Introduction
Abstract
Dehydroepiandrosterone (DHEA) is a steroid hormone secreted in greater quantity
by the adrenal glands than any other adrenal steroid. For many years, scientists assumed that DHEA merely functioned as a reservoir upon which the body could draw to produce other hormones, such as estrogen and testosterone. However, the recent identification of DHEA receptors in the liver, kidney, and testes of rats strongly suggests that DHEA may have specific physiologic actions of its own. Circulating levels of DHEA decline progressively with age; this age-related decline does not occur with any of the other adrenal steroids. Epidemiologic evidence indicates that higher DHEA levels are associated with increased longevity and prevention of heart disease and cancer, suggesting that some of the manifestations of aging may be caused by DHEA deficiency.
Animal and laboratory data indicate that administration of DHEA may prevent obesity, diabetes, cancer (breast, colon and liver), and heart disease; enhance the functioning of the immune system; and prolong life. In humans, evidence exists that DHEA might be associated with autoimmune diseases, such as lupus, rheumatoid arthritis, and multiple sclerosis; chronic fatigue syndrome; acquired immunodeficiency syndrome (AIDS); allergic disorders; osteoporosis; and Alzheimer’s disease. Although administration of DHEA appears to be safe, its long-term effects are unknown, and it is possible that adverse consequences will become evident with chronic use. It is, therefore, important that this hormone be used with care and that practitioners err on the side of caution when contemplating DHEA supplementation.
Introduction
Dehydroepiandrosterone (DHEA) is a steroid hormone secreted by the
adrenal glands and to a lesser extent by the testes and ovaries. First identified in 1934, DHEA was subsequently shown to be produced in greater quantity than any other adrenal steroid. However, although circulating levels of DHEA and its ester DHEA-sulfate (DHEA-S) are 20 times higher than those of any other adrenal steroid, the function of DHEA in the body was, until recently, unknown. Since DHEA can be converted into other hormones, including estrogen and testosterone, scientists assumed that DHEA is merely a “buffer hormone;” i.e., a reservoir upon which the body can draw to produce the other hormones. However, the recent identification of DHEA receptors in the liver, kidney, and testes of rats strongly suggests that DHEA has specific physiologic actions of its own.1
During the past several years, there has been a great deal of interest in DHEA as a possible anti-aging hormone and as a potential treatment for a wide array of medical conditions. This interest has been sparked by two different lines of evidence. First, circulating levels of DHEA decline progressively with age; the levels in 70-year-old individuals are only about 20% as high as those in young adults. This age-related decline does not occur with any of the other adrenal steroids. Furthermore, epidemiologic evidence suggests that higher DHEA levels are associated with increased longevity and prevention of heart disease and cancer. It has, therefore, been suggested that some of the manifestations of aging may be caused by DHEA deficiency.
Second, numerous animal studies have shown that administration of DHEA prevents obesity, diabetes, cancer, and heart disease; enhances the functioning of the immune system; and prolongs life.2 Since most of these studies were done in rodents, which have little circulating DHEA, it is not clear whether the results have relevance to human health. However, a growing body of human research, combined with the intriguing observations of innovative clinicians, suggests that DHEA may indeed have value in the treatment of various medical conditions. If this hormone can be convincingly shown to retard the aging process and to fight certain diseases, then DHEA therapy will be recognized as a major breakthrough in clinical medicine.
DHEA as an “Anti-aging” Hormone
Preliminary results in mice suggest that DHEA might retard the aging process. Animals treated with this hormone looked younger, had glossier coats, and less gray hair than control animals.3
In a recent study, 30 individuals between the ages of 40 and 70 years received 50 mg per day of DHEA or a placebo, each for 3 months, in double-blind crossover fashion. During DHEA treatment, a remarkable increase in physical and psychological well-being was reported by 67% of the men and 84% of the women. There was no change in libido and no side effects were seen.4
In my experience, elderly patients who suffer from weakness, muscle wasting, tremulousness, fatigue, depression, declining memory, and other signs of aging frequently have serum DHEA-S levels near or below the lower limit of normal. Treatment with DHEA (usually 5-10 mg per day for women and 10-20 mg per day for men) often results in improved mood, energy, memory, appetite, and skin color, sometimes after as little as 2 weeks. With continued treatment, the benefits may become even more pronounced and muscle wasting may be partially reversed.
