Dehydroepiandrosterone (DHEA): Uses, side effects, and ...

Fast facts on dehydroepiandrosterone (DHEA) · DHEA is an endogenous steroid hormone, produced by the adrenal glands, gonads, and brain. · Its role is not fully ... HowcanDHEAbenefityourhealth?MedicallyreviewedbyAlanCarter,Pharm.D.—WrittenbyTimNewmanonJune14,2018WhatisDHEA?NaturallyraisinglevelsMedicaluseSideeffectsDruginteractionsRisksWeincludeproductswethinkareusefulforourreaders.Ifyoubuythroughlinksonthispage,wemayearnasmallcommission.Here’sourprocess.Dehydroepiandrosterone,betterknownasDHEA,isasteroidhormone.Itisnaturallysynthesizedbythebodyandperformsanumberofroles.Ithasbeeninvestigatedwidelyforitspossibletherapeuticeffectsinarangeofconditions.Sometimescalledthe“superhormone”andthe“fountainofyouthhormone,”DHEAisacomplexsubstancethatleavesmanyunansweredquestions.ThehumanbodynaturallymakesDHEA.Itcanconvertintoarangeofhormones,includingandrogensandestrogens,themaleandfemalesexhormones.DHEAisalsoavailableinsupplements,madesyntheticallyusingchemicalsfoundinsoyandwildyam.However,consumingwildyamorsoywillnotenablethehumanbodytomakemoreDHEA.DHEAsupplementsclaimtohelpwitharangeofconditions,includingsexualdysfunction,lupus,depression,adrenalinsufficiency,cervicalcancer,vaginalatrophy,andweightloss.Someresearchsupportsitsuse.However,DHEA’seffectivenessiscontroversialandrarelysupportedbyevidence.Inaddition,thequalityofproductsonsaleisnotalwaysconsistent.Whatisdehydroepiandrosterone(DHEA)?ShareonPinterestDHEAisnaturallyproducedbythebodybutsupplementsarealsosyntheticallymadeinlabs.DHEAisanendogenoussteroidhormone.Thismeansitisnaturallymadebythebody,anditspursspecifictissuesorcellsintoaction.Itisalsoknownasandrostenolone,3β-hydroxyandrost-5-en-17-oneand5-androsten-3β-ol-17-one.DHEAisoneofthemostabundantsteroidhormonesinthehumanbody.Itisproducedbytheadrenalglands,thegonads,andthebrain.Itisnormallyfoundintheformofdehydroepiandrosteronesulfate(DHEAS).ThebodyholdsDHEASinreserveandconvertsittospecifichormoneswhenneeded.Itisimportantforcreatingestrogenandandrogensexhormonesandcontributestothedevelopmentofso-calledandrogeniceffects,ormasculinization.Thesechangesincludetheproductionofoilierskin,changesinbodyodor,andthegrowthofarmpitandpubichair.DHEAmayalsohaveotherroles,forexample,asaneurosteroid.Inthisrole,itwoulddirectlyaffectneuronalexcitability.SomesaythatDHEAenhancesathleticperformance.Thereislittleevidencetosupportthis,buttheWorldAnti-DopingAgency(WADA)prohibitsitsuseinsportingcompetitions.ProductionofDHEApeakswhenpeopleareintheir20sand30s,andthenitdeclines.ThisisthemainreasonthatDHEAisconsideredanimportantchemicalintheagingprocess,andapotentialtargetforanti-agingdrugs.WildyamandsoycontainchemicalsthatcanbeconvertedintoDHEAinalaboratory.However,thebodycannotconverttheminthesameway.EatingsoyoryamswillnotincreaseDHEAlevels.ResearchintoDHEAhasincreasedinrecentyears,butmanyquestionsremainaboutitseffectivenessandpossibleadverseeffects.DHEAandthebrainDHEAcanactasaneurosteroid,directlyaffectingtargetsinsidethebrain.Itsactivitiesarenotfullyunderstood,butsomeresearchersbelieveithelpsprotectneuronsfromtoxinsandafterinjuries,suchasstrokes.Someresearchsuggeststhatitmaycontributetonervegrowth,andthatitmayhelpreduceinflammationandpreventcelldeath.Itmayalsomodulatemood.Forthisreason,ithasbeenstudiedforthetreatmentofmooddisorders,suchasanxietyanddepression.ResearchpublishedinthejournalNaturein2013foundthatDHEAenhancedconnectionsbetweentheamygdalaandhippocampusandreducedactivitylevelsinbothregions.Thesechangesarethoughttocontributetoanenhancedmoodandareducedmemoryforemotionalevents.SomestudieshavefoundthatnaturallyhigherlevelsofDHEAandDHEAShaveapositiveeffectonsometypesofcognitivetasks.Astudyofwomenaged21to77yearsfoundthatthosewithhigherlevelsofnaturallyoccurringDHEAShadbetter“executivefunction,concentration,andworkingmemory.”ItshouldbenotedthattheexperimentmeasurednaturallyoccurringDHEAS,andnotsupplements.Similarexperimentshavenotconfirmedthesefindings,andsomehaveproducedoppositeresults.TherearealsoconcernsthatDHEAcantriggermania,psychosis,andothermoodchanges,especiallyinpeoplewithbipolardisorderandothermentalhealthissues.DHEAisnotrecommendedforusealongsidevariousdrugs,includingantidepressants,moodstablizers,andanti-seizuredrugs.NaturallyraisinglevelsofDHEADHEAcanbeincreasednaturallyincertaincircumstances.Undercaloricrestriction,forexample,DHEAquantitiesincrease.Forthisreason,somehavesuggestedthatcaloricrestrictionmightincreaselifespan.Regularexercisealsoraisesthebody’snaturaloutputofDHEA.MedicalusesOverthelastdecade,DHEAhasbeenstudiedforitseffectivenessintreatinganumberofdiseasesandconditions.Successrateshavevaried.BonedensitySomediseasescauseareductioninbonedensity.SomeresearchsuggeststhatartificiallyraisingDHEAlevelshelpsincreasebonedensity,especiallyinwomen.However,notallstudieshaveproducedpositiveresults.DepressionDepressionhasbeenlinkedtolowbloodlevelsofDHEA.ThereisevidencethatDHEAcouldhelprelievesymptomsofdepression.Areviewofresearch,publishedin2014,suggestedthatDHEAmightimprovesymptomsofdepressioninpeoplewithschizophrenia,anorexianervosa,HIV,andadrenalinsufficiency.However,theuseofDHEAisnotrecommendedwithdrugscommonlyusedtotreattheseconditions.WeightlossSomeevidencesuggeststhatDHEAmayhelpreduceweightinolderpatientswithmetabolicconditions.Areviewin2013concludedthat“DHEAsupplementationinelderlymencaninduceasmallbutsignificantpositiveeffectonbodycomposition.”Thiscanonlyhappen,however,ifthebodycanconverttheDHEAinthesupplementsintoandrogensorestrogens.Theeffectonyoungerpeoplewithexcessweightisnotknown.AnorexianervosaAsmallstudyof26peoplewithanorexianervosafoundthatthosewhotook100milligrams(mg)ofDHEAsupplementsfor6monthssawanincreaseinbodymassindex(BMI)andalsoenhancementsinmood.AdrenalinsufficiencyThishappenswhentheadrenalglandsdonotproduceenoughsteroidhormones,includingDHEA.SupplementingwithDHEAcanreducesymptomsofadrenalinsufficiency,butsideeffectscanbesubstantial.Furtherevidenceisneededtoconfirmitseffectivenessoverall.LupusThisisanautoimmunedisorderaffectingtheskinandorgans.DHEAlevelsarelowerthannormalinwomenwithlupus.SomeresearchshowsthatDHEAimprovesanumberoflupussymptoms.SexualfunctionSomestudiessuggestDHEAmayhelppeoplewithdeficitsinsexualfunction,libido,anderectiledysfunction.However,otherresultshavebeeninconclusive.Theeffectappearstobemoresignificantinwomenwhohaveundergonemenopause.Areviewofevidencepublishedin2012concludedthat“DHEAadministrationisnotusefulforimprovingmalesexualfunction.”AgingEvidencethatDHEAsupplementscouldhelpstaveoffage-relatedchangesisweakorunproven.Theremayalsobesideeffects,suchasareductionin“good”HDLcholesterolandheartpalpitations.HIVSomestudieshavesuggestedthatDHEAmighthelppreventreplicationoftheHIVvirusandbolstertheimmunesystem,buttheauthorsofatleastonestudy,publishedin2007,foundthatitdidnothavetheseeffects.TheresearchersdidnotrecommendusingitroutinelyasanadditionaltherapyforpeoplewithHIV.CervicalcancerResultsoflaboratoryinvestigationssuggestthatDHEAmayinhibittheproliferationofcervicalcancercells,andthatitcouldprotectagainstthemigrationofcancercells.MusclestrengthShareonPinterestAthletessometimesuseDHEAtobuildmusclestrength,butthereisalackofevidencetosupportthisuse.SomeathletesuseorhaveusedDHEAtoincreasemusclestrength.Inolderpeople,thereisasmallamountofweakevidencethatsupportsthistypeofeffect.Moststudies,especiallyinadults,havefoundlittleornoeffect.DHEAiswidelyavailabletopurchaseover-the-counter,butthereisscantevidencetosupportitssafetyoreffectiveness.SideeffectsManysourcesadviseagainstusingDHEA,especiallywithoutfirstseekingmedicaladvice,becauseofthepossiblesideeffects.DHEAaffectstheendocrinesystem,whichmeansitaffectshormonalactivity.Hormonalchangescanimpactonarangeofbodysystems.Asaresult,awidevarietyofsideeffectsarepossible.Inaddition,DHEAhasnotbeentestedorwidelyusedoveralongperiodoftime,soitisnotclearwhatthelong-termeffectsmightbe.Sideeffectsappeartovaryindifferentagegroupsandbetweendiseases.Theyinclude:acuterespiratoryfailureanxiety,agitation,nervousness,restlessness,andaggressivebehaviorbloodintheurinechestpainandabnormalheartrhythmcrawlingsensationonthescalpdizzinessdiarrheaeyeproblemsfatigueheadachemoodandemotionalchangesinsomnianightsweatsmaniainpeoplewithbipolardisorderrashesweightgainlowbloodpressureacnebleedingandblood-clottingproblemsDHEAmightaffectmenandwomendifferently.SideeffectsinwomenWomenmightexperiencethefollowing:smallerbreastsizedeepenedvoicelargergenitalsirregularorabnormalmenstruationincreaseddischargeoilyskinincreasedhairgrowthSideeffectsinmenMenmightexperiencethefollowing:smallertestesurgencytourinateenlargedortenderbreastsAnewversionofDHEA,knownas7-keto-DHEAisanaturalbyproductofDHEA.Because7-keto-DHEAisnotconvertedtosteroidhormonesbythebody,theriskofsomeofthehormonalsideeffectsisreduced.Although7-keto-DHEAhasbeenpromotedasassistinginweight-loss,buildingmuscleandstimulatingtheimmunesystem,evidencesupportinganyoftheseclaimsislimited.DruginteractionsShareonPinterestDHEAcaninteractwitharangeofdrugs.Itisimportanttoaskforprofessionaladvicebeforeusingit.Medicationsofteninteractwitheachother.DHEAhasacomplexrole,andarangeofinteractionscanoccurwhenusingitwithothermedications.AnyonewhoisconsideringtakingDHEAsupplementsshouldfirstspeaktoahealthprovider.SpecialcautionisneededwhenusingDHEAalongsideanyofthefollowingdrugsorsubstances:heartmedicationsuchasthebetablockerpropanolol,angiotensin-convertingenzyme(ACE)inhibitors,calciumchannelblockers,andcardiacglycosidesmetformin,commonlyusedbypeoplewithdiabetesmedicationsthataffectestrogenlevels,suchasbirthcontrolpillsandantiestrogens,forexample,anastrozoleantidepressants,suchasbupropion,mirtazapine,selectiveserotoninreuptakeinhibitors(SSRIs),andserotonin-norepinephrinereuptakeinhibitors(SNRIs),suchasvenlafaxine(Effexor)clozapineandotherantipsychotics,asDHEAmightreducetheireffectivenesslithiumandphenothiazines,usedforsomementalhealthconditionsanti-seizuremedication,suchascarbamazepine(Tegretol)andvalproicacid(Depakene)bacillusCalmette-Guérin(BCG)vaccinesedatives,suchastriazolam(Halcion),asDHEAcandepressthecentralnervoussystem(CNS),leadingtoalowbreathingandheartrategamma-aminobutyricacid(GABA)-bindingagentsmorphineandopioidantagonistsMentalHealthAmericaalsocautionsagainstusingDHEAwith:othersteroidsmedicationsandherbsthataffectbloodsugarlevelsanticoagulants,suchaswarfarin(Coumadin)herbswithhormonaleffects,suchasalfalfaandbloodrootherbswithantiplateleteffects,suchasginsenganymedicationorherbthatmayaffectheartrhythmsItcanalsointeractwithsoy,alcohol,licorice,chromium,andfiber.DHEAmustbeavoidedwithtestosteronetherapy,asitcanleadtoalowspermcountandenlargedbreastsinmenandinmalecharacteristicsinwomen.Thislistisnotexhaustive.ItisimportanttospeaktoahealthproviderbeforeusingDHEA.RisksPeoplewiththefollowingrisksorconditionsshouldbeespeciallycarefulwhenconsideringDHEA:ahigherriskofprostate,liver,breastorovariancancerahigherriskofurinarytractinfectionsthyroiddisordersorreceivingthyroidhormonetherapydiabetes,asDHEAcanaffectbloodsugarlevelsheartdiseaseorstrokelowlevelsof“good”HDLcholesterolhightriglyceridelevelsbleedingdisordersbenignprostatichypertrophy(BPH)sweatingdisordersanxietyordepressionjointpainpost-traumaticstressdisorder(PTSD)orsleepdisordersimmunedisordersorareusingimmunosuppressantsmania-associatedpsychiatricdisordersDHEAsupplementsshouldnotbetakenduringpregnancyorwhilebreastfeeding.Childrenshouldnotuseit.DHEAisacomplicatedchemicalwithmanyroles.Inthefuture,itmaybeusedinavarietyoftreatment.Fornow,however,itisbesttobecautiouswhenusingit,asthereisalackofevidenceregardingitssafetyandeffectiveness.ArangeofDHEAsupplementsareavailableforpurchaseonline.LastmedicallyreviewedonJune14,2018EndocrinologySeniors/AgingComplementaryMedicine/AlternativeMedicineMedicallyreviewedbyAlanCarter,Pharm.D.—WrittenbyTimNewmanonJune14,2018LatestnewsMoreevidencethatstressacceleratesbiologicalagingWHOsaysnotoconvalescentplasma,butnoteveryoneagreesOmega-3:Whatitcanandcan'tdoforhealthLinkbetweendementiaandfasterheartratesHIVpreventionmustbe‘tailoredtotheneedsoftransindividuals’RelatedCoverageWhatarephytoestrogens?BenefitsandfoodsMedicallyreviewedbyDebraRoseWilson,Ph.D.,MSN,R.N.,IBCLC,AHN-BC,CHTPhytoestrogensareanaturalcompoundfoundinplants.Wheneaten,theymayaffectapersoninthesamewayasestrogenproducedbythebody.READMOREWhydopeopleusemeldonium?MedicallyreviewedbyDebraRoseWilson,Ph.D.,MSN,R.N.,IBCLC,AHN-BC,CHTMeldoniumisperhapsmostwell-knownforitsroleinsportsdoping.Thisarticlewillexplorethestoryofitsoriginanditsbroadmedicalusesin…READMOREWhydoweneedtestosterone?MedicallyreviewedbyDanielMurrell,MDTestosteroneisasexhormonethatregulatessexualdevelopment,musclemass,andredbloodcellproduction.Itoriginatesmainlyinthetesticlesand…READMOREWhyregularcoffeeintakecouldworsensportsperformanceManyathletesturntocaffeineasawayofboostingtheirperformance,butanewstudysuggeststhatregularcaffeineintakemayhavetheopposite…READMORE