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Doctors' Answers to "Frequently Asked Questions" - Dehyroepiandosterone (DHEA)


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

DHEA
Question: What are the risks of using DHEA? Are there any studies and results that indicate near term or long term health risks for different dosages?

Answer: The well researched information on DHEA is not copious. The current risks are androgenic (male)effects such as acne, hair loss(male pattern baldness), hair development in male patterns(pelvis, chest, face) and deepening of the voice in women. There is a theoretical risk of prostate cancer in men-- especially in families prone to prostate cancer and concern about the potential risk of breast and uterine cancer in women. Dosing information is currently not available relative to these risks.

DHEA
Question: Can you tell me what this drug is used for?

Answer: DHEA is a short hand for dehyproepiandosterone. This is a steroid precursor of both male and female hormones. After several studies showing that high levels were inversely related to heart attacks, it has been used in an attempt to decrease cardiac mortality. It has also been used in patients with different types of cancers, AIDS, multiple sclerosis, etc. Most studies have demonstrated some improvement with use of the drug, especially in sense of well being. Changes in the basic disease processes have not generally been shown. Potential adverse effects include acne, hair loss, change in body habitus to more male patterns(deeper voice, hair distribution etc.) The sexual changes are usually irreversible. My personal recommendation is to wait to see further ongoing research in the risks and benefits. Most steroids have been shown to have potentially severe side effects, and I suspect this will be the case with DHEA. If you don't have a "dying" reason to take the drug, I'd wait.

DHEA
Question: Iím concerned about the use of DHEA supplement. I found out about it through a friend who is taking it with good results-- weight loss, energy level increased, just overall feels better. I started taking it 9 days ago, but I am concerned if I should be taking this. I do have hypothyroid disease but am not taking any current medication for this.

Answer: DHEA (dehydroepiandrosterone) has been popular for about 4-5 years as an adjunct medication. DHEA is a precursor molecule to the formation of androgen and estrogen (male and female steroids). Popularity arose after high levels were associated with decreased cardiovascular disease in men. Since then several trials have been performed in HIV patients, multiple sclerosis patients, etc. Most of these studies have seen an improvement in the subjective feeling of patients in terms of well being, strength, etc. However, objective measurement of improvement has not been found. Several studies have been performed on rats which suggests that DHEA might increase longevity. However, no well controlled long term studies on humans are available(currently in progress). My feeling is that this is a steroid type drug and in general there have not been good results with this class of drugs. I personally am awaiting for some bigger controlled trials before recommending it. I do not think that the benefit currently outweighs the risk. However, initial studies are promising.

DHEA
Question: I am currently taking DHEA supplements. However, my wife heard on the news that DHEA causes cancer and will be banned. How safe is it to take DHEA?

Answer: DHEA is the medical abbreviation for dehydroepiandrosterone. This is a steroid precursor of both male and female hormones. It has gotten a lot of press lately as a treatment for many problems. Mainly it is touted as an anti-aging and anti-cancer drug. It has also been found to be inversely related to cardiovascular death in men (curiously not in women). These studies are mainly based on animal data. Rats given DHEA lived longer with less cancer than rats not given the drug. Human studies are available, but are not well controlled or randomized. Studies in both patients with multiple sclerosis and AIDS patients found an improvement in the feeling of well being, without outcome change. This is similar to a study done in a mixed group of men and women (with blinded crossover) which showed an improvement in the feeling of well being. Long term studies in humans are lacking and the current studies lack reproducible outcomes. Side effects can include masculine features occurring in women (hair loss, growth of beard, acne, deepening of the voice, etc.). There is concern about the role of steroids in breast and prostate cancer (currently unresearched).

My personal feeling about DHEA is that human data is lacking. In the absence of other data I would let other people be guinea pigs for this drug. We know that steroids in general tend to have negative side effects and I doubt that I could convince anyone take the drug if it wasn't available without a prescription.

DHEA hormone supplement
Question: I've heard a lot about the use of DHEA for increasing testosterone levels, thereby increasing lean muscle mass and potentially elevating energy levels. How credible are these claims? What negative side effects or cautions should a person be aware of before taking such a drug? What are the differences in effect between a man taking DHEA vs. a woman? Is this a safe supplement to take and are there side affects that a person should take into account before trying this supplement?

Answer: DHEA is the medical abbreviation for dehydroepiandrosterone. This is a steroid precursor of both male and female hormones. It has gotten a lot of press lately as a treatment for many problems. Mainly it is touted as an anti-aging and anti-cancer drug. It has also been found to be inversely related to cardiovascular death in men (curiously not in women). These studies are mainly based on animal data. Rats given DHEA lived longer with less cancer than rats not given the drug. Human studies are available, but are not well controlled or randomized. Studies in both patients with multiple sclerosis and AIDS patients found an improvement in the feeling of well being without outcome change. This is similar to a study done in a mixed group of men and women (with blinded crossover) which showed an improvement in the feeling of well being. Long term studies in humans are lacking and the current studies lack reproducible outcomes. Side effects can include masculine features occurring in women (hair loss, growth of beard, acne, deepening of the voice, etc.). There is concern about the role of steroids in breast and prostate cancer (currently unresearched).

My personal feeling about DHEA is that human data is lacking. In the absence of other data I would let other people be guinea pigs for this drug. We know that steroids in general tend to have negative side effects and I doubt that I could convince anyone to take the drug if it wasn't available without a prescription.

Dehyroepiandosterone
Question: What is this medication and can it be used to aid in weight loss to increase the feeling of well-being? My husband heard a reporter on newscast claim of losing weight, etc. while taking this medication. Would appreciate any information you can give.

Answer: DHEA is the abbreviation for dehyroepiandosterone. It comes from a class of chemicals called steroids due to their particular molecular configuration. DHEA has received lots of attention in the media as a drug for perpetual "youth" also being investigated are the possibilities of this drug in different kinds of cancers, improving concentration and ability to deduct, heart disease, osteoporosis, and endocrine disorders-including diabetes mellitus. DHEA and DHEA-S are steroids naturally produced in everyone's adrenal glands and are especially high in women's plasma. Recently, a review was published by Casson, et al. in Reproductive Endocrinology (1995: 13:247-56). This review found that DHEA may play a role in the immune system and that supplementation may have a beneficial effect. Supplementation of DHEA have also been shown to change the bodies cholesterol levels; unfortunately, in the wrong direction. Other evidence is currently relatively slim concerning concentration, osteoporosis and other claims. Like many other things in medicine, the claims are present before the evidence, it may be that this drug is beneficial in selected areas. However, our general outlook is that steroid supplementation is potentially fraught with serious long term consequences.

Hormone Replacement
Question:I am male , 55 years , good health . Go through complete check-up every year. Have now been hinted by my Doctor that the DHEA replacement is NOT a bad idea. Suggestion also made to some of my friends when consulting their Gerontologist . Is DHEA effective? Is it safe? My level is around 240 microgram/dL ( DHEA S04 ) Thanks!re especially high in women's plasma. Recently, a review was published by Casson, et al. in Reproductive Endocrinology (1995: 13:247-56). This review found that DHEA may play a role in the immune system and that supplementation may have a beneficial effect. Supplementation of DHEA have also been shown to change the bodies cholesterol levels; unfortunately, in the wrong direction. Other evidence is currently relatively slim concerning concentration, osteoporosis and other claims. Like many other things in medicine, the claims are present before the evidence, it may be that this drug is beneficial in selected areas. However, our general outlook is that steroid supplementation is potentially fraught with serious long term consequences.

Answer:DHEA(dihydroepiandosterone) is one of the most popular drugs sold over the counter. It has received tremendous press about its ability to prolong life and treat numerous medical problems. Currently, research is in progress by the NIH to determine any beneficial effects. To date, research-mainly in rats- is mixed with no definite recommendations forthcoming. DHEA is a steroid ring and these generally cause side effects. Currently, we are not aware of major serious side effects. However? as the number of people using this drug and the length of time that they take it rises, the true side effect profile will emerge. My own personnal belief is to let others be the guinea pigs until definite research establishes the pros and cons of this drug.

Endocrtnology
Question:Are there any known side effects or negative implications with the use of DHEA Prohormone? Is it true all that is being claimed?

Answer:DHEA is the abbreviation for dehyroepiandrosterone. This is a steroid which is currently touted as a cure all. Human studies are fairly limited. There have been studies in HIV, Multiple Sclerosis, and Systemic Lupus patients. These have indicated an improvement in a feeling of well being without observed improvement in function or strength. In some women, there have been reports of virilizing changes-particulary hair loss and voice changes. Since, this is a steroid this isn't particularly surprising. I would recomment caution with this drug until further studies have been performed.

Premarin & DHEA
Question:my wife is taking premarin and another drug in a form of birth control pills to control her endometriosis. She is 43 and this was done to stop an early onset on menopause. She would like to start taking DHEA, the new 'miracle' hormone precursor. Why does it say on the bottle that if you are taking hormones, you should avoid this drug? Can she take DHEA and then reduce the other pills?

Answer:DHEA has gotten a lot of lay press touting its ability to decrease cancers and to increase longevity. While some early human studies have shown an improvement in a feeling of well being(done in AIDS, lupus, etc patients)-measureable improvement in the ongoing disease or any other measurable quantity has been lacking. DHEA is a steroid and has caused virilisization(male characteristics) of women. This drug should be used carefully until further research establishes benefits vs. risks. My own personal recommendation is to let others be the guinea pig until pros or cons are established.

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