DHEA - mystery hormone or "fountain of youth" or both?

Dehydroepiandrosterone (DHEA) is the most abundant steroid in humans. Steroids are hormone or hormone-like compounds derived from cholesterol - testosterone, estrogens, cortisol and progesterone are a few examples of the multitude of steroids found in the human. Largely synthesized in the adrenal gland, DHEA probably acts as a precursor to some of the other steroid hormones and perhaps as a “reserve” for on-demand production in tissues that do not produce DHEA but are capable of converting it into “mature” steroid hormones. 

Humans are unique among the primates in producing large quantities of DHEA (most of it is actually converted to DHEA-S by the addition of a sulfate molecule and in this note, when I speak of DHEA in the body, I mean DHEA-S). Other non-primate mammals produce even less DHEA including typical lab models - rats and mic).

DHEA levels fall dramatically with age in both men and women. Your levels at age 80 are 10-20% of what they were in your twenties.

While there clearly is a correlation of DHEA levels with various health conditions (higher better in maintenance of lean mass, cognition, less cardiovascular disease, less cancer), it doesn’t prove that DHEA is responsible.

What happens when DHEA is given as a supplement?

DHEA administration to rats and mice shows remarkable effects. It prevents obesity, diabetes, cancer and heart disease while at the same time enhancing immune function.

DHEA when given to humans has somewhat more nuanced effects. There still is a need for more long-term trials. However, certain effects appear to be reproducible. These effects are more dramatic in women than men. In one controlled trial, when elderly women were given 50 mg DHEA there were increases libido, skin thickness, skin pigmentation, skin oil production, and bone density. Decreases were seen in visceral and subcutaneous fat. These effects seem to correlate with a general increase in all reproductive steroid hormones (estradiol, progesterone, and testosterone). Other studies show reproducible increases in androgens, IGF-1, bone density, lean mass, and in well-being. 

DHEA use in menopause

Here is a quote from Williams Textbook of Endocrinology (the bible of clinical endocrinology):

"An improvement in symptoms of menopause in peri-menopausal and early post-menopausal women has also been reported with DHEA. Intra-vaginal administration of DHEA was effective for reversing vaginal atrophy in post-menopausal women. DHEA supplementation in early post-menopausal women is interesting. First, no increase of endometrial thickness has been reported with DHEA, probably because endometrial tissue does not have the necessary enzymes to transform it into estrogens, or because estrogen and progesterone are both its derivatives. Finally, the risk for breast cancer does not seem to increase with DHEA."

Sounds pretty good to me...

My recommendation

Basically, DHEA is a very safe supplement which can provide real benefit when taken at the proper dose and for the long-term. None of the beneficial effects happen in short-term. It should be emphasized that few side effects are seen with DHEA therapy (rarely women will develop acne and facial hair). If your DHEA-S levels are low, you probably could use some DHEA supplementation, particularly if you are a woman. I recommend 10-25 mg to start for women and 50-100 mg for men. Dosage can be adjusted on DHEA-S levels and symptoms.