Posted by JLx on October 12, 2003, at 10:00:04
In reply to DHEA - pros? cons?, posted by JLx on October 12, 2003, at 9:54:53
Dehydroepiandrosterone (DHEA)
(Dehydroepiandrosterone)
DHEA has been heavily publicized for its potential use as an anti-aging agent. It is a hormone that functions as a precursor for the production of more than 50 other hormones in the body. It is estimated that from 30 to 50 percent of testosterone in men and about 75 percent of estrogen in women is derived from DHEA. Human production of DHEA normally peaks during a person’s mid-20s and then begins a steady, progressive decline.
DHEA is only produced in the bodies of humans and other primates such as monkeys and apes. There are no good dietary sources of DHEA other than supplementation.
Drug/Nutrient InteractionsAntidepressants
Estrogen and estrogen-like medications
Anticoagulant medications
Central nervous system stimulants
Diabetic / Hypoglycemic medications
Much of the press on DHEA has covered its potential use in slowing the aging process. Studies have suggested that DHEA can enhance muscle strength and lean body mass while boosting immunity. Other benefits may include enhanced energy and sex drive, improved mood and sleep patterns, and a greater capacity to deal with stress.(1) Further studies in animals suggest that DHEA may be helpful for such conditions as obesity, cancer and Alzheimer’s disease.More extensive studies on the use of DHEA in the treatment of depression in elderly people have also yielded promising results.(2) DHEA may improve symptoms of diabetes and lupus.(3, 4, 5) DHEA is also being evaluated for its anti-inflammatory and antioxidant behavior,(6, 7) possibly playing a role in the prevention of atherosclerosis.(8) Recent laboratory work indicates that DHEA may play a role in the prevention and growth of cancerous tumors though the reason why is still unclear.(9, 10)
DHEA has exhibited some promise in easing the symptoms of menopause. As women get older and approach menopause, their DHEA levels begin to decrease. One study showed that among the group of women studied, the older women with lower DHEA levels had more symptoms of depression.(11) Other studies have confirmed that overall mental health is not as good in peri- and postmenopausal women when DHEA levels are low.(12)
DHEA supplementation has improved sexual arousal in postmenopausal women.(13) A study involving 120 postmenopausal women between the ages of 51 and 99 has noted that good DHEA-sulfate levels are directly related to good bone mineral density.(14) One study suggests that long-term use of DHEA may decrease certain cardiovascular risks in postmenopausal women.(15) Also, in postmenopausal women, DHEA has shown similar hormonal effects as estrogen-progestin replacement therapy.(16)
AIDS and HIV are also areas of DHEA research. It has been reported that DHEA reduces the replication of the HIV-1 virus.(17) Also, since DHEA levels decline as the HIV progresses,(18) a human trial involving 32 HIV infected individuals was carried out to determine if DHEA supplementation could improve the quality of life for these individuals. Compared to the individuals taking placebo, those taking DHEA experienced a significant increase in DHEA blood levels as well as a significant improvement in the Mental Health and Health Distress part of the Medical Outcomes Study HIV Health (MOS-HIV) Survey.(19)
Commercially available doses range from 5-200mg. However, doctors have been known to request compounding pharmacists to prepare DHEA prescriptions for patients in doses ranging from 5-200mg per capsule. Men usually take higher doses than women. The most common dosage for DHEA is 25mg daily but ideally doses should be individualized to a patient’s individual needs. Capsules, oral and sublingual tablets, liquid and creams.
Toxicities & PrecautionsBe sure to tell your pharmacist, doctor or other health care providers about any dietary supplements you are taking. There may be a potential for interactions or side effects.
General
This dietary supplement is considered safe when used in accordance with proper dosing guidelines.
Health Conditions
If you have a risk of hormone-related cancer, such as prostate, ovarian, endometrial and breast cancer, talk to your doctor before taking this dietary supplement.
Side Effects
Occasional side effects reported with the use of large doses of this dietary supplement include acne, excessive hair growth, mood changes such as irritability and aggressiveness(20), insomnia, fatigue and low energy. It may be necessary to reduce the dose of this dietary supplement. Tell your doctor if these side effects become severe or do not go away.
Less common side effects include headaches, nervousness, a deepening of the voice, and menstrual cycle irregularities.(21) Tell your doctor if these side effects become severe or do not go away.
Pregnancy/Breast-FeedingTo date, the medical literature has not reported any adverse effects related to fetal development during pregnancy or to infants who are breast-fed. Yet little is known about the use of this dietary supplement while pregnant or breast-feeding. Therefore, it is recommended that you inform your healthcare practitioner of any dietary supplements you are using while pregnant or breast-feeding.
Age Limitations
This supplement should not be used with children unless as recommended by a physician.
Footnotes
1 Yen SS, et al. Replacement of DHEA in Aging Men and Women. Potential Remedial Effects. Ann N Y Acad Sci. Dec1995;774:128-42.2 Goodyer IM, et al. Adrenal Secretion during Major Depression in 8- to 16-year-olds, I. Altered Diurnal Rhythms in Salivary Cortisol and Dehydroepiandrosterone (DHEA) at Presentation. Psychol Med. Mar1996;26(2):245-56.
3 Casson P, et al. Replacement of DHEA Enhances T-lymphocyte Insulin Binding in Postmenopausal Women. Fertil Steril. 1995;63(5):1027-31.
4 Bates GW, et al. Dehydroepiandrosterone Attenuates Study-induced Declines in Insulin Sensitivity in Postmenopausal Women. Ann NY Acad Sci. Dec1995;774:291-93.
5 Suzuki T, et al. Low Serum Levels of DHEA May Cause Deficient IL-2 Production by Lymphocytes in Patients with SLE. Clin Exp Immunol. 1995;99(2):251-55.6 Shen S, Cooley DM, Glickman LT, et al. Reduction in DNA damage in brain and peripheral blood lymphocytes of elderly dogs after treatment with dehydroepiandrosterone (DHEA). Mutat Res. Sep2001;480-481(1-2):153-62.
7 Araghiniknam M, Chung S, Nelson-White T, et al. Antioxidant activity of dioscorea and dehydroepiandrosterone (DHEA) in older humans. Life Sci. 1996;59(11):PL147-57.
8 Khalil A, Fortin JP, LeHoux JG, Fulop T. Age-related decrease of dehydroepiandrosterone concentrations in low density lipoproteins and its role in the susceptibility of low density lipoproteins to lipid peroxidation. J Lipid Res. Oct2000;41(10):1552-61.
9 Schwartz AG, Pashko LL. Cancer prevention with dehydroepiandrosterone and non-androgenic structural analogs. J Cell Biochem Suppl. 1995;22:210-7.
10 Williams JR. The effects of dehydroepiandrosterone on carcinogenesis, obesity, the immune system, and aging. Lipids. Mar2000;35(3):325-31.
11 Morrison MF, et al. DHEA-S levels and depressive symptoms in a cohort of African American and Caucasian women in the late reproductive years. Biol Psychiatry. Nov2001;50(9):705-11.
12 Nagata C, et al. Serum concentrations of estradiol and dehydroepiandrosterone sulfate and soy product intake in relation to psychologic well-being in peri- and postmenopausal Japanese women. Metabolism. Dec2000;49(12):1561-4.
13 Hackbert L, Heiman JR. Acute dehydroepiandrosterone (DHEA) effects on sexual arousal in postmenopausal women. J Womens Health Gend Based Med. Mar2002;11(2):155-62.
14 Takayanagi R, et al. 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. Apr2002;123(8):1107-14.
15 Lasco A, Frisina N, Morabito N, et al. Metabolic effects of dehydroepiandrosterone replacement therapy in postmenopausal women. Eur J Endocrinol. Oct2001;145(4):457-61.
16 Genazzani AD, et al. Oral dehydroepiandrosterone supplementation modulates spontaneous and growth hormone-releasing hormone-induced growth hormone and insulin-like growth factor-1 secretion in early and late postmenopausal women. Fertil Steril. Aug2001;76(2):241-8.
17 Henderson E, Yang JY, Schwartz A. Dehydroepiandrosterone (DHEA) and synthetic DHEA analogs are modest inhibitors of HIV-1 IIIB replication. AIDS Res Hum Retroviruses. May1992;8(5):625-31.
18 Mulder JW, Frissen PH, Krijnen P, et al. Dehydroepiandrosterone as predictor for progression to AIDS in asymptomatic human immunodeficiency virus-infected men. J Infect Dis. Mar1992;165(3):413-8.
19 Piketty C, Jayle D, Leplege A, Castiel P, Ecosse E, Gonzalez-Canali G, et al. Double-blind placebo-controlled trial of oral dehydroepiandrosterone in patients with advanced HIV disease. Clinical Endocrinology. 2001;55(3):325-330).
20 Dean CE. Prasterone (DHEA) and mania. Ann Pharmacother. Dec2000;34(12):1419-22.
21 Cizza G, et al. Circulating plasma leptin and IGF-1 levels in girls with premature adrenarche: potential implications of a preliminary study. Horm Metab Res. Mar2001;33(3):138-43.
Interaction Type: Drug/Nutrient Interactions
Interaction Rating: Potential/Theoretical
Studies report that DHEA may act in the body like some of these medications, which may alter the effects of these medications and possibly the dose needed for treatment. Use with caution.These drugs include fluoxetine, fluvoxamine, paroxetine, sertraline, amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, trimipramine, maprotiline, mirtazapine, trazodone, bupropion, venlafaxine, nefazodone, citalopram, protriptyline, phenelzine, tranylcypromine, isocarboxazid .
Important! If you are using any of these medications or are unsure about which medications you are using, check with your pharmacist or other healthcare professional before using any dietary supplements.
References
1 Hunt PJ, Gurnell EM, Huppert FA, Richards C, Prevost AT, Wass JA, et al. Improvement in mood and fatigue after dehydroepiandrosterone replacement in Addison's disease in a randomized, double blind trial. J Clin Endocrinol Metab. Dec2000;85(12):4650-6.View Abstract2 Wolkowitz OM, Reus VI, Keebler A, et al. Double-blind Treatment of Major Depression with Dehydroepiandrosterone. Am J Psychiatry. Apr1999;156(4):646-9.View Abstract
Journal: Am J Psychiatry
OBJECTIVE: This study was designed to assess possible antidepressant effects of dehydroepiandrosterone (DHEA), an abundant adrenocortical hormone in humans. METHOD: Twenty-two patients with major depression, either medication-free or on stabilized antidepressant regimens, received either DHEA (maximum dose = 90 mg/day) or placebo for 6 weeks in a double-blind manner and were rated at baseline and at the end of the 6 weeks with the Hamilton Depression Rating Scale. Patients previously stabilized with antidepressants had the study medication added to that regimen; others received DHEA or placebo alone. RESULTS: DHEA was associated with a significantly greater decrease in Hamilton depression scale ratings than was placebo. Five of the 11 patients treated with DHEA, compared with none of the 11 given placebo, showed a 50% decrease or greater in depressive symptoms. CONCLUSIONS: These results suggest that DHEA treatment may have significant antidepressant effects in some patients with major depression. Further, larger-scale trials are warranted. Author: Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L, Roberts E.Date: 4/1999
How Dehydroepiandrosterone (DHEA) interacts with Central nervous system stimulants
Interaction Type: Drug/Nutrient Interactions Close Window
Interaction Rating: Potential/Theoretical--------------------------------------------------------------------------------
Studies report that DHEA may act in the body like some of these medications, which may alter the effects of these medications and possibly the dose needed for treatment. Use with caution.These drugs include caffeine, amphetamine, ephedra, methylphenidate, phentermine, pemoline, guarana, methamphetamine, dextroamphetamine, dexmethylphenidate, diethylpropion, benzphetamine, doxapram, modafinil, phendimetrazine, sibutramine .
Important! If you are using any of these medications or are unsure about which medications you are using, check with your pharmacist or other healthcare professional before using any dietary supplements.
References
1 Pirnay F. Le dopage e et sport. Rev Med Liege. Apr2001;56(4):265-8.
View Abstract--------------------------------------------------------------------------------
Author: Labrie F, Diamond P, Cusan L, Gomez JL, Belanger A, Candas B
Date: 10/1997
Journal: J Clin Endocrinol Metab
The effect of 12-month dehydroepiandrosterone (DHEA) replacement therapy has been evaluated in 14 60- to 70-yr-old women who received daily applications of a 10% DHEA cream. Vaginal epithelium maturation was stimulated by DHEA administration in 8 of 10 women who had a maturation value of zero at the onset of therapy, whereas a stimulatory effect was also seen in all three women who had an intermediate vaginal maturation index before therapy. The estrogenic effect of DHEA observed in the vagina was not observed in the endometrium, which remained atrophic in all women. Most interesting, the bone mineral density significantly increased at the hip from 0.744 +/- 0.021 to 0.759 +/- 0.025 g/cm2 after 12 months of treatment (P < 0.05). These changes in bone mineral density were associated with a significant 20.0% decrease (P < 0.01) in plasma bone alkaline phosphatase and a 28% decrease in the urinary hydroxyproline/creatinine ratio. A 2.1-fold increase over the control value (P < 0.01) in plasma osteocalcin was concomitantly observed. The present data describe for the first time a series of medically important beneficial effects of DHEA therapy in postmenopausal women through transformation of the precursor steroid DHEA into androgens and/or estrogens in specific peripheral intracrine tissues without significant adverse effects. The stimulatory effect on the vaginal epithelium in the absence of stimulation of the endometrium is of particular interest because it eliminates the need for progestin replacement therapy. On the other hand, the stimulatory effect on bone mineral density accompanied by an increase in serum osteocalcin, a marker of bone formation, suggests stimulation of bone formation by the androgenic action of DHEA, a finding of particular interest for both the prevention and treatment of osteoporosis.
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