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DHEA: Is It Really the Fountain of Youth?

© Susan Lord MD
 (Excerpted from Mind-Body Connection, The Center for Mind/Body Medicine)

Aging. Mice treated with DHEA looked younger and had glossier coats. Elderly patients had significant improvement in generalized weakness, muscle wasting, tremulousness, and memory loss.

Osteroporosis. DHEA can theoretically work like estrogen, androgen, and progesterone in preventing bone loss and stimulating bone formation. An increase in bone mass has been documented in postmenopausal women.

Who should consider being tested? Certainly, people with any of the above conditions or those at risk of developing them are likely candidates. Perimenopausal and postmenopausal womenwho are at risk for osteoporosis, as well as the elderly complaining of fatigue, inability to gain weight, malaise, and a lack of zest for life often have low DHEA levels. People with multiple chemical sensitivities might want to be tested. In fact, it may be worth testing anyone over 40, who feels his or her physical or emotional health declining despite efforts to live a healthy lifestyle.

Although most doctors will be familiar with DHEA with respect to endocrine disorders, many will not be aware of the latest research. As a scientist, your doctor is trained to make therapeutic decisions based on research, in order to avoid useless or dangerous therapies. Many physicians will respond with interest to references in scientific journals or better yet to the articles, themselves. Information for this article was derived mainly from Preventing and Reversing Osteoporosis by Dr. Alan Gaby. He has written an excellent chapter on DHEA, within the context of overall good health. I've listed some articles from his extensive bibliography of the current literature at the end of this article. You can read the ones pertinent to your own medical situation and share them with your doctor. Another resource is Women's International Pharmacy, which will send your doctor articles and discuss dosing regimens, as well as filling prescriptions for DHEA. The address is below.

DHEA deficiency can be assessed by measuring either serum DHEA or DHEA-S, which is cheaper (about $40) and may be more sensitive. A normal range is given for each decade. (These ranges will vary according to the type of machine used by a particular lab.) As no lab test is perfect and so called normal levels may vary considerably, a patient's clinical condition should also be taken into account in deciding whether to treat. A 60-year-old with general malaise, fatigue, decreased appetite, weight loss and depression associated with a low normal DHEA level may well benefit from supplementation.

At present, no studies have determined the optimal dose of DHEA. Experienced physicians, however, have found doses of 5-15 mg. twice a day to be beneficial for women. Doses at these levels rarely produce side effects, which include acne and an increase in hair growth on the arms and legs. Start with the lowest dose and increase each week until symptoms improve. Dosages for men are often greater than 100 mg. per day. Maintenance doses may have to be gradually increased over time as the endogenous output of DHEA decreases with age. The widely used guideline for determining the maintenance dose is to increase the DHEA level to that of a 25-35 year old. For treatment of serious illnesses like systemic lupus, cancer, and AIDS, much higher doses may be appropriate.

It is important to assess the need for DHEA supplementation within the context of a thorough examination, as other serious illnesses can present with similar symptoms. Your doctor may also want to check levels of other hormones like cortisone and thyroid hormone, to assure that the proper balance of hormones is achieved. For women with breast cancer and men with prostate cancer, there is clearly not enough data to make general recommendations, and caution should be used.

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