DHEA and anti-ageing : What's up ?

The dehydroepiandrosterone is an anabolic steroid hormone that the human adrenal glands naturally produce from the cholesterol. In the organism, more particularly on the brain, the adrenal, the ovaries, the testicles, the adipose tissues, the skin and the blood, we find it under the form of sulphate of DHEA (S-DHEA). It can serve to the organism as a starting material for the production of other hormones such as the oestrogen or the testosterone.

Despite a sensational publication with the general public, numerous recent studies relate that the efficacy of the DHEA is not demonstrated in a satisfying way for any therapeutic use.

Let’s review the different spheres of application relative tot the Medicine “Anti-Ageing”.

DHEA and Neuromuscular ageing

Although the publication of some favourable (and even enthusiastic) researches in medical revues has raised a vague of hopes in painting in glowing colours a mythic Fountain of Youth, the results of the clinical tests are rather mitigated, in reality. No effect of improvement of the muscular performances and of the endurance; no modification of the capacity to do the exercise.

DHEA and Osteoporosis

The study which makes the sellings of DHEA zoom up was directed by the Dr Étienne-Émile Baulieu and was published in 2000. The results to this doubly unknown test with placebo, led by the National Health and Medical Research Institute (France) with 280 persons aged from 60 to 79 years, indicated that a daily contribution of 50 mg of DHEA during one year could improve the bony metabolism of women over 70 years old. In 2001, in a synthesis of clinical test dealing with this question, french searchers yet concluded that, for the moment, we didn’t have at our disposal enough proves allowing to advise the DHEA to treat the symptoms of the menopause.

DHEA and Breakdown depression

The results of an epidemiological study dealing with around 700 menopausal women have allowed to observe a correlation between the breakdown depression and a weak rate of DHEA in the organism. The results of the two previous tests, doubly unknown with placebo (37 patients in all) suggest that the DHEA can improve the sate of patients suffering of major breakdown.

DHEA and Sexuality

A doubly unknown study with placebo led with 22 menopausal women has shown that the injection of an only and very high dose (300 mg) of DHEA had a positive effect on the sexual excitability. The results of a doubly unknown study with placebo, published in 1999 indicated that the taking of 5 mg of DHEA per day during six months can improve the sexuality of men suffering from erectile dysfunction, attributable to hypertension and of those whose sexual trouble isn’t provoked bye any pathological cause.

DHEA and Cardiovascular protection

The authors of a study having dealt with 20 menopausal women to whom we gave either a placebo, either 25 mg of DHEA per day during a year, have reported that this treatment had positive effects on some of the physiological parameters associated with the risk to contract cardiovascular problems after the menopause. The results of a doubly unknown test with placebo led with 24 men in their fifties suffering from hypercholesterolemia indicate that the supplementation of DHEA can reduce the risks of cardiovascular troubles.

DHEA and Cognitive functions

We concluded that for the moment, nothing allowed to confirm the hypothesis claiming that the DHEA improves the cognitive functions.

Counter-indications of the DHEA

The DHEA is counter-indicated to the persons of less than thirty years, pregnant or breast-feeding women, and persons suffering from breast, uterus, ovaries or prostate cancer.

Posology

The dosage depends on each person. First the individuals don’t all produce the same quantity of DHEA. Furthermore, the way of life, the medical antecedents and the metabolism have an influenced on the use of the DHEA. In France, for example, we proceed to an analysis of the rate of DHEA before prescribing it. In the USA, the generally recommended doses are of 25 mg per day for women and of 50 mg fro men. The effects can be felt after four to six months. The specialists deeply advise to inform you treating doctor before taking DHEA and to regularly submit to medical survey, notably for the prostate cancer.

Dosage of the SDHEA

Conclusion

The synthesis of the different searchers studying the DHEA in France and elsewhere thus is rather mitigated; a lot of uncertainties remain on the mode of action of the DHEA, as many others on the reality of the transformation of the Diogenine, contained in the commercial tablets, in DHEA.
On the whole if we had to remember one indication from our experiences of city medicine, we could evoke the case of menopausal women showing a context of asthenia and depressive psycho sexual state, all the more if it’s correlated with a little slow motion adrenal function. A supplementation of 50 mg pf DHEA or better of keto-DHEA, can be considered on a short period from 3 to 6 months, after measure of the blood rate of DHEA, of which the statistic fork given by the laboratories is very large…
But look out, the long-lived effect of a supplementation of DHEA are unknown. By the light of actual knowledge, it would be better to undertake a extended treatment only with a regular verification of the blood rates of cholesterol and of steroids, of the tolerance to glucose, and of the possible appearance of cancerous cells. An increase of the risk of hormone dependent cancers (breast, prostate, for example) is possible.

Bibliography

AFSSAPS,  Rapport du groupe d'experts sur la DHEA, Juillet 2001
AKWA Y., LADURELLE N., COVEY D.F., BAULIEU E.-E. The synthetic enantiomer of pregnenolone sulfate is very active on memory in rats and mice, even more so than its physiological neurosteroid counterpart : distinct mechanisms ? Proc Natl Acad Sci USA (2001) 98, 14033-14037
BEAULIEU E. THOMAS G. LEGRAIN S. et FORETTE F. DHEA, DHEA sulfate, and aging : contribution to the DHEAge study to a sociobiomedical issue. Proc Nal Acad Science USA 97, 4279-84, 2000
BRUCKEL J. Replacement and supplementation of DHEA--is it a wellness hormone? MMW Fortschr Med. 2005 Feb 17;147(7):30-2. 
MAZAT L., LAFONT S., BERR C., DEBUIRE B, TESSIER J.F., DARTIGUES J.F., BAULIEU E.-E. Prospective measurements of dehydroepiandrosterone sulfate in a cohort of elderly subjects : Relationship to gender, subjective health, smoking habits and 10-year mortality Proc. Natl. Acad. Sci. USA (2001) 98, 8145-8150
PARKER R. Dehydroepiandrosterone and dehydroepiandrosterone sulfate production in the human adrenal during development and aging STEROIDS 64 : 640-7, 1999)  
REITER WJ. SYCHA A. SCHATZL G. POKORNY A … and MARBERGER M. DHEA in the treatment of erectile dysfunction : a prospective, double blind,andomised, placebo controlled study. Urology 53 : 590-5, 1999
SCHUMACHER M., GHOUMARI A., GUENNOUN R., LABOMBARDA F., GONZALEZ S.L., GONZALEZ DENISELLE M.C., MASSAAD C., GRENIER J., RAJKOWSKI K.M., ROBERT F., BAULIEU E.E., and DE NICOLA A.F. Progestins and antiprogestins : mechanisms of action, neuroprotection and myelination. Hormones and the Brain.. Kordon et al. eds (Springer-Verlag Berlin, Heidelberg), 111-154, 2005.
SCHUMACHER, M., AKWA, Y., GUENNOUN, R., ROBERT, F., LABOMBARDA, F., DESARNAUD, F., ROBEL, P., DE NICOLA, A.F., BAULIEU, E.-E. Steroid synthesis and metabolism in the nervous system : Trophic and protective effects. Journal of Neurocytology (2000) 29, 307-326
YOUNG J. SCHAISON G. DHEA : Mythes et réalités. Reprod Hum Horm ;14 : 263-8 , 2001