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      DHEA-S

       

      What is DHEA-S

      Dehydroepiandrosterone (DHEA) is a hormone made by the adrenal glands, ovaries, testes, and brain cells. DHEAS levels peak around age 20 and then decline as we age. The sulfated form (DHEA-S) is the most abundant steroid hormone in the body. 98% of circulating DHEA is in the sulfated form. DHEAS is a more stable measure of this hormone as it has a slower clearance from the circulation and does not experience day-to-day fluctuations.[1],[2] DHEA is a precursor to other sex hormones, including testosterone. Low levels of DHEA are associated with heart disease, endothelial dysfunction, atherosclerosis (the root cause behind strokes and heart attacks), bone loss, inflammatory diseases, and sexual dysfunction.[3] DHEA modulates the immune system, and in the elderly, use has been associated with increased muscle strength, bone density, and reduced body fat.[4] Low levels of DHEAS were associated with increased all-cause mortality in elderly men in a meta-analysis.[5] A 2020 meta-analysis of randomized controlled trials found that DHEA did not change blood pressure or body weight but increased lean mass and decreased fat mass.[6]

      Why is DHEA-S part of my treatment protocol?

      Your laboratory tests indicate that your testosterone, DHEAS, or both are outside of the optimal range, and your questionnaire indicated that the symptoms you are experiencing could benefit by supplementation. DHEA supplementation has been shown to increase testosterone levels in men.[7]

      Is DHEA-S effective for restoring normal DHEA-S levels?

      A 1-year double blind placebo controlled RCT of DHEA 100 mg per day found that supplementation increased levels from baseline by threefold in men.[8] Another 1 year RCT of 50 mg per day of DHEA in men 60 to 79 years old found that serum DHEAS levels returned to young adult values after 6 months of supplementation.[9] Other trials have found similar results in that DHEA supplementation effectively increased blood levels.4

      Are there potential side effects from using DHEA-S?

       Oral DHEA and DHEAS supplementation is usually well tolerated. Reported adverse effects include hirsutism, abdominal pain, acne, nausea, urinary urgency, testicular wasting, aggression, breast tenderness or enlargement (gynecomastia) have been reported.4

       

       

      [1] Kamin HS, Kertes DA: Cortisol and DHEA in Development and Psychopathology. Horm Behav 2016.

      [2] Starka L, Duskova M, Hill M: Dehydroepiandrosterone: a neuroactive steroid. J Steroid Biochem Mol Biol 2015;145:254-260.

      [3] Traish AM, Kang HP, Saad F, Guay AT. Dehydroepiandrosterone (DHEA)--a precursor steroid or an active hormone in human physiology. J Sex Med. 2011;8(11):2960-2983. doi:10.1111/j.1743-6109.2011.02523.x

      [4] Rutkowski K, Sowa P, Rutkowska-Talipska J, Kuryliszyn-Moskal A, Rutkowski R. Dehydroepiandrosterone (DHEA): hypes and hopes. Drugs. 2014;74(11):1195-1207. doi:10.1007/s40265-014-0259-8

      [5] Li R, E L, Zha N. Circulating dehydroepiandrosterone sulfate level and cardiovascular or all-cause mortality in the elderly population: a meta-analysis. Ann Palliat Med. 2020;9(5):3537-3545. doi:10.21037/apm-20-441

      [6] Wang F, He Y, O Santos H, Sathian B, C Price J, Diao J. The effects of dehydroepiandrosterone (DHEA) supplementation on body composition and blood pressure: A meta-analysis of randomized clinical trials. Steroids. 2020;163:108710. doi:10.1016/j.steroids.2020.108710

      [7] Li Y, Ren J, Li N, et al. A dose-response and meta-analysis of dehydroepiandrosterone (DHEA) supplementation on testosterone levels: perinatal prediction of randomized clinical trials. Exp Gerontol. 2020;141:111110. doi:10.1016/j.exger.2020.111110

      [8]Morales AJ, Haubrich RH, Hwang JY, et al. The effect of six months treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex steroids, body composition and muscle strength in age-advanced men and women. Clin Endocrinol (Oxf). 1998;49:421–32.

      [9] Baulieu EE, Thomas G, Legrain S, et al. Dehydroepiandrosterone (DHEA),DHEAsulfate,andaging:contributionoftheDHEAgeStudy to a sociobiomedical issue. Proc Natl Acad Sci. 2000;97:4279–84.