Overview

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. Levels of DHEA in the body peak at about age 25 and then decline steadily with age. In people who are 70, for example, DHEA levels tend to be about 80% lower than those in young adults.

Because levels of DHEA decline with age, DHEA has been proposed as a possible anti-aging hormone. Lower than normal levels of DHEA in older people 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. And DHEA supplements can have side effects: they may decrease levels of HDL “good” cholesterol in the body, and in women they may increase levels of testosterone as well as estrogen.

Because the DHEA in supplements is a synthetic hormone, you should talk to your doctor before taking it.

Systemic Lupus Erythematosus (SLE)

Lupus or SLE is an autoimmune disorder. That means that the body’s immune system mistakenly attacks its own tissue, believing it to be a foreign invader. A number of clinical studies have reported that DHEA, used along with other medications, helps improve quality of life for people with lupus, though it probably does not affect their long-term outcome.

A recent review of scientific literature found that DHEA supplements may allow some people to lower the dose of prescription medication they need. It 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 increase levels of testosterone and lower HDL “good” cholesterol. One study found that a lower dose -- 20mg - 30mg -- might also be effective. More studies are needed to see whether DHEA is safe and effective for people with lupus.

Adrenal insufficiency

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. 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 decreased feelings of depression and anxiety). Only a doctor, through laboratory tests, can determine if you have adrenal insufficiency and whether you need DHEA, along with other hormones. Severe adrenal insufficiency can be a medical emergency, particularly when first diagnosed.

Depression

In a few clinical studies of people with major depression, DHEA significantly improved symptoms compared to placebo. However, the results aren’t entirely clear, and the long-term effects of taking DHEA are not known. More research is needed. You should not try to treat depression by yourself; depression can be serious and people with major depression need medical care.

Osteoporosis

Some clinical studies have shown 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 women who were under age 70 did not get any benefit from DHEA.

Obesity

Clinical studies using DHEA to treat overweight people have found conflicting results. While animal studies have found DHEA to be effective in reducing body weight, studies of men and women found that DHEA produced no change in total body weight, although total body fat and LDL ("bad") cholesterol did improve. In one study, the men lowered body fat but the women did not. More studies, with larger numbers of participants, are needed.

Erectile dysfunction

One study found that DHEA helped men with erectile dysfunction have and sustain an erection, possibly because the body converts DHEA into testosterone. However, the study didn’t fully analyze the results, so more research is needed to know whether DHEA really helps.

Improved libido in women

Study results have been mixed, but some seem to suggest that DHEA may help improve libido in older women (but not younger women).

Aging

Because DHEA levels decline with age, some researchers have investigated whether taking DHEA supplements could slow or prevent age-related declines in mental and physical health. Preliminary results from the DHEAge study in France suggested that the hormone may slow bone loss, improve skin health, and improve sexual drive in women over 70. But people in the study did not see any improvement in muscle function and strength. In terms of memory loss, some studies have shown that DHEA improves learning and memory in people with low DHEA levels, but other studies have not found any improvement. More studies are needed to see whether DHEA supplementation helps prevent or slow medical conditions associated with aging.

HIV

People with HIV tend to have low levels of DHEA, and these levels decline even more as the disease progresses. In one small clinical study, DHEA supplementation improved mental function in men and women infected with HIV. However, so far no human studies show whether DHEA supplementation can improve immune function in people with HIV.

Menopause

DHEA has gained some popularity among perimenopausal women. They often used the supplement to relieve symptoms of menopause, including decreased sex drive, diminished skin tone, and vaginal dryness. In one recent clinical study, DHEA supplements did raise levels of certain hormones in postmenopausal women. Although DHEA supplementation has been reported to have beneficial effects in women with adrenal insufficiency, 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 better understand how and whether DHEA works, and if it safe.

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) -- unlike prescription hormone replacement therapy, which does increase risk of these cancers. There is no proof, however, that DHEA does not increase risk of these cancers as well. 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 DHEA replacement may stimulate or inhibit 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 clinical study found that DHEA supplementation was safe and effective for use in ulcerative colitis and Crohn's disease. However, more studies are needed to say for sure whether DHEA helps IBD.

Other conditions

A few clinical studies suggest that DHEA supplementation may be beneficial for other health conditions, including infertility, psoriasis, rheumatoid arthritis, schizophrenia, cocaine withdrawal, cervical cancer, and septicemia (infection in the blood). More studies are needed to know for sure.

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 there’s no evidence that wild yams can be converted into DHEA outside of a lab. 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.

DHEA is not recommended for people under the age of 40, unless DHEA levels are known to be low (less than 130 mg/dl in women and less than 180 mg/dl in men) as determined by a doctor.

Pediatric

DHEA supplements should not be given to children under the age of 18 years of age unless under the supervision of a doctor.

Adult

For adult males 19 years and older: The recommended dosage of DHEA is 50 mg daily.

For adult females 19 years and older: The recommended dosage of DHEA is 25 mg daily. Dosages of 50 mg daily have been used in females with anorexia, adrenal insufficiency, and other conditions that are under medical supervision.

Higher doses have been used to treat lupus. You should not take DHEA without first talking to your doctor.

DHEA is produced by the body primarily in the morning so taking DHEA in the morning will mimic this natural rhythm. Work with your doctor to find the best dosage for you.

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.

DHEA is not recommended for people under 40 years of age, unless DHEA levels are determined to be (less than 130 mg/dL in women and less than 180 mg/dL in men) by your doctor. People taking DHEA should have their blood levels monitored every 6 months.

Very few studies have been done on the long-term safety of DHEA.

Because DHEA is a precursor of 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.

High doses of DHEA may stop the body from making the hormone itself. High doses also may be toxic to liver cells. At least one case of hepatitis has been reported. People who have liver disease should avoid DHEA.

DHEA may increase the production of the male hormone testosterone, so women should be aware of the risk of developing signs of masculinization. These include loss of hair on the head, deepening of the voice, hair growth 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 including sexual aggression, male pattern baldness, and high blood pressure). Call your doctor if any of these symptoms occur.

Other side effects can include high blood pressure, increased insulin resistance, 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, you should not use DHEA without first talking to your health care provider.

AZT(Zidovudine) -- In a laboratory study, DHEA strengthened the effectiveness of a drug used for human immunodeficiency virus (HIV) infections called AZT. However, scientific studies in people are needed before it’s known whether DHEA works and is safe in people.

Barbiturates -- Animal studies suggest that DHEA may strengthen the effects of barbiturates, a kind of medications often used to treat sleep disorders. These medicines include butabarbital, mephobarbital, pentobarbital, and phenobarbital.

Cotricosteroids -- Laboratory studies suggest that DHEA may increase the effects of prednisolone, a steroid medication used to treat inflammation and other disorders.

Estrogen -- DHEA may affect levels of estrogen in the body. Some women on estrogen replacement therapy may need to talk to their doctor about adjusting their dosage.

Oral medications for diabetes and insulin -- DHEA may cause some degree of insulin resistance. It may make insulin and drugs used to lower blood sugar less effective.

Drugs that may decrease DHEA levels -- Drugs that can decrease or lower the levels of DHEA in the body include antipsychotic medications (including chlorpromazine or Thorazine and quetiapine or Seroquel), budesonide (Pulmicort), estrogens, oral contraceptives (birth control pills), dexamethasone (Decadron), metformin (Glucophage), and rosiglitazone (Avandia).

Drugs that may increase 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), and metopirone (Metyrapone).

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