DHEA (Dehydroepiandrosterone)

DHEA is a hormone that is produced by the adrenal glands in the body. The adrenal glands are small glands located just on top of each kidney. They produce several hormones, including testosterone, pregnenolone, DHEA, cortisol, cortisone, progesterone, and estrogens. They also produce other hormones that have been heard of solely by esoteric, armchair researchers who write biochemistry textbooks.

DHEA has recently received considerable media attention regarding its potential as an anti-aging hormone with a multiplicity of possible benefits relating to overall human metabolic functioning. The hormone is present in high concentrations during youth and declines at a somewhat predictable rate with age. The average 70-year old person would have only 15% of the DHEA levels of a person in there 20's.

DHEA was formerly thought to act primarily as a precursor hormone. This is due to the fact that, from DHEA, the body can make multiple other hormones, including those listed above (i.e., estrogens, testosterone, progesterone and cortisol). However, in recent years, there have been several hundred studies clearly demonstrating the efficacy of DHEA's individual metabolic activity, aside from its capacity to act as a supply source for other types of adrenal steroid hormone chemistry.

Current research on DHEA suggests that it may be of value in preventing and treating many disorders, including cardiovascular disease, lipid disorders (such as cholesterol elevations), obesity, cancer, Alzheimer's disease, memory disturbances, immune system disorders, acquired immunodeficiency syndrome (AIDS) and chronic fatigue syndrome. DHEA may also enhance the body's immune response to viral and bacterial infections and, perhaps most interesting, DHEA is currently considered by some to be a valuable anti-aging pharmaceutical. It may also have value in the prevention and treatment of osteoporosis. Following is a brief review of some of the known benefits of DHEA therapy.

DIABETES. Certain inbred strains of mice with a genetic disorder that caused them to develop diabetes have shown prevention of pancreatic cell destruction with a co-administration of DHEA. In human studies, DHEA has been shown to enhance insulin receptor sensitivity, so that, in some instances, insulin-dependent diabetics may be able to reduce the amount of insulin required. Type II diabetics, who do not take insulin, may be able to normalize blood sugar. However, DHEA by itself is no substitute for a common sense diet and regular, vigorous exercise, which would clearly have favorable impact on diabetes as a disease process.

HEART DISEASE. Several published studies, including studies in the New England Journal of Medicine, have shown that DHEA may play a role in preventing heart disease. DHEA levels in epidemiologic studies have shown that higher levels often correlate with lower levels of heart disease and certain types of cancer. Furthermore, among men with healthy hearts, those who had low levels of DHEA were 3.3 times more likely to die of heart disease in the following 12 years than those with normal DHEA levels. Administration of DHEA has also been shown to lower serum LDL cholesterol (the so-called "bad" form of cholesterol), which is associated with heart disease.

OBESITY. Animal studies support the fact that DHEA may be effective in treating some cases of obesity. The doses required were somewhat high but did not seem to cause any toxicity. Human studies of DHEA as an anti-obesity drug have been less promising. However, in my clinical experience, DHEA has helped a small percentage of individuals maintain adequate weight loss. Use of DHEA for obesity is, of course, combined with a proper diet and exercise.

CANCER. In contrast to estrogen, which may promote certain types of cancers, DHEA shows promise as an anti-cancer agent. In multiple studies looking at animal models, DHEA has been shown to augment conventional cancer treatment. It has been used in some cases as a stand-alone therapy to prevent the occurrence of certain types of tumors or to reduce the likelihood of disease progression. There is also a positive correlation between DHEA levels and human breast cancer. Women who tend to have higher DHEA levels tend to have lower rates of breast cancer in many studies. There has been some research suggesting that DHEA may be contraindicated in some types of cancer. However, these are animal model studies and it is difficult to extrapolate to human data. Please talk to your health care practitioner to determine if DHEA may be suitable for your use.

AUTOIMMUNE DISEASES. Diseases in which the body's immune system mistakenly attacks its own tissues are called autoimmune diseases. These diseases include various types of arthritis, lupus, inflammatory bowel diseases (such as ulcerative colitis and Crohn's disease) and other types of inflammatory connective tissue processes, such as rheumatoid arthritis. Many other common conditions, including diabetes, hypertension, heart disease, and others are thought to have an autoimmune component. Studies in animals suggest that DHEA may have a beneficial effect on the process of autoimmune attack through the ability of DHEA to modulate and balance immune activity. In my own experience, I have noted that serum levels of DHEA are often low or in the low range of normal for many patients who have chronic autoimmune processes. Administration of oral or transdermal DHEA has been successful in bringing levels within normal limits. Significant clinical improvement has been associated with adjunctive use of DHEA for many patients.

AIDS. Another immune system-related condition in which DHEA may play a role is acquired immunodeficiency syndrome (AIDS). DHEA has been reported to inhibit the replication of the HIV virus, which is thought to cause the disease AIDS. In addition, the hormone has been shown to enhance the immune response to viral infections. Also of note is that many clinical observations have shown that patients with full-blown AIDS tend to have low levels of DHEA. Men with serum DHEA levels that are below normal and who are HIV-positive are 2.34 times as likely to develop AIDS as those with normal DHEA levels.

CHRONIC FATIGUE SYNDROME. Chronic fatigue syndrome is a debilitating condition first described in the early 1980's. It has become increasingly prevalent among young adults and middle-aged Americans. The disease process seems to stem from a multi-factorial etiology. In some of the cases, low levels of DHEA are a common finding. In these cases, augmentation can be a significant synergistic factor in improving outcome and overall feelings of well being.

AGING. Preliminary results in mice suggest that DHEA may retard the aging process. Animals treated with this hormone look younger, have glossier coats and less gray hair than do control animals. In humans, serum levels of DHEA are known to decline with age, as previously mentioned. This age-related decline is not known to occur with any of the other adrenal steroids. It has, therefore, been suggested that some of the manifestations of aging may be caused by DHEA deficiency. In my experience, older patients, who suffer from weakness, muscle wasting, tremulousness, and other signs of aging, experience noticeable improvements several weeks after beginning small doses of DHEA.

CONCLUSION: DHEA seems to be a very promising therapeutic option, used as a stand-alone therapy or, more often, in synergistic combinations, to approach a particular type of pathologic problem. However, as with any other type of prescription medicine, the long-term effects (20-30 years) of daily DHEA supplementation are not known. Animal studies seem promising and suggest a very low potential for toxicity. However, there are no long-term human trials dating over a span of 25-30 years to gauge safety and efficacy in that standard. However, arguably, there exists a small amount of data in the other types of conventional prescription medicines relating to conventional toxicity.

It is suggested that anyone using DHEA in therapy be monitored by a competent health care practitioner who is familiar with the use of this particular preparation.

Dale Guyer, M.D.