What's the deal with DHEA?
1) Dear Alice,
What do you think about DHEA? I've been hearing so much lately. I have the rudimentary information about what it is, what it is supposed to do, but what do we know about the long-range effects of taking it? Thanks.
2) Dear Alice,
Have you any information on the supplement DHEA (I think I spelled it correctly). It's supposed to be the male supplement counterpart to the female hormone replacement women use (estrogen) to delay or slow the effects of menopause. Any thoughts on this? Testosterone production slows in men as they age. I read that men can take DHEA and slow the aging process or for help with body building. Am I dreaming or what?
3) Dear Alice,
Do you have any advice on DHEA supplements. I have read several interesting articles about the effects of DHEA supplementation in a clinical setting. However, I presume that the DHEA used was the synthetic variety, as opposed to the products that are based on Mexican Yams that are available to the general public without a prescription.
Dehydroepiandrosterone, more commonly known as DHEA, is a hormone produced in the body by the adrenal glands that assists in the production of other hormones such as testosterone and estrogen. Natural DHEA levels peak at about 30 years old, and then gradually decline with age. Because the specific role of DHEA in the body remains unclear, there may be particular reason why the body naturally produces less DHEA with age. To mediate this decline in production, some choose to take DHEA in the form of a nutritional supplement, with intentions of using it for everything from reversing the signs of aging to increasing muscle mass. Little research has been done on the long-term effects of DHEA, especially as few studies on DHEA have been conducted on humans. Additionally, while yams do have the substance that is a precursor to DHEA, diosgenin, it's believed to only be converted to DHEA in a lab setting, rather than in the human body. Read on to learn more about DHEA and its possible effects.
DHEA was sold as an oral supplement in health food stores until 1985, when the Food and Drug Administration (FDA) banned its sales based on a lack of evidence that DHEA was neither safe nor effective. After this ban was lifted in 1994, the FDA approved its over-the-counter distribution as a nutritional supplement. Since nutritional supplements aren't regulated by the FDA, quality, purity, and effectiveness of DHEA supplements vary by manufacturer (which is why some critics say that only prescribed DHEA is effective).
DHEA has been touted as helping with aging, depression, osteoporosis, and vaginal dryness and atrophy. However, there is little evidence that it helps to slow the aging process, and research indicates that its benefits for depression, osteoporosis, and vaginal dryness and atrophy are minimal. It's currently being tested for the treatment of lupus. DHEA is also rumored to remedy symptoms of erectile dysfunction (ED), which are common with age. But, there is a lack of empirical evidence for the use of DHEA in treating ED, whereas prescription medications such as sildenafil have evidence showing them to be effective. Some non-prescription treatment options for ED (such as DHEA) contain unknown amounts of ingredients similar to those in prescription medications, can cause side effects with higher risks, and are actually banned by the FDA (although they're still on the market). All in all, just because a product is labeled as natural doesn't mean it's safe. With that, check out a few of the other risks of taking DHEA:
- Excessive levels of sex hormones (for which DHEA is a precursor) have been linked to hormone-sensitive cancers (e.g., breast, ovarian, and prostate).
- High doses may cause liver damage.
- When excessive doses (100 milligrams or more per day) are taken, those assigned female at birth may grow excess facial hair, experience deepened voice, have acne breakouts and oilier skin, lose hair from the head, and increase their risk of heart disease.
- Those assigned male at birth may develop enlarged breasts and increase their risk of prostate cancer.
- It might lower high-density lipoprotein (HDL) or "good" cholesterol levels and can be dangerous for those who are pregnant, breastfeeding, or have high cholesterol or a condition that affects the supply of blood to the heart (ischemic heart disease).
- It might aggravate psychiatric disorders and increase the risk of mania.
- It may react poorly with the following medications: antipsychotics, carbamazepine, estrogen, lithium, phenothiazines, selective serotonin reuptake inhibitors, testosterone, triazolam, and valproic acid.
Few studies have actually looked at the effects of DHEA on humans; instead, most utilize other animals as subjects, who both produce and respond to DHEA differently than do humans. Most of the studies conducted on humans have been short-term, clinical trials looking at insufficient numbers of older people taking relatively low doses of DHEA. Although many of these studies have reported benefits and few side effects, others have shown no benefits over a placebo. For more definitive information, additional clinical trials studying DHEA use in humans are needed.
If you're interested in taking DHEA, it's recommended that you consult with a health care provider who can ensure that DHEA is appropriate for you and won't interfere with other medications that you may be currently taking. And remember, even if you're using DHEA, consider sticking with a healthy diet and regular physical activity routine. In a nutshell, if you're looking for ways to promote health at any age, there's no substitute for a healthy lifestyle!
Originally published Oct 18, 1996
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