Dehydroepiandrosterone (DHEA): hypes and hopes
- PMID: 25022952
- DOI: 10.1007/s40265-014-0259-8
Dehydroepiandrosterone (DHEA): hypes and hopes
Abstract
Dehydroepiandrosterone (DHEA) and its sulfated form dehydroepiandrosterone sulfate (DHEAS) are the most abundant circulating steroid hormones in humans. In animal studies, their low levels have been associated with age-related involuntary changes, including reduced lifespan. Extrapolation of animal data to humans turned DHEA into a 'superhormone' and an 'anti-aging' panacea. It has been aggressively marketed and sold in large quantities as a dietary supplement. Recent double-blind, placebo-controlled human studies provided evidence to support some of these claims. In the elderly, DHEA exerts an immunomodulatory action, increasing the number of monocytes, T cells expressing T-cell receptor gamma/delta (TCRγδ) and natural killer (NK) cells. It improves physical and psychological well-being, muscle strength and bone density, and reduces body fat and age-related skin atrophy stimulating procollagen/sebum production. In adrenal insufficiency, DHEA restores DHEA/DHEAS and androstenedione levels, reduces total cholesterol, improves well-being, sexual satisfaction and insulin sensitivity, and prevents loss of bone mineral density. Normal levels of CD4+CD25(hi) and FoxP3 (forkhead box P3) are restored. In systemic lupus erythematosus, DHEA is steroid-sparing. In an unblinded study, it induced remission in the majority of patients with inflammatory bowel disease. DHEA modulates cardiovascular signalling pathways and exerts an anti-inflammatory, vasorelaxant and anti-remodelling effect. Its low levels correlate with increased cardiovascular disease and all-cause mortality. DHEA/DHEAS appear protective in asthma and allergy. It attenuates T helper 2 allergic inflammation, and reduces eosinophilia and airway hyperreactivity. Low levels of DHEAS accompany adrenal suppression. It could be used to screen for the side effects of steroids. In women, DHEA improves sexual satisfaction, fertility and age-related vaginal atrophy. Many factors are responsible for the inconsistent/negative results of some studies. Overreliance on animal models (DHEA is essentially a human molecule), different dosing protocols with non-pharmacological doses often unachievable in humans, rapid metabolism of DHEA, co-morbidities and organ-specific differences render data interpretation difficult. Nevertheless, a growing body of evidence supports the notion that DHEA is not just an overrated dietary supplement but a useful drug for some, but not all, human diseases. Large-scale randomised controlled trials are needed to fine-tune the indications and optimal dosing protocols before DHEA enters routine clinical practice.
Similar articles
-
The effect of six months treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex steroids, body composition and muscle strength in age-advanced men and women.Clin Endocrinol (Oxf). 1998 Oct;49(4):421-32. doi: 10.1046/j.1365-2265.1998.00507.x. Clin Endocrinol (Oxf). 1998. PMID: 9876338 Clinical Trial.
-
Six-month oral dehydroepiandrosterone supplementation in early and late postmenopause.Gynecol Endocrinol. 2000 Oct;14(5):342-63. doi: 10.3109/09513590009167703. Gynecol Endocrinol. 2000. PMID: 11109974 Clinical Trial.
-
The Dehydroepiandrosterone And WellNess (DAWN) study: research design and methods.Contemp Clin Trials. 2007 Feb;28(2):153-68. doi: 10.1016/j.cct.2006.04.009. Epub 2006 May 6. Contemp Clin Trials. 2007. PMID: 16784898 Clinical Trial.
-
The use of dehydroepiandrosterone therapy in clinical practice.Treat Endocrinol. 2005;4(2):95-114. doi: 10.2165/00024677-200504020-00004. Treat Endocrinol. 2005. PMID: 15783247 Review.
-
Androgen therapy with dehydroepiandrosterone.World J Urol. 2003 Nov;21(5):346-55. doi: 10.1007/s00345-003-0367-7. Epub 2003 Oct 10. World J Urol. 2003. PMID: 14551720 Review.
Cited by
-
Influence of Androgens on Immunity to Self and Foreign: Effects on Immunity and Cancer.Front Immunol. 2020 Jul 2;11:1184. doi: 10.3389/fimmu.2020.01184. eCollection 2020. Front Immunol. 2020. PMID: 32714315 Free PMC article. Review.
-
TGF-β signaling in the tumor metabolic microenvironment and targeted therapies.J Hematol Oncol. 2022 Sep 17;15(1):135. doi: 10.1186/s13045-022-01349-6. J Hematol Oncol. 2022. PMID: 36115986 Free PMC article. Review.
-
Increased longevity due to sexual activity in mole-rats is associated with transcriptional changes in the HPA stress axis.Elife. 2021 Mar 16;10:e57843. doi: 10.7554/eLife.57843. Elife. 2021. PMID: 33724179 Free PMC article.
-
Sex Hormones and Gender Influence the Expression of Markers of Regulatory T Cells in SLE Patients.Front Immunol. 2021 Mar 3;12:619268. doi: 10.3389/fimmu.2021.619268. eCollection 2021. Front Immunol. 2021. PMID: 33746959 Free PMC article.
-
Resistant ovary syndrome: Pathogenesis and management strategies.Front Med (Lausanne). 2022 Oct 19;9:1030004. doi: 10.3389/fmed.2022.1030004. eCollection 2022. Front Med (Lausanne). 2022. PMID: 36341241 Free PMC article. Review.
References
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials