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Dehydroepiandrosterone (DHEA)

By

Laura Shane-McWhorter

, PharmD, University of Utah College of Pharmacy

Last full review/revision Jul 2020| Content last modified Jul 2020
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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.

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, reverse aging, improve brain function in patients with Alzheimer disease, increase libido, and decrease symptoms of systemic lupus erythematosus.

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). 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 (4).

Adverse effects

Adverse effects are unclear. There are theoretical risks of gynecomastia in men, hirsutism in women, acne, and stimulation of prostate and breast cancer. There is a case report of mania and one of seizure.

Drug interactions

None are well documented.

Dehydroepiandrosterone (DHEA) references

  • 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. 

  • 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.

  • 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.

  • 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 is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

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