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Update on DHEA

HONOLULU, HAWAII. DHEA (dehydroepiandrosterone) and its active metabolite DHEAS (DHEA sulfate) are hormones primarily formed in the adrenal cortex (men also generate DHEA in their testicles). DHEA and DHEAS serve as precursors for both male and female sex hormones; young adults secrete about 4 mg of DHEA and 25 mg of DHEAS per day. The output of DHEA and DHEAS is highest between the ages of 20 and 30 years and then starts declining. By age 80 years the output is only 10-20 per cent of the peak output. This decline in DHEA with age has led to speculation that DHEA supplementation may be useful in the treatment of age-related diseases.

Dr. Joseph Pepping, Pharm.D. of the Kaiser Permanente has released a thorough review of the current status of DHEA and DHEAS. There is clinically substantiated evidence that DHEA replacement therapy may be useful in patients who have abnormally low levels due to chronic disease, suffer from adrenal exhaustion or have undergone therapy with corticosteroids. It may also be useful in the treatment of systemic lupus erythematosus and severe depression, can improve bone density in postmenopausal women, and has been found to combat fatigue and depression in HIV patients. Epidemiological studies have observed that low DHEA levels are associated with a higher incidence of cancer, cardiovascular disease (in men only), Alzheimer's disease, immune function suppression, and progression of HIV infections.

The daily dose of DHEA required by healthy people over 40 years of age in order to increase DHEA levels to those of adults 20 to 30 years of age is about 20-50 mg for men and 10-30 mg for women. Daily doses in the range of 200 mg or higher may be required in the treatment of lupus and depression. Dr. Pepping warns that DHEA supplementation can lead to increased hair growth and oily skin in women. DHEA supplementation is contraindicated in people with sex hormone responsive cancers such as breast, ovarian, endometrial, and prostate and should not be undertaken in men with benign prostate enlargement or a family history of prostate cancer. He concludes that DHEA supplementation may be beneficial in some cases, but should never be undertaken without direct medical supervision. The long-term effects of DHEA supplementation are unknown. [48 references]
Pepping, Joseph. DHEA: dehydroepiandrosterone. American Journal of Health-Systems Pharmacy, Vol. 57, November 15, 2000, pp. 2048-56

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