DHEA levels naturally decline with age. Does replenishing youthful levels have restorative effects?
DHEA: What Is It and What Are Its Benefits?
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Dehydroepiandrosterone (DHEA) is the most abundant steroid hormone circulating in the blood, or rather prohormone. It is produced largely by the adrenal glands, and is then converted locally in tissues into androgens (male sex hormones) or estrogens (female sex hormones). DHEA production in the body peaks between the ages of 25 to 35, and then gradually starts to decline about 2 percent every year. By one’s 80s, DHEA production is down about 80 percent from peak values in early adulthood.
Cross-sectional studies found a link between low DHEA levels and impaired sexual function, less vitality, depressed mood, lower bone mineral density, and compromised cognitive performance in terms of executive function, concentration, and memory. Combined with interventional studies done on rodents showing a wide range of beneficial effects, DHEA was heralded as an “anti-aging” “superhormone” “panacea”— even though rodent adrenal glands don’t even produce the stuff. But U.S. DHEA sales grew to more than $50 million a year on the premise that replenishing youthful levels might have restorative effects.
Given the Premarin debacle with estrogen replacement showing that the reversing of age-related hormonal decline can sometimes do more harm than good, clinical trials were desperately needed. But because DHEA can’t be patented, there has been little research interest among drug companies to study it. In fact, part of its mass appeal is that, due to a legal loophole, DHEA is the only steroid that’s not considered a controlled substance, and therefore is available over the counter as a “dietary supplement” rather than a prescription-only drug. Thankfully, a series of long-term, high-quality randomized controlled trials started to be published within the last 20 years, and early enthusiasm was replaced by a sober skepticism, as the quote-unquote “panacea” repeatedly failed to beat the placebo. The promised DHEA fountain of youth was drying up.
A review of about two dozen randomized controlled trials of oral DHEA in postmenopausal women failed to find evidence of improvements in sexual function, psychological well-being, or cognitive performance. However, there may be a role for intravaginal DHEA for vaginal atrophy, which I covered before. A meta-analysis of about two dozen randomized controlled trials of DHEA in elderly men similarly found no evidence of benefits for metabolism, bone health, sexual function, or quality of life, nor does there seem to be a cognitive benefit. The only benefit found in men was a relatively trivial drop in body fat compared to placebo (less than one pound over a span of eight months).
But in women, DHEA may benefit fertility. Fertility in women starts declining gradually but significantly at age 32 but then more rapidly after age 37. But DHEA may help.
Side effects of taking DHEA supplements include acne, oily skin and hair, and an increase in body hair and blood levels of the cancer-promoting growth hormone IGF-1. As with any supplement, there are concerns about quality control issues. Some so-called “DHEA” supplements just blatantly lie and have no DHEA whatsoever, or up to like 150 percent of the listed dose. For these and other reasons, DHEA supplements are not recommended.
Are there natural ways to boost DHEA, for example for the fertility benefit? Lower protein intake is associated with higher levels, and an interventional trial found increasing fiber intake actively raised levels. So, what about putting them together? Enter “Short-Term Impact of a Lactovegetarian Diet…” After just five days on an egg-free vegetarian diet, blood levels of the DHEA precursor rose nearly 20 percent. Or you can do it the other way; take those already eating a plant-based diet, and switch them to a conventional diet, and their DHEA drops up to nearly 20 percent. The bodies of those eating plant-based appear to hold onto the hormone better (less urinary excretion), which is normally something you only see in fasting.
Please consider volunteering to help out on the site.
- Chimote BN, Chimote NM. Dehydroepiandrosterone (DHEA) and its sulfate (DHEA-S) in mammalian reproduction: known roles and novel paradigms. Vitam Horm. 2018;108:223-250.
- Labrie F, Luu-The V, Bélanger A, et al. Is dehydroepiandrosterone a hormone? J Endocrinol. 2005;187(2):169-196.
- Samaras N, Papadopoulou MA, Samaras D, Ongaro F. Off-label use of hormones as an antiaging strategy: a review. Clin Interv Aging. 2014;9:1175-1186.
- Peixoto C, Carrilho CG, Barros JA, et al. The effects of dehydroepiandrosterone on sexual function: a systematic review. Climacteric. 2017;20(2):129-137.
- Kim MJ, Morley JE. The hormonal fountains of youth: myth or reality? J Endocrinol Invest. 2005;28(11 Suppl Proceedings):5-14.
- Vermeulen A. Dehydroepiandrosterone sulfate and aging. Ann N Y Acad Sci. 1995;774:121-127.
- Davis SR, Davison SL, Donath S, Bell RJ. Circulating androgen levels and self-reported sexual function in women. JAMA. 2005;294(1):91-96.
- Bell RJ, Donath S, Davison SL, Davis SR. Endogenous androgen levels and well-being: differences between premenopausal and postmenopausal women. Menopause. 2006;13(1):65-71.
- Barrett-Connor E, von Mühlen D, Laughlin GA, Kripke A. Endogenous levels of dehydroepiandrosterone sulfate, but not other sex hormones, are associated with depressed mood in older women: the Rancho Bernardo Study. J Am Geriatr Soc. 1999;47(6):685-691.
- Takayanagi R, Goto K, Suzuki S, Tanaka S, Shimoda S, Nawata H. Dehydroepiandrosterone (DHEA) as a possible source for estrogen formation in bone cells: correlation between bone mineral density and serum DHEA-sulfate concentration in postmenopausal women, and the presence of aromatase to be enhanced by 1,25-dihydroxyvitamin D3 in human osteoblasts. Mech Ageing Dev. 2002;123(8):1107-1114.
- Davis SR, Shah SM, McKenzie DP, Kulkarni J, Davison SL, Bell RJ. Dehydroepiandrosterone sulfate levels are associated with more favorable cognitive function in women. J Clin Endocrinol Metab. 2008;93(3):801-808.
- Rutkowski K, Sowa P, Rutkowska-Talipska J, Kuryliszyn-Moskal A, Rutkowski R. Dehydroepiandrosterone (DHEA): hypes and hopes. Drugs. 2014;74(11):1195-1207.
- Davis SR, Panjari M, Stanczyk FZ. Clinical review: DHEA replacement for postmenopausal women. J Clin Endocrinol Metab. 2011;96(6):1642-1653.
- Stewart PM. Aging and fountain-of-youth hormones. N Engl J Med. 2006;355(16):1724-1726.
- Celec P, Stárka L. Dehydroepiandrosterone - is the fountain of youth drying out? Physiol Res. 2003;52(4):397-407.
- Corona G, Rastrelli G, Giagulli VA, et al. Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo-controlled trials. J Clin Endocrinol Metab. 2013;98(9):3615-3626.
- Kritz-Silverstein D, von Mühlen D, Laughlin GA, Bettencourt R. Effects of dehydroepiandrosterone supplementation on cognitive function and quality of life: the DHEA and Well-Ness (Dawn) Trial. J Am Geriatr Soc. 2008;56(7):1292-1298.
- Xu L, Hu C, Liu Q, Li Y. The effect of dehydroepiandrosterone (DHEA) supplementation on IVF or ICSI: a meta-analysis of randomized controlled trials. Geburtshilfe Frauenheilkd. 2019;79(7):705-712.
- Tartagni M, Cicinelli MV, Baldini D, et al. Dehydroepiandrosterone decreases the age-related decline of the in vitro fertilization outcome in women younger than 40 years old. Reprod Biol Endocrinol. 2015;13:18.
- Xie M, Zhong Y, Xue Q, et al. Impact of dehydroepianrosterone (DHEA) supplementation on serum levels of insulin-like growth factor 1 (IGF-1): A dose-response meta-analysis of randomized controlled trials. Exp Gerontol. 2020;136:110949.
- Parasrampuria J, Schwartz K, Petesch R. Quality control of dehydroepiandrosterone dietary supplement products. JAMA. 1998;280(18):1565-1565.
- Goel RM, Cappola AR. Dehydroepiandrosterone sulfate and postmenopausal women. Curr Opin Endocrinol Diabetes Obes. 2011;18(3):171-176.
- Trichopoulou A, Bamia C, Kalapothaki V, Spanos E, Naska A, Trichopoulos D. Dehydroepiandrosterone relations to dietary and lifestyle variables in a general population sample. Ann Nutr Metab. 2003;47(3-4):158-164.
- Remer T, Pietrzik K, Manz F. The short-term effect of dietary pectin on plasma levels and renal excretion of dehydroepiandrosterone sulfate. Z Ernahrungswiss. 1996;35(1):32-38.
- Remer T, Pietrzik K, Manz F. Short-term impact of a lactovegetarian diet on adrenocortical activity and adrenal androgens. J Clin Endocrinol Metab. 1998;83(6):2132-2137.
- Hill P, Garbaczewski L, Helman P, Huskisson J, Sporangisa E, Wynder EL. Diet, lifestyle, and menstrual activity. Am J Clin Nutr. 1980;33(6):1192-1198.
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Dehydroepiandrosterone (DHEA) is the most abundant steroid hormone circulating in the blood, or rather prohormone. It is produced largely by the adrenal glands, and is then converted locally in tissues into androgens (male sex hormones) or estrogens (female sex hormones). DHEA production in the body peaks between the ages of 25 to 35, and then gradually starts to decline about 2 percent every year. By one’s 80s, DHEA production is down about 80 percent from peak values in early adulthood.
Cross-sectional studies found a link between low DHEA levels and impaired sexual function, less vitality, depressed mood, lower bone mineral density, and compromised cognitive performance in terms of executive function, concentration, and memory. Combined with interventional studies done on rodents showing a wide range of beneficial effects, DHEA was heralded as an “anti-aging” “superhormone” “panacea”— even though rodent adrenal glands don’t even produce the stuff. But U.S. DHEA sales grew to more than $50 million a year on the premise that replenishing youthful levels might have restorative effects.
Given the Premarin debacle with estrogen replacement showing that the reversing of age-related hormonal decline can sometimes do more harm than good, clinical trials were desperately needed. But because DHEA can’t be patented, there has been little research interest among drug companies to study it. In fact, part of its mass appeal is that, due to a legal loophole, DHEA is the only steroid that’s not considered a controlled substance, and therefore is available over the counter as a “dietary supplement” rather than a prescription-only drug. Thankfully, a series of long-term, high-quality randomized controlled trials started to be published within the last 20 years, and early enthusiasm was replaced by a sober skepticism, as the quote-unquote “panacea” repeatedly failed to beat the placebo. The promised DHEA fountain of youth was drying up.
A review of about two dozen randomized controlled trials of oral DHEA in postmenopausal women failed to find evidence of improvements in sexual function, psychological well-being, or cognitive performance. However, there may be a role for intravaginal DHEA for vaginal atrophy, which I covered before. A meta-analysis of about two dozen randomized controlled trials of DHEA in elderly men similarly found no evidence of benefits for metabolism, bone health, sexual function, or quality of life, nor does there seem to be a cognitive benefit. The only benefit found in men was a relatively trivial drop in body fat compared to placebo (less than one pound over a span of eight months).
But in women, DHEA may benefit fertility. Fertility in women starts declining gradually but significantly at age 32 but then more rapidly after age 37. But DHEA may help.
Side effects of taking DHEA supplements include acne, oily skin and hair, and an increase in body hair and blood levels of the cancer-promoting growth hormone IGF-1. As with any supplement, there are concerns about quality control issues. Some so-called “DHEA” supplements just blatantly lie and have no DHEA whatsoever, or up to like 150 percent of the listed dose. For these and other reasons, DHEA supplements are not recommended.
Are there natural ways to boost DHEA, for example for the fertility benefit? Lower protein intake is associated with higher levels, and an interventional trial found increasing fiber intake actively raised levels. So, what about putting them together? Enter “Short-Term Impact of a Lactovegetarian Diet…” After just five days on an egg-free vegetarian diet, blood levels of the DHEA precursor rose nearly 20 percent. Or you can do it the other way; take those already eating a plant-based diet, and switch them to a conventional diet, and their DHEA drops up to nearly 20 percent. The bodies of those eating plant-based appear to hold onto the hormone better (less urinary excretion), which is normally something you only see in fasting.
Please consider volunteering to help out on the site.
- Chimote BN, Chimote NM. Dehydroepiandrosterone (DHEA) and its sulfate (DHEA-S) in mammalian reproduction: known roles and novel paradigms. Vitam Horm. 2018;108:223-250.
- Labrie F, Luu-The V, Bélanger A, et al. Is dehydroepiandrosterone a hormone? J Endocrinol. 2005;187(2):169-196.
- Samaras N, Papadopoulou MA, Samaras D, Ongaro F. Off-label use of hormones as an antiaging strategy: a review. Clin Interv Aging. 2014;9:1175-1186.
- Peixoto C, Carrilho CG, Barros JA, et al. The effects of dehydroepiandrosterone on sexual function: a systematic review. Climacteric. 2017;20(2):129-137.
- Kim MJ, Morley JE. The hormonal fountains of youth: myth or reality? J Endocrinol Invest. 2005;28(11 Suppl Proceedings):5-14.
- Vermeulen A. Dehydroepiandrosterone sulfate and aging. Ann N Y Acad Sci. 1995;774:121-127.
- Davis SR, Davison SL, Donath S, Bell RJ. Circulating androgen levels and self-reported sexual function in women. JAMA. 2005;294(1):91-96.
- Bell RJ, Donath S, Davison SL, Davis SR. Endogenous androgen levels and well-being: differences between premenopausal and postmenopausal women. Menopause. 2006;13(1):65-71.
- Barrett-Connor E, von Mühlen D, Laughlin GA, Kripke A. Endogenous levels of dehydroepiandrosterone sulfate, but not other sex hormones, are associated with depressed mood in older women: the Rancho Bernardo Study. J Am Geriatr Soc. 1999;47(6):685-691.
- Takayanagi R, Goto K, Suzuki S, Tanaka S, Shimoda S, Nawata H. Dehydroepiandrosterone (DHEA) as a possible source for estrogen formation in bone cells: correlation between bone mineral density and serum DHEA-sulfate concentration in postmenopausal women, and the presence of aromatase to be enhanced by 1,25-dihydroxyvitamin D3 in human osteoblasts. Mech Ageing Dev. 2002;123(8):1107-1114.
- Davis SR, Shah SM, McKenzie DP, Kulkarni J, Davison SL, Bell RJ. Dehydroepiandrosterone sulfate levels are associated with more favorable cognitive function in women. J Clin Endocrinol Metab. 2008;93(3):801-808.
- Rutkowski K, Sowa P, Rutkowska-Talipska J, Kuryliszyn-Moskal A, Rutkowski R. Dehydroepiandrosterone (DHEA): hypes and hopes. Drugs. 2014;74(11):1195-1207.
- Davis SR, Panjari M, Stanczyk FZ. Clinical review: DHEA replacement for postmenopausal women. J Clin Endocrinol Metab. 2011;96(6):1642-1653.
- Stewart PM. Aging and fountain-of-youth hormones. N Engl J Med. 2006;355(16):1724-1726.
- Celec P, Stárka L. Dehydroepiandrosterone - is the fountain of youth drying out? Physiol Res. 2003;52(4):397-407.
- Corona G, Rastrelli G, Giagulli VA, et al. Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo-controlled trials. J Clin Endocrinol Metab. 2013;98(9):3615-3626.
- Kritz-Silverstein D, von Mühlen D, Laughlin GA, Bettencourt R. Effects of dehydroepiandrosterone supplementation on cognitive function and quality of life: the DHEA and Well-Ness (Dawn) Trial. J Am Geriatr Soc. 2008;56(7):1292-1298.
- Xu L, Hu C, Liu Q, Li Y. The effect of dehydroepiandrosterone (DHEA) supplementation on IVF or ICSI: a meta-analysis of randomized controlled trials. Geburtshilfe Frauenheilkd. 2019;79(7):705-712.
- Tartagni M, Cicinelli MV, Baldini D, et al. Dehydroepiandrosterone decreases the age-related decline of the in vitro fertilization outcome in women younger than 40 years old. Reprod Biol Endocrinol. 2015;13:18.
- Xie M, Zhong Y, Xue Q, et al. Impact of dehydroepianrosterone (DHEA) supplementation on serum levels of insulin-like growth factor 1 (IGF-1): A dose-response meta-analysis of randomized controlled trials. Exp Gerontol. 2020;136:110949.
- Parasrampuria J, Schwartz K, Petesch R. Quality control of dehydroepiandrosterone dietary supplement products. JAMA. 1998;280(18):1565-1565.
- Goel RM, Cappola AR. Dehydroepiandrosterone sulfate and postmenopausal women. Curr Opin Endocrinol Diabetes Obes. 2011;18(3):171-176.
- Trichopoulou A, Bamia C, Kalapothaki V, Spanos E, Naska A, Trichopoulos D. Dehydroepiandrosterone relations to dietary and lifestyle variables in a general population sample. Ann Nutr Metab. 2003;47(3-4):158-164.
- Remer T, Pietrzik K, Manz F. The short-term effect of dietary pectin on plasma levels and renal excretion of dehydroepiandrosterone sulfate. Z Ernahrungswiss. 1996;35(1):32-38.
- Remer T, Pietrzik K, Manz F. Short-term impact of a lactovegetarian diet on adrenocortical activity and adrenal androgens. J Clin Endocrinol Metab. 1998;83(6):2132-2137.
- Hill P, Garbaczewski L, Helman P, Huskisson J, Sporangisa E, Wynder EL. Diet, lifestyle, and menstrual activity. Am J Clin Nutr. 1980;33(6):1192-1198.
Motion graphics by Avo Media
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DHEA: What Is It and What Are Its Benefits?
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Content URLDoctor's Note
What about injections of human growth hormone for anti-aging benefits? See my last video The Side Effects of Human Growth Hormone as an Anti-Aging Therapy for more on that.
For background on the Premarin debacle I mentioned, see How Did Doctors Not Know About the Risks of Hormone Therapy?.
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