DHEA: The Forgotten Anti-Aging Hormone

DHEA is the most abundant steroid hormone in the human body and is involved in the synthesis of testosterone, estrogen, progesterone, and corticosterone.

What is DHEA?

DHEA is short for Dehydroepiandrosterone and also known as androstenolone. This metabolite plays a vital role in the maintenance of hormonal balance and youthful vitality.

The human body derives DHEA from cholesterol via two enzymatic reactions. First, cholesterol is converted into pregnenolone, which is sometimes referred to as “the master hormone” due to its role as a precursor to the hormonal cascade that eventually gives rise to the primary sex hormones testosterone and estrogen. Next, pregnenolone is converted into DHEA (Traish 2011; Samaras 2013; Savineau 2013).

DHEA acts similar to a reservoir to the other hormones, therefore DHEA supplementation cannot take the place of testosterone or estrogen replacement hormonal plans. Of most interest is the inflammatory modulation properties of DHEA, since the inflammatory process is a driving force of many chronic diseases

A series of studies have shown that reduced levels of DHEA-S are linked with some underlying  age-associated disease states, including cognitive decline, cardiovascular disease, bone loss, cancer, depression, sexual dysfunction, and various inflammatory disorders (Samaras 2013; Traish 2011; Savineau 2013; Dong 2012; Zaluska 2009; Labrie 2009; Straub 2000; Krysiak 2008; Lopez-Marure 2011). The key term here is “linked” as there are likely many contributing factors and DHEA may only be one of them.

DHEA and Blood Sugar

When you have an elevated level of sugar molecules in your blood, they have a tendency to bond with other proteins in a formation called glycation and bombard the interior lining of blood vessels somewhat like a being in the middle of desert, naked, during a sandstorm.  These glycation end-products (AGEs) can also be formed outside of the body, but for the purposes of this article we will restrict the discussion to those formed within the body. Glycation makes cells stiffer, less pliable and more subject to premature aging and damage.

While glycation can’t be completely stopped, it can be slowed. Elimination of high-fructose corn syrup (HFCS), which can increase the rate of glycation 10x compared with glucose is a must.  The supplement carnosine may also help slow down the build-up of AGEs (Baynes, 2001., Takeushi, 2004). DHEA appears to increase insulin sensitivity and fight insulin resistance. A study showed that 50 mg of DHEA daily taken over 6 months led to a trend toward reduced insulin resistance (Talaei 2010). When low DHEA-S were combined with three other risk factors (testosterone deficiency, elevated high-sensitivity C-reactive protein, and high plasma N-terminal pro-B-type natriuretic peptide [NTproB]), the risk for cardiovascular mortality jumped a staggering 63-fold above healthy control subjects (Ponikowska 2009).

DHEA and Longevity

It may be considered “normal” for DHEA to decline as we age, however it is not desirable. Adrenal hypofunction, often to referred to as “adrenal fatigue” has become rampant in today’s society. The adrenal glands produce almost all of the body’s DHEA. As the function of this important gland decreases, so does the hormone. A recent study looked at the effects of DHEA supplementation in patients with Addison’s disease. In this randomized, double-blind trial, 39 patients (15 men and 24 women, aged 25-69) were given either 50 mg of DHEA daily for 12 weeks, followed by a 4-week washout period and then 12 weeks of placebo, or the opposite regimen (placebo/washout/DHEA). After DHEA supplementation, the patients’ blood levels of DHEA rose from subnormal to the normal range for young adults. More importantly, the patients taking DHEA showed positive psychological changes, including enhancements in self-esteem and mood, and a decrease in fatigue (Hunt, 2000).

The Baltimore Longitudinal Study of Aging, started in 1958,  has been carefully examining the aging process in more then 1000 people from ages 20 to 90. Among the many physiological factors that have been recorded in this study is the level of DHEAS in the blood – and it has been found that men with higher levels of DHEAS tend to live longer than men with lower levels.

Testing DHEA Levels

Before supplementing with DHEA, it is important to first test your levels to determine if you would be a candidate for replacement. If your levels are sub-optimal, it is recommended that your dosage be under the guidance of a medical professional experienced with hormone replacement therapies. Individuals with hormone sensitive cancers should not take DHEA.  Some rare side-effects may include liver problems, masculinization (in women), breast enlargement (in men), hair loss, aggression, acne, and insomnia.

Treatment

Your doctor will make a dosage recommendation based on your DHEA-S levels from your blood test. It is important that the treatment take into consideration the other hormones in the cascade and not only based upon the single DHEA level. Although DHEA can be bought over the counter in the United States, many physicians prefer to use a compounding pharmacy so that individualized dosage and potency may be controlled.

References
  1. Baynes JW. The role of AGEs in aging: causation or correlation. Exp Gerontol. 2001 Sep;36(9):1527-37.
  2. Dong Y, Zheng P. Dehydroepiandrosterone sulphate: action and mechanism in the brain. J Neuroendocrinol. 2012 Jan;24(1):215-24.
  3. Hunt PA, Gurnell EM, Huppert FA, et al. Improvement in mood and fatigue after dehydroepiandrosterone replacement in Addison’s disease in a randomized, double blind trail. J Clin Endocrin Metab 2000;85(12):4650-6.
  4. Rogers S, Detoxify or Die, Prestige Publishing, 2002
  5. Samaras et al., 2013. A review of age-related dehydroepiandrosterone decline and its association with well-known geriatric syndromes: is treatment beneficial? Rejuvenation Res. 2013 Aug;16(4):285-94. doi: 10.1089/rej.2013.1425.
  6. Savineau JP, Marthan R, Dumas de la Roque E, 2013. Role of DHEA in cardiovascular diseases. Biochem Pharmcol. Mar 15;85(6):718-24.
  7. Takeuchi M, Yamagishi S. TAGE (toxic AGEs) hypothesis in various chronic diseases. Med Hypotheses. 2004;63(3):449-52.
  8. Traish et al., 2011. Dehydroepiandrosterone (DHEA)—A Precursor Steroid or an Active Hormone in Human Physiology (CME) The Journal Of Sexual Medicine. Volume 8, Issue 11, pages 2960-2982, November 2011.

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