DHEA replacement therapy has been studied extensively, and decreased DHEA levels have been implicated in heart disease, high cholesterol, depression, inflammation, immune disorders, schizophrenia, Alzheimer’s disease, diabetes, HIV, and osteoporosis.
More than 150 hormones are made by the adrenal glands. However, the most abundant is DHEA. Humans are thought to make between 10 and 15 mg a day. These numbers are lower in women by about 10 to 20 %. After it is made by these glands it goes into the bloodstream and from then on it travels all over the body and goes into our cells where it is converted into male hormones, known as androgens, and female hormones, known as estrogens. Small amounts are also made in the brain by neurons (brain cells). Many doctors prescribe this hormone supplement to their patients in high dosages without realizing the risks and dangers it can cause.
Dehydroepiandrosterone, or DHEA, is a steroid hormone, a chemical cousin of testosterone and estrogen. It is made from cholesterol by the adrenal glands, which sit atop each kidney. For the first few years of life, the adrenals make very little DHEA. Around age six or seven, they begin churning it out. Production peaks in the mid-20, when DHEA is the most abundant hormone in circulation. From one’s early 30 on, there’s a steady decline in DHEA production, so the average 75-year-old has only 20% of the DHEA in circulation that he or she had 50 years earlier. At all ages, men tend to have higher DHEA levels than women.
Safety
DHEA is produced naturally in the human body and has a safe history of use for the past 15 years. DHEA was administered at a dose of 200 mg/day for 24 weeks with only slight androgenic effects noted. Another study utilized a dose up to 400 mg/day for 8 weeks with few adverse events reported.A longer term study followed patients dosed with 50 mg of DHEA for 12 months with the number and severity of side effects reported to be small. Another study delivered a dose of 50 mg of DHEA for 10 months with no serious adverse events reported. A multitude of additional studies utilizing doses from 25 mg up to 2,250 mg per day for up to 24 months of therapy in men, women and even children have demonstrated that DHEA is well-tolerated and has numerous benefits[citation needed] with no serious adverse events reported.
As a hormone precursor, there has been a smattering of reports of side effects possibly caused by the hormone metabolites of DHEA.
It is not known whether DHEA is safe for long-term use. Some researchers believe DHEA supplements might actually raise the risk of breast cancer, prostate cancer, heart disease, diabetes, and stroke. DHEA may stimulate tumor growth in types of cancer that are sensitive to hormones, such as some types of breast, uterine, and prostate cancer. DHEA may increase prostate swelling in men with benign prostatic hyperplasia, or BPH, an enlarged prostate gland.
DHEA is a steroid hormone. High doses may cause aggressiveness, irritability, trouble sleeping, and the growth of body or facial hair on women. It also may stop menstruation and lower the levels of HDL, or “good,” cholesterol, which could raise the risk of heart disease. Other reported side effects include acne, heart rhythm problems, liver problems, hair loss (from the scalp), and oily skin. It may also alter the body’s regulation of blood sugar.
DHEA should not be used with tamoxifen, as it may promote tamoxifen resistance. Patients on hormone replacement therapy may have more estrogen-related side effects when taking DHEA. This supplement may also interfere with other medicines, and potential interactions between it and drugs and herbs should be considered. Always tell your doctor and pharmacist about any supplements and herbs you are taking.
DHEA is possibly unsafe for individuals experiencing the following conditions: pregnancy and breast-feeding, hormone sensitive conditions, liver problems, diabetes, depression or mood disorders, Poly-cystic Ovarian Syndrome (PCOS), or cholesterol problems. Individuals experiencing any of these conditions should consult with a doctor before taking.
By definition, hormones are chemical messengers made in a gland or tissue that start, stop, or otherwise orchestrate activity in some other issue. That makes DHEA a hormone in name only, since no one knows exactly what it does in the body. For years it was thought to be a kind of chemical trash left over from making other hormones. Today, “we still haven’t been able to identify any mechanism of action.
In fact, about the only thing that researchers can agree on is that DHEA is easily converted into other hormones, especially estrogen and testosterone.
The Food and Drug Administration isn’t sure what to do with DHEA supplements. Ten years ago the agency told companies to stop selling DHEA, which was marketed at the time for weight loss, and classified it as an unapproved new drug, obtainable only by prescription. Then in 1994, DHEA was reclassified as a dietary supplement, allowing sales over the counter.
The Evidence: Much of DHEA’s reputation as a wonder hormone comes from experiments in which mice or rats were fed daily doses. Such studies have shown that DHEA can prevent or delay the onset of cancer, “hardening” of the arteries, lethal viral infections, lowered immunity, obesity, and diabetes. But what works in rodents doesn’t necessarily work in humans. That may be especially true in this case, because rats and mice produce only about 1/10,000 the DHEA we do.
Possible benefits for DHEA: Scientists measured DHEA levels in blood samples taken from almost 2,000 men and women between 1972 and 1974 and looked at how many died from heart disease. In 1986, they reported that men with high DHEA levels were far less likely to have died of heart disease, while women with high DHEA levels were at greater risk. A more detailed analysis published late last year, however, showed that men with above-average DHEA levels back in the early 1970 were only 15% less likely to have died of heart disease, while there was no association between DHEA levels and heart disease in women.
The longest and perhaps most carefully conducted work in humans comes from Dr. Yen and his associates. In their latest study, published last year in a special issue of the Annals of the New York Academy of Sciences devoted to DHEA and aging, eight men and eight women aged 50 to 65 took either 100 milligrams of DHEA or an identical placebo pill each night for three months. For three months after that, they took the opposite pill.
Within two weeks of starting DHEA, circulating levels of the hormone were a bit higher than normally found in young adults. Lean body mass increased slightly in both sexes, as did muscle strength, which also improved with the placebo. Fat body mass decreased in men but increased a bit in women. There was also a rise in some chemical markers that suggested improvement in immune function, though the number of colds and other illnesses was not measured.
An earlier study from Dr. Yen’s group showed that three months of daily 50-milligram doses of DHEA significantly improved the sense of “well-being,” it did not improve sex drive, as advertisements for DHEA often claim..
Another study in which volunteers took DHEA suggests that this hormone may help treat the autoimmune disease lupus. Trials looking at DHEA’s ability to boost the immune system and maintain mental function in older adults are in progress.
Experiments on a few dozen people over six months hardly constitute proof that a treatment works. “What we really need at this point are some long-term clinical trials to identify clear benefits and risks.
One reason why such trials are crucial is that DHEA has side effects, some of which may be irreversible. Since DHEA is converted into testosterone, some women who take it grow body or facial hair and, if they are under age 50 or so, can stop menstruating. DHEA has also been shown to decrease levels of HDL (“good”) cholesterol in women, and could increase the risk of heart disease, the leading killer of older women. “We have no idea what DHEA might do to the risk of breast cancer.
In men, the increased levels of testosterone seen with daily DHEA pills could stimulate the growth of a tiny prostate tumor that would otherwise have remained dormant. Excess testosterone could also cause the prostate to enlarge, making urination difficult.
DHEAS is the sulfate ester of DHEA. This conversion is reversibly catalyzed by sulfotransferase enzyme primarily in the adrenals, the liver, and small intestine. In the blood, most DHEA is found as DHEAS with levels that are about 300 times higher than those of free DHEA. Orally ingested DHEA is converted to its sulfate when passing through intestines and liver. Whereas DHEA levels naturally reach their peak in the early morning hours, DHEAS levels show no diurnal variation. From a practical point of view, measurement of DHEAS is preferable to DHEA, as levels are more stable.
DHEA levels in the body begin to decrease after age 30, and are reported to be low in some people with anorexia, end-stage kidney disease, type 2 diabetes (non-insulin dependent diabetes), AIDS, adrenal insufficiency, and in the critically ill. DHEA levels may also be depleted by a number of drugs, including insulin, corticosteroids, opiates, and danazol.
There is sufficient evidence supporting the use of DHEA in the treatment of adrenal insufficiency, depression, induction of labor, and systemic lupus erythematosus.
DHEA is used for slowing or reversing aging, improving thinking skills in older people, and slowing the progress of Alzheimer.
