|  | DHEAWhat does it do? Little is known about how dehydroepiandrosterone (DHEA) works in the body.1Confusing the picture is the fact that DHEA has very different effects in men, premenopausal women, and postmenopausal women.2
DHEA is the most prevalent of the hormones produced by the adrenal glands. After being secreted by the adrenals, it circulates in the bloodstream as DHEA-sulfate (DHEAS) and is converted as needed into other hormones.
DHEA converts, in part, to testosterone,3 which may account for the fact that low blood levels of DHEA have been reported in some men with erectile dysfunction. Double blind research reported that 50 mg supplements of DHEA taken daily for six months significantly improved erectile function.4
Some,5 6 but not all,7 8 studies find that DHEA supplementation lowers fat mass without reducing total body weight.9 In one trial, the reduction in fat mass occurred in men, but not in women.10
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,11no effect,12 and, at very high amounts (1,600 mg DHEA per day), a worsening of tolerance to sugar.13
DHEA modulates immunity. A group of elderly men with low DHEA levels who were given a high level of DHEA (50 mg per day) for twenty weeks, experienced a significant activation of immune function.14 Postmenopausal women have also shown increased immune functioning in just three weeks when given DHEA in double blind research.14
Reports have suggested that DHEA might reduce the risk of heart disease, perhaps by lowering cholesterol levels. Most research supports this idea weakly for men, but not at all for women.16 17 DHEA has also been reported to act as a blood thinner.18 Unfortunately, DHEA has also been reported to lower HDL (the “good” cholesterol).19
Claims have appeared that DHEA is an antiaging hormone; but to date, no human research supports this claim. The fact that young people have higher levels of DHEA than older people does not necessarily mean that supplementing DHEA will make people younger. In double blind research, DHEA has improved a sense of well-being in some,20 but not all,21 studies.
Systemic lupus erythematosus (SLE), an autoimmune disease, has been linked to abnormalities in sex hormone metabolism.22 Using very high levels of DHEA (200 mg per day) in a double blind study, researchers have shown that people with SLE are less likely to suffer exacerbations of their disease than people given placebo.23 An uncontrolled study confirmed the benefit of 50–200 mg per day of DHEA for people with SLE.24
Where is it found? DHEA is produced by the adrenal glands. A synthetic form of this hormone is also available as a supplement in tablet, capsule, liquid, and sublingual form. Some products claim to contain “natural” DHEA precursors from wild yam; however, the body cannot convert any compounds in the yam into DHEA24 (although a series of reactions in a laboratory can make the conversion).
Dehydroepiandrosterone (DHEA) has been used in connection with the following conditions (refer to the individual health concern for complete information):
Who is likely to be deficient? 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 sixty, DHEA levels are only about 5–15% of what they were at their peak at younger ages.26 Whether the lower level associated with age represents a deficiency remains unclear. Women with asthma have been reported to have depressed levels of DHEA.27
Researchers from the University of California, San Francisco, report that DHEA and DHEAS levels may be lower in depressed patients, and DHEA supplements of 30–90 mg per day for four weeks significantly improved depression in six depressed patients.28 However, experts maintain that DHEA may only be effective for a minority of people with depression.29
People with diabetes who use insulin have been reported to have low levels of DHEA.30 People infected with HIV (AIDS virus) and those with asthma, osteoporosis, and a host of other conditions have been reported to have low levels of DHEA.31 In most cases, the meaning of this apparent deficiency is not well understood.
How much is usually taken? Most people do not need to supplement DHEA. The question of who should take this hormone remains controversial. Some experts believe that 5–15 mg of DHEA for women and 10–30 mg for men are appropriate amounts, depending in part on blood levels of DHEA or DHEAS.32 Due to problems with absorption, a few experts have suggested levels as high as 50 mg per day in postmenopausal women.33 People should consult a nutritionally oriented doctor to have DHEA levels monitored before and during supplementation. Only people with low blood levels of DHEA or DHEAS should take this hormone until more is known about its effects.
People with SLE appear to require high levels (100–200 mg per day) of DHEA. Such levels should never be taken without medical supervision.
Are there any side effects or interactions? Experts have concerns about the use of DHEA, particularly because long-term safety data do not exist.
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%). Less common problems reportedly caused by DHEA include breast tenderness, weight gain, mood alteration, headache, oily skin, and menstrual irregularity.34 Because this trial was not controlled, some of the less common “side effects” were possibly unrelated to DHEA and might have occurred even with placebo.
High amounts of DHEA have caused cancer in animals.35 36 Although anticancer effects of DHEA have also been reported,37 they involve trials using animals that do not process DHEA the way humans do; therefore, these positive effects may have no relevance for people.
Links have begun to appear between higher DHEA levels and risks of prostate cancer in humans.38 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.39 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.40 These cancer concerns make sense because DHEA is a precursor to testosterone (linked to prostate cancer) and estrogen (linked to breast cancer). Until more is known, individuals with breast or prostate cancer or a family history of these conditions should avoid supplementing with DHEA. Preliminary evidence has also linked higher DHEA levels to ovarian cancer in women.41
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.42
At only 25 mg per day, DHEA has lowered HDL cholesterol while increasing insulin-like growth factor (IGF).43Decreasing HDL could increase the risk of heart disease. Increasing IGF might increase the risk of breast cancer.
Certain medications interact in a positive and/or negative way withdehydroepiandrosterone. Refer to the drug interactions summary for dehydroepiandrosterone for a list of those medications.
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