Supplements

DHEA (Dehydroepiandrosterone)

Dehydroepiandrosterone (DHEA) is the most abundant androgen (15 to 30 mg/day) secreted by the adrenal glands and to some extent by the ovaries and testes. It is a precursor for other steroid hormones, such as testosterone and estrogen.

Peak levels of DHEA occur at age 25. By age 80, DHEA levels have decreased to 10 to 20% of the peak level. DHEA has been called an anti-aging hormone because deficiencies of DHEA in old age may make individuals more susceptible to cancer of the breast, prostate, and bladder; atherosclerosis, hypertension, autoimmune diseases (e.g., diabetes, lupus erythematosus, rheumatoid arthritis), osteoporosis, high cholesterol, obesity, memory disturbances, chronic fatigue, and manifestations of aging.

When given to older patients, DHEA increased feelings of physical and psychological well-being, increased immune cell production, and enhanced mood, energy, and sleep. Older individuals with higher DHEA levels are often in better health than individuals with lower levels. The two most important factors concerning DHEA are its decline in old age and its deficiency in several major disease states.

One of the most common reasons that DHEA is prescribed is to overcome fatigue. Our adrenal glands, increasingly overworked and exhausted as we age, secrete diminishing amounts of hormones, including DHEA. People older than fifty can potentially revive energy levels in just a few days to a few weeks with supplemental DHEA.

People with chronic fatigue syndrome, AIDS, and other immune crippling illnesses, often have very low DHEA levels. DHEA strengthens the immune function, relives depression, boost energy and sharpens thinking.

A six-month course of DHEA, in a daily dosage of 200 mg, markedly diminished symptoms of lupus for a small number of women involved in a study of the hormone.

Rheumatoid arthritis is another autoimmune disease for which DHEA is prescribed. Most people who contend with the degenerative joint disease have lower than usual readings of the hormone.

Studies are still underway in DHEA research as it pertains to cancer. Blood concentrations of DHEA are lower in people with bladder cancer than their cancer-free counterparts. However, people with prostate cancer should avoid DHEA because it can stimulate testosterone production, and the male hormone feeds prostatic tumors.

Taking supplements of DHEA may reduce a high cholesterol level. This is one way that DHEA helps to prevent heart disease. It also thwarts blood clot formation and may encourage blood vessels to relax, which could lower high blood pressure.

A four-week study of older adults showed that 75 mg of DHEA daily, improved memory and brightened moods. It may also guard against Alzheimer's disease, but research so far is inconclusive.

Clinical studies are still underway regarding rejuvenation of sex drive in older adults, but both men and women have shown increased sex drives with supplemental DHEA.

Few studies of diabetic persons are available at this time, but results of animal experiments show that supplements may improve the body's sensitivity to insulin, which would help keep blood sugar in line.

Deficiency: Aging, cancer, autoimmune disorders, chronic fatigue syndrome, Alzheimer's

Sources: Most of the DHEA on the market is made in laboratories from sterols (especially diosgenin) extracted from wild yams found in Mexico. Some extracts from wild yams are marketed as "natural DHEA." These extracts of diosgenin are supposedly converted into DHEA by the body. However, because it takes several chemical reactions to convert diosgenin into DHEA, it is unlikely that the body can make this conversion. Thus, only pharmaceutical grade DHEA should be used.

Precautions: High doses of DHEA are associated with negative side effects for both men and women. However, the administration of high doses may be appropriate when treating serious illness (e.g., autoimmune diseases). High doses may inhibit the body's natural ability to synthesize DHEA and may be hepatotoxic.

In addition, women should be alert for any signs of masculinization because the end products of DHEA in women are androgens (male hormones). Possible signs include loss of hair on the head, hair growth on the face, weight gain around the waist, and acne. Men should also be alert for signs of excess testosterone (e.g., sexual aggressiveness, testicular atrophy, aggressive tendencies, male pattern baldness, and high blood pressure).

Blood levels of DHEA should be checked every six months.

Because DHEA is a precursor of estrogen and testosterone, patients with hormone-sensitive cancers (e.g., breast, prostate, ovarian, testicular) should avoid taking DHEA
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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).

The International Olympic Committee and the National Football League recently banned the use of DHEA by athletes because its effects are very similar to anabolic steroids.

Dosage Ranges and Duration of Administration: Dosages for men and women differ; men seem to tolerate higher doses. Men can safely take up to 50 mg/day; women should not take more than 25 mg/day. Positive effects have been noted at dosages as low as 5 mg/day. Because the long-term effects of DHEA supplementation have not been studied and data from clinical trials is virtually nonexistent, the safety and efficacy of DHEA has not been determined.

INTERACTIONS

Azidothymidine (AZT); Zidoyudine
When AZT-resistant and AZT-sensitive human HIV-1 cell isolates were inoculated with DHEA (50 µM), viral replication was suppressed by over 50% (Yang et al. 1994). The addition of DHEA enhanced the cytopathic effect of AZT and inhibited reverse transcriptase activity. DHEA may play a role in the treatment of HIV infection as an adjunct to conventional therapies by inhibiting replication of HIV-1 cells and preventing resistance to AZT.

Barbiturates
DHEA (20 mg/kg) caused a dose-dependent increase in sleep time and enhanced the hypnotic and hypothermic effects of pentobarbital in male mice (Melchior and Ritzmann 1992).

Cisplatin
Pretreatment with DHEA-supplemented diets (6% w/w) amplified therapeutic effects derived from a chemotherapeutic regimen of cisplatin (6 mg/kg) and AZT (400 mg/kg) for the treatment of colorectal carcinoma in mice (Klann et al. 1992). These results warrant further study to determine whether DHEA supplementation enhances the effectiveness of chemotherapeutic regimens in humans.

Predinisolone
Although DHEA alone was 1000 times less potent than prednisolone alone, synergy existed when DHEA was combined with prednisolone to inhibit rat lymphocyte proliferation (Meno-Tetang et al. 1996). Combination therapy could lower the doses of corticosteroids necessary to treat inflammatory disorders.