Is DHEA Useless?

Dr. Frank Shallenberger, MD
September 24, 2018

 

If you’re taking DHEA, you’re wasting your time. At least that’s what an editorial by Paul M. Stewart, MD would have you believe. His comments appeared several years ago in the New England Journal of Medicine. Even though his editorial came out 12 years ago, I still get questions about it. Bodybuilding websites refer to it. And many other websites bring it up as well.

Dr. Stewart concluded that taking DHEA to slow down aging “offers no answer and should not be attempted.” He then states that, “Appropriate regulation would dispel much of the quackery associated with this elusive hormone.”

“Appropriate regulation?” “Quackery?” Whenever you hear doctors haul out words like that, you know they’re upset. What this usually means is that they’re reacting emotionally instead of looking at the facts. So let’s look at the facts, shall we?

Dr. Stewart’s words come on the heels of a study of 87 elderly men and 57 elderly women. The researchers gave roughly half of these men and women DHEA supplements, and they gave the other half placebo capsules. The study went on for two years.

The New England Journal of Medicine study made headlines in the network news – “DHEA is waste of time and money.” More than a few of my patients called me up and wanted to know what the deal was. So here’s what I can tell you about DHEA.

First, there are numerous studies that show DHEA does work. And second, this study had at least four significant errors.

Problems With This Study

(1) The people in the study were not selected because of symptoms. They were selected simply because of low blood levels. That would be like doing a study on glucosamine and testing it on subjects who have no joint pain. It’s ridiculous!

What most people don’t realize is that blood levels are notoriously inaccurate at diagnosing a hormone deficiency. Because of this, it’s almost certain that many of the people chosen did not have a significant deficiency of DHEA. It stands to reason that giving DHEA to someone who doesn’t need it is not going to result in any improvement.

(2) One of the major impacts that DHEA makes is on the brain. Researchers have shown that maintaining healthy DHEA levels as they begin to decrease will dramatically lower the chance of memory loss, insomnia, depression, and dementia. The people in the New England Journal study were started on it way too late to have much of a preventive effect on their brains. They should have started it as soon as they became deficient. DHEA deficiency often occurs in the 40s and 50s. To start replacing deficient levels 10-20 years after the fact is going to seriously limit any chance of improvement.

(3) The study was way too short to examine any of the known anti-aging effects of DHEA. The researchers should have followed these people for at least 5-10 years. Then they would have seen that those taking the DHEA supplements were in much better shape than those who didn’t.

Dr. Stewart was way out of line to conclude that DHEA had no anti-aging effects. He should know that it’s impossible to expect any study to show anti-aging effects in less than 5-10 years. A two-year study is just too short.

(4) And, finally, the results, according to the author, showed that taking DHEA did not improve “body composition, physical performance, insulin sensitivity, or quality of life.”

On average, this was true. But all the study offered was averages. There was no published data on each individual subject. This can be very misleading. If 100 people are studied and 20 of them show benefit, then it doesn’t make any difference what the average was. Those 20 people still saw improvement.

Not only that, but based upon the range of averages that were published in the study, some of the people taking DHEA had improvements in every aspect that was tested. Improvements in bone density, exercise performance, stamina, blood sugar levels, and body composition. For those people, DHEA was very effective.

This statement flies in the face of a good many studies published over the last 20 years that reached the exact opposite conclusions. In fact, many people started taking DHEA supplements when it first became available at the health food stores about 15 years ago. They take it because studies show that it: extends the lifespan in mice, prevents certain cancers, keeps the blood thin, stimulates the immune system, prevents the flu, prevents diabetes, increases stamina, increases bone mass, prevents Alzheimer’s and other forms of dementia, and improves mood, sleep, and libido.

They continue to take it because they see results. DHEA does everything the studies show it does. Some people experience better results than others. But it’s a supplement that really works.

Just remember, your body makes DHEA for good reasons. When it becomes deficient, it only makes sense to replace it. You will live longer and better. One of the most incredible mysteries of life is that your body was made to heal itself. All you have to do is to help it.

DHEA for Erectile Dysfunction

One of the main causes of erectile dysfunction is hormonal. And a study published way back in 1999 backs up what I have already found to be true in many men with this problem. A little dose of DHEA will correct many of these cases.

Doctors at the Department of Urology at the University of Vienna in Austria looked at 40 men with erectile dysfunction. These doctors conducted the gold standard of medical research: a prospective, double-blind, randomized, placebo-controlled study.

Here’s what they did.

First of all, they made sure that the men did not have a neurological cause for their problem by using a prostaglandin E1 test. This involves inserting a suppository of prostaglandin E1 sold as alprostadil, into the urethra. This will cause an immediate erection in men who have adequate nerve function. All 40 men passed the test, so none of them had a neurological cause.

Then the researchers made sure that the men had normal blood levels of testosterone. And lastly, they made sure that they all had levels of DHEA (dehydroepiandrosterone) in the low range. In this study, all of the men had DHEA-s levels below 1.5 micromols/L.

The researchers then divided the men into two groups. For the next six months, one group took 50 mg of DHEA every day. The other group took a placebo. They used a questionnaire called the International Index of Erectile Function (IIEF), to rate the success of the therapy. The men who received the DHEA supplements had higher mean scores for all five parts of the questionnaire.

This means that in each case, the DHEA improved their ED. Additionally, the DHEA treatment did not result in any prostatic problems, nor did it raise their testosterone levels.

In 1994, the Massachusetts Male Aging Study showed that as men get older, the chance of developing impotence increases as the levels of DHEA decrease. So the results of this study make perfect sense.

Second, the levels of DHEA in these men were extremely low. I like to see all of my patients (men and women) have DHEA levels at least five times higher than the 1.5 micromols/L used in this study. (By the way, most laboratories report DHEA levels in micrograms/dl, not in micromols/L. A rough conversion is to divide microgram/dl by 27 to get micromols/L.)

One last reminder. If you’re a man and you take more than 10 mg of DHEA, make sure that your doctor checks your estradiol and PSA levels three to four months after you start, just to make sure your body isn’t converting the DHEA into estrogen. This happens in some men, particularly those over 50.

Elevated estradiol levels are not good for men. They can cause blood clots, prostate enlargement, and, yes, impotence!

DHEA for Your Memory and Your Sex Hormones

DHEA also plays an important roles in memory. People with high levels of DHEA tend to achieve the highest scores on memory tests. The lower the blood level, the lower the score.

One advantage this hormone has is that you can buy it at your local health food store or pharmacy. It also tends to be a lot easier to use than typical estrogen and testosterone therapy. And DHEA can help raise both estrogen and testosterone levels. So it’s a simple way to raise your sex hormone levels.

There is one drawback to taking DHEA. Women who take too much may experience hair loss, acne, or oily skin. If you’re a woman and you notice any of these signs while taking DHEA, simply reduce your dose and the problems should go away.

Men, however, need to be more careful. If they take too much DHEA, their bodies convert it to estrogen. This will decrease libido and increase body-fat percentage. It can also aggravate the prostate, increasing your risk for prostate cancer. And it can enlarge your breasts.

However, there is a form of DHEA that doesn’t have these effects. It’s called 7-keto-DHEA. It’s a regular metabolite of DHEA that’s naturally present in the human body. It’s not easily converted into testosterone or estrogen. The only concern about 7-keto-DHEA is that it may not be as effective as other forms. But it’s a much safer form for men to take. Women can take regular DHEA. Both forms are easy to find online and at local pharmacies and health food stores.

Source:

Reiter, W.J., A. Pycha, G. Schatzl, A. Pokorny, D.M. Gruber, J.C. Huber, and M. Marberger. “Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study.” Urology. 1999 March;53(3):590-4; discussion 594-5.

 

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