Questions remain about using DHEA

On Call

October 03, 1995|By Dr. Simeon Margolis | Dr. Simeon Margolis,SPECIAL TO THE SUN

What do you think of DHEA? Several of my friends who are taking it have felt generally better and more energetic.

DHEA, or an abbreviation for dehydroepiandrosterone, is a steroid hormone produced by the adrenal glands. A form of DHEA, slightly modified by the addition of a sulphate group, is the most plentiful steroid hormone in human blood. (Steroid hormones are formed from cholesterol in the adrenals, testes and ovaries.)

Despite its relatively high blood concentrations, the function of DHEA is unclear. It can, however, be converted to small amounts of the major sex hormone in both men (testosterone) and women (estradiol).

Because blood levels of DHEA fall dramatically as people grow older, it has been suggested that aging individuals can increase their energy, prevent disease and prolong life by taking DHEA pills. DHEA levels are low in late stages of AIDS, and many HIV-positive patients are taking DHEA to overcome fatigue and strengthen their immune system.

While it is certainly possible that DHEA pills are beneficial, there is little or no objective evidence that taking DHEA has any of these desirable effects. Nor is it clear that a fall in the blood levels of DHEA is harmful or that increasing the level with supplements will do any good.

A study reported in 1986 by a respected epidemiologist, Elizabeth Barrett-Connor, found that the incidence of heart disease in middle-aged and elderly men was twice as great in those whose DHEA was low compared to those with high levels. Largely overlooked by the advocates of DHEA is that in this same study heart disease was slightly more frequent in women who had higher levels of DHEA. A larger follow-up study by Dr. Barrett-Connor showed only a 20 percent lower rate of heart disease among men with low DHEA levels.

Several benefits have been reported when DHEA is given to mice, a species that normally has low levels of the hormone. By contrast, evidence in humans is limited to a few, small clinical trials that have shown some benefits of taking DHEA. DHEA has not been approved by the Food and Drug Administration but can be purchased in health food stores and from some mail-order houses.

I agree with Dr. Barrett-Connor, who has expressed astonishment that so many people are taking DHEA even though it is not known how it works. There is limited evidence that it does any good and is free from harmful effects.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

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