Dehydroepiandrosterone, or DHEA, and dehydroepiandrosterone sulfate, or DHEAS, are biologically equivalent steroid hormones produced by your adrenal glands. DHEA can also be produced in the laboratory from plant sources, such as wild yam and soy. Humans cannot convert plant precursors to DHEA, so simply eating yam or soy will not increase your DHEA levels. Supplemental DHEA has been used for a variety of purposes, including prevention of aging, increasing muscle mass and strengthening bones. Its usefulness for preventing or treating osteoporosis in men is unproven. Ask your doctor if you should take DHEA.
Conversion
DHEA is produced from the enzymatic conversion of cholesterol in a multilevel metabolic pathway that generates progesterone, cortisol, aldosterone and other steroid hormones. DHEA serves as the direct precursor for androgens, such as androstenedione and testosterone, and estrogens, such as estrone, estriol and estradiol. DHEA, androgens and estrogens act directly on steroid receptors in a variety of tissues, including bone. A February 2010 review in "Clinical Calcium" reports that estrogens play a greater role in maintaining bone strength than androgens, but both classes of hormones participate in preventing osteoporosis.
Osteoporosis
DHEA levels decrease dramatically with aging, a change that parallels the onset of osteoporosis, say researchers at the University of California in San Diego. Although men are generally believed to be less affected by osteoporosis, an April 2003 "American Family Physician" review reveals that nearly 30 percent of osteoporotic hip fractures occur in men. While the role of estrogens in preventing osteoporosis in both sexes is well-established, that of testosterone and other androgens, including DHEA, is less clear.
Controversy
A study published in the March 2002 issue of the "Chinese Medical Journal" demonstrated that 44 men treated with 100 mg of DHEAs daily for six months exhibited improved bone density when compared to 42 men who received a placebo. DHEA's benefit was obtained without increases in free testosterone, estradiol or PSA levels, leading the study's authors to conclude that DHEA is safe and effective for treating osteoporosis in men. In contrast, the DHEA And Well-Ness Study followed 255 men and women who took 50 mg of DHEA daily for two years and concluded that DHEA was only modestly effective for preserving bone mass in women and that it provided no similar benefit in men.
Considerations
DHEA and DHEAS are equivalent androgen hormones which stimulate bone receptors in men and women. Although some studies suggest DHEA supplementation preserves bone mass in both sexes, others do not demonstrate appreciable benefits in men. Discrepancies may be due to varying DHEA dosages used in these studies, the length of the trials, differences among study subjects or a combination of factors. Daily DHEA dosages ranging from 50 to 100 mg are used in most trials.
Precaution
Scientific evidence supports the use of DHEA in adrenal insufficiency, induction of labor, depression and systemic lupus erythematosus, which is an autoimmune disease. However, DHEA can cause elevated levels of androgens and estrogens in your body, and no studies have evaluated the safety of long-term supplementation with DHEA. Therefore, your risk for hormone-sensitive cancers, such as prostate, breast, ovarian and uterine cancer, could be increased by taking DHEA. Ask your doctor if DHEA is appropriate for you.
References
- MedlinePlus: DHEA
- "Clinical Calcium"; Bone and Men's Health. The Role of Androgens in Bone Metabolism; K. Ashida, et al.; February 2010
- "Osteoporosis International"; Effect of Dehydroepiandrosterone Supplementation on Bone Mineral Density, Bone Markers, and Body Composition in Older Adults: The DAWN Trial; D. von Mühlen, et al.; May 2008
- "American Family Physician"; Osteoporosis in Men; J.M. Campion, M.J. Maricic; April 2003
- "Chinese Medical Journal"; Treatment of Osteoporosis in Men Using Dehydroepiandrosterone Sulfate; Y. Sun, et al.; March 2002
- MayoClinic.com: DHEA
