DHEA Levels and Age
February 1998; Volume 1: 23
Source: Hornsby PJ. DHEA: A biologist’s perspective. J Am Geriatrics Soc 1997;45:1395-1401.
The recent extensive biomedical and lay public interest in dehydroepiandrosterone (DHEA) stems from the frequent suggestion that the marked age-related decline in the plasma level of DHEA sulfate in humans, discussed by the author in this review, amounts to the development of a deficiency state for this hormone. Thus, it has been proposed that replacement therapy with DHEA to restore youthful levels of DHEA sulfate in older individual might have beneficial effects on a variety of age-related conditions, such as cardiovascular and neoplastic diseases, diabetes, immune dysfunction, muscular weakness, and depression. Moreover, numerous effects of DHEA supplementation have, in fact, been documented; they are quite wide-ranging, and it is difficult to discern a singular molecular mechanism that might account for all of them.
COMMENT
This bioscientific review of the DHEA and its secretion by the adrenal glands, its action as an androgen-precursor hormone, its documented effects in humans promoting muscle strength, lean body mass, and well-being, and its possible role in steroid-dependent neoplasms concludes that "DHEA, like other androgens and estrogen, might have a role in hormone replacement therapy in older people, but . . . should be used only in controlled clinical trials because of its dangers as a potent steroid."
This sage warning, of course, vitiates the fountain of youth mythology that accompanies DHEA on the shelves of Walgreens, WalMart, and health food stores everywhere. An accompanying editorial by Richard Miller of the University of Michigan is even more circumspect. Noting that much of the laboratory information about DHEA comes from animals and that there may be more than 100-fold difference in the natural levels of circulating DHEA between species, Miller advocates more and better comparative basic biology before more clinical trials. There is little persuasive human data demonstrating effects on lipid profiles, glucose levels, bone density, or muscle strength, Miller says. Yet, he believes DHEA’s age-dependent levels may be more than just a physiological finding and deserve closer examination.
Recommendation
Had Ponce de Leon found DHEA, he probably would have kept looking. But, DHEA may well have specific clinical effects for particular clinical indications—symptom relief for menopausal symptoms, for example. Whether its worrisome androgen-like risks—potentially accelerating prostate cancer, for example—will be worth its potential benefits remains to be seen. Until more safety and effectiveness data become available, it is not recommended.
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