Continual adrenal cortex suppressive glucocorticoid treatments are partially to blame for the low levels of dehydroepiandrosterone that occur in those with lupus. Decreased levels can be seen even in those who do not undergo such treatment procedures. Dehydroepiandrosterone replacement is sometimes used as a treatment for women for lupus activity reduction and has shown modest results. DHEA is not used as a treatment for men, although it is a popular combatant of erectile dysfunction.
Lupus
Systemic lupus erythematosus is an autoimmune disease of chronic inflammation and unknown cause that affects multiple organ systems. The vast majority of sufferers of lupus are largely female with the addition of African-Americans and Asians, who seem to possess a greater susceptibility to the disease than members of other races. Onset can occur at any age, but it often emerges at ages 10 to 50. The disease is known to peak during years of highest fertility and is exacerbated by pregnancy and oral contraceptive use. Symptoms include chest pain with breathing, lethargy, fever, malaise, loss of hair, sunlight sensitivity, facial rash and painful sores on the inside of the mouth. Lupus is known to affect the central nervous system, heart, skin, digestive tract and lungs, causing other symptoms.
DHEA
In the body, adrenal steroid hormones dehydroepiandrosterone, or DHEA, and DHEA sulphate are metabolized into more active steroids like testosterone, androstenedione, and estrogen. Adrenal insufficiency as a result of lupus causes the level of DHEA to dip below normal, allowing for hormonal imbalances and sexual dysfunction. In past clinical trials on women, doses of 50 to 200 mg/day of DHEA were applied, yielding higher than normal DHEA sulphate body levels. These trials cited androgenic side effects for cessation of the drug's use. A study published in "Journal of Autoimmuinty" in November 2005 found that a DHEA supplement of 20 to 30 mg per day for women with lupus was well received and exhibited few side effects. Significant improvements of well-being and sexuality were seen, whereas other symptoms were not alleviated. The researchers suggested that larger, long-term studies are needed to confirm the beneficial effect of DHEA and evaluate androgen replacement in women with lupus.
Side Effects
DHEA is known to cause acne in those with mild to moderate lupus, and many studies have reported unpleasant, androgen-induced body-hair growth and weight gain in females. It is unknown whether or not DHEA replacement therapy as a treatment for lupus causes serious long-term side effects, evidenced by the insufficient amount of test subjects in studies and inadequate study length. The longest study was carried out over the course of a year. Further research is needed.
Treatment for Mild Cases
Although lupus has no known cure, many treatments are available to control symptoms and increase total quality of life. Mild cases can be treated with non-steroidal anti-inflammatory medications for arthritis and pleurisy, while corticosteroid creams can be used for skin rashes. A drug commonly used for malaria is also known to treat arthritis and skin conditions, and corticosteroids in low-doses are available as well. Full-coverage clothing, protective eye-wear and sunscreen should be worn outside and sun exposure should be limited whenever possible.
Treatment for Severe Cases
Serious symptoms require more aggressive treatment measures by specialists and may include high doses of corticosteroids to prevent the body from attacking itself or even cytotoxic drugs that block cell growth. Some medications can have severe side effects and require the close monitoring of a physician. Screens for osteoporosis, preventative heart care, current immunizations and a well-balanced diet are important, bur how well a person fares depends on disease severity.
References
- "Journal of Autoimmunity"; Effects of Dehydroepiandrosterone Supplement on Health-Related Quality of Life in Glucocorticoid Treated Female Patients With Systemic Lupus Erythematosus; Gunnel Nordmark, et al.; Nov. 2005
- "Cochrane Reviews"; Dehydroepiandrosterone for Systemic Lupus Erythematosus; D. Crosbie, et al.; 2007
- PubMed Health: Systemic Lupus
