Although the results of human DHEA studies appear promising and tantalizing, they still need to be confirmed in large-scale and properly controlled studies. Nonetheless, given the current groundswell in human DHEA-related research, I remain confident that these issues will be fully addressed within the next 5 to 10 years and predict that a therapeutic role for DHEA will be established. This could take the form of hormone replacement therapy (for example, starting DHEA administration around age 30 and keeping the serum level at its zenith) or pharmacologic therapy for specific disease indications.
Joseph Mortola, M.D., Department of Reproductive Endocrinology, Beth Israel Hospital and Harvard Medical School, Boston, MA.
I definitely think this hormone should be considered for replacement therapy, at least in the future, and perhaps now. DHEA has different effects on men and women, therefore, the recommendations and cautions would be different for each sex.
DHEA administration can have an estrogenic effect in tissues of women. I'm only speculating, but if women are on estrogen replacement therapy and they want to add DHEA, they can probably decrease the estrogen dose by half. Even though metabolites of DHEA will stimulate breast tissue, they will do so less than estrogen itself, thus possibly decreasing the risk of breast tumor initiation that has been suggested by some studies on estrogen replacement.
There has been speculation that testosterone, as well, may be appropriate for some women as replacement therapy. Since DHEA also gets converted into testosterone and other androgens in postmenopausal women, it may be a better way to deliver testosterone to tissues. However, lipid profiles and glucose levels should be monitored in women on DHEA.
In men, DHEA should be considered as having more estrogenic effects rather than androgenic. DHEA has some effects by binding to androgen receptors located everywhere through our bodies. This would, in men, act as a buffer to the effects of testosterone. The data are clear that DHEA is beneficial in men, and certainly can't hurt. But, the dosages have not been worked out.
The replacement dose of DHEA in both sexes, in order to be effective, probably needs to be higher than 50 mg. Maybe up to 200 mg daily might be appropriate. However, we need some long-term studies.
Based on everything I know, I would take DHEA if I were older. I'm 42 now. Perhaps in my fifties I would start supplementing, but, by then, I would have the luxury of knowing the results of another decade of studies. As to older people not wanting to wait that long, I can see a justification for them using it now, as long as they are monitored by a qualified physician.
Drs. Yen, Morales and Khorram, Department of Reproductive Medicine, University of California, San Diego, La Jolla, CA (As reported in Ann NY Acad Sci 774:128-142, 1995).
DHEA in appropriate replacement doses appears to have remedial effects with respect to its ability to induce an anabolic growth factor, increase muscle strength and lean body mass, activate immune function, and enhance quality of life in aging men and women, with no significant side effects. Further studies are needed.
And now, the author's opinion
As indicated in this chapter, the consequences of supplementation with DHEA for anti-aging purposes is, at this time, not fully known in humans. There may be many positives, then again, there may be some totally unexpected long-term negative effects. No amount of studies on rodents will give us any definite clues to what will happen in us humans since, among many other differences in metabolism, rodents have little DHEA(S) circulating in their blood.