DHEA

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Dehydroepiandrosterone (DHEA) is a hormone produced by the body's adrenal glands. The body uses DHEA to make androgens and estrogens, the male and female sex hormones. DHEA levels peak at about age 25, then go down steadily as you get older. By the time people are 70 to 80 years old, their DHEA levels are only 10 to 20% those in young adults. DHEA is a synthetic product that can be manufactured from natural sources such as soy and wild yam. DHEA is used orally for improving cognitive function and slowing the progression of Parkinson's and Alzheimer's diseases. DHEA is used for:

  • Slowing or reversing aging
  • Weight loss
  • Rheumatoid arthritis
  • Aging skin
  • Systemic lupus erythematosus (SLE)
  • Sjögren's syndrome
  • Osteoporosis
  • Myotonic dystrophy
  • Fibromyalgia
  • Multiple sclerosis (MS)
  • Addison's disease
  • Depression
  • Schizophrenia
  • Chronic fatigue syndrome (CFS)
  • Exercise-induced muscle damage
  • Inflammatory bowel disease (IBD)
  • Menopausal symptoms
  • Atrichia pubis
  • Sexual dysfunction
  • Improve well-being and sexuality in men and women who have adrenal insufficiency or partial androgen deficiency
  • Preventing coronary heart disease
  • Breast cancer
  • Infertility
  • Diabetes
  • Metabolic syndrome

Intravaginally, DHEA is used for cervical dysplasia, sexual dysfunction, vaginal atrophy, and increasing bone mineral density. Intravenously, DHEA is used for labor induction and myotonic dystrophy.Intramuscularly, DHEA is used for psoriasis. Topically, DHEA is used for aging skin and vaginal atrophy.

Also known as:  3b-Hydroxy-Androst-5-Ene-17-One, 3BetaHydroxy-Androst-5-Ene-17-One, Androstenolone, Déhydroépiandrostérone, DHEA-S, GL701, Prasterone

Diseases and Conditions

DHEA is possibly effective for aging skin and depression. Clinical research has shown that taking DHEA orally increases epidermal thickness, sebum production, and skin hydration, and decreases facial skin pigmentation in elderly men and women. Most clinical research has shown that taking thirty to five hundred milligrams of DHEA daily orally improves symptoms of depression and dysthymia when compared with placebo. DHEA is possibly ineffective for aging, physical performance, psoriasis, rheumatoid arthritis (RA), and withdrawal symptoms. Taking seventy-five milligrams of DHEA per day in men or fifty milligrams per day in women for two years does not seem to improve body composition, bone mineral density (BMD), muscle strength, insulin sensitivity, or quality of life in people aged sixty years or older who have low DHEA-S levels. While some clinical research has suggested that older adults who take DHEA have increased muscle strength when measured by grip strength, leg press, chest press, and other measures, most clinical evidence shows that DHEA provides no benefit to muscle strength in younger and older adults. Clinical research has also suggested that three hundred milligrams of intramuscular DHEA-enanthate weekly does not improve symptoms of psoriasis in most patients. Preliminary clinical research has suggested that taking two hundred milligrams of oral DHEA for sixteen weeks does not reduce symptoms of rheumatoid arthritis in elderly patients. Lastly, clinical research has shown that taking one hundred milligrams of DHEA daily as adjunct to standard therapy for twelve months does not improve drug withdrawal symptoms in heroin addicts when compared to standard therapy alone. DHEA is likely ineffective for improving cognitive function and Sjogren's syndrome.

Safety

DHEA is likely safe when used orally for up to 24 months, topically for up to 12 months,, and intravaginally for up to 12 weeks. It is likely unsafe to use DHEA in orally in high doses and for the long term; do not use more than 50-100mg per day or for a prolonged period. Long-term use of DHEA has been associated with an increased risk for breast cancer, prostate cancer, and other hormone-sensitive cancers. In some cases, even taking the recommended 50-100mg per day can lead to higher than normal physiological DHEA levels. It is likely unsafe for pregnant and breastfeeding women to use DHEA orally because it can increase androgen levels which may adversely affect pregnancy or a nursing infant. Possible side effects of DHEA include:

  • Hair loss
  • Acne
  • Ccular pain and dryness
  • High blood pressure
  • Stomach upset
  • Facial hair growth
  • Cramps
  • Abdominal discomfort
  • Changes in menstrual cycle 
  • Deeper voice
  • Insomnia
  • Headaches
  • Skin itching
  • Nausea
  • Irritability
  • Depression
  • Nervousness 
  • Mood changes 
  • Nasal congestion 
  • Increased cough
  • Elevated liver enzymes

DHEA can also affect the production of cholesterol, insulin, thyroid, and adrenal hormones. Patients with diabetes, hormone-sensitive cancers and conditions, hyperlipidemia, liver dysfunction, mood disorders, and polycystic ovary syndrome are advised not to take DHEA.

Medication Interactions

DHEA has minor interactions with corticosteroids, estrogens, and testosterone; be watchful of these combinations. DHEA has moderate interactions with:

  • Anastrozole
  • Anticoagulant/antiplatelet drugs
  • Antidepressant drugs
  • Cytochrome P450 3A4 substrates
  • Exemestane
  • Fulvestrant
  • Insulin
  • Letrozole
  • Tamoxifen
  • Triazolam
  • Tuberculosis vaccine

DHEA is a potent estrogen agonist, so it may interfere with the anti-estrogen effects of anastrozole and other aromatase inhibitors. DHEA might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs; however, this interaction has not been reported in humans. DHEA may increase the risk of psychiatric adverse events when used with antidepressants, especially in younger individuals with higher baseline DHEA levels. In theory, DHEA may increase levels of drugs metabolized by cytochrome P450 3A4 (CYP3A4) due to enzyme inhibition; however, the clinical significance of these potential interactions is not known. DHEA can overcome the estrogen receptor antagonist action of fulvestrant in estrogen-receptor positive cancer cells. Taking insulin might decrease the effectiveness of DHEA supplements which are converted to DHEA-S in the body. DHEA can increase plasma triazolam concentrations. Lastly, in animals, high doses of DHEA reduced the efficacy of the Bacillus Calmette-Guérin (BCG) tuberculosis vaccine.

Supplement and Food Interactions

DHEA may have interactions with anticoagulant/antiplatelet herbs and supplements, licorice, soy, and fiber. Concomitant use of herbs and supplements that affect platelet aggregation could theoretically increase the risk of bleeding in some people. Some of these herbs include:

  • Angelica 
  • Clove
  • Danshen
  • Garlic
  • Ginger
  • Ginkgo
  • Panax ginseng

Licorice might increase the effects and side effects of DHEA. Soy might decrease the effects of DHEA. Lastly, fiber might also decrease the effects of DHEA. DHEA also may have an interaction with the vegetarian diet. Strict vegetarians and lactovegetarians have higher serum DHEA levels than non-vegetarians, but this difference is not apparent in postmenopausal vegetarians.

Dosage

The recommended dosage for DHEA depends on what it is being used for.

  • For Addison's disease, the recommended dosage is fifty milligrams of DHEA daily for twelve weeks to twelve months.
  • For adrenal insufficiency, the recommended dosage is twenty to fifty milligrams of DHEA daily for up to twelve months.
  • For aging skin, the recommended dosage is fifty milligrams of DHEA daily for twelve months.
  • For Atrichia pubis, the recommended dosage is fifteen milligrams per meters squared of DHEA-S daily.
  • For chronic fatigue syndrome, the recommended dosage is twenty-five milligrams of DHEA daily for four to six weeks.
  • For chronic obstructive pulmonary disease (COPD), the recommended dosage is two hundred milligrams of DHEA daily for three months.
  • For depression, the recommended dosage is thirty to four hundred fifty milligrams of DHEA daily for up to six weeks, either alone or as an adjunct to conventional antidepressants.
  • For exercise-induced muscle damage, the recommended dosage is fifty milligrams of DHEA twice daily during a five day exercise training program.
  • For HIV/AIDS, the recommended dosage is fifty milligrams or one hundred milligrams of DHEA taken once or twice daily for up to twenty-four weeks.
  • For infertility, the recommended dosage is seventy-five milligrams of DHEA taken daily, in single or divided doses, for up to four months prior to in vitro fertilization (IVF).
  • For inflammatory bowel disease, the recommended dosage is two hundred milligrams of DHEA taken daily for eight weeks.
  • For menopausal symptoms, the recommended dosage isten milligrams of DHEA daily for twelve months.
  • For metabolic syndrome, the recommended dosage is fifty milligrams of DHEA daily for six months or one hundred milligrams daily for three months.
  • For osteoporosis, the recommended dosage is fifty milligrams of DHEA daily for six months.
  • For partial androgen deficiency, the recommended dosage is twenty-five millligrams of DHEA once daily for one year.
  • For schizophrenia, it is recommended to take DHEA in escalating doses of twenty-five milligrams daily for the first two weeks, followed by fifty milligrams daily in divided doses for a second two weeks, and one hundred milligrams daily in divided doses for a final two weeks.
  • For sexual dysfunction, the recommended dosage is three hundred milligrams of DHEA as a single dose or fifty to one hundred milligrams daily for six weeks to six months.
  • For systemic lupus erythematosus (SLE), the recommended dosage is twenty to two hundred milligrams of DHEA daily for up to two years.
  • For weight loss, the recommended dosage is fifty milligrams of DHEA daily for six months.
  • For aging skin, the recommended dosage is using one percent topical DHEA cream twice daily to the face and hands for four months.
  • For cervical dysplasia, the recommended dosage is one hundred milligrams of DHEA intravaginally applied once daily for up to six months.
  • For sexual dysfunction, it is recommended to use a specific cream containing DHEA in doses of one-fourth percent, one-half percent, and one percent (Vaginorm, Recipharm, Karlskoga, Sweden), taken daily for twelve weeks as intravaginal ovules (or vaginal suppositories).
  • For vaginal atrophy, it is recommended to apply ovules or suppositories containing one-fourth to one percent DHEA vaginally once daily for twelve weeks.
  • For labor induction, the recommended dosage is one hundred milligrams of DHEA-S dissolved in ten milliliters of five percent glucose solution and given intravenously twice weekly after thirty-eight weeks' gestation.
  • For myotonic dystrophy, the recommended dosage is two hundred milligrams of DHEA-S given intravenously daily for eight weeks.

Foods

There is insufficient evidence to determine if DHEA can be found in foods.

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References

  1. https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=331
  2. https://medlineplus.gov/druginfo/natural/331.html
  3. http://www.umm.edu/health/medical/altmed/supplement/dehydroepiandrosterone
  4. http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=&s=ND&pt=100&id=331&fs=ND&searchid=61465981

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