DHEA Supplement benefits and side effects by Ray Sahelian, M.D. , author of DHEA: A Practical Guide, Mind Boosters, and Natural Sex Boosters
Potential use as hormone replacement therapy and libido boost
You MUST read this article regarding DHEA side effects, risks and danger before you buy a supplement
 

DHEA is short for dehydroepiandrosterone (D-hi-dro-epp-E-an-dro-ster-own), a hormone made by the adrenal glands located just above the kidneys. Scientists have known about this hormone since 1934. More than 150 hormones are made by the adrenal glands. However, the most abundant hormone made by the adrenal glands is DHEA. After it is made by these glands it goes into the bloodstream and from then on it travels all over the body and goes into our cells where it is converted into male hormones, known as androgens, and female hormones, known as estrogens. Small amounts of DHEA are also made in the brain by neurons (brain cells).

Dr. Sahelian says: I do not feel comfortable with the high dosages of 7-keto DHEA supplement, DHEA and pregnenolone sold over the counter. These hormone can have serious side effects. I think a maximum of 5 mg is acceptable when used occasionally. Hormones are powerful substances. They can be very helpful if used appropriately but can cause harm if misused. One of the adverse effects is heart palpitations or arrhythmias. I have had numerous reports over the years that a DHEA supplement in high doses causes cardiac arrhythmia or skipped heart beats. Use hormones in low doses and for short periods of time. Take frequent breaks which I call 'hormone holidays.'    
   Back in 1998 I wrote a letter to the Annals of Internal Medicine mentioning my experience with a DHEA side effect - a case report of heart rhythm irregularities with the misuse of this hormone. It was the first time such an association was made and published. See Ann Intern Med. 1998 Oct 1;129(7):588. Dehydroepiandrosterone and cardiac arrhythmia. Sahelian R, Borken S. Case Reports - Letter. The case report mentioned heart palpitations that occurred in Dr. Borken who was taking 25 mg of DHEA supplement daily. When he stopped the hormone supplement, the palpitations went away, when he resumed the supplement, the palpitations recurred.

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DO NOT EXCEED MORE THAN 5 MG A DAY on a long term basis. Blood and saliva testing and not reliable ways to determine how much DHEA you should take because blood levels do not give a clear view on how this hormone 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 DHEA supplement. For instance, for sexual health consider an herbal sexual enhancement product such as Passion Rx. For mental health, there are various brain supplements including Mind Power Rx. For appetite control, consider Diet Rx which works very well. To improve muscle tissue, consider creatine powder. For more energy, try MultiVit Rx. If there are no other good options, and if you really do need to take a DHEA supplement, use the smallest amount that works in order to prevent side effects.

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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 have side effects, sometimes quite serious.
 

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What about DHEA side effects?
Individuals with normal levels of DHEA who take high doses are likely get DHEA side effects. Common side effects caused by high doses include:
     Acne - due to androgens
     Increased sweat odor and possible scalp itching
     Menstrual irregularities
     Irritability and restlessness - sometimes low doses can actually help induce calmness
     Hair thinning or hair loss - androgenic hormones, such as DHEA, testosterone and androstenedione can cause hair thinning in susceptible individuals. DHEA is likely to raise levels of testosterone and dihydrotestosterone (DHT) in the hair follicles. Too much DHT will lead to scalp hair loss in some individuals. DHEA has not been tested in combination with other medicines, therefore little is known about drug / hormone interactions. For anecdotes relating to the DHEA side effect of hair loss, read the emails below. We have had a report from one female DHEA user that her hair loss recovered after she stopped the DHEA.
     High doses could cause heart palpitations or rhythm disturbances. This is the most serious and potentially life threatening DHEA side effect.
     High dosing for prolonged periods - many years - could theoretically increase the risk for certain cancers such as breast cancer and prostate cancer.

   Here is an example of DHEA and pregnenolone cardiac side effects we received by email in July 2007. We have had many of these types of emails regarding heart rhythm problems these hormones can cause.

"Thank God i found your web site. I have been taking DHEA 30mg daily for 5 years. 2 years ago i developed heart palpitations. Adrenal exhaustion they said. I lived with it. Then i became angry, easily agitated, sleep problems appeared. 2 weeks ago i ordered pregnenolone 25mg, and adrenal cortex 250mg, wanting to address the adrenal problem. On the 5th day of taking the new tablets, plus usual DHEA, i developed extreme dizziness, on 6th day was rushed to hospital by ambulance, placed in cardiac intensive care. ECG showed erratic heart rhythms, they thought my electrolytes were out of whack, and said the electrics of my heart was irregular. They thought i was going to have a heart attack. I have never had high blood pressure, always good cholesterol levels, not overweight, generally very healthy - they were confused because tests all came out normal, and said my symptoms were not typical. After reading your web sight, i now know the new pregnenolone tablets were the straw that broke the camel's back. Your web site is so easy to follow, and packed with vital information. I feel so much better already, and am going to take plenty of hormone holidays. Like everything in life, moderation is the key. P.S. I am a 56 year old female from Australia. Thank you."

How much DHEA does our body make?
Humans are thought to make between 10 and 15 mg of DHEA a day. These numbers are lower in women by about 10 to 20 %.

What do you think of testing for blood or saliva DHEA levels?
Unless you have a medical condition which leads to very low levels of DHEA, it is very difficult to determine the appropriate dosage of DHEA supplements based on testing. At this point I do not recommend blood or saliva DHEA testing unless it is interpreted by an experienced medical professional or unless there is a strong medical suspicion that symptoms are due to low DHEA levels. The interpretation of DHEA saliva testing is difficult and different labs may have different ways of testing DHEA making interpretation even more complicated (and test levels could easily vary throughout the day). I do not see the reason to test for DHEA levels if the hormone is used occasionally. If a person plans to use DHEA as hormone replacement in low doses, such as 1 to 3 mg, again I do not see the need to test for DHEA levels.

When did DHEA become available over-the-counter?
DHEA became widely available to the public without a prescription in 1995, shortly thereafter Pregnenolone supplements also became available over the counter.

What is the role of DHEA in the human body?
DHEA is converted in the body to androgens (such as testosterone) and estrogens, thus influencing practically every organ and tissue in the body, including the brain. However, the physiological role of this hormone has been studied for over three decades and still eludes final clarification. What we know is that DHEA is secreted by the adrenal cortex, and it exerts its action either indirectly in peripheral tissues after its conversion to androgens and estrogens, or directly as a neurosteroid through the interaction with neuronal receptors.

DHEA Caution
High dosages of pregnenolone and DHEA, generally more than 10 mg, cause heart palpitations and irregular beats in some users. I believe that the highest dose of these hormones sold over the counter should be no more than 5 or 10 mg, even though they are often available at 10, 25, 50, and even at 100 mg. These hormones are much more powerful that people realize. Just because they are available over the counter does not mean they have been proven to be completely safe. The Oct 10, 1998 issue of the respected medical journal Annals of Internal Medicine  published my letter to the editor regarding DHEA and cardiac arrhythmias. See http://www.annals.org/cgi/content/full/129/7/588. In my clinical practice I have noticed instances of skipped heart beats or heart rhythm irregularities on high dose of DHEA.

Do DHEA levels in the body stay constant throughout life?
Before puberty, the blood DHEA levels both in males and females is very low, however, it rapidly increases at puberty, and starting in late 20s or early 30s, DHEA levels begin to decrease with age. Whether this represents a harmful deficiency or an age-related adaptation is not known.

Additional human research indicates the following potential benefits:

• DHEA is helpful in older men and women with osteoporosis.
• Is an effective addition to the conventional treatment of those who suffer from hypopituitarism, a condition in which the pituitary gland fails to secrete a variety of pituitary hormones into the circulation.
• May help reverse bone loss and some of the emotional disturbances associated with anorexia nervosa.
• DHEA supplementation improves blood vessel function and insulin sensitivity in middle aged men. These beneficial changes have the potential to attenuate the development of age-related disorders such as cardiovascular disease.
• In a small study, DHEA was found to be beneficial in patients with Crohn's disease and ulcerative colitis.
• May be helpful in women with lupus (systemic lupus erythematosus) although the adverse effects may limit its use.
• The administration of DHEA in patients with advanced HIV infection results in improved mental function

Where does DHEA come from?
DHEA supplements are made commercially from a plant of the Dioscorea family [wild yams] found in abundance in Mexico. Extracts of this plant contain a steroidal saponin called diosgenin which may be converted in a laboratory by a series of 6 to 8 chemical reactions into DHEA. In the human body, DHEA is made from cholesterol.

Have there been human studies?
There have been dozens of studies published in the medical literature regarding DHEA, and the rate of these studies has accelerated ever since this hormone became available over-the-counter. For some reason, some of these studies do not mention the adverse effects that I have encountered in my clinical experience. Sometimes if you don't look for a side effect or sign, you don't find it.

Do DHEA supplements suppress the adrenal gland's natural production?
The production of many hormones is controlled by a "feedback loop," which means that when hormone levels get too high, the body is told to make less, and when hormone levels are too low, the body is told to make more. Cortisol, testosterone, and estrogen are all regulated by this feedback. In other words, if a person takes cortisol, or a similar derivative such as prednisone, it will shut off the body's natural production. DHEA appears to be one of the exceptions. There doesn't seem to be a feedback mechanism for DHEA. In other words, DHEA supplements are not likely to stop the body's own production.

What about medical consultation?
Even though vitamins, herbs, and certain hormones, are available over-the-counter, it is advisable that consumers discuss with their health care provider any supplements they are taking. Unfortunately, many physicians are not familiar with the benefits and risks of supplements and consumers are often left on their own to find reliable information regarding natural supplements.

Does DHEA misuse cause death,?
Thus far, even though DHEA has been sold over-the-counter since the mid 1990s, and hundreds of thousands of individuals, or perhaps more, are estimated to have taken it, there have not been any reports in the medical literature indicating that DHEA has caused fatalities. But I have come across one email from an older gentleman whose wife died of heart rhythm problems after a few months of taking more than 50 mg daily of DHEA and pregnenolone.

Summary and bottom line
DHEA is made from cholesterol and is a natural hormone that has been available over-the- counter since the mid 1990s. No fatalities have been recorded in the medical literature regarding the use of this hormone by the general public. The availability of this supplement and its popularity have stimulated research by the scientific community regarding the potential uses of this once neglected natural hormone. Although DHEA has side effects in high doses, it does not have the acute toxicity that other non-prescription medicines such as aspirin or acetaminophen (Tylenol) have. Aspirin and acetaminophen are known to cause thousands of deaths and overdoses each year.
   There is little justification for DHEA supplementation in healthy elderly subjects, except perhaps in tiny doses of 1 or 2 mg, perhaps up to 5 mg in some people. Thus far studies have failed to prove for beneficial effects of DHEA on muscle function, bone metabolism or cognition. However, more research with DHEA may provide the answers we currently lack.

Review
In my opinion, based on its reported benefits, side effects, and safety profile, I believe it’s important that the public should continue to have access to DHEA as a dietary supplement. However it is recommended that consumers discuss with their health care provider before undertaking any regular use of this hormone. It is also recommended that the natural health industry itself put forward that dietary supplement companies voluntarily sell and recommend only low dosages of this hormone, such as 5 mg.
   Since 5 mg pills of DHEA are difficult to find, those who plan to take this hormone under medical supervision could open a capsule of 25 mg and take only a small portion, or take a portion of a tablet.

Hair loss side effects
Any androgenic steroid, such as DHEA, testosterone and androstenedione can cause the side effect of hair loss in susceptible individuals. DHEA is likely to raise levels of testosterone and dihydrotestosterone (DHT) in the hair follicles. Too much DHT will lead to hair loss. Taking DHEA when a person’s body does not need it will lead to excess DHT and cause hair loss in many people probably even in one’s 20s. Too many people are taking high dosages of these hormones on a regular basis without really needing them. Anyone who wishes to regain their hair should discuss with their physician about stopping the hormones. The temporary (2 to 3 month) use of finasteride [Propecia (1 mg) or Proscar (5 mg)] could stop the hair loss and possibly regrow part or all of the lost. It is difficult to predict how long a person would need to take finasteride. Women may benefit from minoxidil 2% and could discuss with their physician about the use of a medicine called spironolactone. Whether hair regrows on its own after stopping DHEA or whether a medications such as finasteride is necessary to help regrow is not clear at this time.

I have read on your website about DHEA induced hair loss. I also read of one case where it was reversed. I took some DHEA for 2 weeks, not every day, at 25mg. I am a 31 year old female. My period has become scant and early and my hair is thinning rapidly. I am looking for any possible solution. I have already stopped the DHEA (obviously) but it has not slowed the hair loss. I find I can almost control it with curcumin, soy, saw palmetto, evening primrose oil, NAC and taurine. However, I am hoping for either something that can stop this without me taking supplements. Is there any timeframe involved that I should be looking at or is it possible that the hair will continue to fall out even after cessation of supplementation?
   In all likelihood the hair loss should stop after cessation of the hormone supplement. It is difficult to know how long the process will take to reverse. Finasteride medication used temporarily may be an option if the hair loss continues for another month.

Is DHEA the only adrenal hormone?
A. More than 150 hormones are known to be synthesized by the adrenal glands. However, the most abundant hormone made by the adrenal glands is DHEA. After DHEA is made by these glands it goes into the bloodstream, and from then on it travels all over the body and goes into our cells, where it is converted into male hormones, known as androgens, or female hormones, known as estrogens. Whether DHEA gets converted predominantly into androgens or estrogens depends on a person's medical condition, age, genetics, and sex. Every person has a unique biochemistry. In males the testicles also make androgens, while in females, before menopause, the ovaries also make estrogens. So the body has developed at least two organs where sex steroids are made. After menopause, the ovaries no longer make estrogens.

Will natural yam extract pills increase my DHEA levels?
A. Most of the DHEA sold now in vitamin stores or through mail order firms is produced in a laboratory from diosgenin. However, some vitamin companies do sell extracts of wild yams in pill form, without first processing it into DHEA. Some even promote these yam-extract products as "DHEA precursor complexes" or "natural DHEA."
   DHEA is made commercially from a plant of the Dioscorea family [wild yams] found in abundance in Mexico. Extracts of this plant contain a steroidal saponin [called diosgenin] which may be converted in a laboratory by a series of 6 to 8 chemical reactions into DHEA. A comparable series of reactions is not known to exist in nature and certainly not in humans. Consequently it is highly unlikely, perhaps impossible is a better word, that the ingestion of extracts of the Dioscorea plant will lead to the formation, by metabolic transformation of the relevant plant constituent, to either pregnenolone or DHEA.

Cause of high DHEA levels
Very high levels may be caused by Cushing's disease or syndrome. Women with PCOS could have high DHEA levels. However, most of the time, an isolated high DHEA level on a blood or saliva DHEA test may not be significant and it is worthwhile to have the levels tested in a few weeks since levels fluctuate and a one time reading of a high DHEA may not mean anything. Also, it is important, before any therapy is initiated, to have a repeat DHEA test by another laboratory since the measurement of this hormone can vary between different labs.

Fibromylagia
The hormone supplement DHEA may be a popular choice for people with fibromyalgia, but it is unlikely to be helpful in fibromyalgia. Fibromyalgia is a syndrome marked by widespread aches and pains, fatigue and sleep problems, among other symptoms. There are no medications specifically approved for the condition. Instead, medical treatment usually involves a combination of approaches, such as painkillers, antidepressants and exercise therapy. DHEA at 50 mg a day for 3 months was given to 52 women, mostly in their 50s and 60s, who had been diagnosed with fibromyalgia. Overall, the women reported no clear improvement in pain, fatigue, depression and anxiety, and physical and mental function -- with either the supplement or the placebo. SOURCE: Journal of Rheumatology, July 5, 2005.

DHEA Research studies
Dehydroepiandrosterone increases endothelial cell proliferation in vitro and improves endothelial function in vivo by mechanisms independent of androgen and estrogen receptors.
J Clin Endocrinol Metab. 2004 Sep;89(9):4708-15. Related Articles, Links
Dehydroepiandrosterone may be beneficial in cardiovascular health, but mechanisms of DHEA action in the cardiovascular system are unclear. We have therefore 1) determined DHEA effects on the proliferation of cultured endothelial cells (EC), 2) compared effects of DHEA with estradiol (E) and testosterone (T), and 3) examined DHEA effects on subcellular messengers. We have in addition examined effects of DHEA (100 mg/d, 3 months) in 36 healthy postmenopausal women on blood pressure, lipids, and endothelial function, assessed noninvasively in large vessels by flow-mediated dilation of the brachial artery during reactive hyperemia, and in small vessels by laser Doppler velocimetry with iontophoresis of acetylcholine. DHEA, E, and T all increased EC proliferation; the effect of E was abolished by the estrogen receptor antagonist ICI 182,780, and that of T was abolished by the androgen receptor antagonist flutamide; neither blocked the effect of DHEA. In vitro, DHEA increased EC expression of endothelial nitric oxide synthase and activity of extracellular signal-regulated kinase 1/2. In vivo, DHEA increased flow-mediated dilation and laser Doppler velocimetry and reduced total plasma cholesterol. Thus, DHEA increases EC proliferation in vitro by mechanism(s) independently of either androgen receptor or estrogen receptor and in vivo enhances large and small vessel EC function in postmenopausal women.

Pharmacokinetics of dehydroepiandrosterone and its metabolites after long-term daily oral administration to healthy young men.
Acacio BD, Stanczyk FZ, Mullin P et al. Fertil Steril. 2004;81:595-604.
To determine the effects of dehydroepiandrosterone supplementation on the pharmacokinetics of DHEA and its metabolites and the reproductive axis of healthy young men. A prospective, randomized, double-blind, placebo-controlled pharmacokinetic study. General Clinical Research Center and laboratories at the Keck School of Medicine of the University of Southern California, Los Angeles, California. Fourteen healthy men, ages 18-42 years. Daily oral administration of placebo, 50 mg DHEA, or 200 mg DHEA for 6 months. Blood samples were collected at frequent intervals on day 1 and at months 3 and 6 of treatment. Quantification of DHEA, DHEA sulfate (DHEAS), androstenedione, T, E(2), dihydrotestosterone (DHT), and 5alpha-androstane-3alpha-17beta-diol glucuronide (ADG). Physical examination, semen analysis, serum LH, FSH, prostate-specific antigen, and general chemistries were carried out. Baseline DHEA, DHEAS, and ADG levels increased significantly from day 1 to months 3 and 6 in the DHEA treatment groups but not in the placebo group. No significant changes were observed in pharmacokinetic values. Clinical parameters were not affected. DHEA, DHEAS, and ADG increased significantly during 6 months of daily DHEA supplementation. Although the pharmacokinetics of DHEA and its metabolites are not altered, sustained baseline elevation of ADG, a distal DHT metabolite, raises concerns about the potential negative impact of DHEA supplementation on the prostate gland.

Acute dehydroepiandrosterone effects on sexual arousal in postmenopausal women.
Hackbert L, Heiman JR.  University of Washington, Seattle, USA.
J Womens Health Gend Based Med. 2002 Mar;11(2):155-62.
The age-related decline of dehydroepiandrosterone has prompted research on its experimental replacement in women. Although no relationship to sexual functioning in healthy women has been shown to date, DHEA replacement has potential for affecting sexual response. To investigate DHEA effects, 16 sexually functional postmenopausal women participated in a randomized, double-blind, crossover protocol in which oral administration of DHEA (300 mg) or placebo occurred 60 minutes before the presentation of an erotic video segment. Blood DHEA sulfate (DHEAS) changes, subjective and physiological sexual responses, as well as affective responses were measured in response to videotaped neutral and erotic video segments. The concentration of DHEAS increased 2-5-fold following DHEA administration in all 16 women. Subjective ratings across DHEA and placebo conditions showed significantly greater mental and physical sexual arousal to the erotic video with DHEA vs. placebo. Positive affect also increased during the erotic video across drug conditions. Vaginal pulse amplitude (VPA) and vaginal blood volume demonstrated a significant increase between neutral and erotic film segments within both conditions (DHEA and placebo) but did not differentiate drug conditions. In sum, increases in mental and physical sexual arousal ratings significantly increased in response to an acute dose of DHEA in postmenopausal women.

Australian researchers have identified the hormone DHEA as a new marker of low libido in women under 45 years challenging current expert opinion that sexual dysfunction is associated with low testosterone levels. Researchers at the Australian based Jean Hailes Foundation are addressing the complex role of hormones. Their aim is to understand what is normal and whether women may benefit from therapy. In one of the world's most comprehensive studies into women's health and hormones researchers looked at 1423 randomly selected women aged 18-75. Professor Susan Davis, Director of Research at The Foundation is presenting these findings at the Endocrine Society's 86th Annual Meeting this week and said, "We undertook this study to determine whether women with low libido also had low levels of androgens. Until now experts have agreed that sexual dysfunction in women was illustrated by low levels of free and total testosterone. However this study has shown low testosterone bears no relationship to low libido in women under 45 years of age. "We found a strong relationship between the low scores for desire, arousal and responsiveness and low DHEA levels in women under 45, "said Professor Davis. Sexual function is complex and not simply a function of hormone levels. Sexual desire involves an intricate interplay of biological changes such as hormones and psychosocial influences including relationship factors, body image, aging, menopause, social and cultural expectations.

Moderate drinking may boost levels of a hormone that is believed to help protect against artery disease. The findings could help explain some of the cardiovascular benefits of moderate drinking. "People consuming alcohol in moderate amounts may have a healthier hormone status," Dr. Henk F.J. Hendriks at TNO Nutrition and Food Research in the Netherlands told Reuters Health. Many studies have shown that moderate drinking is associated with a reduced risk of cardiovascular disease. Moderate tippling may lower the risk of artery disease through its effects on inflammation, blood clotting and on the way the body metabolizes fats in the blood. There is growing evidence that sex hormones also may be involved in the development artery disease. For example, some studies suggest that high levels of a hormone called DHEAS, or dehydroepiandrosterone, may help keep blood vessels healthy. Levels of DHEA naturally decline with age.

DHEA supplement emails
Q. I have reviewed your comments regarding DHEA supplements and the pros and cons and recommendation that one should supplementation, if necessary, with 5 mg. As a physician do you do a blood test for DHEA sulfate on your patients and regardless of results, still recommend that they start a DHEA supplement with just 5mg.
   A. There should be a good reason before a doctor recommends hormone supplementation. Hormone testing is overdone and should be limited to cases where there are clinical indications that a hormone deficiency or excess is present. Most people who want to begin androgen replacement therapy just for overall enhancement don't need to have a DHEA blood test done if thy only plan to take 1 or 2 mg of DHEA a day. In those cases where hormone level testing has been done due to suspicion of potential endocrine problems, if the DHEA level is very, very low, then it may mean that the patient would benefit taking more than 5 mg. However these cares are very infrequent compared to the vast majority of those who want to take a DHEA supplement in low amounts for believed (rightly or wrongly) health enhancement.

Q. I am a 47 year old male, 5'10", 220 lbs. I went to a vitamin store and it was suggested that I take DHEA to increase my testosterone which I was told would help increase my metabolism. I took one 20mg capsule the first day and when I woke up the next morning my scalp and body skin were itchy. Not realizing these were DHEA side effects I took another 20 mg DHEA capsule and within one hour I was sweating heavily, my heart was racing, and I was very dizzy. And my scalp is more itchy than before. So these symptoms occurred within 24 hours. After reading about the side effects on your website I will never take DHEA again. Scarey.

Q. I am a 50 year old man 235lb almost 19in arms 52 in chest, good shape, strong, etc. Anyway on more than two occasions I have taken DHEA over the period of a few weeks. The dose was 25mgs a day. At first I was happy with the results of increased libido, good workouts, but little by little I started to get more and more aggressive and very short tempered, In fact everything started to piss me off and then my back started to break out. So when I ran out It was some time before I started to use It again and the same results happened. I have not taken It since but am amazed at the reaction DHEA had on me, and have told people that It may not be a good idea to take this stuff. My question to you Is did I already have high levels of DHEA or was It just the way my body and mind reacted to this drug?
   A. Your reaction is normal, whether you had normal or high DHEA levels you were likely to have dhea side effects from these high amounts.

Q. After reading your information on the relationships you have found between heart arrhythmias and DHEA usage, I would like to confirm your finding as I have experienced a severe, life-threatening episode on February of 2005. I had been taking 50mg of DHEA only on training days, that is 4 days a week. This means I had been on DHEA since September 2004. A week or so prior to my episode of severe palpitations, I had felt neck and chest pains and discomfort during activity and during rest. I had felt my heart rate faster than the usual. The week after, I traveled to Northern VA to see my wife. We decided to go to the mall, and that night I started to feel as if I was going to faint, I felt I could not breathe properly, chest pains, shortness of breath, and numbness in my tip of my nose and toes. The worst feeling EVER! I was rushed to the Virginia Hospital Center where they ran every test possible, and fortunately, they found nothing wrong except my heart rate at rest was between 110 and 120. But BP was borderline. The ER attending doctor could not explain this horrific experience and therefore, prescribed 2mg of Ativan to relax me. Thereafter, I saw my primary care physician who continue to treat me with Ativan. As stated, he was under the impression I had anxiety. Not only did I not have a clear answer to what happened to me that night, but I began to have dependency on Ativan. After 8 months of this mystery, I finally have discovered that I have developed PVCs shown by my event monitor. I have now conquered the Ativan withdrawals and my PVCs have disappeared. I believe that DHEA caused this arrhythmia and the withdrawal from the Ativan also permitted for my palpitations. Please note that before this incident, I had been a competitive (DRUG FREE) powerlifter who has always been in shape and who has eaten extremely well. I take 3 grams of Vitamin C daily and I eat a very balanced diet.

Q. Can DHEA convert to progesterone in some women, rather than estrogen and testosterone?
   A. Pregnenolone converts into DHEA and progesterone. DHEA does not convert into progesterone, rather it converts into estrogen and testosterone.

Q. hello, i am a 39yr old desperate female with no testosterone (per doc) low progesterone and adrenal fatigue. I have a lot of hair loss from stress or something else. My doctor told me to take DHEA 50mg 3x week. i only took it 3 times and my hair loss became much worse. My doctor said it was impossible for the hair loss to worsen from the DHEA after only taking it 3x and wants me to continue it. All the reading i'm doing on adrenal fatigue says i need the DHEA, but i know it made the hair loss worse and will not take it anymore. About 8 years ago i took DHEA and that's originally when the hair loss started, i stopped it back then, but the hair loss has progressed over the years and now there's not much left. Have you ever seen the hair loss be that quick from DHEA ?
   A. We have come across cases where DHEA led to hair loss rather quickly. The hair loss side effects of taking DHEA are not known by many doctors.

Q. THANK YOU! THANK YOU! THANK YOU! I thought I was going insane! I have mitral valve prolapse and have been having major heart palpitations for the past few weeks. I thought my valve was going to need replaced. I went to see my doctor this past week and I am being scheduled for tests. He told me to discontinue caffeine products and I disagreed with him that caffeine was not the problem. The palpitations came on suddenly and could not have been from drinking caffeine. I came home and analyzed what had recently changed in my life. About 4 weeks ago, my mother had recommended me to take DHEA because I was complaining to her about my low sex drive. I went to Wal-Mart and bought DHEA 50 mg that day. Since then, I have been extremely moody, my hair has been coming out more easily than before, my eyes feel like they are about to explode from increased pressure, and the very frequent palpitations. I decided to research DHEA this morning and typed in DHEA side effects. I came across your website and I now know what has been wrong with me. I am not going crazy! I am discontinuing the DHEA pill TODAY and I will be calling my doctor to let him know about my findings that DHEA has serious side effects. Maybe I can help him with future patients. I am so grateful that you put this information out there!

Q. My husband has just had some saliva tests done which showed his DHEA level to be very high (88ng/ml compared with a norm for his age (53) of 3-10). He is not taking a DHEA supplement. He has many of the symptoms of high DHEA - acne, palpitations etc. Are there any known risks with a high natural DHEA level?
   A. First, I am not convinced saliva tests for DHEA are completely accurate since different labs may have different ways of doing them, and I suspect saliva levels may not reflect accurately levels in various cells in the body where it really counts. Second, there are other causes for acne and heart rhythm irregularities, not just DHEA. If it is true that someone has high levels of DHEA or androgens, it is possible that over time this could increase the risk for androgen sensitive tumors such as prostate cancer or other problems like hair loss or enlarged prostate. Before accepting these high levels to be true, it would be best to have the DHEA level tested by another health care provider at another lab, and this time by blood. And then repeat the DHEA blood study a couple of more times over a period of several weeks or months.

Q. I know you probably won't be able to answer me, but I am desperate. I am a 43 year old woman and took a 25 mg DHEA supplement recommended by my doctor. He was not really clear about how long I should take DHEA, nor did he give me any warnings about possible DHEA side effects. Unfortunately I took it for 6 months and now am experiencing pretty severe hair loss. I have lost 50% of my hair in the last 2 months. I really had NO IDEA what I was taking and feel very stupid for not researching DHEA before I took it. My DHEA levels were tested and were high (260 in a scale of 14-244). I have stopped the supplement as of 3 weeks ago. Can you give me any hope (at all!) about regaining my hair once the DHEA level drops? I know you won't recommend treatments but if you could direct me to some information I would be grateful. This is causing me unbelievable anxiety.
   A. Unfortunately we have had many emails regarding hair loss associated with misuse of DHEA. There is hope that some of the hair, maybe most or all could grow back, but it is impossible to predict. Perhaps some herbs as mentioned on my web page on hair could be tried, or your doctor could prescribe finasteride for hair regrowth, at least for a few weeks or months.

Q. What explains the fact that DHEA can initially cause increased libido, but then that effect wears off in a couple of weeks?
   A. This may happen in some people. I am not sure, there could be some feedback loop that suppresses some hormone release, hence occasional use of DHEA for libido enhancement is preferable.

Q. I am 44 and a testicular cancer survivor (back when I was 33). About the time I turned 43, my libido declined like a light switch had been  turned off. It went from strong to nothing in the space of about 3 months. I did research including your site and I decided to follow your recommendation of a reduced dose. I am using 25 mg DHEA supplements but I am using a pill cutter to split them into 4 roughly 6mg pieces. I started taking them and I was astonished. The next day, my libido surged back and the response has been consistently  strong and immediate when I take them. I cycle them a few days off every couple weeks so I take them about 10 days out of 14. There have been other subtle effects as well. I used to have a constant good mood that went away about the same time and I started being a bit crabby and negative. My good mood returns after a couple days of taking the DHEA supplements. I appreciate the work and research you have done on DHEA and wanted to let you know it made a great positive difference in my life.

Q. I have been reading your articles regarding DHEA since 1998. I currently take 15 mg for approximately 3 weeks and stop once the onset of my menstrual cycle appears. I have found that if I take the DHEA during my menstrual cycle I will continue to bleed for up to a week. I am 50 years old now and my periods have begun to subside significantly. Although I continue to have regular periods they are much lighter. It is clear though that taking the DHEA will produce heavier periods and longer duration. In addition to this I have been taking longer vacations from the hormone for 1-2 months at a time. I have experienced some of the side affects such as heart palpitations, thinning hair, however I am not at all sure these are not just the affects of aging and menopause. However, upon reading your latest update I have decided to order 5 mg supplements to be sure I am not overdoing a good thing. Thank you for your research.

Q. I want to comment on DHEA. I have a daughter and very good friend who suffer from severe asthma. In and out of hospitals, regularly. Seven years ago my friend began taking 25-50mg of DHEA for other reasons. We were discussing an asthma attack my daughter had just encountered when my friend said she had not had one for seven years. She had just mentioned taking DHEA for seven years. I thought about our conversation and suggested that my daughter take the supplement. Her hospitalizations and use of a nebulizer have subsided. She only needs a nebulizer treatment when she gets a severe cold. I recommended the supplement to three other asthmatics and they have had the same results.
   A. DHEA in this case may be acting as a steroid hormone similar to cortisol. I'm not so comfortable using it for this purpose for prolonged periods.

Q. I came upon your website during my search for DHEA information. My blood test revealed a very low DHEA level.  I am a 50 year old female dealing with the onset of menopause. I began taking 25 mg. DHEA tablets two months ago.  I gradually began developing symptoms, especially acne and increased facial and body hair.  Finally, I realized it must be the DHEA and stopped taking it last week.

Q. Congrats that you are spreading the word not to take more than 5 mg DHEA daily. I cringe when I see/hear people taking 50-100mg and even more per day . Here's the kick. Even at 5 mg DHEA, it can trigger a very aggressive / explosive feeling in me that I don't like. Verbal, not physical. I lose my temper very easy even on 5mg dhea. It's almost embarrassing to me going through this. Temper can be awful. Every time I come off it, that temper subsides within 2-3 days, completely gone within a week. I think everyone should be aware of this. DHEA can ruin lives if people do not understand it. There is alot of good with DHEA but there are drawbacks, some major, as stated above. Two other potential drawbacks for me (and others). DHEA actually seems to be addicting. I have now started / stopped DHEA for 8 periods (being on for a few weeks each time). Each time I start out swearing I'll only take 5mg every other day and by the end of the month, I'll be taking 5-10mg each day, one time even going up to 30mg a day. I also have a hard time stopping it even knowing it's building up and my moods are going haywire. I've often read about the mood elevation of DHEA. BUT, I notice it's not steady (for me). I can go up and down, sometimes way down, quite often when taking this hormone supplement. Again, I've read this from others also. I think we need to be fair/realistic when touting any med or supplement. Bottom line: There can be major drawbacks / side effects when taking even small doses of DHEA

Q. Does the DHEA you buy in the store convert to free testosterone once in the body?
   A. Yes, it most likely does.

Q. I started taking DHEA at 50mg for the first 2 days and then dropped to 25mg as didn't like the sour / metallic taste in my mouth. After just two days on the lower dose, I had a 'presumed' heart flutter that last just a second or two where I wasn't sure exactly what it was. A second heart flutter occurred a day later that lasted about 15 seconds and felt like a large butterfly with rather strong wings fluttering in my upper chest.  No dizziness or lightheadedness. Based on your comments on the website, I will be lowering my dose to half a pill per day, or perhaps should stop altogether. I do seem to feel quite a bit better and rather hate to stop, but don't want to compromise my heart health either! I am a 44 year old female and take 125mg of Unithroid for last 3 years but otherwise am healthy.  Unithroid dose has been steadily increased over the last two years yet I can't seem to regain my pre-hypothyroidism stamina and energy. T3 never measured as doctor feels it unnecessary. 

Q. I started taking DHEA in October of 1996 and it has totally ruined my life. Yes, at first it gave me energy, the reason I started taking it, and it did actually give me a feeling of well-being. However, after about a year or a year and a half, I began to lose good judgment, became too sexual for my own good or anyone else's for that matter, had a total personality change, became aggressive, and fearless. No one, including my doctor, suspected that these were DHEA side effects. The results ruined my marriage and other people's lives, caused me to lose my good reputation, all of my assets, my business, and my health. I have been on psychiatric medicine ever since stopping this supplement (several years) not really knowing what was wrong, have relocated to another town in shame and guilt (even though these actions were not really actions I was responsible for), and continue to go through life in survival mode. I am not at all the person I use to be and I, along with others, blame it entirely on this supplement. Some watched in amazement as I turned before their very eyes into someone they didn't know at all.

Q. During a five month period of time, I (26 year old healthy male) was taking an energy / sex enhancement pills with DHEA and tribulus in them. foolishly i had looked at the other ingredients (gingko, ginseng, saw palmetto) and since i knew what these were i assumed the other ingredients were benign. i did take more than the recommended dose (usually 4-6 pills daily instead or 1-2) and i had no idea what DHEA and tribulus were. After noticing depression, sleeplessness, hair loss, body hair increases and chest enlargement i finally stopped taking the pills. I am very angry at myself and at the fact you can get this stuff over the counter at a drugstore. There are no warnings on this that the ingredients were testosterone precursors or anything.

Q. How is it possible to find out if the amount of DHEA which is on the label of an over the counter product is really in it? Also, I am taking 25 mg per day of Natrol over the counter DHEA and I do feel much better but notice if I take 50mg I feel even better and my joints don't ache. Also, when I first started taking it my libido was better then great. Now its seems to have disappeared to the point of like when you are on an antidepressant. I am 50.
   A. A few years ago I purchases a dozen DHEA products on the market and sent them to a laboratory to be tested. They all were fine and true to their label. There is a lot we don't know about the long term use of hormones and that is why I mention on this web site to take hormone holidays and use the least amount that works. Perhaps there is a feedback loop that somehow decreases the sex boosting effect of dhea. It's just a guess.

Q. Have you heard of DHEA causing high IOP (intraocular pressure) or possibly temporary glaucoma. I have been taking DHEA for about a year. I like the benefits it has provided both physically and mentally. However my last flight physical for the military showed me having high IOP in both eyes. I suspected the use of DHEA as a cause and did some research on the subject. I have not found any literature concerning this specifically, but I did find info on steroid induced glaucoma. My eye pressures were tested multiple times and found to be high. Two days after I stopped taking DHEA my pressures where back to normal. Coincidence or direct result? I know IOPs can fluctuate like blood pressure, which makes it all the more confusing. What do you think?
   A. I have not heard of this side effect yet, and I have not seen it mentioned in the medical literature, however it is a possibility to consider. There's a lot we don't know about the long term effects of DHEA. If your IOP is increased again after restarting the DHEA and then returns to normal after stopping, then that would make it quite likely that in your case the DHEA was involved.

Q. I am 56 year old physician assistant and can easily monitor blood levels of DHEA in our office. After stumbling on to your web site, I checked my DHEA levels (DHEA sulfate) in morning and found them to be very low at 35 ng/dl. I began supplementation at 25 mg and found a marked improvement in my energy. Levels increased to 198. Experimentally I increase the dose to 50 mg/day and found an even larger increase in energy and levels at 268. However, the 50 mgs caused marked insomnia, increased tachycardia and multiple PVC's.

Q. Thanks for helpful research info in the past. I see that new studies may implicate testosterone supplements in atherosclerosis development. I am female with a family history on father's side of coronary artery disease with normal cholesterol. I am not requesting personal recommendations but seek info to help me make my own informed choices. Dhea did cause breakouts in myself so I scaled back to 2 mg or less daily with no problems. I'd hate to give it up as it does provide energy and lifts mood. Over the past few years you have also recommended lower doses so I am sure that you have been taking note of some new developments. Is there any indication of the effect on females re: heart disease with dhea?
   A. High levels of testosterone or DHEA may increase the risk of heart disease, however it is not clear what low levels will do. I don't know what effect a daily dose of 1 or 2 mg of DHEA has on the body in the long run and whether the benefits exceed the potential DHEA side effects.

Q. I am generally sensitive but recently started both melatonin and DHEA. The DHEA dosages were: 1wk 6mg daily and next 2 weeks were 12mg daily. I developed menstrual irregularities. Could this be due to melatonin or strictly the DHEA ? My blood levels for DHEA is low, and my endocrine doctor suggest I go to 25mg DHEA (but never yet reached that dosage).
   A. Although both melatonin and DHEA may theoretically cause menstrual irregularities, DHEA is by far the more likely to do so.

Q. I stumbled across your website while searching for information on dhea-induced hair loss in women, and i hope and fervently PRAY you can answer my question. here it is. If i have lost hair on the top of my head due to taking dhea, will it grow back now that i've stopped taking it? I'm a woman, 39yrs old. Although i have been losing hair for several years now (related to other health issues), my hair has gotten remarkably thin on top since i started taking dhea a couple of months ago, and i suspect dhea is the main problem with the recent precipitous loss. I stopped taking the dhea (only 5 mgs a day or every other day) when i noticed my scalp showing through my hair when it was wet, but i am deathly afraid my hair won't grow back even though i've stopped taking the hormone. What has your experience been in such a situation?

Q. My hair loss has recovered. I felt it important to share with your female readers that I did recover completely from DHEA hair loss. I am a woman who began taking 50mg DHEA at 35yrs. of age. I took it for approx. one year. I stopped due to hair loss. Within 24 hours of stopping I experienced withdrawal symptoms just like those of withdrawal from benzodiazepines. These severe symptoms lasted 6 months, tapered at a year, and were not completely gone for 2 years. I feel it imperative that people are made aware of the seriousness of abrupt withdrawal from DHEA. It has now been 5 years and I am finally feeling good again, and yes...my hair is fine as well. Needless to say I no longer take any supplements or pharmaceuticals of any kind, instead I rely on moderate organics, common sense, and a strong belief in a higher power.

Q. I wrote to you a few months back regarding the heart flutters I thought were caused my my intake of 25mg of dhea daily. Once I stopped taking DHEA the flutters stopped within a matter of days! However, I have noticed since I have not been taking DHEA my all over well being is not as great and my libido has all but disappeared.

Q. I just read some information you had on the internet concerning DHEA. I have been diagnosed with PVCs via several stress tests and Holter monitor. While they are uncomfortable, they are not bad enough to warrant medication. However, I started taking DHEA about 10 months ago because I read that it helped female libido. I am a 52-year-old female. It did seem to help, but then I gradually began to notice that my PVCs were much worse. It didn't dawn on me that it could be anything I was taking until I ran out of DHEA. I noticed almost immediately that my heart didn't flutter when I climbed the stairs. Thank you so much for the information.

Q. I have not seen this question in any of your books or on the website or in any FAQs about DHEA. As a postmenopausal woman, I took DHEA cream in a combo formula with pregnenolone for a month and then monitored the results with a saliva test. I was as surprised as could be to find out DHEA rose to maximum for me but did not convert at all into estradiol nor testosterone. There isn't a single source of writing that prepared me for this result. I wanted and still do a partial conversion. Some conversion. I would like to know, in your experience, whether different forms of DHEA--cream, pills, sublinguals, etc--metabolize differently and give different results. Once again, I want to say how much I would appreciate you taking a moment out of your busy schedule to answer me. It truly is difficult to navigate these waters alone.
   A. When taking hormone supplements it is very difficult to know exactly what is happening in the tissues of the body. Blood or saliva tests may not show conversions that go on when DHEA enters a particular tissue, for instance skin, breast, brain, etc, and converts there to other hormones. I find blood and saliva tests of limited value. Hormone replacement is a very difficult and complex issue with no clear answers. If I can make any generalizations they would be to use the lowest effective dose, err on the side of taking less not more, and to take breaks from use. Different forms of ingestion, pills, cream, injection, sublinguals, etc. metabolize differently.

Q.  I am just starting to experiment with DHEA trying 25 mg a day or less I am waiting for your book to arrive. I noticed right away even before I new about the visual enhancements that my vision and colors had become noticeably clearer and brighter. Is this a good indication that a person is lacking DHEA in the body?
   A. DHEA and pregnenolone can sometimes enhance color perception and vision, however this does not mean you are lacking in the hormones. The visual improvement would occur even in individuals who have normal levels.

Q. I am 74 years old and writing from Paris, France. After reading about DHEA in your book, I had a friend from the USA send a parcel of DHEA 10 mg, 300 capsules. I took one every day for 6 months and thanks to you I feel very well and I'm in a good mood. The most important phenomena are the increasing libido feelings. Unfortunately my dear wife doesn't participate any more and I am alone but the feeling is good. I want to send you all my gratitude and faithful thanks.
   A. I'm glad DHEA helped you, you may consider trying a lower dose such as 5 mg to see if you still get benefits.

Q.  I am an 18 year old "extreme" athlete.  I recently started taking 100mg DHEA in the mornings along with a well balanced diet.  In just three days I had noticed a huge difference in my aggression and strength. Out of all of the supplements I have taken, DHEA shows significant results... fast!!  I am aware of taking time off from it on the weekends and see no reason why I shouldn't take it.  Everybody says don't do it because you're so young, but with results this good I don't see why I should stop. Is it okay for me to take 100mg a day in your opinion, even if there are awesome results?
   A. There are short term benefits to taking large doses of DHEA which you have noticed, but sooner or later side effects will appear, such as thinning of hair, or acne, or potentially more serious medical problems. It is unclear at this point whether the hair thinning is reversible. I don't recommend anyone take DHEA for prolonged periods unless they have had blood studies and a medical evaluation to determine that they are deficient in this hormone.

Q. Thank you for your books. "Mind Boosters" is terrific. I am recommending it to friends. I have been using an estradiol patch for several years. Recently I began taking 5 mg a day of DHEA. I feel very good on this, more energetic, better mood and more focused in thinking.  I am wondering if I should see about decreasing the estradiol dose since I gather DHEA supplies some estrogen as it breaks down. Is there any way to estimate how much estrogen 5 mg DHEA as a capsule supplies?
   A. It's difficult to estimate the conversion of DHEA into estrogen since every person has a different metabolism. I do think the dose of estrogen should be reduced when adding DHEA. How much to reduce is difficult to know but it's better to err on the side of taking less than more. Discuss with your health care provider. Thanks for recommending the Mind Booster book.

Q. My friend is 42 and took DHEA 25mg for about 2 months. Her breasts have started to swell painfully. She already needs a bigger bra size. Is this normal ?
   A. I have not heard this before, but I guess it could be possible. I would recommend stopping the DHEA and restarting in one month to see if there it is the DHEA that is causing the swelling or perhaps it was a coincidence.

Q. I am a 37 year old female with asthma. I had chronic fatigue, weight gain, depression, irritability, low sex drive, and irregular menstrual cycle even on birth control pills. I went to one internist that did blood work and only found a urinary tract infection. Basic thyroid test normal. I finally found another internist that gave me an exam and gave me an adrenal stress test and complete thyroid test. My DHEA level was low and my Free T-4 and Free T-3 showed signs of hypothyroid. My doctor put me on Thyroid 60 and DHEA 25 mg. It has been 3 weeks and I feel so much better. I noticed improvement after 3 days which I suspect was the DHEA. I finally had a normal menstrual cycle and my sex drive has increased. I am feeling back to normal and have the energy to exercise on my new treadmill almost every day! I will have another visit in 3 weeks for lab work to check my levels. I am considering asking my Doctor if 15mg 2x a day would be better.
   A. I'm glad DHEA helped you, I would recommend you ask your doctor to use the lowest effective dose of DHEA.

Q. I am a non practicing nutritionist in suburbs of Philadelphia. I have CFS for 5 years. I am happy to see in your writings and books that you take a conservative approach to dosage of natural hormones. I am 59 and have prostatitis for 1 year. I keep it under control with many of the latest nutrients for prostate. My doctor prescribed too much, 50mg of DHEA, since I was low and my psa shot up to 4 from 2.5. I stopped all DHEA and now it is down to 2.5 again. My latest results on saliva testing show normal DHEA, estradiol and testosterone, but results from another lab show below normal DHEA. I am confused as to what to do next. May I ask what I should do in your opinion? Also, do you think 7-keto DHEA would be a safe and effective substitute?
   A. There's still much to be learned about interpreting results from saliva and blood tests as it relates to DHEA levels. Unless you are clearly and significantly deficient in DHEA, it is better you not take or take a very small amount, such as 5 mg. There are hardly any human studies with 7-keto, therefore, I am not able to comment much on this hormone at this time.

Q. I have myalgic encephalomyalitis and adrenal insufficiency. I take progesterone and testosterone skin creams. My doctor put me on 15 mg of DHEA and I had heart arrhythmias and high heart beat. Also, I cannot sleep without the light on, or the radio, which is hard on my husband Then, my DHEA levels were found to be high. So I stopped the DHEA and my heart beat is now slower after 3 days and the arrhythmia is less, according to a pulse oximeter. I still have to sleep with the light on. Does this have to do with DHEA? I started the supplement about a year ago.
   A. DHEA does cause heart arrhythmias in some individuals and can also cause insomnia in high doses since it enhances alertness.

Q. I have taken two separate saliva tests to check my DHEA level -- both before and after starting daily supplementation -- and found it to be low both times. The two different labs I used both advise to collect the saliva samples in the morning prior to the next usage. The normal ranges of DHEA levels for different age groups on the back of the test results reflect levels found 8-12 hours after last usage. However, based on your DHEA book and other sources, I take my DHEA supplement in the morning. Should DHEA supplements be taken at night if one is to take a morning saliva test, and, if so, how long does one need to supplement at night prior to taking a morning saliva test in order to get an accurate reading. Thank you. P.S. I just bought a copy of Mind Boosters and am finding it most informative and well written.
   A. The whole issue of DHEA testing, accuracy of lab results, interpretation of results, and clinical significance of these results is still a murky issue with no definitive guidelines or medical consensus. Blood or saliva levels don't completely tell us what's going on inside cells and how much of these hormones are in the cells and tissues of hair, skin, brain, liver, other organs, etc. Since there are a number of unanswered questions medicine still has to resolve, the best approach is to take low doses of DHEA (if you plan to take it at all) and not put an overemphasis on saliva or blood testing. It's quite likely that if you take a DHEA pill in the morning, unless it is a very high dose, it would be practically out of your system by next morning when you are having your saliva test. If you take the DHEA the night before, even a few hours difference on the timing could make a  difference in your saliva levels. Basically, for the time being, blood or saliva levels of DHEA are a way to know if you are deficient, and help give a clue as to whether or not to take the hormone.
    You may also wish to reevaluate why you are taking DHEA in the first place. Are there other non-hormone supplements that could help you achieve your desired goals (energy, mood, sex drive, vitality, memory, etc.) and would have fewer side effects? Perhaps you could take some of these supplements and thus lower your dose of DHEA. In chapter 2 of Mind Boosters (an engine alone does not run a car) I mention that it is better to use a few different supplements together in small dosages as opposed to one or two in higher amounts. 

Q. Will DHEA interfere with my regular dosage of hormone replacement therapy with Premarin and progestin?
   A. Yes, DHEA is converted to both estrogen and testosterone and your dose of estrogen and progesterone may need to be reduced if your doctor plans to add DHEA.

Q. My regular doctor, an internist, recently told me that I should stop taking DHEA (I have been taking 25 mg daily for the past year or so). He said that DHEA could harm my liver. I am certain that DHEA has been boosting my energy level, my sex drive. I am 58 years old and I would like to continue taking some daily or every other day dosage. I see that you recommend smaller dosages like 5 mg. My question is the following: Is there any data or studies out that show that liver damage can result from DHEA usage? If so, can you direct to those studies? Many thanks for your educational website.
   A. Some studies in rodents and fish have shown large doses of DHEA (equivalent by weight in humans to a few hundred mg per day) causes harm to the liver. It is extremely unlikely that 5 mg a day causes liver damage. However, we don't know the long term effects of DHEA use and those planning to take this hormone have to balance the potential benefits versus the potential risks.

Q. A general question - why would dhea cause an increase danger or prostate enlargement and hair loss if in fact testosterone levels decline in aging males and increase the probability of these conditions occurring anyway.
   A. This is a very good question and I don't have all the answers. We need to keep in mind that different tissues in the body including hair, skin, prostate, brain, have different levels of enzymes that convert different steroid hormones and the decline or shift in these enzymes varies within different tissues and among different individuals. There is little doubt though that some people are experiencing hair loss on high dosages.

Q. At what age should one start taking DHEA or hormone replacement?
   A. This is a personal decision that has to be made in consultation with a physician. A thorough medical history and physical exam must be done. Mid to late fifties is the time that some people start noticing benefits from taking these hormones. Others may never need to use a hormone replacement.

Q. What's the right dosage of DHEA?
   A. The dosage needs to be individualized to each person's needs. This is based on regular evaluations of a basic physical exam, including blood pressure, heart rate, examination of hair and skin, evaluation of routine blood studies, and monitoring of mood, sleep patterns, energy levels, and motivation. Women need to have regular breast exams and Pap tests. Men need to have their prostate exam. Although blood or saliva DHEA levels are important to monitor, in the end, the important point to keep in mind is what kind of influence DHEA or other hormones are having on our brain, organs and tissues. Having said all this, it's best, until more research is done, to stay on very low dosages such 1 to 5 mg. Most people are overdosing. It's possible that taking too much of these hormones could actually shorten lifespan. DHEA and pregnenolone are not like vitamin C. More is not necessarily better. There's a smaller range to play with. I get uncomfortable when I hear of doctors prescribing 25 or 50 mg a day to their patients. I also get very nervous when I see bottles of DHEA or pregnenolone being sold over the counter in high dosages.

Q. What about cycling the use of hormones?
   A. It would certainly be safer if there were times when you stop taking these hormones. You could call this 'cycling' or I call it taking 'hormone holidays.' There are many ways to do this. You could take these hormones every other day, five days on, two days off, take them for a week and off a week or take them for three weeks and off a week. Each person needs to find the program that works for them best.

Q. What time of day should a person take DHEA or pregnenolone?
   A. Since DHEA can increase alertness, morning  is best; although each individual is unique and some prefer mid-day or even bedtime dosing. Bedtime dose should be very low in order not to interfere with sleep.

Q. What are the findings in terms of DHEA and reduction of pain in lupus, and rheumatoid arthritis.
   A. According to limited studies, DHEA provides, at most, only a slight added benefit when given to patients with lupus or rheumatoid arthritis. Rheum Dis Clin North Am 2000 May;26(2):349-62, and Lupus 1999;8(3):181-7.

Q. Have you heard of DHEA slowing down  psoriasis or psoriatic arthritis? If so, would there be any interactions with methotrexate or indomethacin?
   A. A 1995 study found lower DHEA levels in those with psoriasis. (Clin Exp Rheumatol 1995 May-Jun;13(3):345-8.) There's also a German study from 1973 that gave DHEA to those with psoriasis but I am not able to get the translation (Therapy of psoriasis with dehydroepiandrosterone-enanthate. II. Intramuscular depot application of 300 mg weekly. Arch Dermatol Forsch. 1973;247(1):23-8.) I suspect, though, if DHEA is helpful, it is only a minor part in the overall therapy of psoriasis. I am not aware of any studies evaluating the interaction of DHEA with methotrexate and indomethacin. 

Q. I am puzzled by claims that daily supplementation of moderate doses of DHEA can lead to hair loss in men. It has always been my understanding that male pattern hair loss is caused principally by the action of DHT (dihydrotestosterone) in the hair follicles of those genetically predisposed to baldness and that testosterone is converted to DHT by the 5-alpha reductase enzyme. According to your book, DHEA supplementation does not significantly increase levels of testosterone in men. Even if it did, how would that increase levels of DHT? Will daily use of Propecia prevent additional hair loss as a result of taking as much as 25 mg of DHEA each day? I have enjoyed reading your books.
   A. Even if DHEA supplementation does not significantly increase levels of testesterone in the bloodstream, it is still quite possible, and perhaps likely, that DHEA can enter hair follicles, and be converted to testosterone, and on to DHT locally, thus contributing to hair loss, particularly in those whose hair follicles are sensitive to DHT. The study of hormones is called endocrinology, and there is increasing attention to the study of hormones inside tissues and cells. This is called intracrinology. It is difficult to predict whether taking Propecia at the same time as DHEA will help prevent hair loss. It would be much better to take less DHEA or take hormone holidays. Actually, it's best not to take DHEA unless a person has been found to be deficient in this hormone.

Q. I took 25 mg of dhea for 3 weeks. I found myself getting irritable and had fluttering in the chest. I stopped taking dhea, and within a week to a week and a half, i began alot of strange symptoms: anxiousness, perspiration, clamminess about the neck, and extremities, panic attacks, tingling out the head and both arms. I have been off dhea supplements for two weeks now. What is the half-life of supplementation once halted, and are there any known side-effects associated with cessation of the hormone?
   A. The half life of DHEA is less than a day. DHEA likely caused the irritability and fluttering of the chest, but I'm not eager to blame the DHEA for your symptoms that started a week later. I do recommend a medical evaluation to rule out a cardiac or other condition that accounted for your symptoms. My recommendation for DHEA dosage on a regular basis is 5 mg or less.  I believe 25 mg of DHEA is a high dose. I am often criticized by some individuals in the vitamin industry for my low dosage recommendations for hormones and supplements, and your case of fluttering in the chest (which I have come across often) confirms my position on keeping my dosage recommendations for DHEA on the low side.

Q. I'm a MD in the field of neurology and psychiatry in Amsterdam, Holland. I have been taking DHEA for about one year now, in the dosage of 50mg/day. Since a few weeks I was having complaints of palpitations, which after examination appeared to be caused by supraventricular extrasystoles, 1-3 per minute, going on for about 2-3 weeks. I'm not sure whether there is some relationship with the intake of DHEA, but as a doctor i'm interested in finding out the cause of this cardiac irregularity. Other causes could be stress, use of stimulants such as caffeine of thyroid pathology, among other causes. Are there more reports of extrasystoles due to excessive use of DHEA? Thank you for any information.
   A. I was the first to submit a letter to the editor at Annals of Internal Medicine regarding my concern of DHEA in high doses causing this problem. See Sahelian, R., and Borken, S. Dehydroepiandrosterone and cardiac arrhythmia. Ann Intern Med. 1998 Oct 1;129(7):588.

Q. What does it mean when one's natural DHEA level is already high (based on blood tests)? How does it happen? Will I have all the symptoms of someone who is taking too many DHEA supplements? What supplements are available to reduce those natural DHEA levels? What are the medical consequences of a naturally high DHEA? In my web search I've found lots of information about increasing your DHEA levels but none so far on reducing them.
   A. An excessively high DHEA level (without taking supplements) often is due to overproduction by the adrenal glands or the ovaries. I recommend a medical evaluation to find out why this is happening, sometimes a tumor or cysts can be the cause of this excessive production. Steps can be taken to resolve this problem if the source of the overproduction is found. I'm not aware of any natural supplements that lower DHEA levels. Body hair growth, acne, menstrual changes, etc. are some of the consequences of excess DHEA. Perhaps weight loss can decrease the levels of this hormone in some individuals.

Q. Thank you for your insight on DHEA. I was thinking of purchasing 50 mg of DHEA at The DHEA Store (www.dhea.com) where they also sell your dhea booklet. However, they dispute your dhea testimonials regarding negative side effects saying that their product is micronised dhea which absorbs better and does not cause such side effects as heart palpitations, hair loss, irritability etc. They think that it might be 7-keto that consumers are experiencing the side effects with. Are there differences between the types of dhea?
   A. There is a lot of information on dhea on the internet, and it is up to consumers to decide which website dhea information they can trust.

Q. Is having more energy a dhea side effect? Also, is difficulty urinating a dhea side effect?
   A. Yes, a positive dhea side effect is having more energy. I have not heard of difficulty urinating being a dhea side effect, yet.

Q. I’m told by one of my patients that they currently take a daily amount of a product by the name of Super Plus which, they claim, is an amalgamation of various herbs and natural ingredients which supposedly stimulate the body’s production of its own natural DHEA. Have you heard of this product and if so, what is your evaluation of it and its efficacy as a precursor for natural DHEA enhancement?
   A. According to a website selling Super Plus, the promoters claim Super Plus stimulates the adrenal cortex to increase DHEA production. They also claim, "In addition to the Wild Yam, (150 mg's of 4-1 extract) equating to 600 mgs, the makers of Super-Plus incorporated many other nutritional ingredients to assist in the boosting of natural Progesterone, DHEA, cleansing the cells, and strengthening the immune system. Extensive research and care in the formulation, quality control and manufacturing process make Super-Plus the finest, safest, most effective product on the market for better health."
   Whenever you see a product being promoted with these kinds of adjectives: finest, safest, most effective product on the market," you can immediately be quite suspicious that the company making this product lacks integrity. Have they tested their product against tens of thousands of other products on the market to determine that it is the "finest, safest.... etc"? Of course not. When I see this kind of promotion, I no longer feel the need to learn more about this product since I lose trust in the company. Furthermore, in the unlikely case that this product stimulates DHEA production, this may not necessarily be a healthy thing for many people since excess DHEA could lead to hair loss and tumor formation.
   There is no evidence that wild yam converts into DHEA in the human body.

Q. I was quite surprised to read Dr. Sahelian’s comments regarding DHEA. As a physician with extensive experience in this field, I would share that the cause of heart palpitations after DHEA initiation is usually sub clinical hypothyroidism. The DHEA ramps of enzyme D1, which stimulates the conversion of T4 to T3. However, this effect spontaneously resolves within a few days. Simply lowering the dose briefly is usually enough. Women should take DHEA in very low dosages, but nearly all males do very well on 25mg twice daily. More than a total of 50mg DHEA per day is converted into estrogen in men. This, too can be very detrimental. There is absolutely nothing wrong with supplementing DHEA on a daily basis. Think about it: does the body produce DHEA every day normally, or “only ten days per month”? Our goal is to normalize hormonal pathways. I believe your recommendation is not in the public’s best interest.
   A. We have different viewpoints on this topic.

Q. First off, thank you to you and your staff for such dedication and research into the often confusing world of health and nutrition! I have referenced your site often and will continue to do so in the future, as well as tell others about your site. I am a 40 yo female; extremely healthy all my life. However, this past year, the hormone fairy decided to pay a little more than a visit; she moved in. My mother experienced menopause at 40, shortly after having me. Now it seems it is my turn! Life seemed to suddenly come to a screeching halt for me. Never being sick in my life, I new something must be awry with my hormones. I am currently undergoing (very recently started) bio-identical hormone pellet therapy from an M.D. team out of Houston and I am satisfied so far because a complete blood work up revealed my levels were all in the lower 1-5% of the desired 'bell curve'. I've felt the first relief in nearly two years. Anyway, my doctors have also suggested I take their DHEA and pregnenolone for certain reasons. I know the DHEA causes me to feel anxious to outright aggressive and mean; in even doses as low a 5mg. I've asked to avoid taking it, but they strongly encouraged me to at least take the pregnenolone to help keep my very low progesterone levels elevated as well as for brain-support and breast-cancer preventative measures. Dosage 25 mg /day 3 x week. (=I am also on oral progesterone up to 200 mg/day (normally 100 mg) as well as the creams from Life-Flo. So, I came home to research more thoroughly pregnenolone. Earlier I had read your website about the cautions regarding dosage, and when I learned it can also convert into DHEA, I immediately did not want to take it. I found some early research done on pregnenolone and the 'safety' in high doses that was concluded. I really would like your input on this information since it seems very conflicting.
   Coming from a science background myself, I realize that data/research that is older than 5 (sometimes 10) years is usually regarded as 'no longer valid' in the research circles. But since it seems pregnenolone, like many others, have taken a back seat to expensive synthetic drugs, I felt the attention warranted.
   A. There are many web sites on the internet that tout the benefits of the hormones DHEA and pregnenolone while minimizing their side effects. Their are doctors who prescribe high dosages of these hormones without realizing the risks they pose. I have a different viewpoint. These hormones are powerful and they can cause serious side effects as listed at the top of the page. You may ask your doctors to read about the DHEA dangers and pregnenolone dangers on this web site.

Q.  I read you articles on DHEA hormone. A doctor prescribed 25 Mgs daily of DHEA for my wife. She stopped taking it after 3 months when her menstrual cycle became irregular and did not stop bleeding. Her hair is also coming out. As we are trying to normalize her again, would you know how long DHEA stays in the body before it reverts to normal? Do you have any recommendations of what she may need to take to overcome this hormone so she can have normal periods again?
   A. The side effects of DHEA supplement use should decrease as each day and week go on. It is up to her doctor to decide on a course of treatment. Doing nothing is also an option since the effects of DHEA will go away over time.
      Q. I will pass this on to my wife. She is having such a tough time due to taking this hormone. If we had researched it better ahead of time, she would never have agreed to take it. Lesson well learned.

Lately a few diet books have mentioned taking hormone supplements. I bought a DHEA 5mg, and 25mg pregnenolone (the lowest they had). After taking both at different times within months of each other, I had the very same reaction after one dose. I started to feel very, very assertive, angry, very manly. I am a 48yo woman I just started menopause this year after being perimenopause the past 10 years. I have to say this reaction scare me very much and I stopped immediately. Of course I kept hearing all these positive things about the supplements so months later I tried DHEA again and immediately it happened with the first 5mg tablet. I took them because in the past 2 years I have been having symptoms of hypothyroid, diabetes, adrenal fatigue, fibromyalgia. I gained 50lbs within 5 months. it's ridiculous. But just wanted to let you know about my experience with the supplements. No matter what I try for my above problems nothing helps.

References
Andus T, et al. Patients with refractory Crohn's disease or ulcerative colitis respond to dehydroepiandrosterone: a pilot study. Aliment Pharmacol Ther. 2003 Feb;17(3):409-14.
Chang DM, et al. Dehydroepiandrosterone treatment of women with mild-to-moderate systemic lupus erythematosus: a multicenter randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2002 Nov;46(11):2924-7.
Gordon CM, et al. Effects of oral DHEA on bone density in young women with anorexia nervosa: a randomized trial. J Clin Endocrinol Metab. 2002 Nov;87(11):4935-41.
Hackbert L, Heiman JR. Acute dehydroepiandrosterone (DHEA) effects on sexual arousal in postmenopausal women. J Womens Health Gend Based Med. 2002 Mar;11(2):155-62.
Hirshman E, et al. The effect of dehydroepiandrosterone (DHEA) on recognition memory decision processes and discrimination in postmenopausal women. Psychon Bull Rev. 2003 Mar;10(1):125-34.
Johannsson G, et al. Low dose DHEA affects behavior in hypopituitary androgen-deficient women: a placebo-controlled trial. J Clin Endocrinol Metab. 2002 May;87(5):2046-52.
Kawano H, et al. DHEA supplementation improves endothelial function and insulin sensitivity in men. J Clin Endocrinol Metab. 2003 Jul;88(7):3190-5.
Lovas K, et al. Replacement of DHEA in adrenal failure: no benefit for subjective health status and sexuality in a 9-month, randomized, parallel group clinical trial. J Clin Endocrinol Metab. 2003 Mar;88(3):1112-8.
Percheron G, et al. Effect of 1-year oral administration of DHEA to 60- to 80-year-old individuals on muscle function and cross-sectional area: a double-blind placebo-controlled trial. Arch Intern Med. 2003 Mar 24;163(6):720-7.
Piketty C, et al. Double-blind placebo-controlled trial of oral DHEA in patients with advanced HIV disease. Clin Endocrinol (Oxf). 2001 Sep;55(3):325-30.
Sahelian, R, Borken, S. DHEA and cardiac arrhythmia. Ann Intern Med. 1998 Oct 1;129(7):588.
Andus T, et al. Patients with refractory Crohn's disease or ulcerative colitis respond to DHEA: a pilot study. Aliment Pharmacol Ther. 2003 Feb;17(3):409-14.
Arlt W, Callies F, Allolio B. DHEA replacement in women with adrenal insufficiency--pharmacokinetics, bioconversion and clinical effects on well-being, sexuality and cognition. Endocr Res. 2000 Nov;26(4):505-11.
Chang DM, et al. DHEA treatment of women with mild-to-moderate systemic lupus erythematosus: a multicenter randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2002 Nov;46(11):2924-7.
Hackbert L, Heiman JR. Acute dehydroepiandrosterone (DHEA) effects on sexual arousal in postmenopausal women. J Womens Health Gend Based Med. 2002 Mar;11(2):155-62.
Hirshman E, et al. The effect of dehydroepiandrosterone (DHEA) on recognition memory decision processes and discrimination in postmenopausal women. Psychon Bull Rev. 2003 Mar;10(1):125-34.
Johannsson G, et al. Low dose DHEA affects behavior in hypopituitary androgen-deficient women: a placebo-controlled trial. J Clin Endocrinol Metab. 2002 May;87(5):2046-52.
Kawano H, et al. DHEA supplementation improves endothelial function and insulin sensitivity in men. J Clin Endocrinol Metab. 2003 Jul;88(7):3190-5.
Lovas K, et al. Replacement of DHEA in adrenal failure: no benefit for subjective health status and sexuality in a 9-month, randomized, parallel group clinical trial. J Clin Endocrinol Metab. 2003 Mar;88(3):1112-8.
Percheron G, et al. Effect of 1-year oral administration of DHEA to 60- to 80-year-old individuals on muscle function and cross-sectional area: a double-blind placebo-controlled trial. Arch Intern Med. 2003 Mar 24;163(6):720-7.
Piketty C, et al. Double-blind placebo-controlled trial of oral DHEA in patients with advanced HIV disease. Clin Endocrinol (Oxf). 2001 Sep;55(3):325-30.
Sahelian, R, Borken, S. DHEA and cardiac arrhythmia. Ann Intern Med. 1998 Oct 1;129(7):588.