What does dehydroepiandrosterone (dhea) do?
Little is known about how DHEA works in the body.1 Confusing the picture is the fact that DHEA often has different effects in men, premenopausal women, and postmenopausal women.2 Supplementation with DHEA-S (a form of DHEA) has resulted in increased levels of testosterone and androstenedione, two steroid hormones.3
The conversion of DHEA into testosterone4 may account for the fact that low blood levels of DHEA have been reported in some men with erectile dysfunction. The findings of a double-blind trial using 50 mg supplements of DHEA taken daily for six months suggests that DHEA may improve erectile function in some men.5
Some,6 7 but not all,8 9 clinical trials have found that DHEA supplementation lowers fat mass without reducing total body weight.10 In one trial, the reduction in fat mass occurred in men but not in women.11
DHEA is believed to indirectly affect blood sugar levels, but information remains incomplete and contradictory. Attempts to affect blood sugar levels in humans have led to improvements,12 no effect,13 and, at very high amounts (1,600 mg DHEA per day), a worsening of tolerance to sugar.14
DHEA modulates immunity. A group of elderly men with low DHEA levels who were given 50 mg of DHEA per day for 20 weeks experienced a significant activation of immune function.15 Postmenopausal women have also shown increased immune functioning in just three weeks when given DHEA in double-blind research.16
Some reports have suggested that DHEA might reduce the risk of heart disease, perhaps by lowering cholesterol levels. DHEA may also be a blood thinner, an effect that in theory should help protect against heart disease.17 However, most research supports the idea that DHEA protects against heart disease only weakly for men, and not at all for women.18 19 In fact, higher levels of DHEA and DHEAS have been associated with cardiovascular risk factors in women, including high blood pressure and smoking.20 Moreover, DHEA has also been reported to lower HDL ("good" cholesterol).21 Until more is known, DHEA should not be used to protect against heart disease.
Claims have appeared that DHEA is an anti-aging hormone. However, the fact that young people have higher levels of DHEA than older people does not necessarily mean that supplementing DHEA will make people appear younger. In some,22 but not all,23 double-blind trials, DHEA has improved the sense of well being in elderly individuals. In one double-blind trial, DHEA supplementation did appear to reduce some of the adverse effects of aging, though it did not create "supermen/superwomen."24 In that trial, healthy elderly women and men were given either 50 mg of DHEA or a placebo daily for one year. In addition to a re-establishment of more youthful levels of DHEAS, slight increases were also observed in other hormones, such as testosterone and estrogens. In women over 70 years of age, bone mineral loss was improved. A significant increase in most measures of libido was also seen in these older women. Improvements of the skin were also observed in both women and men, but particularly in women, in terms of hydration, thickness, pigmentation and production of sebum (oily secretion that lubricates the skin and hair).
Systemic lupus erythematosus (SLE), an autoimmune disease, has been linked to abnormalities in sex hormone metabolism.25 Supplementation with very large amounts of DHEA (200 mg per day) improved clinical status and reduced the number of exacerbations of SLE in a double-blind trial.26 A preliminary trial has confirmed the benefit of 50-200 mg per day of DHEA for people with SLE.27
DHEA may play some role in protecting against depression. Low DHEA levels have been reported in older women suffering from this condition, though at least one report has linked severe depression to increased DHEA levels. After six months using 50 mg DHEA per day, "a remarkable increase in perceived physical and psychological well-being" was reported in both men and women in one double-blind trial.28 In another double-blind trial, after only six weeks of taking DHEA at levels up to 90 mg per day, at least a 50% reduction in depression was seen in 5 of 11 participants.29 Other researchers have reported dramatic reductions in depression at extremely high amounts of DHEA (90-450 mg per day) given for six weeks to adults who first became depressed after age 40 (in men) or at the time of menopause (in women) in a double-blind trial.30 Limiting supplementation to only two weeks is inadequate in treating people with depression.31
Despite the dramatic results reported in trials lasting at least six weeks, some experts claim that in clinical practice, DHEA appears to be effective for only a minority of depressed people.32 Moreover, due to fears of potential side effects, most healthcare professionals remain concerned about the use of DHEA. As with other uses of DHEA, depressed people should not take this hormone without supervision from a healthcare professional.
Where is dehydroepiandrosterone (dhea) found?
Dehydroepiandrosterone (DHEA) Benefits
Who is likely to be deficient of dehydroepiandrosterone (dhea)?
Meaningful levels of DHEA do not appear in food, and therefore dietary deficiency does not exist. Some people, however, may not synthesize enough DHEA. DHEA levels peak in early adulthood and then start a lifelong descent. By the age of 60, DHEA levels are only about 5–15% of what they were at their peak at younger ages.34 Whether the lower level associated with age represents a deficiency or a normal part of aging that should not be tampered with remains unknown.
People with true adrenal insufficiency (i.e., Addison’s Disease; not the hypothetical adrenal “fatigue” or “burnout” that is sometimes incorrectly referred to as “insufficiency”) have below normal levels of DHEA. When women with adrenal insufficiency were treated with 50 mg of DHEA every morning for three or four months, their DHEA and DHEAS levels returned to normal, with a simultaneous improvement in well-being and sexuality.35 36
Some studies have reported lower DHEA levels in groups of depressed patients.37 38 However, in one trial, severely depressed people were reported to show increases in blood levels of DHEA.39 Despite these contradictory findings, a few clinical trials suggest that at least some people who are depressed may benefit from DHEA supplementation. (See “
What does dehydroepiandrosterone (dhea) do?
People with multi-infarct dementia (deterioration of mental functions resulting from multiple small strokes) may have lower than normal DHEAS levels, according to a preliminary trial.40 In this trial, intravenous injection of 200 mg per day of DHEAS for four weeks increased DHEAS levels and improved some aspects of mental function and performance of daily activities.
People infected with HIV41 and those with insulin-dependent diabetes,42 congestive heart failure,43 multiple sclerosis, 44 asthma,45 46 chronic fatigue syndrome,47 48 rheumatoid arthritis,49 50 51 osteoporosis, and a host of other conditions have been reported to have low levels of DHEA in most,52 but not all, studies.53 54 In most cases, the meaning of this apparent deficiency is not well understood.
Men under 60 years of age with erectile dysfunction have been found to have lower DHEAS levels than men without the condition.55 (See “
What does dehydroepiandrosterone (dhea) do?
Most,56 57 58 59 but not all, 60 61 studies have found that people with Alzheimer’s disease have lower blood DHEAS levels than do people without the condition.
How much dehydroepiandrosterone (dhea) is usually taken?
People with systemic lupus erythematosus (SLE) have been shown to improve after taking 100–200 mg per day of DHEA. Such large amounts should never be taken without medical supervision.
Discrepancies between label claims and actual DHEA content of DHEA supplements have been reported.65 Regrettably, the authors of this report failed to identify which brands were properly labeled and which were not.
Are there any side effects or interactions with dehydroepiandrosterone (dhea)?
Side effects at high intakes (50–200 mg per day) appear to be acne (in over 50% of people), increased facial hair (18%), and increased perspiration (8%). In a preliminary trial, DHEA was also reported to induce less common side effects, including breast tenderness, weight gain, mood alteration, headache, oily skin, and menstrual irregularity in some people.66 Since this trial was not controlled, some of these less common “side effects” might have occurred even with a placebo. A case of mania has been reported in an older man who took 200–300 mg of DHEA per day for six months.67 However, in that case report, other causes of mania could not be ruled out.
Significant increases in testosterone levels in both men and women have been reported in some trials.68 69 Other reports have found this change in women but not in men.70 An increase in testosterone might increase the risk of several cancers, and high amounts of DHEA have caused cancer in animals.71 72 Moreover, a possible link between higher DHEA levels and risks of prostate cancer in humans has been reported.73 At least one person with prostate cancer has been reported to have had a worsening of his cancer, despite feeling better, while taking very high amounts (up to 700 mg per day) of DHEA.74
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.75 76 Most,77 78 79 80 81 but not all, studies82 83 84 have found that as DHEA blood levels increase, so does the risk of breast cancer.
Supplementation with high levels of DHEA (100 mg per day) has adversely affected other indicators of cancer risk in both women and men.85 86 Elevated DHEA levels have been reported to be associated with both higher,87 and lower risk for ovarian cancer.88 The reason for this discrepancy is unknown.
The lack of knowledge about how DHEA supplementation might affect cancer risks provides a reason for caution. Until more is known, people with breast or prostate cancer or a family history of these conditions should avoid supplementing with DHEA.
Although anticancer effects of DHEA have also been reported,89 they involve trials using animals that do not process DHEA the way humans do. Therefore, these positive effects may have no relevance for people.
Some doctors recommend that people taking DHEA have liver enzymes measured routinely. Anecdotes of DHEA supplementation (of at least 25 mg per day) leading to heart arrhythmias have appeared.90
The relationship between DHEA, blood pressure, and heart disease is poorly understood. Increased blood levels of DHEAS have been associated with increased blood pressure91 and other cardiovascular risk factors in some,92 but not all,93 studies. One study found that people with hypertension had significantly decreased blood levels of DHEA.94 Until clinical trials clear up these inconsistencies and confirm its safety, people with hypertension should avoid using DHEA, except under the close supervision of a doctor.
At only 25 mg per day, DHEA has lowered HDL cholesterol while increasing insulin-like growth factor (IGF).95 Decreasing HDL could increase the risk of heart disease. Increasing IGF might increase the risk of breast cancer.
Are there any drug interactions?