DHEA

Since its introduction to the public back in 1996, DHEA has had its ups and downs and highs and lows of popularity. Scientific opinion is also all over the map on this precursor hormone, even though it is extremely well represented in the literature with multiple studies. As with vitamins, there is an overtone of tremendous resistance to acknowledgement of its anti-aging and other benefits by orthodox physicians. None-the-less DHEA is a very clinically useful tool used by natural medicine physicians to improve the health and vitality of patients. I thought it would be worthwhile to review the clinically relevant benefits of DHEA for my readers at this time.

In overweight patients it has been shown that obese women have lower DHEA levels than lean ones. Although not a fast fix for overweight individuals, DHEA does improve insulin sensitivity, increase lean muscle mass, and increase the oxidation and utilization of fatty acids released from fat stores. Lower insulin levels resulting from improved insulin sensitivity and quicker glucose utilization promotes a fat reducing hormonal environment in the body. This also reduces the risk of adult onset diabetes, which puts the aging process into high gear.

Studies suggest that DHEA can help improve the overall sense of well-being in depressed and tired patients, but that effect too does not occur overnight. Two studies, apparently designed to discredit DHEA rather than to get at the truth of the matter, concluded DHEA was useless for depression after a study period of only 2 weeks! The brain manufactures a lot of DHEA. Levels are very low in Alzheimers patients,

In cardiovascular cases we have learned that small increases in DHEA blood levels correspond to a 48% reduction in the risk of cardiac death, and 36% reduction in mortality from all causes. These effects may be mediated by increases in HDL and reduction in LDL and total cholesterol. Not bad results. Way better than the statin drugs which poison the system and the heart by blocking CoQ10 and MAY reduce cardiac mortality by a few percentage points in well selected cases.

In hypothyroidism, DHEA has been implicated in the very common autoimmune dysfunction that may cause the thyroid to go underactive. In fact, high levels of anti-thyroid antibodies have been correlated with low DHEA levels.

In anti-aging medicine, changes such as slowed metabolism, higher blood sugars and insulin levels, expanding waist lines, increasing percentage of body fat, and failing memory are not so much problems in themselves as they are symptoms of the underlying aging process. Aging occurs when the delicate balance maintained between damage and repair gets tipped over toward the damage side. This occurs from improper lifestyle and environmental stressors and is mediated by free radical pathology. At the same time, falling hormone levels, including DHEA, translate into weaker regenerative processes. Falling DHEA  is not THE cause of aging, but it is one cause.DHEA carries one of the most comprehensive anabolic (repairing) signals in the human body. It also counters the effects of the stress hormone cortisol, and has immune stimulating and brain degeneration-fighting effects. The Baltimore Longitudinal Study on Aging found that like the effect of calorie restriction in other animals, men with lower insulin levels and higher DHEA levels survive longer than their peers. Studies of people between 90 and 106 found that they had higher than expected DHEA levels, and was associated with a higher muscle to fat ratio, and greater functional ability. DHEA is important to maintain bone mass. Another hormone study in the aged found that the maintanence of good physical functional ability and quality of life is related to serum testosterone, estrogen, and DHEA concentrations. 

Regarding its role in cancer, it has been fingered by its critics as a cell proliferator that might accelerate hidden tumors, or even start new cancers growing. The data instead suggests that it is a cell regulator and that it in fact prevents cancer. DHEA levels in cancer patients are directly and inversely related to mortality rates. Cancer patients tend to have lower than normal DHEA levels, and cancer is less common in young people who have higher DHEA concentrations in their blood. Cancer may be related to several specific processes found in the aging human, including impaired apoptosis (programmed cell death), decreased immune surveillance, and activity of NK (natural killer) cells. DHEA has been shown to improve every one of these factors. It also increases IL-2, an immune factor which may prevent cancer. Yes DHEA was shown to produce cancer in rodents who were continuously given the human equivalent of 10,000 mg per day over a human equivalent of 76 years. Fifty other rodent studies shows DHEA reduces cancer risk. In not one of 5500 published studies on DHEA, not one has ever shown DHEA to stimulate cancer growth. Nothing to worry about there. My only clinical caveats would be to monitor hormone levels carefully in women with a history of estrogen responsive breast cancer, those on tamoxifen, and in men with prostate cancer. Some conversion of DHEA into estradiol (and testosterone) is possible, although it has not been a common problem, and a study specifically to monitor this possible conversion in doses up to 50mg per day failed to document any need for concern. Most breast and prostate cancer patients have also been shown to have low DHEA levels. In studies, even high dose DHEA has not been shown to raise PSA levels in normal men.

To summarize, DHEA levels at age 70 are only 15% of what they were at age 25. High levels of DHEA correlate with longevity, while low levels relate to depression, dementia, obesity, diabetes, autoimmune disorders, osteoporosis, cancer, cardiovascular disease, and higher overall mortality. Your levels can be accurately determined by blood testing DHEA-S, while looking at urinary DHEA metabolites can show us what has been termed the anabolic drive. Metabolic derivative ratios are converted into an anabolic/catabolic index or ACI, giving us a valid biomarker for the aging process. Rather than striving for age appropriate normal levels, we believe that DHEA levels are best replentished and anabolic drive enhanced by obtaining the levels characteristic of age 30 by oral replacement therapy. There is no clinical or scientific data to suggest that blood test monitored, rational dose DHEA replacement therapy carries any risks outside of oily skin, acne, and an occasional unwanted hair occurring in those who are taking more than their correct metabolic requirement. I suggest that everyone have their DHEA-S level measured and have a competent natural medicine physician prescribe and oversee their use of DHEA over the long term.

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