Hormone fails to fulfil 'fountain of youth' billing

DOES IT WORK?DHEA for general health and vitality

ONE OF the steroid hormones produced naturally in the body is DHEA (shorthand for dehydroepiandrosterone). Research has shown that DHEA is involved in producing several compounds that impact many tissues and organs throughout the body.

When it was noted that DHEA levels start to fall off as people approach 30, connections were proposed between DHEA and ageing. In 1994, US regulators changed DHEA from an unapproved drug to a food supplement. It quickly became available in health food shops and on the internet, being promoted as the hormonal fountain of youth. Because it is a steroidal hormone, it remains a prescription-only medication in Ireland.

DHEA is said to relieve depression, give feelings of energy, boost libido, improve memory and generally improve wellbeing. Many of these symptoms accompany chronic illnesses, leading to wide interest in DHEA. Much promotion has been directed at women because their levels are generally lower than men for unknown reasons.

In spite of considerable research in recent years, much remains unknown about the DHEA’s role in the body. DHEA levels are lower during a number of chronic illnesses, including rheumatoid arthritis and major depression, and also during periods of high stress.

One area of considerable interest for DHEA is adrenal insufficiency. This condition is caused by several factors, and leads to the adrenal glands (located beside the kidneys) producing inadequate levels of several hormones.

DHEA is produced by these glands, and people with adrenal insufficiency produce little or no DHEA. Common symptoms include fatigue, muscle weakness, loss of appetite, mood changes, nausea, and dizziness or fainting from low blood pressure.

Conventional treatment involves steroid therapy, but even when this effectively restores steroid levels to normal, people’s quality of life often remains poor. Hence, there has been much interest in using DHEA to improve such patients’ general wellbeing.

A systematic review was published in October bringing together all the controlled research in women with adrenal insufficiency. Ten randomised controlled trials were found, with inconsistent results.

When these results were summarised statistically, they found an overall small benefit in quality of life and depression – what the authors rated as “clinically trivial”. The summary scores showed no benefits for anxiety, libido or sexual satisfaction.

Another systematic review of DHEA was published a couple of years ago in the Cochrane Library. This review found no evidence of DHEA benefiting elderly men and women who took it to improve memory and other cognitive functions. The evidence from other DHEA trials in men and women generally does not support a beneficial effect on wellbeing.

People in clinical trials frequently report side effects related to the fact that DHEA is a steroid hormone. Men taking DHEA supplements develop elevated levels of female hormones, while women develop higher levels of male hormones.

These are connected to the common side effects seen in women, including acne, itchy scalp, odorous sweat and, rarely, facial hair. However, some women found some of these effects beneficial, especially those with dry skin and hair who developed additional greasy secretions.

DHEA is a steroid hormone and should be treated with caution. Research demonstrates that DHEA is not a modern fountain of youth. As each new review is published, calls are made in the US to remove DHEA’s status as a food supplement. This recognises that while DHEA may have a legitimate role in the treatment of specific medical conditions, its widespread availability as a supplement is not warranted.

Although serious adverse effects have not been reported, taking any steroid regularly will disturb the complex balance of hormones that exist within the body. Much remains to be learned about why DHEA levels decrease with ageing, but boosting those levels indiscriminately is not warranted.

Dónal OMathúna has a PhD in pharmacy, researching herbal remedies, and an MA in bioethics, and is a senior lecturer in the School of Nursing, Dublin City University. He is author of Alternative Medicine: The Christian Handbook, Updated and Expanded Edition, Zondervan, 2007