Dehydroepiandrosterone (DHEA): hypes and hopes

Area of Science:

• Endocrinology
• Immunology
• Gerontology

Background:

• Dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) are abundant human steroid hormones.
• Low levels are linked to age-related decline and reduced lifespan in animal models.
• DHEA has been marketed as an anti-aging supplement, with recent human studies investigating its efficacy.

Purpose of the Study:

• To evaluate the evidence supporting DHEA's purported 'anti-aging' and therapeutic claims in humans.
• To review DHEA's effects on immune function, physical and psychological well-being, and various disease states.
• To identify factors contributing to inconsistent study results and determine the potential clinical utility of DHEA.

Main Methods:

• Review of recent double-blind, placebo-controlled human studies.
• Analysis of DHEA's effects in elderly populations, individuals with adrenal insufficiency, systemic lupus erythematosus, inflammatory bowel disease, cardiovascular conditions, asthma, and allergies.
• Examination of DHEA's impact on hormonal levels, immune cell counts, physical function, and disease-specific markers.

Main Results:

• DHEA demonstrates immunomodulatory effects, increasing monocytes, TCRγδ T cells, and NK cells in the elderly.
• Improvements observed in physical/psychological well-being, muscle strength, bone density, and skin health.
• Benefits noted in adrenal insufficiency, including improved lipid profiles, insulin sensitivity, and bone density.
• DHEA shows potential as a steroid-sparing agent in lupus and may induce remission in inflammatory bowel disease.
• Cardiovascular benefits include modulation of signaling pathways, anti-inflammatory effects, and vasorelaxation.
• Protective effects against asthma and allergies by attenuating inflammation and hyperreactivity.
• Improved sexual satisfaction, fertility, and vaginal atrophy in women.

Conclusions:

• DHEA is more than a supplement, showing therapeutic potential for specific human diseases.
• Inconsistent results stem from reliance on animal models, non-pharmacological doses, rapid metabolism, and comorbidities.
• Large-scale randomized controlled trials are essential to define DHEA's clinical indications and optimal dosing.