DHEA – dehydroepiandrosterone.
The compound dehydroepiandrosterone – DHEA is often called the “mother of hormones,” this chemical is required by the body as a chemical precursor for the biosynthesis of all types of human hormones, that includes the female hormone estrogen and the male hormone testosterone, for example. The endocrine organs known as the adrenal glands that are found on top of the kidneys secrete most of the DHEA, in addition, the human skin, the brain, the testicles, and ovaries also secrete this chemical precursor. In terms of its biosynthesis, men secrete more DHEA than women. The internal production of DHEA also declines with age, with younger individuals secreting more than older people. The production of DHEA in both sexes declines steeply with the increase in age, the levels of DHEA in a seventy-year-old person are eighty per cent lower than a thirty-year-old. While it has been known for a long time that DHEA production declines with age, its health or biochemical significance and its effects on the body are still unknown.
DHEA supplementation and its beneficial effects on the body have been hyped up, though this has strictly not been supported by evidence from scientific studies. It has been claimed that DHEA boosts the libido, helps in boosting memory and intelligence, as well as stimulating weight loss and also prevents osteoporosis; however, these claims are not supported by clinical evidence. At the same time, it is known from clinical studies that supplements of DHEA may actually boost the general well-being of older people, though its mode of action is not worked out, it is also believed to help diminish the risk of heart disease in people susceptible to such illnesses, it is said to boost immune system functioning, as well as easing the physical symptoms of the autoimmune disease lupus, and is believed to help in managing life style disease such as diabetes.
There are some benefits of DHEA, in older men, higher end normal levels of DHEA in the blood may help lower the risk of heart disease. Results from a clinical comparative study of DHEA levels in men show, that men who had naturally high levels of DHEA in the blood also tended to possess less body fat and had higher levels of the HDL or “good” cholesterol when compared with men with low levels of DHEA in the blood. In further studies, the physical performance of men with high levels of DHEA was also better compared to other men, in exercise stress tests, that measured the condition of the heart when all of them undertook physically demanding exercises. At the same time, such associations between DHEA levels and physical performance or other benefits were not observed in women, put under the same type of tests. The opposite seemed to be true, and as a matter of fact, DHEA supplements seemed to slightly give a higher risk for heart disease in women. The results from other clinical research, in addition, shows that high DHEA levels in the blood could help in “thinning” the blood, this may be linked to a reduction in the risk of sudden blood clot formation in the veins and arteries and to possibly help in voiding a heart attack in an otherwise susceptible individual.
The immune system supporting the action of DHEA is also supported by some evidence as deduced from the results of a clinical study in older individuals who received flu shots – DHEA levels in the blood may help boost immune system response across age groups. In the study of these older people administered DHEA, the response of the immune system to the injected weakened flu virus was significantly strengthened. Another field of recent research has many researchers hopeful that increasing levels of DHEA in the blood is likely to improve the immune responses of people infected by the HIV virus – the causative agent of full-blown AIDS, which severely weakens the immune system of the affected person ultimately leading to death as a result of some opportunistic disease.
DHEA and its effects on postmenopausal women were studied in a small trial, the results seemed to suggest that women who took DHEA supplements when compared to those on a placebo, had lower levels of triglycerides, which is a blood fat chemically related to cholesterol. Such women were in addition, able to utilize the hormone insulin much more efficiently in their bodies. The results from this study, while inconclusive, may possibly point to a role for the use of DHEA supplements in the treatment of diabetes and related blood sugar disorders.
Patients affected by the auto-immune disorder called lupus may also possibly be helped by supplements of DHEA; some clinical reports suggest that this autoimmune disease may be alleviated through the use of these supplements. In some patients, the DHEA supplement helped bring relief from some of the physical symptoms, this translated into a reduction in the total amount of medication normally required by such patients.
Dosage of Supplements:
The dosage of supplemental DHEA has to be monitored carefully, those desirous of taking the supplements in spite of legal concerns, should do so primarily as a means of raising the body’s level of hormone to the normal range. The supplement must never be used when hormone levels start exceeding normal ranges nor should they be used to boost the hormone levels above normal – excess amounts of hormones can play havoc with the body’s biochemistry. Initially, the doses must be small, about five mg of the supplement for women and ten mg of supplement for men. Once the person gets used to the dose, it may be gradually increased to higher levels till the desired effect is reached. At any time, doses that exceed twenty five mg of supplement a day must never be used. High doses above the maximum dose may only be used in treating specific disorders, like lupus or AIDS. The best time to supplement with DHEA is in the mornings. DHEA supplements are not required by otherwise healthy people below fifty years of age.
The potency of supplemental DHEA is greater than other nutrients or herbs. However, the long-term supplemental use of DHEA is still unclear and requires further study. With regard to the use of DHEA, the supervision of an endocrinologist is believed necessary by most experts. Many clinicians believe that this supplement must only be taken under the careful supervision of a qualified endocrinologist – a specialist on hormones and their effects on the body.
Men and women, who intend to take supplements of DHEA, must be medically examined by a doctor for signs of prostate cancer in the men or signs of breast cancer, in women and men. This is an essentially medical intervention step as such cancers are heavily influenced by the levels of hormones in the body of a person. This initial examination must then be followed by a blood test to determine the existing levels of DHEA in the blood of the person, the DHEA supplement must then be prescribed only if the blood levels of this hormone precursor are low or below normal. Once supplementation with the DHEA has begun, a test must be conducted after three weeks, to assess or adjust the dosage so as to avoid giving an excess dosage. Supplements need not be taken at high doses, if the body’s level of the hormone precursor is checked periodically, a dose consisting of as little as five to ten mg of DHEA given in a week can help maintain a satisfactory level of DHEA in the body.
Possible Side Effects and Precautions:
At very high or excessive doses, the DHEA supplements can induce specific symptoms including extreme oily skin and acne, it can lead to undesirable hair growth in women, and it can lead to a deepening of the voice, and induce sudden mood changes and swings. Excessive doses of DHEA were also linked to liver cancer in test animals during one clinical test conducted on animals.
Oral supplementation of DHEA supplements at recommended doses are associated with very few side effects in most people. High doses above the recommended dosage level can induce many side effects, which can include physical fatigue, spells of nausea and headaches, great abdominal discomfort, as well as nasal congestion, it can bring on acne, and some people may experience rapid or irregular heartbeats. DHEA produces some specific side effects in women, high doses of DHEA taken by women bring some common side effects such as splitting headaches, abnormal menstruation, it can lead to emotional changes and mood swings, and may bring on insomnia and other sleep disorders. DHEA supplements must never be used by any person with a medical history of abnormal heart rhythms and cardiac problems, such supplements must also be avoided by all individuals who have a high risk of blood clots forming in the blood vessel and those who suffer from hypercoagulability. Such supplements must also be avoided by all patients with a history of disorders affecting the liver. The DHEA supplements can induce complications in all such cases.
High levels of the chemical DHEA in the body of a person bring specific effects, as this chemical is a hormone precursor similar in many respects to the other male and female hormones normally found in the body – it displays specific side effects that are connected to its hormonal action. Elevated levels of DHEA in the body can for example, lead to the virilization of the female body – the development of masculine features. It may induce the formation of acne on the skin, it can cause greasy skin, it can lead to the development of facial hair and hair loss in women, it may greatly enhance the rate of perspiration, and it can also lead to the development of a deeper voice in women and cause a gain in weight. Similarly, elevated levels of DHEA in men can lead to the opposite effect, inducing the develop of more prominent breasts – in a condition known as gynecomastia, it may cause tenderness in the breasts, it may lead to a rise in the blood pressure, it can result in testicular wasting, or make the man more aggressive in behavior. Men may in addition suffer from other types of hormone related side effects of DHEA, they may develop resistance to insulin, the blood sugar levels may be raised, and the patients may suffer from changed cholesterol levels as well as changed thyroid hormone levels in the blood, the supplement may also completely change the functioning of the adrenal glands. DHEA supplements must be used with great care by patients already suffering from diabetes or hyperglycemia, people affected by high cholesterol levels, all kinds of disorders of the thyroid, or any type of other endocrine associated hormonal abnormalities must also use the supplement with caution. When DHEA supplements are used, a medical examiner must be around to monitor the serum glucose and cholesterol levels, the thyroid levels may also need to be monitored by a healthcare professional on a continuing basis, it may also be necessary to change and adjust the medication dosage from time to time.
Supplements of DHEA could theoretically speak, increase the risk of developing certain types of cancers, including ovarian and breast cancer in women and prostate cancer in men. Supplements of the DHEA might also be contributing to tamoxifen resistance in breast tissues of women affected by breast cancer. DHEA supplements have also been linked to other side effects when used for a long period of time, these symptoms can include psychological agitation and delusions, the development of sleep disorders including insomnia, extreme nervousness and mental irritability, a psychosis or manic state of mind.
Excessive supplements of DHEA, leading to elevated levels of the chemical in the body has been associated with the condition known as Cushing’s syndrome. If the condition develops in a person unexpectedly, excessive supplementation of DHEA supplements is most likely to blame.
- Pregnancy and Breastfeeding
- Supplements of DHEA are not advised for nursing mothers and the chemical must also be avoided completely during a term of pregnancy. As the DHEA functions like a hormone in the body and is passed to the nursing baby or fetus though the milk or blood, it may lead to developmental problems in the child.
- The chemical interaction of DHEA supplements with other common supplements has been tested and is elucidated below. In fact, the majority of herbs and nutritional supplements commonly used are not thoroughly tested for chemical interactions they have with other herbs, supplements, drugs, or foods in the body. The list of the likely interactions of DHEA with other supplements given below were made on the basis of clinical reports found in scientific publications, reports gleaned from the results of laboratory experiments, or the wisdom gained from traditional use of the supplements. A good rule to follow when using supplements is to make sure to read the product’s label carefully. A qualified healthcare provider must always be consulted before the start of a therapy, especially if the person intending to begin supplementation is already suffering from a medical condition, if he or she is already using other drugs, supplementing with herbs, or ingesting other supplements. Safety is a primary issue where supplements are concerned, and the user must be very responsible about his or her safety, taking appropriate precautions before starting on a regimen.
- Interactions with Drugs
- Within the human body, DHEA present at high levels could interfere with the natural biochemical processes involved in the denaturation and removal of certain drugs normally routed through the liver’s “cytochrome P450” enzyme system. If the turnover rate of any of these drugs in the liver is affected by DHEA, it may lead to an increased concentration of the drugs in the blood, the results can include increased activity by the drugs due to their longer residence in the body, or a potential adverse biochemical reaction due to the persistence of the drugs in the body. Chemicals and drugs that affect the functioning of the central nervous system, drugs like carbamazepine and phenytoin for example, could affect the functional state of P450 enzymes that metabolize DHEA and DHEA-S in the liver – this can lead to a reduction in the volume of circulating concentrations of these hormones in the blood. All possible interactions need to be analyzed as they could pose a health hazard, for this reason, all patients who are already using any kind of medication must read the package insert in the product being used carefully and then consult with a qualified healthcare professional and pharmacist to check for the probability of chemical interaction before taking DHEA supplements.
Supplements of DHEA have specific metabolic effects as well; doses of the supplement may increase the levels of blood sugar. The use of medications like metformin – Glucophage – which can also lower blood sugar levels needs to be done with care if DHEA is already used as a supplement. Diabetics who are intent on taking DHEA supplements and who are already using oral diabetic drugs or insulin must be closely monitored or supervised by a qualified doctor or healthcare professional. This supervision is required as it may be necessary to adjust the medications to avoid possible adverse reactions in the body due to the supplemental use of DHEA.
People who use supplemental DHEA may also be at an increased risk of sudden blood clot formation. Consultation with a doctor or clinician is mandatory before starting DHEA supplements for all patients who are already using anticoagulants – blood thinning agents, or platelet destroying drugs – aspirin, for example – such drugs are normally given to patients who suffer from a risk of sudden blood clot formation. Other drugs normally used to thin blood include products such as heparin, warfarin – sold as Coumadin, and clopidogrel – marketed as Plavix. Habits such as smoking and the use of other hormone supplements also raise the risk of blood clot formation. Women who use birth control pills and post menopausal women who are on hormone replacement therapy – HRT – are particularly susceptible to sudden blood clot formation. DHEA supplements should not be used with any of these medications except under medical supervision from a qualified healthcare professional.
The heart rate and cardiac rhythm may be affected or altered significantly by DHEA, for this reason, supplements of DHEA must be used with extreme caution when supplemented along with other heart medications or drugs which also affect heart rhythm. The effects of DHEA on the body may be enhanced by alcohol.
The levels of activity of DHEA in the human body may also be increased by the presence of high levels of human growth hormone or drugs such amlodipine, canrenoate and anastrozole – generic name Arimidex in the body, the same effects are observed with methylphenidate, nicardipine, and various other calcium channel blockers including diltiazem – sold as Cardizem, and alprazolam – sold as Xanax, according to reports from some studies, the presence of these substances in the body could lead to increased side effects when combined with supplements of DHEA. While further studies are required in the laboratory, these substances could enhance the DHEA levels in the body. The use of supplemental DHEA combined with estrogen or androgen hormonal therapies will theoretically lead to an increase the hormone concentration in the body. Patients on psychiatric drugs such as clozapine – sold as Clozaril – has to be monitored if they use DHEA supplements as it can chemically interact with the drug in the body.
Inside the human body, DHEA may also interfere and interact with the drugs targeted at GABA – receptors in the brain, normally used in the treatment of seizures or pain. The effectiveness of methadone may also be decreased by DHEA in the body. In women suffering from breast cancer, DHEA might boost the effects of clofibrate or may possibly increase tamoxifen resistance in cancerous tissues.
The presence of high DHEA levels in the body has also been said to cause a decreased rate in the production of developing protective antibodies after influenza vaccination, based on titer values.
Chemical substances such as the neurotransmitter substance dopamine, corticosteroids like dexamethasone, and generic drugs like danazol used in the treatment of endometriosis, various opiate painkillers, and anti-psychotic drugs tend to reduce the normal levels of DHEA produced by the human body everyday. The levels of DHEA in the blood may be increased by chemicals such as metopirone, alprazolam, and benfluorex. To get a complete picture of the many other possible interactions of DHEA with other substances in the body, all patients are advised to consult a qualified medical professional, and a professional such as a pharmacist, before starting on supplements.
- Interactions with Herbs and Dietary Supplements
- According to the evidence garnered from animal tests and laboratory studies, high levels of DHEA in the body due to the use of supplements could interfere with the biochemical processing of certain herbs and supplements via the “cytochrome P450” enzyme system present in the liver. One result of this interference from DHEA is that the blood levels of all other herbs or chemical supplements will soar. The DHEA present in the body may possibly alter the biochemical effects normally induced by other herbs or nutritional supplements on the P450 system in the liver.
At the physiological level, the presence of DHEA in the body could also induce insulin resistance in the body and perhaps boost the blood sugar levels. In addition, DHEA levels may boost the effects of supplemental herbs or other supplements resulting in an increase in the sugar level in the blood. DHEA can add to the effects of herbs like cocoa and ephedra – combined with caffeine, or bolster the effects of arginine and melatonin on the body. The action of herbs such as aloe vera, bilberry, and American ginseng or other supplements that may decrease the blood sugar level is counteracted by the DHEA. Patients who use DHEA supplements must be monitored closely for their serum glucose levels by a qualified healthcare professional for the duration of the supplemental regimen. Adjustments to the dosage are often required and such supervision ensures that dose changes are made in proper time.
Theoretically speaking, the risk of blood clotting is increased by the use of supplemental DHEA, moreover, the supplement augments the effects of different herbs and various supplements that tend to increase the risk of clotting of blood, examples include supplemental coenzyme Q10 and the Panax ginseng herb. At the same time, the effects of herbs and nutritional supplements that act to “thin” the blood may be counteracted by DHEA, thus diminishing the risk of clotting of blood, herbs such as ginkgo Biloba, the common garlic, and the saw palmetto herb are such blood thinning herbs.
The exact physiological effects that take place when the effect of DHEA is combined with the effect of supplemental herbs remains unknown, though it is believed to induce hormonal effects in the body of the person. Chemical agents with possible estrogen-like effects in the body – known as a phytoestrogen effect – are found in herbs such as the black cohosh, alfalfa, and the bloodroot. The physiological effect of a combination of these herbs with supplemental DHEA is not known.
The cardiac rhythm and heart beat rate may also be changed or altered by the presence of DHEA in the blood. DHEA should be supplemented with care when other herbs or supplements that affect the functioning of the heart or that include cardiac glycosides in them are already being used in a supplemental form. Herbs such as the foxglove containing digitalis, the adonis, and the balloon cotton, are prime examples in this regard.
The levels of DHEA active in the blood may be increased by agents like chromium picolinate. Research also suggests that carnitine and DHEA have possible additive effects when taken at the same time. Supplements of DHEA could also boost the production of the neurotransmitter melatonin in the brain and possibly prevent the biochemical destruction of vitamin E in the body, according to the results gleaned from recent animal studies.
DHEA could also be interacting with flavonoids, dietary fibers, as well as polyunsaturated fatty acids, different probiotics, soy protein, and yam is taken in the diet. While such interactions have not been studied well, safety is an issue and patients supplementing with DHEA must be aware of this potential interaction and take appropriate precautions.