Herbs & Supplements

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DHEA is one of the natural steroid hormones produced in small amounts primarily by the human adrenal glands. It is converted by the body into androgen and estrogen, hormones that affect sexual development and function. Individuals who have a condition known as Addison's disease (also known as primary adrenal insufficiency, adrenocortical insufficiency, or hypocortisolism) do not produce enough of the adrenal steroids--including DHEA. Overall symptoms of Addison's disease usually appear gradually and they may include anemia, darkened skin and mucous membranes, fatigue, and weight loss. DHEA replacement in Addison's disease is controversial--with some studies finding positive effects such as lessened fatigue and improved mood; and other studies finding no effects. One study that lasted for a year had mixed results--bone mineral density improved for some participants taking DHEA, but no changes were seen in fatigue or sexual function. Currently, DHEA supplementation is not standard treatment for Addison's disease, although a prescription DHEA product does have an orphan drug designation for treating adrenal insufficiency. An orphan drug has been approved by the U.S. Food and Drug Administration (FDA) for extremely limited uses, such as for the treatment of a rare disease.

Other advanced scientific research concerning DHEA centers on treating systemic lupus erythematosus (SLE), an autoimmune disease of connective tissue. Symptoms of SLE include arthritis, fever, and rash. SLE can also affect the central nervous system (the brain and spinal cord) and internal organs such as the kidneys. Because DHEA has shown some short-term effectiveness in the treatment of SLE, a prescription form of DHEA is undergoing additional clinical trials that were requested by the FDA before it can be approved for treating SLE. Long-term effectiveness and risks have not yet been determined.

Because natural DHEA production decreases as individuals get older, some researchers believe that restoring DHEA to higher levels may delay some of the effects of aging. In a Japanese study that followed paticipants for up to 27 years, higher blood levels of DHES generally correlated to longer life for the men, but not for the women. Especially in the last few years, DHEA has also been touted to increase the function of the immune system and to restore mental ability. Therefore, it has been studied for the treatment of numerous conditions that include AIDS, Alzheimer's disease, chronic fatigue syndrome, erectile dysfunction (ED), and Parkinson's disease. In most human studies, DHEA-enhancement seems to be more beneficial for men than for women. Low blood levels of DHEA have also been found in chronic inflammatory conditions such as inflammatory bowel disease. High levels of blood sugar and conditions such as fibromyalgia and nonalcoholic fatty liver disease also may decrease DHEA. While clinical research continues for the use of DHEA to treat several of these conditions, no definitive results prove that DHEA supplementation is effective for any of them.

DHEA has also been associated with other effects on health. For example, supplemental DHEA and its breakdown product DHEA-sulfate (DHEA-S) may have produced improvements in osteoporosis for elderly individuals as well as for younger individuals who have osteoporosis that results from conditions such as anorexia nervosa or from drugs such as corticosteroids. Results of a recent 2-year long study of 130 individuals over the age of 60 years showed that DHEA produced slight improvement in bone density. No improvements were seen in body structure, insulin sensitivity, muscle strength, or oxygen utilization, however. In mice and other laboratory animals, DHEA supplements may have increased both the production of insulin and the body's ability to use insulin more effectively. However, laboratory animals commonly used for research produce such tiny amounts of natural DHEA that giving them even very small amounts of supplemental DHEA may produce effects that may not be achievable in humans. In addition, many animal studies of DHEA used injected forms that are not commonly available.

DHEA may play a role in many other human conditions. In human research studies, low levels of DHEA have been measured in individuals with schizophrenia. Unbalanced amounts of DHEA as compared to other natural steroids may be linked with some types of depression, as well. In one small study of humans, DHEA supplementation appeared to be related with a decreased risk of cataracts. In a study of women who had infertility problems, those who took DHEA before undergoing in vitro fertilization procedures were about twice as likely to became pregnant as women who did not take DHEA. Another study found that DHEA may help to reduce the symptoms of menopause. It may improve bone strength to lessen osteoporosis for women (but apparently not for men). It may also have an anti-obesity effect. Additionally, although no convincing evidence proves that DHEA supplementation alone helps to increase muscle size and activity, a few small studies have shown that it may enhance the muscle-building effects of exercise. Therefore, DHEA is banned from use by Olympic athletes. Much more research is needed to prove or disprove all of the potential effects of DHEA supplementation.

Conversely, high blood levels of DHEA or DHEA-S may be harmful in some cases. For example, high levels of DHEA-S were associated with obesity and abnormal cholesterol levels in 6-year-old to 8-year-old boys in one recent large study. No similar results were seen in girls of the same age group who also participated in the study, however. In a large observational study of older women, blood levels of DHEA and DHEA-S generally were slightly higher in those who suffered heart attacks. The risk of breast cancer may also be higher among individuals with high levels of DHEA in their blood. Again, however, these possible effects are not proven.

When topical forms of DHEA (creams or gels) are applied to the skin, 50% or more of its active ingredients are absorbed into the body. High-strength (10%) topical DHEA may be used to restore vaginal tone and possibly increase bone mineral density for postmenopausal women. Lower strengths (usually 1%) creams or gels may promote the skin's production of collagen, oils, and proteins. As a result, some of the dryness and wrinkling caused by aging or sun exposure may be lessened. Topical DHEA--often combined with other ingredients--is available commercially without a prescription.