DHEA is a precursor of other hormones, which means
that upon arrival, it sets off a chain reaction that produces another kind of hormone.
Once in the tissues, it is converted to the appropriate sex hormone for that tissue. For
some tissues, the male hormone testosterone is required. Other tissues receive the
principal female sex hormone, estrogen, and still others get both types of hormones.
When a woman gets DHEA, for example, its
converted to estrogen in the ovaries. In a man, its converted to testosterone in the
prostate. In both sexes, DHEA is transformed into testosterone
and estrogen in the muscles. Add together these hormonal effects, and it becomes apparent
why proponents are making so many claims for DHEA. This hormone supplement, they say,
should stop or even reverse the aging process and the diseases that can occur in our later
years.
There is a danger in taking DHEA supplements,
though, because a number of tumors are hormone-dependent, says Richard L. Sprott, Ph.D.,
executive director of the Ellison Medical Foundation, an organization that funds research
on the biology of aging, in Bethesda, Maryland.
If you have an existing hormone-dependent tumor such
as a testicular or prostate tumor, DHEA could be sent directly to the tumor,
where it would be converted into the testosterone that the tumor needs to grow. "The
tumor will kill you sooner than it would have otherwise," Dr. Sprott explains. The
same may be true for endometrial, ovarian, and breast tumors in women.
For elderly men, there could be a significant risk.
Among men ages 70 to 74 in the United States, more than 1 in 100 will be diagnosed with
prostate cancer each year. But that doesnt mean that its the leading cause of
death among this group. According to Dr. Sprott, "Its a very slow-growing
cancer that wont kill them before they die of other causes. But if you were to feed
DHEA to the tumor and accelerate its rate of growth, the cancer might become significant
and life-threatening."
DHEA production peaks between the ages of 25 and 30,
then declines with age. This decline is the reason that some suggest that aging may be
linked to DHEA deficiency. Replenish DHEA, they argue, and youll slow the effects of
aging. But diminishing DHEA levels could also mean that elderly people simply dont
need as much, says Dr. Sprott.
"Many things decline with advancing age,"
he adds. "Whether DHEA is important in that decline is unknown,
although the dietary supplement industry suggests that its a causal relationship. We
dont know that it is. Were not trying to say that DHEA has no effect, but we
do think that there is significant risk that has not been explained to the consumer."
- Taking these risks into account, researchers are still exploring the possible benefits of DHEA . As studies continue, doctors may find that DHEA, taken
judiciously, has other promising uses. Dr. Sprott says that the most encouraging DHEA data
hes seen was a study of systemic lupus. In this type of lupus, the immune system
seems to attack normally healthy cells and tissue. There are many long-lasting symptoms
that involve the skin, joints, kidneys, and other tissues and organs.
In a study of women with mild to moderate systemic
lupus, 14 received 200 milligrams of DHEA daily for three months, while a second group of
14 women received a look-alike pill (placebo) that contained no DHEA. At the end of the
study, two-thirds of those receiving DHEA showed marked improvement. Women in the placebo group showed
almost no improvement.
There is also preliminary evidence that DHEA
may boost immunity, enhance memory, and
improve mood, energy, and libido in the elderly. It may reduce the risk of type 2
(non-insulin-dependent) diabetes. One study even suggested that DHEA may have a future
role as an adjunct to hormone replacement therapy, helping out the estrogen thats a
standard element in this treatment for postmenopausal women.
Its important to note that much of the DHEA research is based on animal data, says Arthur G.
Schwartz, Ph.D., researcher and microbiologist at Temple University Medical School in
Philadelphia, who has been studying DHEA for over 20 years.
Many supplement manufacturers are picking up on the
results of animal studies and applying them to humansan irresponsible practice, as
Dr. Schwartz sees it. One of his studies reporting anti-obesity effects of DHEA on laboratory animals was widely touted by manufacturers as
proof that DHEA could promote weight loss in humans, but its not true, he says.
Doses found in supplements are based on the doses
given to animals in laboratory experimentsfrom 25 to 50 milligrams daily, says Dr.
Schwartz. When you convert that amount to what a human would need to get the same or
similar effects for weight loss, though, youd have to increase the dose to up to
2,000 milligrams a day.
Working with the National Cancer Institute, Dr.
Schwartz has also tested a modified compound of DHEA. It may have some of the positive
benefits of DHEA, but at a lower dose and without producing the hormonal side effects.
Even if the results continue to be promising and the DHEA passes tests for approval,
however, dont expect to find modified DHEA on store shelves, Dr.
Schwartz says. For this form of DHEA, you will probably need a prescription.
Most people who take DHEA are overdosing, says Ray
Sahelian, M.D., a physician in Marina del Rey, California, and author of DHEA: A Practical
Guide. Although hes a proponent of DHEA, hes concerned that many people are
taking doses of 25 milligrams or more daily, an amount that can lead to side effects
hes seen in his patients, including acne, growth of facial hair on women,
irritability, accelerated scalp hair loss in both men and women, and even irregular heart
rhythms. A less measurable effect may be the possibility of accelerating tumor growth,
according to Dr. Sprott.
Dr. Sahelian says that he has lowered his
recommended dose significantly, to 1 to 5 milligrams daily, since he first started
prescribing DHEA to his patients. The problem is that many supplements are
sold in 25-milligram or 50-milligram capsules.
Almost nothing is known about DHEAs
interactions with other drugs or its long-term effects. "This doesnt work fast,
like poison. Youre not going to take DHEA for a week, develop a testicular tumor,
and die. This is something whose effects you might not see for 5 to 10 years. And by then,
its too late, because youve been accumulating a risk over a long period of
time," warns Dr. Sprott.
The Food and Drug Administration (FDA) banned
over-the-counter sales of DHEA in 1985, but the ban was lifted with the passage of the
Dietary Supplement Health and Education Act of 1994. This law allows certain substances to
be sold for human consumption without FDA approval, as long as they are marketed as
"dietary supplements" and not labeled for a particular use like prescription or
over-the-counter drugs.
To make DHEA supplements, vitamin and
pharmaceutical companies extract sterols, most commonly diosgenin, from wild yams. Some
supplements, however, are extracts of wild yams that havent been processed into
DHEA. These are marketed as containing natural precursors for the bodys production
of DHEA , but they
have not been found to boost DHEA levels.