Herbs & Supplements:
DHEA (Dehydroepiandrosterone)
Supplement Forms / Alternate Names
•
DHEA Sulfate
Principal Proposed Uses
•
Lupus, Osteoporosis, Adrenal Failure
Other Proposed Uses
•
Sexual Dysfunction in Women, Impotence, Depression, Chronic Fatigue Syndrome, HIV Support, Immune Support, Performance Enhancement, Fighting Aging, Preventing Heart Disease
Dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands, is the most abundant hormone in the steroid family found in the bloodstream. Your body uses DHEA as the starting material for making the sex hormones testosterone and estrogen.
Exciting evidence tells us that DHEA might be helpful for the autoimmune disease lupus, at least in women. DHEA might also help prevent osteoporosis (again, in women). Additionally, DHEA appears to be beneficial when taken along with standard treatment for women with adrenal failure.
Other uses with some evidence include improving sexual function in men and women and alleviating depression. However, keep in mind that DHEA is not a natural supplement. The DHEA you can buy at the store is made by a synthetic chemical process, and it is a hormone, not a nutrient. Although DHEA appears to be safe to use in the short term, its safety when taken for prolonged periods is unknown.
Sources
The body makes its own DHEA; we get very little in our diets. DHEA production peaks early in life and begins to decline as we reach adulthood. By age 60, our bodies produce just 5 to 15% as much as when we were 20. It's not clear whether this decline in DHEA is a bad thing, but some believe that it may contribute to the aging process.
For use as a dietary supplement, DHEA is manufactured synthetically from substances found in soybeans. Contrary to popular belief, there is no DHEA in wild yam.
Therapeutic Dosages
A typical therapeutic dosage of DHEA is 50 to 200 mg daily, although some studies used dosages above and below this range. A cream containing 10% DHEA may also be used; it is typically applied to the skin at a dosage of 3 to 5 g daily.
Physicians sometimes check DHEA levels and adjust the daily dose to achieve blood levels of 20 to 30 nmol/L.
Therapeutic Uses
Most of the evidence for DHEA involves benefits in women.
Exciting evidence suggests that DHEA might help reduce symptoms in women with lupus.1,2,3
Increasing evidence suggests that DHEA may also be helpful for preventing or treating osteoporosis in postmenopausal women (epsecially those over age 70), but probably not in men.4,5,6,74 In addition, there are good theoretical reasons (but little direct evidence) to believe that individuals taking corticosteroids such as prednisone might be protected from osteoporosis and other drug side effects by taking DHEA at the same time.7,8
In some individuals, the adrenal glands fail to work, typically due to illness (or surgical removal of the adrenal glands). Traditionally, such people are given a variety of hormonal medications to make up for what their own adrenal glands are not producing. These hormones preserve the lives of individuals with adrenal failure, but they don't completely restorehealth. This may be due to the fact that the normal adrenal gland makes DHEA, a hormone not usually supplied in standard treatment. The results of two small double-blind trials suggest that adding DHEA supplements to the usual treatment for adrenal failure can improve feelings of well-being, fatigue, and perhaps sexual function in women.9,10 However, keep in mind that the vague concept of "adrenal weakness," widely discussed in natural medicine circles, is not the same as adrenal failure, and there is no reason to believe that DHEA would make a differencein those circumstances.
Evidence suggests that DHEA might improve libido in older women, but not younger women.11,75,76
A small double-blind study suggests that DHEA might be helpful for men who find it difficult to achieve an erection, when blood tests show they are low in this hormone.14
DHEA is also sometimes proposed for depression, on the basis of one small double-blind study and one observational study.15,16
Highly preliminary evidence suggests that DHEA might be helpful for chronic fatigue syndrome.17
According to very preliminary evidence, DHEA might help improve the immune response to vaccinations,18,19 and strengthen immunity following burns.20,21
DHEA seems to decrease in people with AIDS, possibly because of malnutrition22 and/or stress.23 One small double-blind trial suggests that DHEA (50 mg per day) may improve subjective feelings of mental function and well-being;24 another small trial found inconclusive results regarding mood and fatigue.25
Athletes have used DHEA on the belief that it might limit the body's response to cortisol and thereby cause an increase in muscle tissue growth. However, study results have been mixed, so it's uncertain whether DHEA really interferes with cortisol or not.26,27 In any case, most (but not all) studies have found no performance benefits from taking DHEA.28,29,30
Primarily because DHEA naturally decreases with age, this hormone has been widely hyped as a kind of fountain of youth. However, there is no real evidence that it is helpful for aging in general. Seven studies have found that DHEA supplementation does not improve mood or increase the general sense of well-being in older individuals.31–36,73 In addition, although some reports suggest that declining DHEA levels cause impaired mental function in the elderly, large studies have not found a connection between the two.37,38 Indirect evidence does suggest that DHEA supplements might reduce the risk of heart disease, especially in men, but this is far from proven.39–44
DHEA has been proposed a weight loss aid, but the little evidence that is available appears more negative than positive.45
What Is the Scientific Evidence for DHEA (Dehydroepiandrosterone)?
Lupus (Systemic Lupus Erythematosus, or SLE)
A 12-month double-blind placebo-controlled trial of 381 women with mild or moderate lupus evaluated the effects of DHEA at a dose of 200 mg daily.46 While participants in both treatment and placebo groups improved (the power of placebo is amazing!), DHEA was more effective, reducing many symptoms of the disease. However, DHEA was found to adversely affect cholesterol levels (specifically, the ratio of total cholesterol to HDL cholesterol) and raise levels of testosterone. For this reason, study authors recommend the monitoring of serum cholesterol and keeping watch for adverse effects caused by increased testosterone.
Similarly positive results were seen in earlier small studies.47,48
Even if DHEA is not strong enough to completely control symptoms of SLE on its own, it might allow a reduction in dosage of the more dangerous standard medications. In addition, it might directly help offset some of the side effects of corticosteroid treatment, such as accelerated osteoporosis.49,50 (Calcium, vitamin D, and ipriflavone might also help prevent corticosteroid-induced osteoporosis.)
Osteoporosis
DHEA appears to be helpful for osteoporosis in older women. A double-blind, placebo-controlled trial of 280 men and women ranging in age from 60 to 79 years evaluated the effects of 50 mg of DHEA daily for 1 year.51 The results suggest that DHEA can fight osteoporosis in women over 70. However, younger women did not respond to treatment with DHEA.
Additional evidence that DHEA might help osteoporosis in older women comes from previous smaller clinical trials and observational studies.51-54
DHEA does not appear to affect men’s bones to any significant extent.74
Adrenal Insufficiency
Two double-blind trials support adding DHEA to the usual hormone regimen for adrenal failure. One double-blind placebo-controlled crossover trial evaluated the effects of DHEA in 24 women with this condition. The results showed that DHEA improved sexual function, feelings of overall well-being, and cholesterol levels during a 4-month treatment period.55 Another double-blind crossover trial enrolled 39 men and women and found improvements in general feelings of well-being, mood, and energy level over a 3-month treatment period.56
Improving Libido and Sexual Function in Women
Some evidence suggests that DHEA may be helpful for improving sexual function in older women, but not for younger women.
The one-year, double-blind, placebo-controlled trial of 280 men and women described under Osteoporosis also looked for effects on sexual function.57 The results indicate that for women over 70, daily use of DHEA at 50 mg improves libido. Neither men nor younger women responded. Two studies did not find benefit, but they enrolled much fewer individuals and also ran for a shorter time.12,13
Two small, double-blind, placebo controlled studies tested whether a one-time dose of DHEA at 300 mg could increase sexual arousability in pre- or postmenopausal women respectively.75,76 The results again indicate that DHEA is effective for older women but not for younger women.
Improving Sexual Function in Men
A double-blind placebo-controlled study enrolled 40 men with difficulty achieving or maintaining an erection, who also had low measured levels of DHEA.58 The results showed that DHEA at a dose of 50 mg daily significantly improved sexual performance; however, the authors failed to provide a statistical analysis of the results, making the meaningfulness of this study impossible to determine.
Performance Enhancement
A small double-blind study found no benefit with DHEA at a dose of 150 mg per day for men undergoing weight training.59 In addition, a 12-week double-blind study of 40 trained male athletes given either DHEA or androstenedione at 100 mg daily found no improvement in lean body mass or strength, or change in testosterone levels.60
A 12-month double-blind placebo-controlled crossover trial of 16 individuals aged 50 to 65 found some evidence of fat loss and strength improvement in the male participants during the period in which they received 100 mg of DHEA daily.61 No improvement was seen in female participants.
Safety Issues
DHEA appears to be safe when taken in therapeutic doses, at least in the short term. One study found no significant side effects in 50 women who took up to 200 mg daily for up to 1 year.62
However, DHEA, even at the low dose of 25 mg per day, may decrease levels of HDL ("good") cholesterol.63,64 In addition, DHEA may cause acne and male pattern hair growth.65,66
Concerns have been raised by one study in rats and another in trout that linked DHEA to liver cancer.67,68 However, at least four other animal studies suggest that DHEA may have some anticancer effects.69,70
A 15-year human observational trial looking for a connection between naturally occurring DHEA levels and breast cancer found no relationship, either positive or negative.71 However, another study found a relationship between higher levels of DHEA and ovarian cancer.72 Overall, the long-term safety of DHEA supplements remains unknown. This is the case with many supplements, but because there are animal studies suggesting that DHEA might increase the risk of liver cancer, caution is warranted. Estrogen is one example of a hormone that increases the risk for certain forms of cancer, and it took years for researchers to discover that risk. Keep in mind also that the body converts DHEA into other hormones, including estrogen and testosterone. This could be dangerous for women with hormone-influenced diseases such as breast cancer.
The safety of DHEA in young children, pregnant or nursing women, and individuals with severe liver or kidney disease has not been established. We also don't know whether DHEA interacts with other hormone treatments, such as estrogen, although it certainly stands to reason that it might.
View References
Last reviewed May 2002 by Medical Review Board
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