DHEA: Effective AND Safe

DHEA: Effective AND Safe

Julian Whitaker, MD

The New England Journal of Medicine published the results of a study on the effects of DHEA supplementation in elderly men and women. Researchers from the Mayo Clinic and the University of Padua, Italy, gave 75 mg of DHEA daily to 29 men and 50 mg to 27 women, while 31 men and 30 women took a placebo. (Another arm of the study looked at a low-dose testosterone patch in 27 men.)

At the end of two years, there wasn’t much to report. There were small but significant increases in bone density; no changes in body composition, lipid or hormone levels, glucose tolerance, or physical performance; and absolutely no adverse side effects.

Yet this study and the editorial accompanying it generated a maelstrom of vitriolic press about DHEA, culminating in a call for it to be removed from the market! At best, this is, to quote William Shakespeare, “much ado about nothing.” At worst, it’s a witch hunt against yet another safe, natural, useful supplement.

DHEA Is Not an Anabolic Steroid

I can understand some confusion about DHEA, since testosterone, estrogen, and other naturally occurring steroidal hormones are made during a cascade of chemical conversions that begins with cholesterol and ends with DHEA, the direct precursor of these hormones.

But a little knowledge is a dangerous thing. DHEA is not an anabolic hormone. As this study shows, it doesn’t raise hormone levels, increase muscle mass, or otherwise behave as an anabolic steroid. Nor is there any good evidence that DHEA raises testosterone levels in men (although it does increase them slightly in women).

Nevertheless, this supplement, which has been around for 20 years, has come under attack in the sports community, and it has been banned by the Olympics, NFL, and NBA. Call it guilt by association—plus an inexcusable lack of knowledge of the medical literature—but this is simply an overreaction to the rampant abuse of steroids in professional sports in recent years. And the fact that this small, benign study of elderly men and women even enters the dialogue about steroid abuse is preposterous.

Fountain of Youth?

So should you take DHEA? I take it myself and recommend it to most of my older patients, and I will continue to do so. DHEA, as this study shows, helps preserve bone mass. (Oddly, this wasn’t mentioned in the study’s conclusion, which said DHEA had no “physiologically relevant beneficial effects.”) Scores of other clinical trials have revealed additional benefits in older people, including maintenance of muscle mass, and improvements in libido and sexual performance, lipid levels, insulin sensitivity, mood, and sense of well-being. One paper, which was actually cited in the above study, concluded that the blood level of DHEA “is independently and inversely related to death from any cause and death from cardiovascular disease in men over age 50.”

Yet the center ring of this media circus overlooked these benefits and instead attacked DHEA for being touted as a “fountain-of-youth hormone.” The most absurd quote came from the Associated Press. “No harmful side effects were detected. That is good news, but it does not mean the supplements are altogether safe.” How in the world could they have come to that conclusion?

By the way, the DHEA study came out in the same week that JAMA published a CDC study reporting that adverse reactions to medications send more than 700,000 Americans to emergency rooms every year. Where are the calls to get some of these dangerous drugs off the market?

References

  • Nair KS et al. DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med. 2006 Oct 19;355(16):1647–1659.
  • Stewart PM. Aging and fountain-of-youth hormones. N Engl J Med. 2006 Oct 19;355(16):1724–1726.
  • Budnitz DS et al. National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006 Oct 18;296(15):1858–1866.

Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2006. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healingclick here

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