DHEA

There has been a great deal written about DHEA in the lay press. Much is true, even more is false. You no doubt have heard it referred to as a “fountain of youth in a pill” in health magazines, or read that it can cause prostate or breast cancer. The truth is that it is just one of the important hormones in an overall hormone replacement therapy program; that its blood level declines continuously and sharply from adolescence to old age; that this decline has been correlated with an increased risk of cardiovascular disease in men, decreased immune system function in both sexes, decreased insulin sensitivity, and decreased IGF-I levels.

Human studies in which the level of DHEAS (the form found circulating in the blood) was replaced back to the levels of a 25 year old have shown impressive results in older adults and in various disease states in which the level is lower than expected for the age group. Yen and Morales administered 50 mg of DHEA for six months to 13 men and 17 women aged 40 to 70 years. These patients experienced an increase in lean muscle mass and a decrease in fat mass, although the latter only in the men. In addition, they had a remarkable increase in their perception of their psychological and physical well being. These same researchers did a similar study to assess the effect of DHEA on immune function and found that there was an increase in natural killer cell function, the white blood cell responsible for killing viruses and tumor cells before they grow into cancers. Many other studies have been done documenting the beneficial effect of bringing the DHEAS level back to younger adult levels in lupus, diabetes, heart disease, obesity, and prior to vaccination.

DHEA is so safe and relatively free of side effects that the FDA does not require a prescription for its sale. There is no evidence that its use causes an increased risk of breast or prostate cancer, but if one already has either of these cancers it can cause increased growth of the tumor because the body can convert it into estradiol and testosterone. Because of this we screen for breast cancer with a mammogram and a breast exam and prostate cancer with a PSA and rectal exam prior to starting therapy. The only side effects of DHEA in the doses we use (which bring DHEAS levels back to that of a 25 year old) are a slight increase in acne in some patients predisposed to it and in some women increased hair growth, both of which resolve with dose reduction.

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