13 Oct DHEA
Available dosage forms:
|Capsules||Up to 200mg|
|Troche||Up to 200mg|
|Cream||Up to 10% (100mg/g)|
What is DHEA?
DHEA is a hormone that is naturally made by the human body. It can also be made in the laboratory from chemicals found in wild yam and soy. However, the human body cannot make DHEA from these chemicals, so simply eating wild yam or soy will not increase DHEA levels. DHEA serves as a precursor to male and female sex hormones (androgens and estrogens). DHEA levels in the body begin to decrease after age 30. This decrease occurs more quickly in women than men.
DHEA is taken by mouth for slowing or reversing aging, improving thinking skills in older people, and slowing the progress of Alzheimer’s disease, for weight loss, decreasing the symptoms of menopause, rheumatoid arthritis, and aging skin.
Athletes and other people take DHEA to improve physical performance. But DHEA use is banned by the National Collegiate Athletic Association (NCAA) and Olympic Committee.
Special precautions & warnings
Pregnancy and breast-feeding: DHEA can cause higher than normal levels of a male hormone called androgen. This might be harmful to the baby. Don’t use DHEA if you are pregnant or breast-feeding.
Diabetes: DHEA can affect how insulin works in the body. If you have diabetes, monitor your blood sugar carefully if you are taking DHEA.
Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, uterine fibroids or polycystic ovary syndrome (PCOS): DHEA is a hormone that can increase estrogen levels. If you have any condition that might be made worse by exposure to estrogen, don’t use DHEA.
High cholesterol: DHEA might lower “good cholesterol” (high lipoprotein cholesterol, HDL). If your HDL level is already too low, discuss DHEA with your healthcare provider before you start taking it.
Liver problems: DHEA might make liver problems worse. Don’t use DHEA if you have liver problems.
Depression and mood disorders: if you have a history of depression, bipolar or other mood disorders you should discuss the use of DHEA with your doctor. If treatment is initiated pay attention to any changes in how you feel.
Herbs, Supplements and Food interactions
Herbs and supplements that might slow blood clotting: Using DHEA along with herbs that can slow blood clotting could increase the risk of bleeding in some people. These herbs include angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, and others.
Licorice: Taking licorice increases the levels of DHEA in the body, which then increases the side effects of DHEA.
Soy: Soy might increase or decrease DHEA levels in the body.
Fiber: Eating fiber while taking DHEA might decrease the effects of DHEA.
Vegetarian diet: Strict vegetarians have higher levels of DHEA in their blood than non-vegetarians. However, this difference seems to disappear after menopause. Researchers aren’t sure how important these findings are.
Are there interactions with medications?
|Moderate / Be cautious with this combination.
(Inform your doctor)
|Minor / Be watchful with this combination.
(Inform your doctor)
|· Anastrozole (Arimidex)
· Exemestane (Aromasin)
· Fulvestrant (Faslodex)
· Letrozole (Femara)
· Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
· Medications for depression (Antidepressant drugs)
· Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
· Tamoxifen (Nolvadex)
· Triazolam (Halcion)
· Tuberculosis Vaccine
· Medications for inflammation (Corticosteroids)
Acne, hair loss, stomach upset, and high blood pressure. Some women can have changes in menstrual cycle, facial hair growth, and a deeper voice after taking DHEA.
Are there safety concerns?
DHEA is POSSIBLY SAFE when taken by mouth for 12-24 months or applied to the skin for up to 12 months.
Pharmacologic Classifications: Hormone Modifier, Androgen
Dehydroepiandrosterone (DHEA) is a C19 steroid also known as 5-androsten-3 beta-ol-17-one. DHEA and DHEAS (an active, sulfated form of DHEA), are endogenous hormones secreted by the adrenal cortex in primates and a few non-primate species in response to ACTH. DHEA is a steroid precursor of both androgens and estrogens, and thus is often called ‘the mother hormone’. Endogenous DHEA is thought to be important in several endocrine processes, but current medical use of DHEA is limited to controlled clinical trials. In 1997, Pharmadigm, Inc. received an orphan drug designation to enroll patients with thermal burns who require skin-grafting into trials using injectable DHEAS, known as PB-005.
Mechanism of Action
Endogenous DHEA is a complex hormone, and researchers still have much to discover in regards to its physiologic effects in males and females. Less is known regarding the mechanisms of action of exogenously administered DHEA.
CNS actions: Both DHEA and DHEAS may be synthesized de-novo by the central nervous system, and concentrations of DHEA and DHEAS are higher in the brain than in other organs. The two neurohormones appear to have excitatory activity at both GABA and NMDA receptors.1
As a nutritional supplement, DHEA is most commonly administered by the oral route. Many DHEA products available as nutritional supplements contain varied amounts of DHEA and do not appear to be manufactured according to good manufacturing processes (GMP). Using HPLC techniques, one study found that only 7 out of the 16 assayed products contained DHEA within a 10% variation of the labeled content.7 Some products contained no detectable DHEA.7
Contraindications and Precautions
Your health care provider needs to know if you have any of these conditions: breast cancer (men or women); cancer of the lining of the uterus (endometrial cancer); diabetes or high blood sugar; immune system problems; infertility; liver disease; post-menopause; prostate cancer or an enlarged prostate gland; rheumatoid arthritis; uterine cancer; vaginal bleeding or menstrual problems; vaginal cancer; an unusual or allergic reaction to progesterone, DHEA, soy, other medicines, foods, dyes, or preservatives; pregnant or trying to get pregnant; breast-feeding. Visit your doctor or health care professional for regular checks on your progress.
Dehydroepiandrosterone, DHEA should be considered a pregnancy category X drug, similar to other androgenic hormones. Studies of the role of endogenous fetal and maternal DHEA in pregnancy indicate that the ratio of DHEA or DHEAS to other hormones in the serum or placenta may influence the processes of fetal development, parturition, and labor. Endogenous DHEA and DHEAS appear to be important in the functional development of the adrenal cortex and other endocrine activities in the fetus; it is assumed that exogenous DHEA supplementation to a pregnant woman could potentially have deleterious effects on fetal development or viability. The androgenic effects of DHEA could potentially result in masculinization of a female fetus. No controlled trials of DHEA in primate or human gestation exist. Do not administer DHEA to a pregnant woman.
DHEA is a hormone and should not be supplemented in a lactating woman who is breast-feeding her infant. Most hormones are excreted in breast milk. Like other androgenic hormones, it is possible that DHEA could inhibit lactation. It is unknown what effect DHEA would have on the breast-feeding infant.
NOTE: Many prasterone, dehydroepiandrosterone, DHEA preparations contain a variety of other ingredients, including minerals, vitamins, hormones and/or herbs, and each individual component may need to be evaluated for the presence of drug interactions. Only drug interactions pertaining to DHEA are discussed in this monograph.
Adverse Reactions/Side Effects
NOTE: Some prasterone, dehydroepiandrosterone, DHEA preparations are a combination of several hormones and/or herbs, and each individual component may need to be evaluated in the presence of adverse reactions. Only adverse reactions pertaining to DHEA are discussed in this monograph. Human side-effect data to date have been collected in non-systematic fashion via the FDA special nutritional adverse effect monitoring system (SNAEMS) or relatively small clinical trials.
How is this medication best taken?
The cream formulation is for external use only: do not take by mouth. Follow the directions on the prescription label. Take your medicine at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your doctor’s advice. This medicine is not approved for use in children.Follow the directions on the prescription label. Take your medicine at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your doctor’s advice. This medicine is not approved for use in children.
What do I do if I miss a dose?
If you are given your dose at a clinic or doctor’s office, call to reschedule your appointment. If you give your own injections and you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.
Store this medication at 59°F to 86°F (15°C to 30°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the expiration date. Do not flush unused medications or pour down a sink or drain.
Do not share or take any one else’s medicine. Talk with your healthcare provider before starting any new medicine, including over-the-counter, natural products, or vitamins. This medication was compounded specifically for you. This patient information summarizes the most important information about your medication; if you would like more information, talk with your doctor.
1. Kroboth PD, Slalek FS, Pittenger AL et al. DHEA and DHEA-S: a review. J Clin Pharmacol 1999;39:327-348.
2. Skolnick AA. Medical news and perspectives-scientific verdict still out on DHEA. JAMA 1996;276:1365-1367.
3. Kreider RB. Dietary supplements and the promotion of muscle growth with resistance exercise. Sports Med 1999;27:97-110.
4. Araneo BA, Ryu SY, Barton S, et al. Dehydroepiandrosterone reduces progressive dermal ischemia caused by thermal injury. J Surg Res 1995;59:250-262.
5. Jesse Rl, Loesser K, Eich DM, et al. Dehydroepiandrosterone inhibits human platelet aggregation in vitro and in vivo. Ann N Y Acad Sci 1995;774:281-290.
7. Parasrampuria J, Schwartz K, Petesch R. Quality control of dehydroepiandrosterone dietary supplement products. JAMA 1998;280:1565.
8. Katz S, Morales AJ. Dehydroepiandrosterone (DHEA) and DHEA-sulfate (DS) as therapeutic options in menopause. Semin Reprod Endocrinol 1998;16:161-170.
9. Rosenfield RL. Ovarian and adrenal function in polycystic ovary syndrome. Endocrinol Metab Clin North Am 1999;28:265-293.
10. Wellman M, Shane-McWhorter L, Orlando PL et al. The role of dehydroepiandrosterone in diabetes mellitus. Pharmacotherapy 1999;19:582-591.