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  DHEA  
 
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In the prime of life (age 20 to 25), men produce about 31mg of DHEA daily and women about 19mg daily. DHEA production slowly declines over the years and by the age of 75, DHEA production can decrease by 80-90%. It is claimed that maintaining correct DHEA levels can produce:

  • Energy
  • Youthfulness
  • Increased metabolism to burn fat
  • Increased sex drive
  • Improved memory
  • Reduced tendency to depression
However, increasing evidence exists to the contrary. Several studies like the following have not shown an obvious benefit. Four months of supplementation with DHEA ( 50mg per day) had no effect on serum lipids, bone markers, body composition, exercise capacity, sexuality or mood scores in a double blind cross-over study of 22 healthy men (50-69 years old) with age-related physiological decline of DHEA production. [J Clin Endocrinol Metab 2001;86(10): pp.4686-4692]

DHEA is the hormone precursor for testosterone and estrogens. When DHEA levels are low, but the sex hormones are normal or elevated, a different form of DHEA should be used. 7-keto DHEA has DHEA activity but is reported to not increase sex hormone levels.

A primary concern regarding the use of DHEA in men has been its partial conversion into estrogen. By promoting a healthy estrogen metabolism, use supplemental use of DIM by men will increase the safety and benefits of long term supplementation with DHEA.

Caution is advised against higher doses of DHEA (greater than 50mg) because of possible short- and long-term side-effects, including acne and increased facial hair (the primary short-term side-effects.)

There may a possible link between elevated DHEA levels and prostate, breast and ovarian cancer risk. While younger women with breast cancer may have low levels of DHEA, postmenopausal women with breast cancer appear to have high levels of DHEA, which has researchers concerned. Until more is known, it would be prudent for people with breast or prostate cancer or a family history of these conditions to avoid supplementing with DHEA, or monitor their levels.

Related OTC hormones have been used as performance enhancers but an eight week trial of supplementation with a steroid combination (224mg per day of 19-nor-4-androstene-3,17-dione and 120mg per day of 19-nor-4-androstene-3,17-diol)
had no effect on strength or body composition in a blinded, placebo-controlled study of 10 men who participated in resistance training an average of four days per week. [Effects of norandrostenedione and norandrostenediol in resistance-trained men. Nutrition 2002;18(9): pp.734-737]
 

 
 

DHEA can help with the following:
 
 
Aging  Parkinson's Disease / Risk
 C.A. Hackethal, M.D. has reported excellent success in treating Parkinson's Disease by use of replacement therapy of DHEA. Apparently the bad side-effects of L-Dopa are avoided, and the Parkinsonian victim is restored to appropriate functioning. Until further confirmation, one should not expect miraculous results based upon this one reference.

  Senile Dementia

Autoimmune

  Lupus, SLE (Systemic Lupus Erythromatosis) / Risk
 One hundred-twenty women with active SLE were randomly given 200mg per day of DHEA or placebo for 6 months. During the study, 18.3% of the patients in the DHEA group experienced a flare-up of their disease, compared with 33.9% of those in the placebo group. The incidence of disease flare-ups was 46% lower in the DHEA group than in the placebo group. No serious side effects were seen, but DHEA treatment increased testosterone levels and increased the incidence of acne.

In other conditions, DHEA is typically administered in much lower doses. But, it has not been demonstrated that lower doses will provide any benefit in SLE. [Arthritis Rheum 2002;46: pp.2924-2927]

  Chronic Thyroiditis
 Some doctors report finding that a high percentage of patients with autoimmune disorders, such as thyroiditis, are also deficient in DHEA, and should be tested for this hormone.

  Multiple Sclerosis / Risk

Circulation

Not recommended for:
  Arrhythmias/Dysrhythmias
 Ray Sahelian, MD has reported arrhythmias of different types in individuals using as little as 50mg DHEA or 25mg Pregnenolone. [TLDP Feb 1998, p.119]

Hormones

  Low DHEA Level
 The optimal dosage range for DHEA varies considerably between individuals. Men and women should consider taking a total of 15 to 75mg per day in one to three divided doses. Many human studies use a daily dose of 50mg. DHEA can be taken with or without food, though some believe that fat helps DHEA to assimilate better. DHEA can be taken in a cream form along with other hormones.

Primarily because DHEA naturally decreases with age, this hormone has been widely used 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. 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.

Some doctors are very cautious about using large doses of DHEA and do not go over 10mg in women and 15-20mg in men. Acne can result from taking too much, too quickly.

  Low Testosterone Level
 Androstenedione is a metabolite of DHEA and a natural precursor of testosterone. 25 to 50mg of androstenedione taken at bedtime, and perhaps again first thing in the morning, will mimic the body's normal diurnal rhythm of testosterone.

This same dose may be taken 30 to 60 minutes before exercise to enhance performance, or after completion of exercise to enhance muscle recovery and growth. Serum levels of testosterone start rising about 15 minutes after oral administration and stay elevated for around 3 hours. Blood testosterone levels usually peak in around 1 to 1.5 hours after ingestion. Because the elevated testosterone levels swiftly return to normal baseline levels, there is little risk of negative feedback suppression of your usual testosterone levels.

  Low Testosterone Level, Female
 Normal women were given either 100mg of DHEA or 100mg of androstenedione, a metabolite of DHEA, in an older trial. The study found that both hormones led to elevated testosterone levels, but androstenedione increased testosterone levels twice as much as DHEA. In the women given DHEA, testosterone levels (normally less than 199 ng/dl), rose to 280 ng/dI within 60 minutes. The second group, taking androstenedione, had testosterone levels elevated as high as 660 ng/dl an hour later. This elevation lasted only a few hours, indicating that androstenedione may be useful for specific purposes such as climax enhancement or body building.

  Hypopituitarism / Empty Sella Syndrome
 Six months of treatment with DHEA at 30mg/d if over 45 years of age and 20mg/d if under 45 years of age, induced androgen effects on skin and axillary and pubic hair in a study of 38 women with androgen deficiency due to hypopituitarism. Improved alertness, stamina, and initiative was also reported. [J Clin Endocrinol Metab 2002;87(5): pp.2046-2052]

  Low Sex Drive
 The occasional use of androstenedione as a libido-enhancer in women has been reported, with onset of effects occuring within 30 to 60 minutes.

  Low Progesterone or Estrogen Dominance
  Low Estrogen Levels

Not recommended for:
  Hirsutism

Immunity

  Chronic Fatigue / Fibromyalgia Syndrome
 It is possible that many of the benefits of growth hormone use in CFS / Fibromyalgia can also be achieved by simply optimizing DHEA levels.

  Immune System Imbalance (TH2 Dominance)
 DHEA increases TH1 cytokines which help balance the immune system.

Inflammation

  Chronic Inflammation
 DHEA has been shown to suppress IL-6, an inflammatory cytokine that often increases as people age. Typical doses of DHEA are 25-50 mg daily, although some people take 100 mg daily.

Lab Values

  Low T-Helper Cell Level
 One study has found that DHEA therapy (75mg per day) increased CD4 and CD8 cell counts in the majority of HIV patients. [Hasheev, D, et al. Intl AIDS Conference Abstract no PB0322, 1994]

Mental

  Depression
 DHEA is a plentiful adrenal steroid hormone whose quantity decreases with age and may have significant psychiatric effects. In one study, six middle-aged and elderly patients with major depression and low plasma DHEA or DHEA-S levels were openly administered DHEA (30-90mg per day for 4 weeks) in doses sufficient to achieve circulating plasma levels observed in younger healthy individuals. Depression ratings as well as aspects of memory performance significantly improved.

One treatment-resistant patient received extended treatment with DHEA for 6 months: her depression ratings improved 48-72% and her semantic memory performance improved 63%. These measures returned to baseline after treatment ended. Improvements in depression ratings and memory performance were directly related to increases in plasma levels of DHEA and DHEA-S and to increases in their ratios with plasma cortisol levels. [Biol Psychiatry, 1997 Feb; 41:3, pp.311-8]

Another study evaluated the efficacy of very high doses of DHEA (450mg) in the treatment of midlife-onset dysthymia. In 15 patients who completed the study, a robust effect of DHEA on mood was observed compared with placebos. 60% of the patients responded to DHEA at the end of the 6-week treatment period compared with 20% on placebo. A significant response was seen after 3 weeks of treatment on 90mg per day. The symptoms that improved most significantly were anhedonia (failure to experience pleasure), loss of energy, lack of motivation, emotional "numbness", sadness, inability to cope, and worry. [Biol Psychiatry 1999 Jun 15; 45(12): pp.1533-41]

In a study conducted by S. S. C. Yen and associates at the University of California, San Diego, researchers found that 50mg a day of DHEA administered for 6-months restored levels of DHEA in both men and women. This DHEA replacement was associated with an increase in perceived physical and psychological well-being for both men (67%) and women (84%).

Another study at UCSD was conducted in which researchers considered the association between levels of DHEA and depression. Nine different hormones (including DHEA) were measured in 699 older women. Out of all of these hormones, only low levels of DHEA were linked with depression.

In studies conducted at Cambridge University in England, researchers discovered that children with major depression have abnormally low levels of DHEA accompanied by abnormally high levels of cortisol.

University of California San Francisco At the University of California, San Francisco, DHEA was given to people with depression to determine its antidepressant effects. After 6 weeks, psychological tests indicated that about half the participants responded to DHEA therapy, with an overall enhancement of mood scores by over 30%.

In another study conducted by the Department of Psychiatry at UCSF, DHEA was administered to six middle-aged and elderly patients with major depression. In patients who received extended treatment with DHEA for six months, depression ratings improved 48-72%.

In a study conducted by researchers at the National Institute of Mental Health, middle-aged people with dysthymia (a chronic, low-grade depression) were given 90 mg of DHEA a day for 3 weeks. This study concluded that this amount significantly alleviated the participants' depression.

DHEA is the only hormone besides cortisol and serotonin that has consistently been linked to depression. But unlike cortisol, where high levels increase depression high levels of DHEA actually alleviate depression.

Researchers have different theories about how DHEA alleviates depression. DHEA and can cross the blood-brain barrier and interact with the brain directly. DHEA can affect serotonin, GABA receptors, and other brain factors. It might modulate the serotonin-signaling pathway. In addition, DHEA is the precursor for estrogen and testosterone, which also enhance mood.

DHEA also has antistress effects that may be part of its antidepressant action. Research shows that cortisol, the stress hormone, is elevated in major depression. DHEA counteracts cortisol. Calmness is also associated with higher levels of DHEA.

  Schizophrenia
 Treatment with DHEA can relieve some of the symptoms of schizophrenia. 30 schizophrenic inpatients in a state hospital were randomly assigned to receive DHEA or a placebo in addition to their usual medication for six weeks. The initial dose of DHEA was 25mg per day; this was increased to 25mg twice a day after two weeks, and then to 50mg twice a day for the final two weeks of the study. The improvement in negative symptoms was significantly greater in the group receiving DHEA than in the placebo group; the beneficial effect of DHEA was noticeable by the third week and persisted until the end of the study. In addition, participants receiving DHEA experienced significant improvements in depression and anxiety. In contrast, DHEA had no effect on positive symptoms (delusions and hallucinations). No side effects of DHEA were reported.

It is not known how DHEA improves the negative symptoms of schizophrenia. Although DHEA has previously been shown to be beneficial in some cases of depression, the results in the new study cannot be attributed solely to an antidepressant effect, since the improvement in negative symptoms was independent of any improvement in depression. [Archives of General Psychiatry 2003;60: pp.133-41]

  Poor Memory
 In a study of six middle-aged and elderly patients with major depression and low plasma DHEA levels, memory performance and depression improved significantly when DHEA was supplemented sufficiently to raise their plasma DHEA to levels found in healthy younger people. [Biol Psychiatry, 1997 Feb, 41:3, pp.311-8] Other, larger studies have not supported this claim.

However, it is common for depressed individuals to find their memory abnormally poor for their age. It is interesting to note that people taking DHEA for depression also often find their memory improves, and the effect may be enhanced for some when taking 7-keto DHEA instead of DHEA.

Metabolic

  Problem Caused By Being Overweight
 7-Keto DHEA supplements, at a dose of 200mg per day in adults 25 to 55 years of age has been shown in a double-blind trial to enhance weight loss, aid in the reduction of body fat and effect thyroid hormone levels. This two-month study also demonstrated that 7-Keto does not significantly affect blood sugar, testosterone, estradiol, liver or kidney function.

How much DHEA we maintain may be involved in determining how fat is actually stored in the body. In another study, DHEA was given to five male, normal weight subjects at a dose of 1600mg per day, divided into 4 doses. After 28 days, with diet and physical activity remaining normal, 4 of the 5 exhibited a mean body fat decrease of 31% with no overall weight change. This meant that their fat loss was balanced by a gain in muscle mass characteristic of youth. At the same time, their LDL levels fell by 7.5% to confer protection against cardiovascular disease.

7-Keto DHEA does not become converted to sex hormones as does DHEA. The choice of whether to use DHEA or 7-Keto DHEA will be influenced by your sex and adrenal hormone status. Laboratory testing is required to determine this.

Musculo-Skeletal

  Rheumatoid Arthritis
 The incidence of osteoporosis is elevated in women with rheumatoid arthritis. DHEA levels correlated significantly with, and were predictive of, bone mineral density, even after corticosteroid therapy was taken into account. Raising DHEA levels by supplementation in these women should reduce the risk of osteoporosis. [Gaby, AR. Holistic Medicine. Spring, 1993: p.22]

Dr. Hackethal has observed some rheumatoid patients taking DHEA become well even when C-reactive protein and Rh- factor are positive.

Respiratory

  Pulmonary Fibrosis / Interstitial Lung Disease

Risks

  Increased Risk of Coronary Disease / Heart Attack
 A landmark study in 1986 of 242 men aged 50-79 and based on 12 years of research stated that a small supplementation of DHEA corresponded to a 48% reduction in death from heart disease and a 36% reduction in death from any cause, other than accidents. Indirect evidence does suggest that DHEA supplements might reduce the risk of heart disease, especially in men, but this is far from proven.

  Increased Risk of Liver Cancer
  Increased Risk of Lung Cancer
  Cancer / Risk - General Measures
  Increased Risk of Colon Cancer
  Increased Risk of Basal Cell Skin Cancer
  Increased Risk of Squamous Cell Skin Cancer
  Increased Risk of Prostate Cancer

Skin-Hair-Nails

Not recommended for:
  Adult Acne
 
 


KEY
May do some good
Likely to help
Highly recommended
May have adverse consequences
Reasonably likely to cause problems







GLOSSARY

Acne:  A chronic skin disorder due to inflammation of hair follicles and sebaceous glands (secretion glands in the skin).

Cancer:  Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

DHEA:  Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. DHEA may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEA-S. One form is converted into the other as needed.

Estrogen:  One of the female sex hormones produced by the ovaries.

Hormones:  Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Lipid:  Fat-soluble substances derived from animal or vegetable cells by nonpolar solvents (e.g. ether); the term can include the following types of materials: fatty acids, glycerides, phospholipids, alcohols and waxes.

Metabolism:  The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Milligram:  (mg): 1/1,000 of a gram by weight.

Over-The-Counter:  A drug or medication that can legally be bought without a doctor's prescription being required.

Postmenopause:  The postmenopausal phase of a woman's life begins when 12 full months have passed since the last menstrual period and any menopausal symptoms have become milder and/or less frequent.

Prostate:  The prostate gland in men that surrounds the neck of the bladder and the urethra and produces a secretion that liquefies coagulated semen.

Serum:  The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Steroid:  Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.

Testosterone:  The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.