Dehydroepiandrosterone is a prohormone and a hormone secreted in large amounts by the adrenals in humans and other primates, but not in lower species. It is secreted in larger quantities than cortisol and is present in the blood at concentrations only second to cholesterol. All the enzymes required to transform dehydroepiandrosterone into androgens and/or estrogens are expressed in a cell-specific manner in a large series of peripheral target tissues, thus permitting all androgen-sensitive and estrogen-sensitive tissues to make locally and control the intracellular levels of sex steroids according to local needs. This new field of endocrinology has been called intracrinology. In women, after menopause, all estrogens and almost all androgens are made locally in peripheral tissues from dehydroepiandrosterone which indirectly exerts effects, among others, on bone formation, adiposity, muscle, insulin and glucose metabolism, skin, libido and well-being. In men, where the secretion of androgens by the testicles continues for life, the contribution of this hormone to androgens has been best evaluated in the prostate where about 50% of androgens are made locally from dehydroepiandrosterone.
effects and safety
See the link above for a full list of side effects, risks and dangers including hair loss and heart rhythm problems.
Dehydroepiandrosterone (DHEA) and its sulfate represent the most abundant sex steroid in humans. In addition to age-related reduction, serum DHEA shows large interindividual variability. Studies suggest that lower levels are associated with cardiovascular, cognitive and sexual impairment in women but more research is needed to determine its benefit versus risk in terms of supplementation.
This hormone supplement may be of benefit in increasing bone mineral density in older women, and improving sexual vitality in men and women.
Depression, mood, psychiatric conditions
J Affect Disord. 2014. Clinical significance of decreased protein expression of dehydroepiandrosterone sulfate in the development of depression: A meta-analysis. Previous evidence has shown that adrenal androgens, dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEAS) have significant functions related to the control of mood, affect, and anxiety. Elevated DHEAS protein expression may be correlated with the biological pathophysiology of depression, indicating that checking DHEAS levels and administration of DHEAS could contribute to the effective treatment of depression.
Dehydroepiandrosterone and its sulfate (DHEAS) are the main adrenal androgens produced in humans. Production of these steroids, like that of cortisol, is under the control of hypothalamic corticotropin-releasing hormone (CRH) and pituitary ACTH. Other factors, however, appear to be involved in AA secretion because there are many instances in which their circulating levels do not change in parallel to those of cortisol. Apart from physiological alterations associated with fetal adrenal regression, adrenarche and aging, the main instances of divergence in AA production compared with those of corticosteroids occur when immune function is activated or is aberrant. Relative reductions in DHEA and DHEAS have been noted in subjects with rheumatoid arthritis (RA), systemic lupus erythematosus, human immunodeficiency virus (HIV) and autoimmune deficiency syndrome (AIDS), sepsis, and trauma. In some instances, differences in the AA responses have been linked to a clinical course. The mechanisms for impairments in AA production in the absence of suppressed corticoid secretion are unclear but may involve circulating cytokines or locally released mediators from immune system cells in the adrenal gland. There also is evidence that DHEA and DHEAS play a role in immune competence, displaying biological effects opposite to those of corticosteroids.
Dehydroepiandrosterone is the major steroid produced by the adrenal zona reticularis and, in contrast to cortisol and aldosterone, its secretion declines with ageing. This has generated major interest in its putative role as an 'anti-ageing' hormone. However, it is not clear that the age-associated, physiological decline in DHEA secretion represents a harmful deficiency. DHEA exhibits its action mainly by conversion to sex steroids. In addition, it has neurosteroidal properties and may exhibit direct action via specific binding sites on endothelial cells. There is convincing evidence for beneficial effects in patients with adrenal insufficiency and future research will hopefully elucidate its role in patients receiving pharmacological glucocorticoid treatment. However, in healthy elderly subjects, current evidence from randomised, controlled trials does not justify the use of DHEA, with no major beneficial effects reported and, in addition, potentially adverse effects on sex steroid-dependent tumour growth need to be considered.
Dehydroepiandrosterone and lupus
Effects of dehydroepiandrosterone supplement on health-related quality of life in glucocorticoid treated female patients with systemic lupus erythematosus.
The objective of this study was to evaluate the efficacy of low dose dehydroepiandrosterone on health-related quality of life (HRQOL) in glucocorticoid treated female patients with systemic lupus erythematosus (SLE). Forty one women ( >or= 5 mg prednisolone / day) were included in a double-blind, randomized, placebo-controlled study for 6 months where dehydroepiandrosterone was given at 30 mg/20 mg daily, or placebo, followed by 6 months open dehydroepiandrosterone treatment to all patients. HRQOL was assessed at baseline, 6 and 12 months, using four validated questionnaires and the patients' partners completed a questionnaire assessing mood and behaviour at 6 months. dehydroepiandrosterone treatment increased serum levels of sulphated dehydroepiandrosterone from subnormal to normal. The dehydroepiandrosterone group improved in SF-36 "role emotional" and HSCL-56 total score. During open treatment, the former placebo group improved in SF-36 "mental health" with a tendency for improvement in HSCL-56 total score. Both groups improved in McCoy's Sex Scale during active treatment. dehydroepiandrosterone replacement decreased high-density lipoprotein (HDL) cholesterol and increased insulin-like growth factor I (IGF-I) and haematocrit. There were no effects on bone density or disease activity and no serious adverse events. Side effects were mild. We conclude that low dose dehydroepiandrosterone treatment improves HRQOL with regard to mental well-being and sexuality and can be offered to women with SLE where mental distress and/or impaired sexuality constitutes a problem.
Osteoporosis and bone strength
Dehydroepiandrosterone replacement therapy in older adults: 1- and 2-y effects on bone1,2,3
Am J Clin Nutr 89: 2009. From the Division of Geriatrics and Nutritional Sciences, Department of Internal Medicine, Washington University School of Medicine, St Louis, MO; the Department of Nutrition and Dietetics, Saint Louis University, St Louis, MO; and the Division of Food Science, Human Nutrition and Health, Istituto Superiore di Sanitá, Rome, Italy. Supported by NIH research grant.
Age-related reductions in serum dehydroepiandrosterone concentrations may be involved in bone mineral density (BMD) losses. The objective was to determine whether DHEA supplementation in older adults improves BMD when co-administered with vitamin D and calcium. In year 1, a randomized trial was conducted in which men and women aged 65–75 y took 50 mg/d oral DHEA supplements or placebo. In year 2, all participants took open-label DHEA (50 mg/d). During both years, all participants received vitamin D (16 µg/d) and calcium (700 mg/d) supplements. BMD was measured by using dual-energy X-ray absorptiometry. In men, no difference between groups occurred in any BMD measures or in bone turnover markers during year 1 or year 2. The free testosterone index and estradiol increased in the DHEA group only. In women, spine BMD increased by 1.7% during year 1 and by 3.6% after 2 y of supplementation in the DHEA group; however, in the placebo group, spine BMD was unchanged during year 1 but increased to 2.6% above baseline during year 2 after the crossover to DHEA. Hip BMD did not change. Testosterone, estradiol, and insulin-like growth factor 1 increased in the DHEA group only. In both groups, serum concentrations of bone turnover markers decreased during year 1 and remained low during year 2, but did not differ between groups. DHEA supplementation in older women, but not in men, improves spine BMD when co-administered with vitamin D and calcium.
androgen deficiency in women
Very short term dehydroepiandrosterone treatment in female adrenal failure: impact on carbohydrate, lipid and protein metabolism.
Eur J Endocrinol. 2005.
In female adrenal insufficiency, dehydroepiandrosterone secretion is impaired and circulating androgen levels are severely reduced. We wanted to analyse the acute effects of physiological dehydroepiandrosterone substitution on substrate metabolism. We studied nine females with adrenal insufficiency after 9 days of oral dehydroepiandrosterone replacement (50 mg/day) in a double-blind, placebo-controlled crossover study. Whole body and regional substrate metabolism was assayed in the basal state and during a euglycemic hyperinsulinemic glucose clamp by means of isotope dilution techniques (glucose, phenylalanine, tyrosine), indirect calorimetry and in situ lipolysis (microdialysis technique). Treatment normalized the levels of all androgens. Basal and insulin-stimulated total energy expenditure and rates of protein, lipid and glucose oxidation were unaffected by dehydroepiandrosterone. Whole body turnover of glucose and protein were also unaffected by dehydroepiandrosterone. Forearm breakdown of protein was reduced by insulin to the same extent after placebo and dehydroepiandrosterone. Insulin sensitivity as expressed by the glucose infusion rate during the euglycemic clamp was similar after placebo and dehydroepiandrosterone. Finally, the interstitial release of glycerol in adipose tissue was not significantly influenced by dehydroepiandrosterone. Short-term oral dehydroepiandrosterone replacement in women with adrenal insufficiency was not associated with measurable changes in total or regional substrate metabolism.
Influence on other hormone levels
PLoS One. 2014 Feb 21. Dehydroepiandrosterone Sulfate (DHEAS) Stimulates the First Step in the Biosynthesis of Steroid Hormones. DHEAS enhances the conversion of cholesterol by 26%. These findings indicate that DHEAS affects steroid hormone biosynthesis on a molecular level resulting in an increased formation of pregnenolone.
I am a 69 year old male having had a prostatectomy 4 years ago, with follow up radiation treatment. I am in good health and do take 25 mg of dihydroepiandrosterone, which completely cleared up my bout with Polymyalgia rheumatica, DHEA improved my wellbeing significantly.
Hi Dr Sahelian, your website and comments are very
informative. Thank you. I had a question about 5 mg sublingual dihydroepiandrosterone which I am told has is the equivalent of 20 mgs oral. Do
you think this form is safer. Would it be wise to cut tablet in 2
reducing dosage to 2.5 mgs and take one day on one day off?
We can't say whether one form is safer than the other, I would guess both forms of DHEA, sublingual or oral would not be safe after a certain dosage and each person has a different threshold after which side effects would occur, and it is impossible for me to know in your case. As to the equivalency, we have not come across such research and we don't know what information this is based on.
supplement 5 mg
DO NOT EXCEED MORE THAN 5 MG A DAY on a long term basis. Blood and saliva testing are not a reliable way to determine how much dehydroepiandrosterone supplement one should supplement because blood levels do not give a clear view on how dehydroepiandrosterone is interacting within each cell in organs and tissues such as brain, skin and hair, liver, breast, prostate, and other parts of the body. It's better to be safe and proceed with caution. You may consider other options to improve your health instead of taking a hormone supplement. For instance, for sexual health consider an herbal sex product. For mental health, there are various brain supplements. To improve muscle tissue, consider creatine. But if you do need a DHEA supplement, take the smallest amount that works to prevent dehydroepiandrosterone side effects.