
Notify your health care provider if any of these symptoms occur.
Other adverse effects that have been reported include high blood pressure and
reduced HDL ("good") cholesterol.
The International Olympic Committee and National Football League recently
banned the use of DHEA by athletes because its effects are very similar to those
of anabolic steroids.
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If you are currently being treated with any of the following medications, you
should not use DHEA without first talking to your healthcare provider.
AZT (Zidovudine)
In a laboratory study, DHEA enhanced the effectiveness of an HIV medication
known as AZT. However, scientific studies in humans are needed before DHEA can
be used for this purpose in people.
Barbiturates
Animal studies suggest that DHEA may increase the effects of barbiturates, a
class of medications often used to treat sleep disorders including butabarbital,
mephobarbital, pentobarbital, and phenobarbital. However, scientific studies in
humans are needed before it is known whether this same effect occurs in people
and whether it is safe for DHEA and barbiturates to be used together.
Cisplatin
An animal study indicates that DHEA may increase the effectiveness of an
anti-cancer medication known as cisplatin; further studies are needed to know if
this effect applies to people.
Steroids
Laboratory studies suggest that DHEA may increase the effects of prednisolone, a
steroid medication used to treat inflammation and other disorders. Additional
research is needed to determine if this effect applies to people.
Estrogen
It is possible that DHEA may influence the level of estrogen in the body. For
this reason, some women on estrogen replacement therapy may need to adjust their
dosage. This should be discussed with your healthcare provider.
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Arlt W, Callies F, van Vlijmen JC, Koehler I, Reincke M, Bidlingmaier M, et
al. Dehydroepiandrosterone replacement in women with adrenal insufficiency. N
Engl J Med. 1999;341(14)-1013-1020.
Barnhart KT, Freeman E, Grisso JA. The effect of dehydroepiandrosterone
supplementation to symptomatic perimenopausal women on serum endocrine profiles,
lipid parameters, and health-related quality of life. J Clin Endocrinol Metab.
1999;84:3896-3902.
Barry NN, McGuire JL, van Vollenhoven RF. Dehydroepiandrosterone in systemic
lupus erythematosus: relationship between dosage, serum levels, and clinical
response. J Rheumatol. 1998;25(12):2352-2356.
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(8):4279-4284.
Broeder CE, Quindry MS, Brittingham K, et al. The Andro Project:
Physiological and hormonal influences of androstenedione supplementation in men
35 to 65 years old participating in a high-intensity resistance training
program. Arch Intern Med. 160:3093-3104.
Corrigan AB. Dehydroepiandrosterone and sport. [Review]. Med J Aust.
1999;171(4):206-8.
de la Torre B, Hedman M, Befrits R. Blood and tissue dehydroepiandrosterone
sulphate levels and their relationship to chronic inflammatory bowel disease.
Clin Exp Rheumatol. 1998;16:579-582.
Dyner TS, Lang W, Geaga J, et al. An open-label dose-escalation trial of oral
dehydroepiandrosterone tolerance and pharmacokinetics in patients with HIV
disease. J Acquir Immune Defic Syndr. 1993;6:459-465.
Flynn MA, Weaver-Osterholtz D, Sharpe-Timms KL, Allen S, Krause G.
Dehydroepiandrosterone replacement in aging humans. J Clin Endocrinol Metabol.
199;84(5):1527-1533.
Gaby AR. Dehydroepiandrosterone. In: Pizzorno JE, Murray MT, eds. Textbook of
Natural Medicine. Vol 1. 2nd ed. Edinburgh: Churchill Livingstone; 1999:695-701.
Genezzani AD, Stomati M, Strucchi C, Puccetti S, Luisi S, Genazzani AR. Oral
dehydroepiandrosterone supplementation modulates spontaneous and growth
hormone-releasing hormone-induced growth hormone and insulin-like growth
factor-1 secretion in early and late postmenopausal women. Fertil Steril.
2001;76(2):241-248.
Gordon C, 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;14:136-145.
Hansen PA, Han DH, Nolte LA. DHEA protects against visceral obesity and
muscle insulin resistance in rats fed a high-fat diet. Am J Physiol.
1997;273:R1704-R1708.
Hinson JP, Raven PW. DHEA deficiency syndrome: a new term for old age?
[Commentary]. J Endocrinol. 1999;163:1-5.
Klann RC, Holbrook CT, Nyce JW. Chemotherapy of murine colorectal carcinoma
with cisplatin and cisplatin plus 3'- deoxy-3'- azidothymidine. Anticancer Res.
1992;12:781-788.
Kurzman ID, Panciera DL, Miller JB, MacEwen EG. The effect of
dehydroepiandrosterone combined with a low-fat diet in spontaneously obese dogs:
a clinical trial. Obes Res. 1998;6(1):20-28.
Labrie F. DHEA as physiological replacement therapy at menopause. J
Endocrinol Invest. 1998;21:399-401.
Labrie F, Diamond P, Cusan L, Gomez J-L, Belanger A, Candas B. Effect of
12-month dehydroepiandrosterone replacement therapy on bone, vagina, and
endometrium in postmenopausal women. J Clin Endocrinol Metab. 1997;82:3498-3505.
Melchior CL, Ritzmann RF. Dehydroepiandrosterone enhances the hypnotic and
hypothermic effects of ethanol and pentobarbital. Pharmacol Biochem Behav.
1992;43:223-227.
Meno-Tetang GML, Hon YY, Jusko WJ. Synergistic interaction between
dehydroepiandrosterone and prednisolone in the inhibition of rat lymphocyte
proliferation. Immunopharmacol Immunotoxicol. 1996;18(3):443-456.
Miller RA,Chrisp C. Lifelong treatment with oral DHEA sulfate does not
preserve immune function, prevent disease, or improve survival in genetically
heterogeneous mice. J Am Geriatr Soc. 1999;47(8):960-966.
Moffat SD, Zonderman AB, Harman SM, et al. The relationship between
longitudinal declines in dehydroepiandrosterone sulfate concentrations and
cognitive performance in older men. Arch Intern Med. 2000;160:2193-2198.
Mortola JF, Yen SS. The effects of oral dehydroepiandrosterone on
endocrine-metabolic parameters in postmenopausal women. J Clin Endocrinol Metab.
1990;71(3)696-704.
Nestler JE, Barlascini CO, Clore JN, Blackard WG. Dehydroepiandrosterone
reduces serum low density lipoprotein levels and body fat bud does not alter
insulin sensitivity in normal men. J Clin Endocrinol Metab. 1988;66(1):57-61.
Parasrampuria J. Quality control of dehydroepiandrosterone dietary supplement
products [Letter to the editor]. JAMA. 1998;280(18):1565.
Piketty C, Jayle D, Leplege A, et al. Double-blind placebo-controlled trial
of oral dehydroepiandrosterone in patients with advanced HIV disease. Clin
Endocrinol (Oxf). 2001;55(3):325-30.
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(3):590-595
Reynolds JE. Martindale: The Extra Pharmacopoeia. 31st ed. London, England:
Royal Pharmaceutical Society; 1996:1504.
Schifitto G. Autonomic performance and dehydroepiandrosterone sulfate levels
in HIV-1 infected individuals; relationship to TH1 and TH2 cytokine profile.
Arch Neurol. 2000;57(7):1027-1032.
Stoll BA. Review:Dietary supplements of deydroepiandrosterone in relation to
breast cancer risk. Eur J Clin Nut. 1999;53:771-775.
Tan RS, Pu SJ. The andropause and memory loss: is there a link between
androgen decline and dementia in the aging male? Asian J Androl.
2001;3(3):169-174.
Vallee M, Mayo W, Le Moal M. Role of pregnenolone, dehydroepiandrosterone and
their sulfate esters on learning and memory in cognitive aging. Brain Res Rev.
2001;37(1-3):301-312.
van Vollenhoven RF. Dehydroepiandrosterone for the treatment of systemic
lupus erythematosus. Expert Opin Pharmacother. 2002;3(1):23-31.
van Vollenhoven RF, Morabito LM, Engleman EG, McGuire JL. Treatment of
systemic lupus erythematosus with dehydroepiandrosterone: 50 patients treated up
to 12 months. J Rheumatol. 1998;25(2):285-289.
Welle S, Jozefowicz R, Statt M. Failure of dehydroepiandrosterone to
influence energy and protein metabolism in humans. J Clin Endocrinol Metab.
1990;71(5):1259-1264.
Williams JR. The effects of dehydroepiandrosterone on carcinogenesis,
obesity, the immune system, and aging. Lipids. 2000;35(3):325-331.
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;156:646-649.
Yang J, Schwartz A, Henderson EE. Inhibition of 3' axido-3' deoxythymidine-resistant
HIV-1 infection by dehydroepiandrosterone in vitro. Biochem Biophys Res Commun.
1994;201(3):1424-1432.
Yen SSC, Morales AJ, Khorram O. Replacement of DHEA in aging men and women.
Potential remedial effects. Ann NY Acad Sci. 1995;774:128-142.
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list of all supplements, vitamins
Reviewed: 05/2006
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