Dehydroepiandrosterone (DHEA) is a hormone produced by the body's adrenal glands. The body uses DHEA to make androgens and estrogens, the male and female sex hormones. DHEA levels peak at about age 25, then go down steadily as you get older. By the time people are 70 to 80 years old, their DHEA levels are only 10% to 20% those in young adults.
Because levels of DHEA decline with age, researchers have wondered if DHEA could work as an anti-aging treatment. In older people, lower than normal levels of DHEA have been associated with osteoporosis, heart disease, memory loss, and breast cancer. But there's no proof that low levels of DHEA cause these conditions, or that taking DHEA can help prevent them. Plus DHEA supplements vary widely in quality. Many products tested don't have the amount of DHEA in them that the label says they do.
Also, DHEA supplements can have side effects. They may lower levels of HDL ("good") cholesterol in the body, and in women they may raise levels of testosterone, as well as estrogen.
The DHEA in supplements is a synthetic hormone, so you should talk to your doctor before taking it.
Studies show DHEA helps reduce abdominal fat and improve insulin resistance. Other studies suggest that DHEA helps reduce inflammation in the arteries and reduce arterial stiffness.
Studies link low DHEA levels with an increase in heart disease. Researchers aren't sure whether supplementing with DHEA is safe or reduces risk.
Systemic lupus erythematosus (SLE)
Lupus or SLE is an autoimmune disorder. That means that the body's immune system mistakenly attacks its own tissue. Several studies show that taking DHEA along with other medications helps improve quality of life for people with lupus, though it probably does not change the overall course of their disease.
Several studies have found that some people who take DHEA supplements may be able take less prescription medication. DHEA may also reduce the frequency of flare ups, enhance mental function, and boost bone mass in women with lupus. Many studies use 200 mg per day of DHEA, which can raise levels of testosterone and lower HDL ("good") cholesterol. One study found that a lower dose -- 20 to 30 mg -- might also work. Most of these studies have been small. So more studies are needed to determine whether DHEA is safe and effective for people with lupus.
DHEA is one of the hormones made by the adrenal glands. With adrenal insufficiency, the adrenal glands do not make enough hormones, including DHEA and cortisol. That happens either because of problems with the pituitary gland or damage to the adrenal glands themselves (also called Addison's disease).
Several studies suggest that taking DHEA may help improve mood, fatigue, and well being. In one study, women with this condition who took DHEA supplements reported improved sexuality and sense of well being, including fewer feelings of depression and anxiety.
Adrenal insufficiency requires a doctor's care. You shouldn't take DHEA on your own for adrenal insufficiency. Severe adrenal insufficiency can be a medical emergency, especially when first diagnosed.
A few studies of people with major depression found that DHEA improved symptoms compared to placebo. The results aren't entirely clear, and researchers don't know what the long-term effects of taking DHEA might be. More research is needed. DO NOT try to treat depression by yourself. People with depression need medical care.
Preliminary studies suggest that DHEA may help reduce bone loss in older women. It doesn't seem to have the same effect in men. And in one study it didn't help women who were under age 70.
Studies using DHEA to treat overweight people have found conflicting results. Animal studies have found DHEA to help reduce body weight. Human studies found that taking DHEA didn't change total body weight. But it did improve total body fat and LDL ("bad") cholesterol. More research is needed.
One study found that DHEA helped men with erectile dysfunction (ED) get and sustain an erection, possibly because the body converts DHEA into testosterone. However, more research is needed to know whether DHEA really helps.
Improved libido in women
Research suggests that DHEA may help improve sex drive in older women (but not younger women). More studies are needed.
Since DHEA levels decline with age, some researchers have investigated whether taking DHEA supplements could slow or prevent age-related mental or physical problems. Preliminary results from the DHEAge study in France suggested DHEA may slow bone loss, improve skin health, and improve sex drive in women over 70. People in the study didn't have any improvement in muscle function and strength. Another study found that men and women over 60 who took DHEA for 2 years didn't have any improvement in bone density, muscle strength, insulin sensitivity, or quality of life.
In terms of memory loss, some studies have shown that DHEA improves learning and memory in people who have low DHEA levels. But other studies have not found any improvement. More research is needed.
People with HIV tend to have low levels of DHEA. And these levels decrease even more as the disease progresses. One small study found that DHEA improved mental function in men and women with HIV. However, no human studies show whether DHEA can improve immune function in people with HIV.
DHEA has been popular among perimenopausal women, seeking relief from menopausal symptoms, including decreased sex drive, diminished skin tone, and vaginal dryness. Studies have been mixed.
Preliminary studies show DHEA supplements raised levels of some hormones in postmenopausal women. However, DHEA supplementation in healthy pre- and postmenopausal women is controversial. Clinical studies show conflicting results as to whether DHEA can improve sexual function, metabolism, and overall well being. More studies are needed to determine whether DHEA is safe and effective.
People who believe in using DHEA claim that it relieves menopausal symptoms without increasing the risk of breast cancer or cancer of the lining of the uterus -- unlike prescription hormone replacement therapy, which does increase risk of these cancers. But there is no proof that DHEA does not also increase risk of these cancers.
People with a history of cancer, or who are at high risk for cancer should not take DHEA without their doctor's supervision. DHEA can be converted into either estrogen or testosterone in the body, which may be dangerous for women or men with a history of hormone-sensitive cancers, such as breast or prostate cancer. Women with breast cancer tend to have low levels of DHEA in their bodies. Scientists don't know whether taking DHEA may increase or reduce growth of breast cancer cells.
Inflammatory bowel disease (IBD)
DHEA levels appear to be low in people with ulcerative colitis and Crohn's disease. A small study found that DHEA was effective for use in ulcerative colitis and Crohn's disease. But the study wasn't well designed. More studies are needed to say for sure whether DHEA helps IBD.
Studies suggest that DHEA supplementation may be beneficial for other health conditions, including infertility, schizophrenia, cocaine withdrawal, anorexia nervosa, and dementia. More research is needed.
Most DHEA supplements are produced in laboratories from diosgenin, a plant sterol extracted from Mexican wild yams (Dioscorea villosa). Some extracts from wild yams are marketed as "natural DHEA." Advertisers claim that these "natural" extracts are converted into DHEA by the body. But this is not true. Your body can't covert those extracts into DHEA. For this reason, it is best to look for labels that list DHEA rather than diosgenin or wild yam extract.
It is important to choose high quality DHEA supplements. One way to avoid buying a product with contaminated DHEA is to purchase it through a professional health care provider.
DHEA is available in capsules, tablets, chewing gum, sublingual (under the tongue) drops, and topical (on the skin) creams.
How to Take It
If you are under 40, you shouldn't take DHEA without your doctor's supervision. Your doctor can determine whether your DHEA levels are low (less than 130 mg/dl in women and less than 180 mg/dl in men).
DO NOT give DHEA to a child unless your child's doctor tells you to.
The dose of DHEA may depend on a person's gender, age, and condition. Laboratory tests can assess your DHEA levels before you take it, and can monitor levels after you start. Talk to your doctor to find the right dose for you.
Higher doses have been used to treat lupus. People with lupus should not take DHEA without first talking to their doctor.
Your body makes DHEA primarily in the morning, so taking DHEA in the morning will mimic this natural rhythm.
Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.
People under 40 shouldn't take DHEA unless they have low levels as determined by their doctors. People taking DHEA should have their blood levels checked every 6 months.
Very few studies have been done on the long-term safety of DHEA.
Because your body uses DHEA to make estrogen and testosterone, people with hormone-related cancers, such as breast, prostate, ovarian, adrenal, and testicular cancer, or a family history of these cancers, should not take DHEA.
DHEA may make other hormone-related conditions, such as endometriosis or polycystic ovarian syndrome, worse.
Some experts think people with a history of depression or bipolar disorder may have side effects from using DHEA including mania and irritability.
High doses of DHEA may prompt the body to stop making the hormone. High doses may also be toxic to liver cells. At least one case of hepatitis has been reported. People who have liver disease should avoid DHEA. Some experts are concerned that DHEA may make liver problems worse.
People with diabetes should not take DHEA, because it may increase insulin resistance.
DHEA may increase the production of the male hormone testosterone. Women should be aware of the risk of developing signs of masculinization. These include loss of hair on the head, deepening of the voice, growth of hair on the face, weight gain around the waist, or acne. Men should be aware of the risks of too much testosterone, such as shrinkage of the testicles, aggression, male pattern baldness, high blood pressure, and possible higher risk for testosterone-related cancers. Call your doctor if any of these symptoms occur.
Other side effects can include high blood pressure and reduced HDL ("good") cholesterol.
The International Olympic Committee and National Football League banned the use of DHEA because its effects are similar to those of anabolic steroids.
If you are currently being treated with any of the following medications, or with any medications designed to alter the levels or metabolism of various hormones in your body, you should not use DHEA without talking to your doctor first.
In a laboratory study, DHEA strengthened the effects of AZT, used to treat HIV. However, researchers don't know if that would be true or safe in humans.
Animal studies suggest that DHEA may strengthen the effects of barbiturates, a sedative often used to treat sleep disorders. These medicines include butabarbital, mephobarbital, pentobarbital, and phenobarbital.
Laboratory studies suggest that DHEA may increase the effects of prednisolone, used to treat inflammation and other disorders.
Estrogen and testosterone therapy
DHEA may affect levels of estrogen and testosterone in the body. People who are taking hormone therapy should talk to their doctors to see if their doses need to be adjusted.
Oral medications for diabetes and insulin
DHEA may make insulin and drugs used to lower blood sugar less effective, raising the risk of high blood sugar.
Drugs that may lower DHEA levels
Drugs that can decrease or lower the levels of DHEA in the body include:
- Antipsychotic medications, including chlorpromazine (Thorazine) and quetiapine (Seroquel)
- Budesonide (Pulmicort)
- Oral contraceptives (birth control pills)
- Dexamethasone (Decadron)
- Metformin (Glucophage)
Drugs that may raise DHEA levels
Drugs that may increase DHEA levels in the body include:
- Alprazolam (Xanax)
- Amlodipine (Norvasc)
- Anastrozole (Arimidex)
- Nifedipine (Procardia)
- Danocrine (Danazol)
- Diltiazem (Cardizem)
- Methyphenidate (Ritalin)
- Metopirone (Metyrapone)
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