Scientific Verdict Still Out on DHEA
Dehydroepiandrosterone (DHEA) has hit the media spotlight in recent weeks. Claims of effect on aging, fat metabolism, muscle building, libido, immune modulation, heart disease, cancer, diabetes, memory loss, lupus, Alzheimer’s disease, and Parkinson’s disease have surfaced, none of which are substantiated by large, randomized, placebo-controlled clinical trials. On the down side, animal and epidemiological studies suggest that elevated levels of DHEA may be associated with increased risk for ovarian and prostate cancers, and possibly others.
DHEA is being sold as a "food supplement," even though there is no evidence indicating it as part of the regular human diet, which allows it to bypass FDA perusal. Even though in rodents, for instance, DHEA has shown some antiobesity effect, the mechanism is unknown, and the high pharmacological doses required to produce this effect in animals with naturally very low levels of circulating DHEA call into question the role in humans.
DHEA in humans circulates in adults primarily as the sulfate form (DHEAS), but it tends to decline precipitously in senior men. An open-label pilot study of six adults 51-72 years of age with major depression who received oral DHEA 30-90 mg daily demonstrated improvements in depression scores. Trials to examine immune booster effect tested tetanus and influenza vaccine in patients who received supplemental DHEAS; there was no effect on tetanus status but a greater likelihood of improved antibody response to influenza vaccine.
For cardiovascular disease, a 19-year study of natural DHEAS serum levels and fatal cardiovascular disease in men and women showed a modest reduced risk (0.85) in men who had higher DHEAS serum levels.
The FDA position is that DHEA and DHEAS are not approved for any indication. Adverse effects, including transient hepatitis and an increased risk of ovarian cancer in a case-control study, have been reported. Physicians who wish to report any suspect adverse reactions to a dietary supplement may call 1-800-FDA-1088.
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