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DHEA helps alleviate adrenal insufficiency

IHN logo WUERZBURG, GERMANY. Adrenal insufficiency involves a progressive destruction of the adrenal gland and is characterized by fatigue, weakness, anorexia, nausea, weight loss, and hypotension. The disease is usually treated with cortisone, prednisone, and fluorocortisol. Researchers at the university hospitals in Wuerzburg and Munich now report that oral supplementation with DHEA (dehydroepiandrosterone) can markedly improve the well-being of women suffering from adrenal insufficiency.

The study involved 24 women aged 23 to 59 years who had suffered from adrenal insufficiency for anywhere from 2 to 37 years. Fourteen of the women had primary adrenal insufficiency (Addison's disease) while the remaining 10 had secondary adrenal insufficiency (six as a result of pituitary surgery). The women were randomly assigned to receive either a 50 mg DHEA tablet or a placebo daily for a four-month period; this was followed by a one- month wash-out period and then the alternative treatment for another four months. Hormone levels were measured at baseline, after one and four months of DHEA therapy, after one and four months of placebo, and one month after the end of the last treatment period. Psychological evaluations were performed at each visit to the laboratory using five different validated questionnaires.

All the women had low blood serum concentrations of DHEA, DHEA- sulfate, and active androgens at baseline, but these increased to normal or near-normal levels after treatment with DHEA. Serum IGF-1 concentrations (in women with primary insufficiency) increased significantly during the DHEA treatment while total and HDL cholesterol levels decreased. Overall well-being improved substantially after four months of treatment, anxiety and depression scores declined significantly, and sexuality scores (sexual thoughts and interest, and satisfaction with both mental and physical aspects of sexuality) increased very markedly. The researchers conclude that DHEA improves well-being and sexuality in women with adrenal insufficiency.

In an accompanying editorial Dr. Wolfgang Oelkers, MD of the Benjamin Franklin Clinic in Berlin says "it is now justifiable to prescribe a daily dose of 25 to 50 mg of DHEA as long-term treatment in patients with adrenal insufficiency whose strength and well-being are subnormal, provided that they are monitored for breast or prostatic cancer." Dr. Oelkers also suggests that DHEA supplementation may reduce the risk of osteoporosis in rheumatoid arthritis and systemic lupus erythematosus patients.
Arlt, Wiebke, et al. Dehydroepiandrosterone replacement in women with adrenal insufficiency. New England Journal of Medicine, Vol. 341, September 30, 1999, pp. 1013-20
Oelkers, Wolfgang. Dehydroepiandrosterone for adrenal insufficiency. New England Journal of Medicine, Vol. 341, September 30, 1999, pp. 1073-74 (editorial)

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