Dehydroepiandrosterone (DHEA): What does it do?
is one of the hormones produced by the adrenal glands. After
being secreted by the adrenal glands, it circulates in the bloodstream as DHEA-sulfate (DHEAS)
and is converted as needed into other hormones.
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 i
Where is Dehydroepiandrosterone (DHEA) 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 these
substances into DHEA33 (although a series of reactions in a laboratory can make the
conversion).
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 “
Dehydroepiandrosterone (DHEA): What does it do?
” above for more information about use of DHEA supplements
in the treatment of depression.)
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 “
Dehydroepiandrosterone (DHEA): What does it do?
” above for more information about
use of DHEA supplements in the treatment of men with erectile dysfunction.)
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?
Most people do not need to supplement DHEA. The question of who should take this hormone
remains controversial. Some experts believe that daily intakes of 5–15 mg of DHEA for
women and 10–30 mg for men are appropriate amounts for people with deficient blood
levels of DHEA or DHEAS.62 While a few researchers suggest supplementation with as
much as 50 mg per day in postmenopausal women,63 others consider this level
excessive.64 People should consult a doctor to have DHEA levels monitored before
and during supplementation. Healthy people with normal blood levels of DHEA or DHEAS should
not take this hormone until more is known about its effects. However, some doctors recommend
DHEA supplementation for selected people with
depression, autoimmune diseases, or other problems, even if their blood levels are
normal.
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)?
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%). 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
Special United Kingdom considerations
DHEA is either not available or may require a prescription. People should check with their
physician.
Dehydroepiandrosterone (DHEA) Reviews
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The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in
vitro), clinical experience, or traditional usage as cited in each article.
The results reported may not necessarily occur in all individuals. For many of
the conditions discussed, treatment with prescription or over the counter
medication is also available. Consult your doctor, practitioner, and/or
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making any changes in prescribed medications.
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