DIRECTORY

Ask Dr. Zarkov

Q:I have been using DHEA supplements for at least 6 years, and I really like the extra energy, sexual interest, and zest for life that it has given me. But I’ve read that the U.S. government is planning to criminalize the possession of DHEA as part of its War On Drugs. Government officials claim that DHEA has no medical value and is dangerous. To me, the part about no medical value seems like an outright lie — it has certainly been of value to me, and also, I think, to many others. Can you tell me what is known about this subject? I see no reason why I should be considered a criminal for trying to improve my mental and physical health.

A:Some other countries have already banned DHEA. In Australia, for example, people have been arrested, jailed, and fined thousands of dollars for bringing a few DHEA capsules into the country.1 In 2005 a group of arrogant politicians in Washington tried to ban DHEA in the U.S. Their proposed legislation is currently awaiting review by a committee. The claim, that DHEA has no medical value and is dangerous, is indeed an outright lie. Many medical studies of DHEA supplementation have shown benefits to patients suffering from a variety of ailments that will be discussed below.

Overview

DHEA is a substance produced by the adrenal glands, brain, skin, and other tissues. From it the body makes various hormones, including testosterone and estradiol. DHEA is the most abundant steroid in the bloodstream; high concentrations are found in the brain. The body’s DHEA production peaks at puberty in women and at about age 20 in men, then decreases with age.2

Reviews on the subject of DHEA as a supplement

The medical literature contains many reviews of various aspects of DHEA supplementation. For a non-technical, even-handed overview, we recommend the review by Thorne Research.2 A negative overview — one that reflects the dismissive attitudes of American physicians — can be read at the PDRhealth website.3 Other useful reviews are those by Binello,4 Saad,5 Legrain,6 Labrie/Luu,7, and Bovenberg.8 A review by Webb, et al., discusses recently discovered DHEA receptors which may be responsible for some of DHEA’s most interesting and important effects.9

Research into the possible benefits of DHEA supplementation has been plagued by political controversy ever since DHEA became popular and widely used. On the one hand, some DHEA enthusiasts and vendors have hyped the supplement far beyond the available evidence, even going so far as to call it ‘the fountain of youth’.10 On the other hand, War-On-Drugs fanatics are eager to add DHEA to the ever-growing roster of illegal substances.11

The medical profession and sports nutritionists have carried out a low-key campaign to discredit DHEA.12 Thus, many published reviews downplay the evidence of benefit or emphasize the inconsistency of research results.13 Reviews and reports — even when they acknowledge a significant benefit from DHEA treatment — often end with a warning that DHEA supplements need to be studied further before they are used clinically to treat diseases.14,15 This is like telling someone who is dangling by a fraying rope over a precipice, “Ho there! We could toss you a stronger rope, but we’re going to wait until we do more tests on it.”

Despite this opposition, a great deal of good clinical research has been carried out using DHEA supplementation, and much of it demonstrates benefits to patients suffering from a variety of diseases. The main focus has been on:

  • fat and obesity
  • hormone replacement
  • heart disease
  • cancer
  • muscle building
  • bone and osteoporosis
  • skin
  • anti-aging
  • energy and fatigue
  • immunity, infections
  • cognition
  • mood and depression
  • lupus
  • menopausal symptoms and fibromyalgia
  • sexual function
  • fertility

Other subjects that have received some attention are:

  • multiple sclerosis
  • Parkinson’s
  • allergies and asthma
  • schizophrenia
  • herpes encephalitis
  • diabetes
  • neuronal growth and survival

Let us look briefly at what researchers have reported about these potential applications of DHEA supplementation.

Fat and obesity

In 1988 a small clinical trial was conducted in which healthy men consumed 1600 mg/day of DHEA for 28 days. The astonishing result was an average loss of bodyfat of 31%, and a corresponding increase in muscle mass. Two other small studies at the same dosage — one in obese young men,16 the other in healthy men17 — showed no such improvements. The discrepancies between these three studies has never been explained, but could have involved factors such as the formulations used, or dietary, genetic, or other differences between the groups of subjects.

All later studies of the effects of DHEA on fat and muscle used far lower doses than the 1988 study and had less dramatic results (some positive,18,19 some null). The medical profession, always ready to dismiss any new treatment that it isn’t compelled by overwhelming evidence to accept, has therefore dismissed DHEA as a fat burner.

Nevertheless, a large dose of DHEA significantly increases the body’s metabolic rate. You can easily demonstrate this simply by trying it yourself (1000 mg micronized DHEA taken with food) and observing the increase in body temperature and increased warmth of your skin. An increase in metabolic rate generally causes the body to draw upon its body fat.

DHEA supplementation reduces the lipodystrophy caused by HIV drugs,20 and it lowers circulating cortisol levels.21 (The hormone cortisol promotes the storage of visceral fat — the fat that surrounds the digestive tract and can cause the belly to protrude.20

Hormone replacement therapy (HRT)

In patients with impaired adrenal glands, DHEA supplementation elevates the body’s production of testosterone and estrogens.13,22,23,24,25

Age-related declines in DHEA levels can be corrected with DHEA dosages of about 50 mg/day for women, 100 mg/day for men.26 Higher doses may be required for other purposes. Age-related declines in estrogens and testosterone can sometimes be corrected by DHEA supplementation. Low-dose studies in subjects 40-70 years of age showed that 50 mg/day restored estrogen and testosterone to youthful levels in women, and restored estrogen levels (but not testosterone) in men. Both sexes experienced an increase in the tissue-building hormone ‘IGF-1’ (insulin-like growth factor) and “a remarkable increase in perceived physical and psychological well-being”.18 Testosterone levels in elderly men increased 46% with 6 months of DHEA supplementation at 50 mg/day.27

Contrary to anti-HRT propaganda generated by neo-luddites and carried by the media, the use of hormone supplements (androgens and estrogens) to restore youthful hormone levels is, by and large, beneficial rather than harmful for both sexes. HRT improves the condition of skin, bone, and other tissues, improves cognition, and contributes to libido. HRT does increase the risk of certain medical conditions, but this elevation in risk is much smaller than other risks that we take for granted, such as those of automobile accidents or falls.

Many DHEA clinical studies have used too low a dosage of DHEA. In women, this can lead to side effects such as sleepiness, restlessness, headache, acne, body hair growth, scalp hair loss, or odors. In men it results in a failure to raise testosterone levels.

DHEA was used in a 2006 clinical study to treat HIV-related declines in steroid hormone levels. At 100-400 mg/day of DHEA, significant increases in testosterone and other steroid hormone levels were achieved.28

Heart disease

In 1988, Nestler, et al., reported that when healthy men were given oral doses of 1600 mg/day of DHEA, their LDL levels fell by 7.5% in 4 weeks.29 Two years later the study was repeated by other researchers, who found no changes in LDL levels.17 (Such contradictions are not unusual in the medical research literature.) Subsequent studies have shown undramatic effects of DHEA on cholesterol levels — but these studies used doses of 20 to 100 mg/day.

In recent years, as reviewers have tried to summarize and draw conclusions from past clinical studies, many have decided that the 1988 results must be wrong, since they are contradicted by most later studies.30 They ignore the fact that the small doses used after 1990 make comparisons with Nestler’s study impossible. The discrepancy between the 1988 and 1990 studies might easily be due to something as simple as the fineness with which the DHEA was ground up before dosing, or whether it was consumed with food, or some other factor that was never examined by the reviewers.

So we should be skeptical about claims that DHEA supplements fail to improve cholesterol or LDL profiles, or that they are useless for treating or preventing heart disease. Some reviewers consider this supplement to be of proven benefit to the cardiovascular system.5 The last word is not yet in on these subjects.

There is less controversy over findings that cortisol levels in both sexes can be reduced by DHEA supplementation at 200 mg/day.21 (Cortisol correlates with heart disease.)

Indirect evidence suggests that DHEA may lower the incidence of atherosclerosis.31

Cancer

DHEA treatment appears to inhibit cancers of the breast,32,33,34 prostate,35 colon, liver, and skin.2 Most of this evidence comes from animal experiments — very few clinical studies have addressed the issue in humans.

Most cancer-related work using DHEA has been focused on breast cancer. From epidemiological studies it is known that premenopausal women with high blood levels of DHEA develop less breast cancer than those with low levels.32 There is also abundant evidence from studies in cell culture, rats, and humans, that androgens (such as testosterone and DHEA) inhibit the proliferation of breast cancer cells.32 As a breast cancer therapy DHEA may be the best available androgen, since it has only mild androgenic effects in other tissues, yet has a strong inhibitory effect in breast tissue.33,34

Prostate cancer has also received some attention from DHEA researchers. Recent evidence suggests — in direct contradiction to current treatment paradigms — that androgens such as testosterone protect the prostate from tumor growth.35 Such an anti-cancer effect has actually been demonstrated in lab animals,35 but no human clinical tests have been performed.

Muscle building

Does DHEA supplementation increase the size and strength of muscles? The answer will probably be “no” if you ask sports nutritionists,36 War-On-Drugs zealots, or the physicians’ lobby. But it will probably be “yes” if you ask medical researchers fortunuate enough to have funding sources and social environments that allow them to study the matter objectively.

Most research into DHEA’s muscle-building capabilities has been done in elderly subjects. In a 1994 study, 50 mg/day of DHEA for six months resulted in a 16% increase in blood levels of the hormone IGF-1 in men, and a 31% increase in women. (IGF-1 is a tissue-building hormone that promotes muscle growth.) Another study at the same dosage showed increases in IGF-1 of 32% and muscular increases of about 2.5%.27

At 100 mg/day DHEA increased muscular strength in men by 15%.19 Nestler’s 1988 study reported a significant increase in muscle mass in men taking 1600 mg/day.29

Bone and osteoporosis

In elderly women and men, bone density increases were seen with DHEA supplementation at 50 mg/day.5,37,27,38,39,40 A 2000 study, for example, showed 1.6-2.5% increases in bone mineral density after six months of DHEA usage.27 Even a 25 mg/day DHEA regimen showed significant reductions in joint pain in men.41

Skin

When DHEA was applied to the buttock skin of volunteers 12 times during 4 weeks it promoted the synthesis of procollagen and protein; the researchers concluded that DHEA could be an anti-aging agent for the skin.42

Improvement in skin pigmentation took place in elderly women given DHEA at 50 mg/day.37

In 2005 it was reported that DHEA levels correlate strongly with protection against chronic venous ulceration in humans, and it was shown that DHEA accelerated healing in wounded mouse skin.43

Anti-aging and longevity

No clinical studies have tried to determine whether longevity is increased by DHEA use. But if DHEA ameliorates ailments of aging (such as heart disease and cancer), then it is logical to expect an increase in longevity.

Energy and fatigue

DHEA supplementation at 200-500 mg/day significantly reduced fatigue in HIV patients.44 It had a similar effect in non-HIV subjects,45,41 and produced an increase in stamina in women with androgen deficiency.46

Immunity

DHEA protects mice from viral, bacterial and parasitic infections by enhancing immunity.47 Immunity enhancement has also been been reported in humans.5 In a 20-week experiment, men in their 60s who were given 50 mg/day of DHEA saw major increases in measures of immunity.48

Cognition

The effects of DHEA on cognition are complex, since they depend on a person’s hormonal conditions. Consequently, most studies of the cognitive effects of DHEA in humans have produced null results49 — in contrast to animal studies, which have shown significant cognitive benefits.

However, patients with advanced HIV disease experienced significant improvement in cognition when they were given 50 mg/day of DHEA for 4 months.50

Mood and depression

When people with midlife-onset depression were given DHEA (3 weeks at 90 mg/day followed by 3 weeks at 450 mg/day), half of the patients achieved a 50% reduction in depression score.51 In depressed schizophrenic patients, DHEA at 100 mg/day improved depression and anxiety.52 Dosages of DHEA in the range of 100-500 mg/day resulted in improved mood and less depression in HIV patients.44,8

Women with low hormone levels experienced higher alertness, stamina, and initiative after using DHEA.46 In aging men with low androgen levels, 25 mg/day of DHEA caused a “progressive improvement in mood”.41

Lupus

At 200 mg/day DHEA reduced the incidence of lupus flares,53 apparently because DHEA decreases the production of Interleukin-10, an inflammatory cytokine.54 Other research studies have shown similar results.55,56

Menopausal symptoms

In menopausal women DHEA has been reported to reduce vasomotor symptoms, increase sexual arousal, and improve cognitive performance.57

Sexual function

Clinical trials have shown that DHEA supplementation improves libido and other sexual functions in elderly women,37 men and women with sexual dysfunction,5 and younger men and women with hormone deficiencies.15,46,22 DHEA also decreases erectile dysfunction.58 Libido studies are lacking for normal young men and women.

Fertility

DHEA supplementation at 80 mg/day improved lackluster responses to ovarian stimulation.59 General effects on fertility have not been studied.

Other ailments

Studies in humans, monkeys, and rodents suggest other possible uses for DHEA:

  • reducing incidence and severity of multiple sclerosis60
  • inhibiting progression or reducing symptoms of Parkinson’s61,62
  • ameliorating allergies such as atopic dermatitis63 and allergy-induced asthma64
  • preventing herpes virus type 2 encephalitis65
  • preventing diabetes, and increasing insulin sensitivity in diabetics66
  • increasing neuronal growth and survival67

Because its areas of application are so broad, DHEA is used by many people for general health.

Only micronized DHEA is worth buying — non-micronized DHEA is hardly absorbed at all. A 10-20 mg dose of piperine (Bioperine®) taken with, or up to an hour before, a DHEA dose may further improve bioavailability.

You can contact Dr. Zarkov at AskDrZarkov@yahoo.com.

Last modified 2006.Oct.5


References


Disclaimer: The information provided in this “Ask Dr. Zarkov” article contains no medical advice whatsoever — it contains ‘biological information’. Nothing in the article constitutes an effort to persuade readers to use, or not to use, this biological information as a basis for action.