DHEA - What Is It?
by PJ Hennessy 2006
Dehydroepiandrosterone (DHEA) and its sulfate metabolic partner (DHEAS) have attracted much attention in the last fifteen years from scientists and nutritional and supplement proponents alike. While it is known to be one of the most abundant steroid molecules present in the human body, its precise function remains perplexingly elusive. Once thought to be made in the adrenal glands, new studies show that it is also made in the brain and joins other hormones such as estrogen and testosterone that are known to be neuro active7, that is, they have a profound effect on mood and cognitive function. Right now its best descriptor: multifunctional steroid hormone.
Researchers studying the ageing process recognize that DHEA increases steadily through puberty and into young adulthood. It then gradually declines and by age fifty through sixty, may be at 50-60% of peak levels or less2 - much like ovarian and testicular hormones.
Scientists have also observed DHEA levels to be low in such illnesses as lupus, rheumatoid arthritis and depression. Other studies show low levels of DHEA in cardiovascular disease3, obesity1, certain cancers4, as well as erectile dysfunction5. A well designed study on men and women forty through fifty years of age (randomized, placebo control, cross over trial) used nightly DHEA of 50mg for six months6. The results were convincing and numerous - DHEA levels were restored to young adult levels, there was an increase in muscle strength and lean body mass, there was activation of immune markers (IGF-1) associated with prevention of diabetes and obesity, and improved well being (by self report) in 67% of the men and 84% of the women.
Is It Safe?
There are no known drug interactions with DHEA and no side effects reported in doses less than 100mg. In doses of 200mg, mild occasional acne is the only side effect reported. The cautionary approach reminds us that there are no long-term studies to guide us, but this is the case with many of the substances we use in medicine.
How Can It Help?
I am currently recommending it to women as they move out of their fifties and into their sixties as an adjunct or even a substitute for estrogens. For men, I recommend testing and then replacement when indicated. For purity and safety, a bioidentically compounded product is what I prescribe in doses of 10mg to 100mg daily. A three to six month trial is the first step in therapy and then re-evaluation and review of progress.
Most of us do not want to actually turn back the clock, but mimicking the youthful physiology may be a safe and useful disease prevention strategy.
Thoughts To Ponder
It is curious that most of the American research stopped ten years ago despite very promising research findings – the Euros especially the Germans and Austrians have carried on. Was this research in the back seat of the electric car?
News Flash! (November 2006)
As we took this article to (cyber) press, the New England Journal of Medicine published an article on DHEA (K.S. Nair. et al. DHEA In Elderly Men and Women. NEJM. 2005. Vol 335 (16). pp 1647-1659). Their reported findings were on data collected from 144 men and women whose average age was nearly seventy and whose DHEA levels were very low at entry. The study showed that DHEA was very safe (no side effects) in doses of 50-100mg over a two-year period, and bone density and libido were improved. The study also showed that DHEA does not improve muscle strength, aerobic capacity, blood glucose, or insulin levels. Their findings regarding well-being were inconclusive.
Readers can glean from this that DHEA is safe over time, has bone and libido benefits, and does not improve some other markers of aging. Unfortunately its effects on the immune system and mood were not explored in this two-year study.
1. Barrett Connor. et al. 1999 Journal of American Geriatric Society. 47. 685-691
2. Salvini. et al. 1992 Journal of Clinical Endocrinologic Metabolism. 74. 139-143
3. Barrett Connor. et al. 1986 New England Journal of Medicine. 315. 1519-1524
4. Gordon. et al. 1993 Cancer Epidemiology Biomarkers. Prev 2, 33-35
5. Reiter. et al. 1999 Urology. p 590-595
6. Yen. et al. 1995 Annals of New York Academy of Science. 128-141
7. Rupprecht. 2003 Psychoneuroendocrinology. 28. 139-168
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