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 dehydroepiandrosterone to androgens has been best evaluated in the prostate where about 50% of androgens are made locally from dehydroepiandrosterone.

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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 dehydroepiandrosterone 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.

DO NOT TRUST ANYONE - NO MATTER WHAT THEIR CREDENTIALS - WHO SAYS A DHEA SUPPLEMENT IS SAFE IN HIGH DOSES WHEN TAKEN FOR PROLONGED PERIODS. Without a doubt, high doses of dehydroepiandrosterone have side effects, sometimes quite serious.

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Dehydroepiandrosterone and the Immune System
Dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) are the main adrenal androgens (AAs) 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 (SLE), 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 and Aging
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, DHEA has neurosteroidal properties and may exhibit direct action via specific binding sites on endothelial cells. There is convincing evidence for beneficial effects of DHEA 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.
Autoimmunity. 2005 Nov;38(7):531-40. Department of Medical Sciences, Section of Rheumatology, University Hospital, Uppsala, Sweden.
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 ( <or= 45/ >or= 46 years) 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 dehydroepiandrosterone  treatment, the former placebo group improved in SF-36 "mental health" with a tendency for improvement in HSCL-56 total score (p=0.10). Both groups improved in McCoy's Sex Scale during active treatment (p<0.05). 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.

Dehydroepiandrosterone for androgen deficiency in women
Very short term dehydroepiandrosterone treatment in female adrenal failure: impact on carbohydrate, lipid and protein metabolism.
Eur J Endocrinol. 2005 Jan;152(1):77-85. Medical Department M, Arhus Sygehus, Arhus University Hospital, Arhus, Denmark.
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). RESULTS: dehydroepiandrosterone  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. CONCLUSIONS: Short-term oral dehydroepiandrosterone  replacement in women with adrenal insufficiency was not associated with measurable changes in total or regional substrate metabolism.

Dehydroepiandrosterone sulfate is sometimes misspelled as dihydroepiandrosterone

40 3 acetyl 7 oxo dehydroepiandrosterone

Dehydroepiandrosterone  Emails
Q. 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 dehydroepiandrosterone, which completely cleared up my bout with Polymyalgia rheumatica, DHEA improved my wellbeing significantly.

Q. Hi Dr Sahelian, your website and comments are very informative. Thank you. I had a question about 5 mg Sublingual DHEA dehydroepiandrosterone which I am told has is the equivalent of 20 mgs oral. Do you think this form of DHEA 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?
   A. 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.