Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal gland and is a precursor of estrogens and androgens. Effects on the body are similar to those of testosterone. DHEA can also be synthesized from precursors in the wild Mexican yam; this form is the most commonly available. However, consumption of wild yam is not recommended as a supplement as the body is unable to convert the precursors to DHEA.
(See also Overview of Dietary Supplements.)
Claims
DHEA supplements are said to improve mood, energy, sense of well-being, and the ability to function well under stress. They are also said to improve muscle strength and athletic performance, stimulate the immune system, deepen nightly sleep, lower cholesterol levels, decrease body fat, build muscles, increase bone mineral density, relieve depression, reverse aging, improve the appearance of aging skin, improve brain function in patients with Alzheimer disease, treat infertility in females undergoing assisted reproduction, increase libido, and decrease symptoms of systemic lupus erythematosus. A prescription DHEA ovule or suppository has been used to treat vaginal atrophy.
Evidence
The medicinal claims of DHEA have not been fully supported by the evidence. In addition, DHEA is banned by numerous professional sports organizations as it is classified as a "prohormone."
DHEA levels are known to naturally decrease with age and therefore people in search of the unattainable fountain of youth have turned to DHEA supplementation as a possible solution to ailments associated with age. Studies have been reported showing both positive and negative results. More thorough studies are warranted not only with aging but with all clinical health conditions.
An analysis of data from 4 randomized controlled trials in women and men aged ≥ 55 years found that daily supplementation of DHEA compared to placebo resulted in significant increases in lumbar spine and trochanter bone mineral density in women but not men, although men had a significant decrease in fat mass (1).
A 2013 meta-analysis of data collected from studying 1353 older men in a number of trials indicated that DHEA supplementation was associated with a reduction of fat mass; however, no effect was observed for numerous other clinical parameters, including lipid and glycemic metabolism, bone health, sexual function, or quality of life (2). A similar analysis was performed in women with adrenal insufficiency and indicated that DHEA supplementation may improve the quality of life and symptoms of depression, while having no effect on anxiety and sexual well-being (3).
A 2020 systematic review and meta-analysis of 15 randomized controlled trials in 853 subjects reported that, compared to placebo, DHEA significantly improved depressive symptoms. However, the authors stated there was low quality of evidence because included studies had small populations with varying psychiatric diagnoses, and the results were divergent (4).
A 2006 systematic review of 5 studies found little evidence of a beneficial effect of DHEA supplementation on cognitive function of middle‐aged or older people who did not have dementia (5).
The Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines on complementary and alternative medicine treatments for depression treatment have stated that DHEA may be considered as third-line treatment for depression (6).
Adverse Effects
Adverse effects are unclear. There are theoretical risks of gynecomastia in men, hirsutism in women, acne, headache, mood changes, and stimulation of prostate, liver, and breast cancers. It may decrease HDL cholesterol, increase triglycerides, and worsen polycystic ovarian syndrome (PCOS). There are case reports of mania and one of seizure.
Drug Interactions
(See also table Some Possible Dietary Supplement–Drug Interactions.)
References
1. Jankowski CM, Wolfe P, Schmiege SJ, et al: Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition: a pooled analysis of four clinical trials. Clin Endocrinol (Oxf) 90(2): 293-300, 2019. doi: 10.1111/cen.13901
2. Corona G, Rastrelli G, Giagulli V, et al: Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo controlled trials. J Clin Endocrinol Metab 98(9):3615-3626, 2013. doi: 10.1210/jc.2013-1358
3. Alkatib AA, Cosma M, Elamin MB, et al: A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency. J Clin Endocrinol Metab 94(10):3676-3781, 2009. doi: 10.1210/jc.2009-0672
4. Peixoto C, José Grande A, Gomes Carrilho C, et al: Dehydroepiandrosterone for depressive symptoms: a systematic review and meta-analysis of randomized controlled trials. J Neurosci Res 98(12):2510-2528, 2020. doi:10.1002/jnr.24721
5. 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(4):CD006221, 2006. doi:10.1002/14651858.CD006221
6. Ravindran AV, Balneaves LG, Faulkner G, et al: Canadian network for mood and anxiety treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: Section 5. Complementary and alternative medicine treatments. Can J Psychiatry 61(9): 576-587, 2016. doi: 10.1177/0706743716660290
More Information
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
National Institutes of Health (NIH), National Center for Complementary and Integrative Health: General information for patients about complementary health practices for menopausal symptoms
