Dehydroepiandrosterone (DHEA) is the most abundant
androgen (male steroid hormone) secreted by the adrenal glands (small hormone
producing glands which sit on top of the kidneys), and to a lesser extent, by
the ovaries and testes. DHEA can also be converted into other steroid hormones,
including testosterone and estrogen. Considerable interest in DHEA has developed
in recent years with reports that it may play a role in the aging process.
Circulating levels of DHEA peak at age 25 and then steadily decline with age.
DHEA levels in 70-year-old individuals tend to be roughly 80 percent lower than
those in young adults.
Some researchers consider DHEA a possible anti-aging hormone because DHEA
deficiencies in older individuals have been associated with a number of medical
conditions including breast cancer, cardiovascular disease, impaired memory and
mental function, and osteoporosis. In addition, population-based studies have
suggested that people with higher DHEA levels tend to live longer, healthier
lives than those with lower levels of DHEA. However, low levels of DHEA being
linked to certain diseases does not necessarily mean that DHEA supplements will
reduce the risk or improve the outcome of these conditions.
The United States Food and Drug Administration (FDA) removed DHEA supplements
from the market in 1985 due to false claims about health benefits. However,
since the passing of the US Dietary Supplement Health and Education Act of 1994,
DHEA has made its way back on the market and its popularity continues to grow.
Despite this growth and attention, support for the health claims, particularly
as tested on people, is lacking. Plus, given that DHEA products are sold as
dietary supplements, there is no control over their contents or the
manufacturing practices of the companies that make the supplements. One
independent evaluation found that the amount of DHEA in over the counter
products ranged from 0% to 150% of what the content stated on the
Given that DHEA levels decline with advancing age, some researchers have
investigated whether DHEA supplementation may slow or prevent age-related
declines in mental and physical function. Preliminary results from the DHEAge
study in France suggest that the hormone may slow bone loss, improve skin
health, and enhance sexual drive in aging adults, particularly women older than
70 years of age. Animal studies that have shown a boost in memory for older rats
taking DHEA supplements. Results from human studies, however, have been
conflicting. Some studies have shown that DHEA improves learning and memory in
those with low DHEA levels, but other studies have failed to detect any
significant cognitive effects from DHEA supplementation. Further studies are
needed to determine whether DHEA supplementation helps prevent or slow medical
conditions associated with the aging process.
As mentioned earlier, DHEA is one of the hormones made in the adrenal glands.
When the adrenal glands do not make enough hormones, this is called adrenal
insufficiency. Women with this condition who were given DHEA supplements
reported improved sexuality and sense of well-being (including decreased
feelings of depression and anxiety). Only a doctor can determine if you have
adrenal insufficiency and if DHEA, along with other hormones, is needed. Adrenal
insufficiency can be a medical emergency, particularly when first diagnosed.
This is especially the case if your blood pressure is low, which can cause you
to experience dizziness or lightheadedness. Another reason to seek medical
attention right away in the case of adrenal insufficiency is swelling of the
ankles or legs.
Studies suggest that DHEA supplementation may help impotent men have and
sustain an erection.
Studies have shown that DHEA cream applied to the inner thigh may boost bone
density in older women.
Women with anorexia nervosa are at increased risk for bone fractures and can
develop osteoporosis at a younger age than women without eating disorders. It
has been observed that adolescents and young adults with anorexia nervosa tend
to have low levels of DHEA. Some studies suggest that DHEA may help protect
against bone loss in people who are anorexic.
Although DHEA supplements are widely used by athletes and body builders to
boost muscle mass and burn fat, there is little evidence to support these
claims. There are no published studies of the long-term effects of taking DHEA,
particularly in the large doses used by athletes. Plus, the building blocks of
testosterone, including DHEA, may adversely affect cholesterol in male athletes
by lowering HDL ("good") cholesterol.
Lupus is an autoimmune disorder. Autoimmune diseases are a group of
conditions in which a person's antibodies attack a part of their own body
because the immune system believes the body part is foreign. Studies have shown
that DHEA helps regulate the immune system and may play a role in the prevention
and/or treatment of certain autoimmune diseases.
A recent review of scientific literature found that DHEA supplementation may
reduce the need for medications and the frequency of flare-ups, enhance mental
function, and boost bone mass in women with lupus. Further studies are needed to
determine whether DHEA is safe and effective for both men and women with this
DHEA levels tend to be low in individuals infected with the human
immunodeficiency virus (HIV), and these levels decline even further as the
disease progresses. In one small study, DHEA supplementation improved mental
function in men and women infected with HIV. However, studies have yet to
demonstrate whether DHEA supplementation can improve immune function in people
with this condition.
In a preliminary study of individuals with major depression, DHEA
significantly improved symptoms of depression compared to placebo. However,
results of this study and others conducted to date on DHEA and depression are
not conclusive. The potential value of using DHEA for depression, therefore,
remains unclear, and the long-term effects of taking this supplement are
The results of studies using DHEA to treat overweight people have been
conflicting. While animal studies have found DHEA to be effective in reducing
body weight, studies of men and women showed that DHEA produced no change in
total body weight, although total body fat and LDL ("bad") cholesterol did
improve. These differences may be due to the fact that higher dosages were used
in the animal studies than in the human studies (such high doses would cause
intolerable side effects in people). Further studies are needed to determine
whether DHEA is an effective way to reduce body weight in obese people. Until
the safety and effectiveness of DHEA is fully tested, it is best not to use this
supplement for weight loss.
DHEA has gained some popularity among peri-menopausal women. They often used
the supplement to alleviate symptoms of menopause including decreased sex drive,
diminished skin tone, and vaginal dryness. In one recent study, DHEA supplements
did raise levels of certain hormones in post-menopausal women. However, clinical
studies regarding the value of DHEA for improving menopause symptoms have had
Those who believe in the use of DHEA claim that it relieves the menopausal
symptoms described above without increasing the risk of breast cancer or cancer
of the endometrium (lining to the uterus). The risk of each of these cancers may
be increased with regular, prescription hormone replacement therapy. There is no
proof, however, that DHEA does not stimulate these cancers as well. Women with
breast cancer tend to have low levels of this hormone in their bodies. But
replacement may lead to either inhibition or stimulation of growth of breast
Inflammatory Bowel Disease (IBD)
DHEA levels appear to be low in people with ulcerative colitis and Crohn's
disease. It is premature to say whether DHEA supplements have any impact,
positive or negative, on these two bowel diseases.
DHEA is a hormone produced in the body and is not obtained through the
Most DHEA supplements are produced in laboratories from diosgenin, a plant
sterol extracted from Mexican wild yams. Some extracts from wild yams are
marketed as "natural DHEA." Advertisers claim that these "natural" extracts of
diosgenin are converted into DHEA by the body. However, it takes several
chemical reactions to convert diosgenin into DHEA, and there is no evidence that
the body can make this conversion. For this reason, it is best to look for
labels that list DHEA rather than diosgenin or wild yam extract. Also, it is
important to select products that state it is pharmaceutical grade.
One way to avoid purchasing a product with contaminated DHEA is to purchase
it through a professional healthcare provider.
DHEA is available in capsules, chewing gum, drops that are placed under the
tongue, and topical creams.
|How to Take It|
DHEA is not recommended for people under the age of 40, unless DHEA levels
are known to be low (<130 mg/dL in women and <180 mg/dL in men).
DHEA supplements should not be used in children.
Dosages for men and women differ. Men can safely take up to 50 mg/day, but
women should generally not take more than 25 mg/day, although up to 50 mg has
been used for women with anorexia, adrenal insufficiency, and other medical
conditions under medical supervision. DHEA is produced by the body primarily in
the morning hours. Taking DHEA in the morning will mimic the natural rhythm of
DHEA production. Positive effects have been noted at dosages as low as 5 mg/day
and the lower the dose the better.
Because of the potential for side effects and interactions with medications,
dietary supplements should be taken only under the supervision of a
knowledgeable healthcare provider.
DHEA is not recommended for people under 40 years of age, unless DHEA levels
are known to be low (less than 130 mg/dL in women and less than 180 mg/dL in
men). People taking DHEA should have their blood levels monitored every 6
No studies have been conducted on the long-term safety of DHEA.
Because DHEA is a precursor of estrogen and testosterone, patients with
cancers affected by hormones (such as breast, prostate, ovarian, and testicular
cancer) should avoid this hormone supplement.
High doses of DHEA may inhibit the body's natural ability to make the hormone
and also may be toxic to liver cells. At least one case of hepatitis has been
DHEA increases the production of the male hormone testosterone, so women
should be aware of the risk of developing signs of masculinization (such as loss
of hair on the head, deepening of the voice, hair growth on the face, weight
gain around the waist, or acne), and men should be aware of the risks of excess
testosterone (such as shrinkage of the testicles, aggressive tendencies
including sexual aggression, male pattern baldness, and high blood pressure).
Notify your health care provider if any of these symptoms occur.
Other adverse effects that have been reported include high blood pressure and
reduced HDL ("good") cholesterol.
The International Olympic Committee and National Football League recently
banned the use of DHEA by athletes because its effects are very similar to those
of anabolic steroids.
If you are currently being treated with any of the following medications, you
should not use DHEA without first talking to your healthcare provider.
In a laboratory study, DHEA enhanced the
effectiveness of an HIV medication known as AZT. However, scientific studies in
humans are needed before DHEA can be used for this purpose in people.
Animal studies suggest that DHEA may increase the
effects of barbiturates, a class of medications often used to treat sleep
disorders including butabarbital, mephobarbital, pentobarbital, and
phenobarbital. However, scientific studies in humans are needed before it is
known whether this same effect occurs in people and whether it is safe for DHEA
and barbiturates to be used together.
An animal study indicates that DHEA may increase the
effectiveness of an anti-cancer medication known as cisplatin; further studies
are needed to know if this effect applies to people.
Laboratory studies suggest that DHEA may increase the
effects of prednisolone, a steroid medication used to treat inflammation and
other disorders. Additional research is needed to determine if this effect
applies to people.
It is possible that DHEA may influence the level of
estrogen in the body. For this reason, some women on estrogen replacement
therapy may need to adjust their dosage. This should be discussed with your
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|Review Date: April 2002|
|Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD,
Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University
and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh
(Pediatric Dosing section February 2001), Johnson Drugs, Natick, Ma; Steven
Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's
Administrative Hospital, Londonderry, NH; Margie Ullmann-Weil, MS, RD,
specializing in combination of complementary and traditional nutritional
therapy, Boston, MA. All interaction sections have also been reviewed by a team
of experts including Joseph Lamb, MD (July 2000), The Integrative Medicine
Works, Alexandria, VA;Enrico Liva, ND, RPh (August 2000), Vital Nutrients,
Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy (March 2000), Clinical
Assistant Professor, University of Maryland School of Pharmacy; President, Your
Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH, MBA (July 2000),
President and Chairman, Hawaii State Consortium for Integrative Medicine,
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