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DHEA

Other common name(s): none

Scientific/medical name(s): dehydroepiandrosterone, prasterone

Description

Dehydroepiandrosterone (DHEA) is a steroid hormone produced by the adrenal gland. The body converts it into other important hormones, including the sex hormones estrogen and testosterone. It is normally found in humans, plants, and animals and is available as a dietary supplement.

Wild yam plant extract, also available as a dietary supplement, is thought by some to contain substances from which the body can make DHEA. However, there is no scientific evidence available to suggest that the body can convert any part of the wild yam or its extract into hormones such as DHEA.

Overview

Available scientific evidence does not support claims that DHEA supplements are safe or effective for treating cancer. Caution is advised in their use in people who have cancer, especially types of cancer that respond to hormones, such as certain types of breast cancer, prostate cancer, and uterine cancer. People younger than 30 may run the risk of suppressing the body's natural production of DHEA if they take DHEA supplements. While there are hints that DHEA may have some use in treating certain hormone deficiencies, autoimmune diseases, and mood and memory problems of older age, more research is needed to determine its long-term safety and effectiveness.

How is it promoted for use?

Supporters suggest that DHEA supplements may prevent the growth and recurrence of some types of cancer, protect against heart disease, improve memory, reduce the risk of osteoporosis in women, and help prevent other diseases such as diabetes, Parkinson disease, and Alzheimer disease. Some say that DHEA may be an effective treatment for lupus, colitis, and depression.

Since the body's natural levels of DHEA usually begin to decline after a person reaches 30 years of age, some claim that the supplements can help slow the aging process. Some supporters also contend that DHEA boosts the immune system, reduces fat, builds muscle, promotes sleep, increases a person's overall sense of well-being, and increases sex drive.

What does it involve?

DHEA is taken by mouth or applied to the skin. It is made into tablets, capsules, and creams and can also be made into a tea. There are no widely accepted dosage guidelines for DHEA.

What is the history behind it?

DHEA was first discovered in the 1930s. Over the next 50 years, researchers learned that it was made by the adrenal glands and was a precursor to other steroid hormones in the body. Some early research in laboratory animals hinted that it might be helpful in certain conditions, although it now appears that the role of DHEA in humans is different from its role in rodents and other animals. No large studies were reported in humans before the 1990s.

DHEA was banned by the U.S. Food and Drug Administration (FDA) in 1985 because of its unproven safety and effectiveness. This ban was removed by the 1994 Dietary Supplement Health & Education Act, and DHEA supplements became available to the public soon after. The National Football League (NFL), the National Basketball Association (NBA), and some other sports groups do not allow players to use DHEA because of the concern that its effects may be similar to those of anabolic (muscle-building) steroids.

What is the evidence?

Very few valid clinical research studies have been done on the link between DHEA supplements and improved health. Some studies have looked at the relationship between DHEA levels in the body and certain diseases, with mixed and sometimes conflicting results.

Available scientific evidence does not support claims that DHEA can slow down or prevent the growth of cancer in humans. Some early laboratory studies found that DHEA can slow the growth of certain types of cancer cells. Others, however, found that DHEA causes some cancer cell lines, such as prostate cancer cells, to grow more quickly. One animal study concluded that DHEA had no influence on either cancer or life span.

One study found no relationship between DHEA levels in the blood and the risk of breast cancer in post-menopausal women, while another found that a high level of DHEA in the blood was linked to a higher risk of breast cancer among women older than 45 years. Although this second study observed a statistical correlation but did not test the effect of DHEA supplements on breast cancer risk, it does raise concern that intentionally increasing a woman's DHEA levels may be unsafe.

Some studies have also looked the relationship between DHEA and heart disease. One early study showed that men who had high levels of DHEA in their blood were less likely to have died of heart disease, but women who had high DHEA levels were at greater risk of dying of heart disease. A recent analysis of the research found that there was little association between levels of DHEA and heart disease in men or women.

In addition, DHEA has been studied for any possible benefit for other health condition. No clinical research has convincingly shown that DHEA supplements increase muscle mass, reduce fat, or prevent disease. A study of humans taking DHEA supplements suggested that it may help treat lupus, an autoimmune disease. DHEA's ability to stimulate the immune system is being studied in clinical trials. A 2005 double-blind clinical trial of older women with fibromyalgia found that, although DHEA supplements raised blood levels of DHEA, they did not help with pain, tiredness, mood, brain function, or other quality of life measures.

A small pilot study suggested that DHEA may improve mood, energy, libido, and, in some cases, memory performance in the elderly. However, an analysis of studies available to date showed no convincing evidence that DHEA improved memory in older adults. Some early test results raise the possibility of DHEA being useful in older people with depression, although larger, double-blind clinical trials are needed. DHEA may help some people with adrenal insufficiency (poorly working adrenal glands).

Are there any possible problems or complications?

This product is sold as a dietary supplement in the United States. Unlike companies that produce drugs (which must provide the FDA with results of detailed testing showing their product is safe and effective before the drug is approved for sale), the companies that make supplements do not have to show evidence of safety or health benefits to the FDA before selling their products. Supplement products without any reliable scientific evidence of health benefits may still be sold as long as the companies selling them do not claim the supplements can prevent, treat, or cure any specific disease. Some such products may not contain the amount of the herb or substance that is written on the label, and some may include other substances (contaminants).
Though the FDA has written new rules to improve the quality of manufacturing processes for dietary supplements and the accurate listing of supplement ingredients, these rules do not take full effect until 2010. And, the new rules do not address the safety of supplement ingredients or their effects on health when proper manufacturing techniques are used.
Most such supplements have not been tested to find out if they interact with medicines, foods, or other herbs and supplements. Even though some reports of interactions and harmful effects may be published, full studies of interactions and effects are not often available. Because of these limitations, any information on ill effects and interactions below should be considered incomplete.

It is not known whether DHEA is safe for long-term use. Some researchers believe DHEA supplements might actually raise the risk of breast cancer, prostate cancer, heart disease, diabetes, and stroke. DHEA may stimulate tumor growth in types of cancer that are sensitive to hormones, such as some types of breast, uterine, and prostate cancer. DHEA may increase prostate swelling in men with benign prostatic hyperplasia, or BPH, an enlarged prostate gland.

DHEA is a steroid hormone. High doses may cause aggressiveness, irritability, trouble sleeping, and the growth of body or facial hair on women. It also may stop menstruation and lower the levels of HDL, or "good," cholesterol, which could raise the risk of heart disease. Other reported side effects include acne, heart rhythm problems, liver problems, hair loss (from the scalp), and oily skin. It may also alter the body's regulation of blood sugar.

DHEA should not be used with tamoxifen, as it may promote tamoxifen resistance. Patients on hormone replacement therapy may have more estrogen-related side effects when taking DHEA. This supplement may also interfere with other medicines, and potential interactions between it and drugs and herbs should be considered. Always tell your doctor and pharmacist about any supplements and herbs you are taking.

Women who are pregnant or breastfeeding should not use DHEA. Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.

Additional resources

More information from your American Cancer Society

The following information on complementary and alternative therapies may also be helpful to you. These materials may be found on our Web site (www.cancer.org) or ordered from our toll-free number (1-800-ACS-2345).

Dietary Supplements: What Is Safe?

The ACS Operational Statement on Complementary and Alternative Methods of Cancer Management

Complementary and Alternative Methods and Cancer

Placebo Effect

Learning About New Ways to Treat Cancer

Learning About New Ways to Prevent Cancer

References

Arnold JT, Le H, McFann KK, Blackman MR. Comparative effects of DHEA vs. testosterone, dihydrotestosterone, and estradiol on proliferation and gene expression in human LNCaP prostate cancer cells. Am J Physiol Endocrinol Metab. 2005 Mar;288(3):E573-584. Epub 2004 Nov 9.

Finckh A, Berner IC, Aubry-Rozier B, So AK. A randomized controlled trial of dehydroepiandrosterone in postmenopausal women with fibromyalgia. J Rheumatol. 2005 Jul;32(7):1336-40.

Grimley Evans J, Malouf R, Huppert F, van Niekerk JK. Dehydroepiandrosterone (DHEA) supplementation for cognitive function in healthy elderly people. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD006221.

Igwebuike A, Irving BA, Bigelow ML, Short KR, McConnell JP, Nair KS. Lack of dehydroepiandrosterone effect on a combined endurance and resistance exercise program in postmenopausal women. J Clin Endocrinol Metab. 2008;93:534-538.

Kaaks R, Berrino F, Key T, Rinaldi S, Dossus L, Biessy C, et al. Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst. 2005 May 18;97(10):755-765.

Memorial Sloan Kettering Cancer Center. Dehydroepiandrosterone. Accessed at:

http://www.mskcc.org/mskcc/html/69201.cfm on June 11, 2008.

PDRhealth. DHEA. Accessed at: www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/dhe_0094.shtml on June 11, 2008.

Pugh TD, Oberley TD, Weindruch R. Dietary intervention at middle age: Caloric restriction but not dehydroepiandrosterone sulfate increases lifespan and lifetime cancer incidence in mice. Cancer Res. 1999;59:1642-1648.

Schardt D. Remembering gingko & DHEA; claims of dietary supplement have not been proven. Nutr Action Healthletter. 1998;25:9.

Tworoger SS, Missmer SA, Eliassen AH, Spiegelman D, Folkerd E, Dowsett M, Barbieri RL, Hankinson SE. The association of plasma DHEA and DHEA sulfate with breast cancer risk in predominantly premenopausal women. Cancer Epidemiol Biomarkers Prev. 2006;15:967-971.

Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation.

Last Medical Review: 11/01/2008
Last Revised: 11/01/2008