DHEA: Supplements, What Works

DHEA stands for dehydroepiandrosterone, a hormone that was first discovered in 1934. Its significance has been somewhat of a mystery ever since. Claims made for DHEA include that it prevents or slows the aging process, promotes weight loss, prevents or alleviates Alzheimer's disease, and combats AIDS, lupus, and some cancers. More than ten thousand scientific papers have been written about DHEA, and two international conferences have been held on DHEA research.

DHEA is the most abundant steroid hormone in our bodies. It is mainly produced in the adrenal glands, and also in the brain and skin. In the body, DHEA is converted in both men and women into estrogen, testosterone, and other steroid hormones. Production of DHEA peaks at about age thirty, and then gradually declines, reaching about 5 to 15 percent of the peak level at about age sixty. DHEA levels also drop during illness.

Research has shown that low DHEA levels in the blood are associated with heart disease, breast cancer, and a decline in immune competence. Most of the information about DHEA at present comes from animal studies, test tube experiments, and human population studies. Human clinical research is currently limited, with no long-term trials. It is not known at this point whether the effects of DHEA are due to the hormone itself or to the sex hormones and other steroids that the body produces, nor is it known which organs DHEA affects.

DHEA was found in one study to produce liver cancer in fourteen out of sixteen rats. While this does not necessarily mean that it would produce cancer in humans, if such a response were to occur in human research, DHEA would probably be banned by the FDA. Other studies have shown that DHEA supplementation can lead to increased insulin resistance, unwanted hair growth, and a drop in levels of "good" HDL. It must be remembered that DHEA is a hormone, and replacing any hormone that declines normally with aging must be carefully researched.

• Aging. Human studies on the effect of DHEA replacement on the aging process look promising, but it is too early to draw definite conclusions. In a 1994 study by Morales at the University of California at San Diego, people ages forty to seventy who took DHEA reported a substantial increase in physical and psychological well-being. However, HDL levels declined slightly in women.
  
  
• Weight control. Clinical research by Dr. William Regelson in 1996, done only on animals, showed that DHEA promoted weight loss in overweight animals even when they ate their usual diet. A 1991 human population study by Dr. Elizabeth Barrett-Connor found that lower DHEA levels in the blood were associated with increased body mass and impaired glucose tolerance.
  
  
• Menopausal symptoms. DHEA may help replace hormones in postmenopausal women, and thus protect against cancer, osteoporosis, and cardiac disease. Research is still preliminary, but in Europe, DHEA products are being marketed for menopause-related depression, and are being used in conjunction with estrogen to treat hot flashes and other menopausal symptoms. In a Canadian study by Dr. Pierre Diamond of twenty postmenopausal women, DHEA yielded reductions in blood insulin and glucose levels. Weight remained the same, but there was an improvement in the body muscle-to-fat ratio, an increase in bone density, a drop in blood cholesterol, and an improvement in vaginal atrophy and secretions.

Studies by Casson in 1993 and 1995 also suggest that DHEA may help postmenopausal women, affording protection against heart disease by reducing blood lipid levels.

• Heart disease. DHEA may help to protect against heart disease in people besides postmenopausal women. A 1995 study by Herrington, reported at the New York Academy of Sciences, found significantly lower blood levels of DHEA in men who had blocked arteries. Another study reported at the conference showed DHEA supplementation reduced platelet aggregation, or the tendency of blood cells to stick together. Excessive platelet aggregation is another risk factor for cardiovascular disease.
  
  
• Immune problems. Researchers have reported that DHEA activated immune system functioning. In a 1993 study by Casson, 25 mg daily improved immune regulating response in postmenopausal women.

There is some suggestion that autoimmune disorders also respond. In a 1995 study by Dr. Ronald van Vollenhoven of the Stanford University School of Medicine, twenty-five female lupus patients who received 200 mg of DHEA showed improvement in their symptoms, had more energy, and were able to reduce their prednisone dosage.

In conclusion, while popular literature enthusiastically endorses the use of DHEA, it is too early to recommend routine supplementation. Anyone considering DHEA supplementation should have their DHEA levels checked to make sure that they are low. Serum levels of steroids should be monitored medically while taking DHEA supplements. DHEA is not fat soluble, so any fat in a meal will block absorption of the supplement. Letting DHEA absorb under the tongue is one way to bypass the intestinal tract, but some people object to the taste. Since blood levels of DHEA are highest in the morning, supplemental DHEA should be taken in the morning, to follow the body's natural rhythm.

Because DHEA is converted into steroid hormones, it is not known what its impact might be on cancers that are sensitive to hormones. There is some evidence that DHEA exacerbates breast cancer, and possibly prostate cancer. If any kind of cancer is present, DHEA supplementation should not be undertaken without medical approval.

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From THE BEST ALTERNATIVE MEDICINE: WHAT WORKS? WHAT DOES NOT? by Dr. Kenneth R. Pelletier.
Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc.
Reprinted by permission of Simon & Schuster, Inc., New York, New York.

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