DHEA for Anti-Aging or other purposes … what’s the truth?

Here is my review of DHEA from my book, Alternative Medicine: The options, the claims, the evidence, how to choose wisely.

Alternative Medicine - 2009

Recommendations

At this point, research does not conclusively support the use of DHEA supplements for most of the purposes for which they are marketed. Although it may not be unreasonable for a health care provider to use this supplement while monitoring blood or salivary levels, there is still virtually no compelling evidence that this type of intervention is effective — and there are significant theoretical risks from DHEA since it is a steroid hormone that can impact numerous biochemical processes in humans and may stimulate cancer. Therefore, some researchers have commented that use of DHEA outside of a carefully monitored clinical trial is unwarranted. Those interested in eternal youth should look elsewhere (Revelation 21:4).

What It Is

Dehydroepiandrosterone (DHEA) is a steroid hormone, meaning it is a chemical messenger carrying information around the body. It is found in high concentrations in the brain. Our bodies produce it in particularly high quantities during two periods of our lives.

The first is during fetal development, with the production almost stopping at birth.

The second period begins around the age of seven and rises to a maximum in the mid-twenties before gradually dropping off.

By the time you are in your sixties, you will typically have only 10 to 20 percent of your youthful peak values of the hormone.

This drop-off rate has led people to speculate that DHEA may be the elusive fountain of youth. Yet the actual function of DHEA is unknown. All that is certain is that our bodies normally use it to make many of the other hormones we need.

Claims

Daily DHEA supplements are supposed to slow aging, burn fat, and build muscle mass, strengthen the immune system, treat lupus, and help prevent heart disease, cancer, diabetes, Alzheimer’s disease, and Parkinson’s disease.

DHEA allegedly boosts libido, alleviates depression, and increases general feelings of strength, stamina, and well-being.

It is said to be able to slow down the mental deterioration that can accompany aging and improve memory.

The latest claim is that it will be a natural alternative to hormone replacement therapy in postmenopausal women and will treat vaginal dryness and increase bone strength.

Other alternative medicine providers promote DHEA supplements for conditions such as chronic fatigue and immune dysfunction syndrome and fibromyalgia syndrome.

Most of these providers will first check either serum or salivary levels of DHEA and then supplement with small amounts of DHEA (10 to 50 mg per day) and monitor DHEA levels.

Study Findings

The last couple of decades have produced studies suggesting that DHEA may actually play a role in many of the conditions listed in the above claims.

However, most of these studies were done on animals.

In general, animal studies are an important step to developing safe and effective treatments for humans. However, there is a very significant caution needed with animal studies — and those with DHEA in particular.

Humans and a few primates are the only species known to produce DHEA naturally and to have such high blood levels.

This means that the results of these animal studies are not directly applicable to humans.

They help move research along but should not be used to make confident claims about the effect of DHEA in humans.

Unfortunately, because marketers have seized on the results of early studies that may or may not turn out to be applicable to humans, abundant unfounded claims circulate about the benefits of DHEA.

Since 1994, it has been widely advertised and freely available as a dietary supplement, which has helped to promote widespread use before its effectiveness and safety have been fully investigated.

These early, positive studies stimulated research into DHEA in humans, the results of which are starting to appear.

Some studies in older people have shown preliminary evidence that DHEA can enhance people’s mood and can have antidepressant effects.

A 2001 Cochrane review examined studies using DHEA to improve mental function and boost memory. The review found four studies with inconclusive results and concluded there was no evidence to support the use of DHEA in normal older people to improve mental performance.

Research results released in 2000 showed that low DHEA levels are associated with an increased risk of heart disease in middle-aged men—those with the lowest DHEA levels had a 59 percent higher risk.

However, these data do not answer the question of whether taking DHEA will bring up these levels or reduce cardiovascular risk in men.

DHEA has been recommended for systemic lupus erythematosus (SLE), a chronic inflammatory autoimmune disease that affects many tissues, especially the skin, joints, kidneys, nervous system, and mucous membranes. The symptoms come and go in intensity.

Research showed that those with SLE had reduced DHEA levels. DHEA was then used to treat SLE in a small number of clinical trials. Although preliminary, the results have been generally positive with flare-ups being less severe and less frequent.

Patients were also able to reduce the doses of other medications they were taking.

None of these studies lasted more than one year, which is an important limitation given the cyclic nature of SLE. This means that the improvement may have been due not to DHEA but merely to the normal course of the disease.

Some athletes who use DHEA claim it increases testosterone levels to allow muscle building and more vigorous training.

Very few studies have examined these claims, but one study with young, healthy men given DHEA found that it neither increased testosterone levels nor gave the men any more muscle or strength gains than when they took a placebo.

Overall, DHEA has some useful therapeutic actions. However, it has been proposed to treat a huge range of conditions.

A search for research studies carried out on DHEA shows that it has been tested for many conditions but often with only one or two studies on each illness.

Until a clearer picture emerges of what DHEA helps and what it doesn’t help, only tentative recommendations can be made for most indications.

Cautions

One of the biggest concerns about DHEA arises from it being a natural steroid.

These compounds are powerful, with a wide range of actions. When taken orally, at doses of 50 mg per day or less, adverse effects with DHEA are infrequent and generally mild.

At doses of 200 mg per day, DHEA frequently causes adverse effects.

High blood levels of DHEA have been linked to a number of cancers, especially breast cancer in women and prostate cancer in men.

DHEA can be converted in the body into testosterone, estrogen, and other sex hormones. This leads to fears that high doses will have negative effects on the many functions influenced by these other hormones.

High levels of these hormones have also been implicated in a number of cancers and heart disease. This is of special concern if DHEA is used for extended periods of time.

In addition, DHEA use is associated with acne, increased facial hair, loss of scalp hair, deepening of the voice, weight gain, decreased HDL cholesterol (“good” cholesterol), abnormal liver tests, insulin resistance, and mild insomnia.

Mania is rarely reported in people taking daily doses ranging from 50 to 300 mg. However, the mania may not begin until two to six months after starting DHEA.

DHEA is not considered safe for use in children or in women who are pregnant or lactating.

Another problem with DHEA arises from its availability since 1994 under the Dietary Supplement Health and Education Act. These products are no longer regulated by the FDA or any other federal agency.

So, for example, a 1998 study of DHEA products found that fewer than half of them contained the amount of DHEA stated on the label; some contained none at all.

Other products claim to contain plant steroids that can be converted into DHEA. However, this chemical conversion process does not occur within the human body!

ConsumerLab.com tested seventeen DHEAcontaining supplements. Fourteen products were DHEA only, and three included other herbal, vitamin, or mineral ingredients.

The tests found that three of the seventeen products (18 percent) contained significantly less DHEA than claimed. One product claimed it was “Pharmaceutical Quality” yet was found to have only 19 percent of what its label claimed.

Another product had only 79 percent of the claimed DHEA yet indicated that it met “USP standards.”

You can find the most recent ConsumerLab tests of DHEA in my blog “DHEA Supplements, Touted For Anti-Aging And Strength, Reviewed By Consumerlab.Com.”

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