For Patients & Caregivers
Dehydroepiandrosterone (DHEA) has not been shown effective in treating cancer.
DHEA is the most abundant hormone secreted by the adrenal glands. Clinical trials have shown that DHEA is effective in treating certain forms of depression and anxiety, lupus, sexual dysfunction, and Addison’s disease. High blood levels of DHEA have been associated with increased risk of breast, ovarian cancers; DHEA supplementation resulted in flare-up of prostate cancer.
Studies have shown that DHEA is effective in treating Addison’s disease.
DHEA was not found to be beneficial for patients with Alzheimer’s disease.
Although studies have been done to determine DHEA’s benefits for cancer patients, results are not conclusive.
DHEA has been shown to reduce symptoms of manic depression.
DHEA is not effective in treating memory loss.
Studies have shown that DHEA benefits patients with schizophrenia.
DHEA has been shown to be effective for erectile dysfunction.
Systemic lupus erythematosus
A few studies have shown that DHEA reduces the number of flare-ups but there was no reduction in overall disease activity.
- In premenopausal women, high levels of DHEA have been associated with increased risk of ovarian and breast cancers.
- When taken for an extended period by postmenopausal women, DHEA may increase the risk of breast cancer, especially in obese subjects.
- Patients with hormone-sensitive cancer should avoid DHEA because the hormone is converted to sex steroids.
- Patients who are pregnant or breast-feeding should avoid DHEA because of its effect on estrogen levels.
For Healthcare Professionals
The most abundant hormone secreted by the adrenal glands, DHEA circulates in the blood as the sulfate ester, dehydroepiandrosterone-3-sulfate (DHEA-S). Both are precursors for other hormones, including estrogen and androgens (1). Animal studies indicate that DHEA may have chemopreventive effects (2) (3), blocks the development of tumors (4), and enhances immune response following hepatitis (5) and influenza (6) vaccinations. Although it has been postulated that DHEA may play a role in increasing immune response in acquired immune deficiency syndrome (AIDS) (7), no antiviral or immunostimulatory effects were observed in HIV-positive participants receiving DHEA (8).
In clinical trials, DHEA was shown effective in treating Addison’s disease (13) (14) (15) (16) (17), major depression (9), schizophrenia-induced anxiety (10), systematic lupus erythematosus (11), osteoporosis (12), and erectile dysfunction (13). Topical application of DHEA in postmenopausal women resulted in increased sebum production and epidermal thickening in the hands and face (18). However, other studies did not find effectivess of DHEA in treating Alzheimer’s disease (19), obesity in adolescents (20), or perimenopausal symptoms (21). Furthermore, DHEA does not increase muscle mass (22) or physical performance (23), enhance insulin secretion or action (24), or improve cognitive performance (25) in elderly individuals. DHEA supplementation, believed to enhance physical strength, did not improve physical performance or quality of life in a study done in older men and women (26). However conflicting data suggest improvements in cognitive (43) and physical function (44) in older women. DHEA has been used to treat sexual dysfunction in postmenopausal women. But results from clinical studies are mixed (28) (29). Whether DHEA is effective for treating adrenal insufficiency is not clear (41) (42).
DHEA alters some of the activities of the cytochrome P-450 enzyme that metabolizes several drugs (3). In premenopausal women, high levels of DHEA have been associated with increased risk of ovarian (7) and breast (27) cancers. High DHEA-S levels have also been shown to contribute to tamoxifen resistance and disease progression in breast cancer (28). A case of cancer flare-up was reported in a patient with advanced prostate cancer undergoing DHEA treatment (29).
DHEA is an endogenous hormone secreted by the adrenal cortex in response to adrenocorticotropin. DHEA is metabolized into androstenedione in the body and may be further converted into either testosterone or estrogen. Low levels of endogenous DHEA have been associated with the following disease states: burn trauma, coronary artery disease, non-insulin-dependent diabetes mellitus, obsessive-compulsive disorder, rheumatoid arthritis, and systemic lupus erythematosus (5). Endogenous DHEA concentration peaks around 20 years of age and declines with age.
DHEA has been shown to stimulate insulin growth factor-1 (1). G6PD is necessary for nicotinamide adenine dinucleotide phosphate (NADPH) production. DHEA has also been shown to increase levels of interleukin-2 in animal models (7). DHEA reduces the effects of inflammatory cytokines such as interleukin-6, which are thought to reduce flares in systemic lupus erythematosus (11). Numerous studies have reported an inverse relationship between DHEA concentration and cardiovascular disease (5). DHEA administration improved mental function scores in patients with advanced HIV infection (32), enhanced influenza vaccination in elderly patients (6), and decreased oxidative stress markers in patients with type II diabetes in part by negatively influencing TNF-alpha signaling (33). Although DHEA-S concentration does not appear to be correlated with cognitive decline in aging men (34), the anti-depressive effects of DHEA may be mediated by GABAA receptor modulation (35). DHEA has also been shown to affect cytochrome P-450 enzymes in the liver (3). The exact effect that this will have on other drugs remains unclear.
Analogs of DHEA that cannot be converted to androgens and estrogens have been developed and have demonstrated anti-proliferative effects (7) (31). DHEA inhibits glucose-6-phosphate dehydrogenase (G6PD) in vitro and blocks the development of tumors in mice (4). It was also shown to induce authophagic cell death in human hepatoma cells via a mitogen activated protein kinase (JNK)-transciption factor (Nrf2)-protein complex p62 axis (46).But an increase in concentration of sex hormones including DHEA has been shown to increase the risk of breast cancer (30). And prolonged intake of DHEA in postmenopausal women may increase the risk of breast cancer particularly in obese subjects (36). The sulfate ester DHEA-S also stimulates estrogen receptor-positive cell growth (28).
- Serum concentrations of DHEA and DHEA-S can be increased by alprazolam, amlodipine, diltiazem, and metformin
- Serum concentrations of DHEA and DHEA-S can be decreased by dexamethasone, insulin, and morphine (5)