Every time we think we know it all, something else turns up to keep us humble. I have been studying the roles of various hormones in the body, and the research being done on them, since even before the subject came to be of consuming personal interest to me about 15 years ago!

Perhaps the most compelling thing about hormones is how little is required to bring about powerful actions in the body  and the organism, knowing this, is set up to defend itself against them. Almost all hormones "foreign" to you are removed from circulation in  what is called the "first pass" through the liver: their possible actions are so dangerous, that nature is not taking any chances -  Dr. Lee picturesquely pointed out that an amount of hormone equivalent to a grain of salt in a swimming pool can cause consequences! Most experts will say that natural hormones do not impose themselves on the body, but make themselves available if needed, and are therefore free of side effects - but they are certainly not without EFFECTS.

One concern is that supplying the body with a hormone will set into motion a feedback loop, which would shut off the body's natural production even further. So far, this does not seem to be the case with DHEA, but as yet, there are no long term studies one way or the other.  Caution is definitely in order.

DHEA is a star star partner in the complicated dance that is the relationship between our adrenal and sex hormones This hormone, which is made mostly in the adrenals, is the most abundant hormone in our blood until we reach about the age of 30, when it begins to decline at a rate of about 2% per year. When we reach the age of 80, we have only 10-20% of the levels we had when we were 20.

In structure, DHEA is similar to our other hormones, namely progesterone, estrogen and testosterone, and can be converted to them as needed.  The DHEA molecule is remarkably similar to  the testosterone and estrogen molecules . Drinking, smoking and birth control pills deplete DHEA,  but stress has the most serous consequences for DHEA levels. . 

Research that is now being done into the effects DHEA has on aging immune systems, Alzheimer's and memory, depression and the general unpleasantness associated with aging, is very interesting indeed. A double-blind study done in 1999 (Am. J. of Psych.156646-49) using DHEA for 1 month on depressed older subjects showed significant improvement.  The Rancho Bernardo study (J.Am Geriatric Soc.47: 685-691, 1999) found a connection between low levels of DHEA and depression in elderly women, but not other sex hormones.   The theory is that by bringing up the levels of DHEA with supplementation, we will be able to slow down the signs of aging, alleviate some of the problems, and prevent many degenerative diseases. 

Since DHEA is a natural substance that cannot be patented, none of the big Drug Company research money is behind it, which means clinical trials are not being done: but an interesting study with mice & memory showed greatly increased success in running mazes, and as a result of this, Doctors at Harbor-UCLA medical center are examining DHEA's effect on patients with mild-to-severe Alzheimer's. Stanford University Medical Center in California has done some very encouraging research with DHEA and lupus, administering it to 10 female patients who all showed improvement in symptoms such as swollen joints, pain and skin rashes. However, no long term research has been done on its safety, and I feel strongly that it should not be taken by anyone below the age of 40, and even over that age only by those prepared to monitor their DHEA levels on a regular basis - there is a simple saliva test which can provide this information. (see RESOURCES at right) 

Women with Lupus will be interested to hear that a recent study published in Arthritis Rheum. 2002;46(7):1820-1829 showed that doses of prednisone could be significantly reduced, if 200 mg of DHEA were added to the regimen.  "Prasterone (Lynn: DHEA) has corticosteroid-sparing effects in SLE, especially among patients with active disease,"  Dr. Petti and her colleagues write. "Patients with SLE who are maintained for long periods of time on supraphysiologic doses of glucocorticoids may benefit from controlled tapering of glucocorticoids to physiologic doses, with consequent reduction of glucocorticoid toxicity, during treatment with prasterone."

So far, no studies have been done on men with Lupus and DHEA.

There are also studies that show mice do not develop breast cancer if treated with DHEA, but they do not show whether it is the DHEA itself, or the sex hormones and other steroid hormones the body converts it into. It does seem that DHEA has a protective effect on DNA, which may be the mechanism that prevents cancer.

 I am also very interested in studies showing that DHEA increases life span, with one group of elderly men finding that taking DHEA for a year led to a 75% increase in their sense of well-being, helping them cope better with stress, be more physically mobile, and sleep better. Another study in 1986 of 242 men aged 50-79 stated that a small amount of DHEA supplementation corresponded to a 48% reduction in death from heart disease. Many anecdotal accounts also suggest that DHEA has an enhancing or normalizing effect on libido in both men and women. (Fountain of Youth,  Beth Ley p.131)

In fact, Dr. Alan Gaby in a recent book suggests DHEA may have influence over high cholesterol, cardiovascular disease, diabetes, obesity, cancer, memory, immune system disorders, osteoporosis and chronic fatigue.

As new research on this interesting hormone becomes available, it may be that it will take its place alongside Pregnenolone, Progesterone, Estrogen , and other Corticosteroid hormones as an important hormonal substance with benefits from supplementation. In fact, new (2001) studies from Italy suggest that treatment with dehydroepiandrosterone (DHEA) is similar to that with estrogen-progestin replacement therapy in its effects on several endocrine parameters in postmenopausal women.

Dr. Alessandro D. Genazzani, now with the University of Modena, and associates from the University of Pisa treated 31 women with oral DHEA 50 mg daily for 6 months. The subjects were grouped according to age and body mass index. Hormone evaluations and a growth hormone releasing hormone (GHRH) test were performed before and after the trial.

"Oral DHEA treatment annulled the differences observed between early and late postmenopause, including those strictly related to excess body weight," the physicians write in the August issue of Fertility and Sterility.

Plasma levels of steroids that derived from DHEA metabolism increased, as did osteocalcin, growth hormone (GH), and insulin-like growth factor 1 (IGF-1). Levels of luteinizing hormone and follicle stimulating hormone decreased. In fact, treatment with DHEA was comparable to treatment with estrogen-progestin, the  group concluded. Their recommendation is that DHEA be considered an effective hormone  replacement, and not just a dietary supplement. 
(Fertil Steril 2001;76:241-248.)

However, until studies have been done that confirm its safety long term - i.e. over periods of 10, 15 or even 20 years, I strongly recommend a cautious and moderate approach, with regular monitoring, and the 1-1-1 method of use: do not take it for one day each week, one week each month, and one month each year.  Doses of 5 to 10 mg, with a top limit of 50, are presumed safe used in this manner:  take with food, since it is fat soluble, and take it early in the morning to coincide with your body's natural rhythm of DHEA production.  

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