DHEA: An Anti-Aging Hormone for Some Seniors?
By Alan R. Gaby, MD
Healthnotes Newswire (December 23, 2004)—Supplementing with DHEA can partially reverse the accumulation of abdominal fat and the insulin resistance that frequently accompanies advancing age, reports a study in the Journal of the American Medical Association (2004; 292:2243–8). When combined with earlier (though conflicting) research indicating that DHEA can improve bone density, muscle mass, strength, skin texture, libido, and erectile function in older people, there is now strong evidence that DHEA is an “anti-aging” hormone for some people.
DHEA is a steroid hormone manufactured in the adrenal glands and, to a lesser extent, in the sex organs of both men (testes) and women (ovaries). The concentration of DHEA in the body reaches a peak around age 25 and declines progressively thereafter. Blood levels of DHEA among people age 70 or older are an average of 80% lower than the levels in young adults. Some of the typical manifestations of aging appear to be related in part to this decline in DHEA levels and are, therefore, potentially reversible with DHEA–replacement therapy.
In the new study, 56 men and women between ages 65 and 78, most of whom were overweight, were randomly assigned to receive 50 mg of DHEA per day or a placebo for six months. Compared with the placebo, DHEA significantly reduced the amount of fat in the abdominal area. DHEA also significantly improved blood sugar regulation, as demonstrated by an increase in insulin sensitivity (i.e., less insulin resistance). Increased abdominal fat and insulin resistance are often precursors to diabetes, so the results of this study suggest that maintaining adequate DHEA levels might prevent diabetes in older people.
While these findings are promising, we still have a lot to learn about DHEA. Many DHEA supplementation studies have failed to show any benefit, and it is likely that DHEA is effective for only a subset of the elderly population. Exactly who is most likely to benefit should be the topic of future research. In addition, although few side effects have been reported in DHEA studies, there are at least theoretical risks associated with taking this hormone. DHEA is converted in the body to estrogen and testosterone, so it is possible that long term use could increase the risk of hormone-dependent cancers, such as cancer of the breast, ovary, uterus, or prostate. On the other hand, animal studies suggest that DHEA might help prevent cancer.
Most practitioners who prescribe DHEA recommend it primarily for people whose blood levels of the hormone (measured as DHEA-sulfate) are below or towards the lower end of the normal range for young adults. In addition, the amount of DHEA used in many studies (50 mg per day) will sometimes push the blood level of DHEA-sulfate above the normal range, suggesting that that dose is too high for some people. In this writer’s clinical experience, the average effective dose of DHEA is 10 mg per day (range, 5 to 15 mg per day) for women and 20 mg per day (range, 10 to 30 mg per day) for men. While DHEA is available without a prescription, it is a powerful steroid hormone, and a knowledgeable healthcare practitioner should supervise its use.
Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Three Rivers Press, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Three Rivers Press, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.
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