Introduction
I have had an enormous number of inquiries regarding DHEA from my patients. This steroid hormone cannot be prescribed by any physician because it is not FDA (Food and Drug Administration) approved for any medical use. It can be sold by health food stores due to its classification as a food supplement and it is not under the regulation of the FDA. The information for this article was derived from The Medical Letter, October 11, 1996.
BackgroundDHEA (dehydroepiandrosterone) is an early member of a chain of reactions that eventually produce the sex hormones. In women the dominant hormone that is produced from DHEA is estrogen; in men, testosterone. These hormones then produce and maintain the usual sexual and reproductive characteristics of women and men. It has been known that the levels of DHEA reach a peak at approximately 20 years of age and gradually decline with further aging. Researchers have conducted several studies involving a small number of patients to see if raising DHEA levels to those seen in young adults would be beneficial to older patients.
Clinical Studies
In fact, several of the studies suggested that those treated with DHEA reported improvement in both physical and psychological categories. There were also studies done on patients with chronic medical illnesses such as AIDS, lupus and multiple sclerosis who also reported similar improvements in well being.
Side Effects
Reported side effects involved mainly women and involved male hormone related problems such as acne and hair loss. Also reported was increased hair growth and deepening of the voice which in some cases is permanent. Much more ominous is the potential for increased sex hormone levels to increase the incidence of cancer in sex hormone sensitive organs such as the prostate in men and breast or uterine cancer in women, though this has not been demonstrated at this time.
ConclusionsThe Medical Letter strongly recommends against the use of DHEA and I concur. The Medical Letter also states that there is no convincing evidence that DHEA has any beneficial effect on aging or any disease. I personally find the evidence intriguing but I agree not convincing. Larger and long term clinical trials will be needed to clarify unresolved issues of effectiveness and safety. If you are motivated to try DHEA, I would suggest that you consult with a licensed medical practitioner who can order blood tests to monitor your DHEA levels and adjust the dosage as needed.
Lloyd Ito, MD
11/30/03