DHEA

Last Updated: January 9, 2024

DHEA is a steroid hormone produced by the adrenal glands. It’s a precursor to (i.e., is made into) estrogen and testosterone, and can exert weak benefits on its own. As an “antiaging” or performance enhancing supplement, its benefits are inconsistent.

DHEA is most often used for

What is DHEA?

The body produces 5–8 grams of DHEA every day, mostly in the adrenal glands. DHEA is made from another steroid hormone, pregnenolone, which itself is made from cholesterol.[1] In humans, DHEA is the second most abundant steroid after its sulfate ester, DHEA-S.[2] Rather than DHEA levels, blood tests usually measure DHEA-S levels, which are about a hundred times higher and fluctuate less during the day.[1]

The secretion of DHEA or supplementation with DHEA leads to increased levels of DHEA-S, a hydrophilic storage form of DHEA that stays in circulation. DHEA is the form that is transported into the tissues to be converted into the sex hormones (e.g., androgens and estrogens). Both DHEA and DHEA-S decrease significantly with age, with people in their 70s having less than 20% of the peak DHEA-S levels of young adults.[2][3][4][5] Since DHEA and DHEA-S are the most abundant circulating steroids in the body, and they decline with age, there is speculation that supplementation with DHEA and/or DHEA-S may reduce age-related declines in health.[2][6]

What are DHEA’s main benefits?

The strongest evidence for DHEA is for increasing estrogens and androgens (e.g., testosterone) in women over 60, and for improving postmenopausal symptoms.[7][8][9] However, DHEA might also increase testosterone levels in younger (<60 years old) populations.[7] While the evidence that DHEA supplementation increases androgens is fairly consistent,[10][9][1][11] the evidence that DHEA supplementation increases estrogens is as consistent, if not more so.[9][1][11] However, these androgen and estrogen increases tend to be small; DHEA supplementation has had no clinical effect on muscle strength, muscle size, fat loss,[12][13][14] or sexual function in older men.[1]

What are DHEA’s main drawbacks?

DHEA is well-tolerated, but may cause side effects by increasing estrogen or testosterone levels. For example, in a study of postmenopausal women, 3 of 38 women in the DHEA group experienced acne, and 2 of 38 experienced facial hair growth.[15] In another study, the researchers noted an increase in voice lowering, another common effect of testosterone supplementation in women, among the DHEA group as compared to the placebo group.[16]

Supplementation with testosterone itself may adversely affect cardiovascular risk factors.[17] However, trials examining cardiovascular-risk-related outcomes (blood pressure[14] and liver enzymes[18]) have found no change after DHEA supplementation.

There are commonly occurring associations between sex hormones and the risk of certain types of cancer. For example, supplemental estrogen may increase the risk of some breast and gynecological cancers, and supplemental testosterone and its metabolite, dihydrotestosterone (DHT), may increase the risk of prostate cancer. For instance, one meta-analysis reported a 23% increased risk of breast cancer in participants who had used hormone replacement therapy (HRT).[19] Another meta-analysis examined exercise, HRT, and breast cancer risk. This study found that women who exercised the most reduced their risk of breast cancer—with the exception of women who also used HRT, who saw no exercise-related reduction in their breast cancer risk.[20] Furthermore, an increased risk of breast cancer recurrence was associated with HRT in hormone-receptor-positive breast cancer survivors.[21]

With regard to DHEA and gynecological cancers, the evidence is less clear. One study reported that in participants with endometrial cancer, increased DHEA and DHEA-S levels were noted in participants who survived longer, compared to participants with shorter survival duration.[22] Larger, stronger studies note that the evidence linking estrogen-containing HRT with endometrial cancer is so weak that it does not suggest significant harm, though the researchers noted a lack of high-quality evidence in certain areas.[23][24][25][26]

One meta-analysis reported no association between the risk of prostate cancer and DHEA-S levels, and also found no association with other androgens such as testosterone and DHT,[27] which have sometimes, but not consistently, been found to be associated with prostate cancer risk.[28] Furthermore, while this meta-analysis did find a relationship between sex hormone binding globulin (SHBG) and prostate cancer risk, DHEA does not tend to affect SHBG levels.[29][10]

Based on the possible increased risks of breast cancer, anyone supplementing with DHEA should discuss their plans with their doctor, with whom the benefits and risks of DHEA supplementation, and the resultant possible changes in sex hormones, can be appropriately evaluated for their individual situation.

How does DHEA work?

DHEA is believed to work indirectly by being converted to androgens or estrogens in peripheral target cells, and might theoretically also work directly by stimulating neurotransmitter receptors in the brain.[3]

What else is DHEA known as?
Note that DHEA is also known as:
  • DHEA
  • Pradesterone
  • Hydroxyandrosterone
  • 3β-Hydroxy-5-Androstene-17-one
  • Dehydroepiandrosterone
DHEA should not be confused with:
Dosage information

Supplementation of DHEA appears to be effective in persons over 40 in the dosage range of 25-50mg, while prolonged usage of 100mg appears to be safe in this demographic. While the usage of DHEA in young persons for the purpose of testosterone enhancement is not clear, it tends to be used at 200mg for this purpose.

DHEA may require a prescription in certain countries (such as Canada).

Examine Database: DHEA
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2023-07-17 16:56:09

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References
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Examine Database References
  1. Cognitive Decline - Muller M, van den Beld AW, van der Schouw YT, Grobbee DE, Lamberts SWEffects of dehydroepiandrosterone and atamestane supplementation on frailty in elderly menJ Clin Endocrinol Metab.(2006 Oct)
  2. Estrogen - Kenny AM, Boxer RS, Kleppinger A, Brindisi J, Feinn R, Burleson JADehydroepiandrosterone combined with exercise improves muscle strength and physical function in frail older womenJ Am Geriatr Soc.(2010 Sep)
  3. Power Output - Percheron G, Hogrel JY, Denot-Ledunois S, Fayet G, Forette F, Baulieu EE, Fardeau M, Marini JF; Double-blind placebo-controlled trialEffect of 1-year oral administration of dehydroepiandrosterone to 60- to 80-year-old individuals on muscle function and cross-sectional area: a double-blind placebo-controlled trialArch Intern Med.(2003 Mar 24)
  4. Testosterone - Stomati M, Monteleone P, Casarosa E, Quirici B, Puccetti S, Bernardi F, Genazzani AD, Rovati L, Luisi M, Genazzani ARSix-month oral dehydroepiandrosterone supplementation in early and late postmenopauseGynecol Endocrinol.(2000 Oct)
  5. Testosterone - Igwebuike A, Irving BA, Bigelow ML, Short KR, McConnell JP, Nair KSLack of dehydroepiandrosterone effect on a combined endurance and resistance exercise program in postmenopausal womenJ Clin Endocrinol Metab.(2008 Feb)
  6. Testosterone - Alessandro D Genazzani, Massimo Stomati, Francesca Bernardi, Matteo Pieri, Lucio Rovati, Andrea R GenazzaniLong-term low-dose dehydroepiandrosterone oral supplementation in early and late postmenopausal women modulates endocrine parameters and synthesis of neuroactive steroidsFertil Steril.(2003 Dec)
  7. Testosterone - Genazzani AR, Pluchino N, Begliuomini S, Stomati M, Bernardi F, Pieri M, Casarosa E, Palumbo M, Genazzani AD, Luisi MLong-term low-dose oral administration of dehydroepiandrosterone modulates adrenal response to adrenocorticotropic hormone in early and late postmenopausal womenGynecol Endocrinol.(2006 Nov)
  8. Testosterone - Dayal M, Sammel MD, Zhao J, Hummel AC, Vandenbourne K, Barnhart KTSupplementation with DHEA: effect on muscle size, strength, quality of life, and lipidsJ Womens Health (Larchmt).(2005 Jun)
  9. Estrogen - Jedrzejuk D, Medras M, Milewicz A, Demissie MDehydroepiandrosterone replacement in healthy men with age-related decline of DHEA-S: effects on fat distribution, insulin sensitivity and lipid metabolismAging Male.(2003 Sep)
  10. Serum DHEA - Wallace MB, Lim J, Cutler A, Bucci LEffects of dehydroepiandrosterone vs androstenedione supplementation in menMed Sci Sports Exerc.(1999 Dec)
  11. Lean Mass - Jankowski CM, Gozansky WS, Van Pelt RE, Wolfe P, Schwartz RS, Kohrt WMOral dehydroepiandrosterone replacement in older adults: effects on central adiposity, glucose metabolism and blood lipidsClin Endocrinol (Oxf).(2011 Oct)
  12. Bone Mineral Density - von Mühlen D, Laughlin GA, Kritz-Silverstein D, Bergstrom J, Bettencourt REffect of dehydroepiandrosterone supplementation on bone mineral density, bone markers, and body composition in older adults: the DAWN trialOsteoporos Int.(2008 May)
  13. Estrogen - Martina V, Benso A, Gigliardi VR, Masha A, Origlia C, Granata R, Ghigo EShort-term dehydroepiandrosterone treatment increases platelet cGMP production in elderly male subjectsClin Endocrinol (Oxf).(2006 Mar)
  14. Blood glucose - Kawano H, Yasue H, Kitagawa A, Hirai N, Yoshida T, Soejima H, Miyamoto S, Nakano M, Ogawa HDehydroepiandrosterone supplementation improves endothelial function and insulin sensitivity in menJ Clin Endocrinol Metab.(2003 Jul)
  15. Menopausal Symptoms - Ma H, Sullivan-Halley J, Smith AW, Neuhouser ML, Alfano CM, Meeske K, George SM, McTiernan A, McKean-Cowdin R, Baumgartner KB, Ballard-Barbash R, Bernstein LEstrogenic botanical supplements, health-related quality of life, fatigue, and hormone-related symptoms in breast cancer survivors: a HEAL study reportBMC Complement Altern Med.(2011 Nov 8)
  16. Lean Mass - Abrams DI, Shade SB, Couey P, McCune JM, Lo J, Bacchetti P, Chang B, Epling L, Liegler T, Grant RMDehydroepiandrosterone (DHEA) effects on HIV replication and host immunity: a randomized placebo-controlled studyAIDS Res Hum Retroviruses.(2007 Jan)
  17. Stress Signs and Symptoms - Taylor MK, Padilla GA, Stanfill KE, Markham AE, Khosravi JY, Ward MD, Koehler MMEffects of dehydroepiandrosterone supplementation during stressful military training: a randomized, controlled, double-blind field studyStress.(2012 Jan)
  18. Estrogen - Brown GA, Vukovich MD, Sharp RL, Reifenrath TA, Parsons KA, King DSEffect of oral DHEA on serum testosterone and adaptations to resistance training in young menJ Appl Physiol.(1999 Dec)
  19. Estrogen - Ostojic SM, Calleja J, Jourkesh MEffects of short-term dehydroepiandrosterone supplementation on body composition in young athletesChin J Physiol.(2010 Feb 28)
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  21. Estrogen - Kahn AJ, Halloran B, Wolkowitz O, Brizendine LDehydroepiandrosterone supplementation and bone turnover in middle-aged to elderly menJ Clin Endocrinol Metab.(2002 Apr)
  22. Estrogen - Weiss EP, Shah K, Fontana L, Lambert CP, Holloszy JO, Villareal DTDehydroepiandrosterone replacement therapy in older adults: 1- and 2-y effects on boneAm J Clin Nutr.(2009 May)
  23. Testosterone - Yamada S, Akishita M, Fukai S, Ogawa S, Yamaguchi K, Matsuyama J, Kozaki K, Toba K, Ouchi YEffects of dehydroepiandrosterone supplementation on cognitive function and activities of daily living in older women with mild to moderate cognitive impairmentGeriatr Gerontol Int.(2010 Oct)
  24. Subjective Well-Being - Kritz-Silverstein D, von Mühlen D, Laughlin GA, Bettencourt REffects of dehydroepiandrosterone supplementation on cognitive function and quality of life: the DHEA and Well-Ness (DAWN) TrialJ Am Geriatr Soc.(2008 Jul)
  25. Cortisol - Parsons TD, Kratz KM, Thompson E, Stanczyk FZ, Buckwalter JGDhea supplementation and cognition in postmenopausal womenInt J Neurosci.(2006 Feb)
  26. Growth Hormone - Libè R, Barbetta L, Dall'Asta C, Salvaggio F, Gala C, Beck-Peccoz P, Ambrosi BEffects of dehydroepiandrosterone (DHEA) supplementation on hormonal, metabolic and behavioral status in patients with hypoadrenalismJ Endocrinol Invest.(2004 Sep)
  27. Testosterone - Morales A, Black A, Emerson L, Barkin J, Kuzmarov I, Day AAndrogens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiencyAging Male.(2009 Dec)
  28. Fibromyalgia Symptoms - Axel Finckh, Isabelle Carey Berner, Bérengère Aubry-Rozier, Alexander Kai-Lik SoA randomized controlled trial of dehydroepiandrosterone in postmenopausal women with fibromyalgiaJ Rheumatol.(2005 Jul)
  29. Fertility - David Barad, Norbert GleicherEffect of dehydroepiandrosterone on oocyte and embryo yields, embryo grade and cell number in IVFHum Reprod.(2006 Nov)
  30. Fertility - Wiser A, Gonen O, Ghetler Y, Shavit T, Berkovitz A, Shulman AAddition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective studyHum Reprod.(2010 Oct)
  31. Fertility - Wang J, Liu B, Wen J, Qu BThe Role of Dehydroepiandrosterone in Improving Fertilization Outcome in Patients with DOR/POR: A Systematic Review and Meta- Analysis.Comb Chem High Throughput Screen.(2023)