Is DHEA safe?
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Safety of Dehydroepiandrosterone (DHEA)
Introduction to DHEA Safety
Dehydroepiandrosterone (DHEA) is a hormone that serves as a precursor to androgens and estrogens. It is widely used as a supplement, particularly among aging populations, to counteract the decline in natural hormone levels. However, the safety of DHEA supplementation has been a topic of extensive research and debate.
Short-Term Safety in Elderly Populations
Several studies have investigated the short-term safety of DHEA supplementation in elderly populations. A study involving 24 healthy elderly men and women found that daily oral administration of DHEA (25/50 mg) for 8 days did not result in the accumulation of steroids or worrying transformations to androgens and estrogens, suggesting that it is safe for short-term use in elderly subjects. Another study involving postmenopausal women over a 52-week period found that a daily dose of 50 mg DHEA did not significantly alter lipid profiles, insulin sensitivity, or adversely affect the endometrium, further supporting its short-term safety.
Cardiovascular Risk Factors
Research on the impact of DHEA on cardiovascular risk factors has shown mixed results. A study on older women with frailty characteristics found significant changes in hormone levels but no significant changes in cardiovascular risk factors such as lipid profiles, body fat, fasting glucose, or blood pressure after 6 months of DHEA supplementation. This suggests that short-term DHEA therapy may be safe concerning cardiovascular risk factors in older women.
Sexual Function and Menopausal Symptoms
DHEA has been studied for its effects on sexual function and menopausal symptoms. Intravaginal DHEA has been shown to improve sexual dysfunction in women with vulvovaginal atrophy and dyspareunia, with no significant adverse effects reported. However, a meta-analysis concluded that DHEA does not significantly improve menopausal symptoms or sexual function compared to placebo and may increase androgenic side effects such as acne and hirsutism.
Neurotoxicity and High-Dose Concerns
While DHEA is generally considered safe at recommended doses, high concentrations have been associated with neurotoxicity. Animal studies have shown that high doses of DHEA can inhibit mitochondrial respiration and lead to neuronal death, particularly under hypoglycemic conditions. This highlights the importance of adhering to recommended dosages to avoid potential neurotoxic effects.
COVID-19 Considerations
During the COVID-19 pandemic, concerns have been raised about the use of DHEA due to its potential to exacerbate the severity of the disease. DHEA is an inhibitor of Glucose-6-phosphate Dehydrogenase (G6PD), and G6PD-deficient cells are more susceptible to coronavirus infection. The unrestricted availability of DHEA as a dietary supplement in the U.S. has led to calls for more stringent regulation and clinical trials to ensure its safety during the pandemic.
Conclusion
Overall, DHEA appears to be safe for short-term use in elderly populations and for improving sexual function in women with specific conditions like vulvovaginal atrophy. However, its long-term safety, particularly at high doses, remains a concern due to potential neurotoxic effects. Additionally, the role of DHEA in exacerbating COVID-19 severity warrants further investigation. Users should adhere to recommended dosages and consult healthcare providers before starting DHEA supplementation.
Sources and full results
Most relevant research papers on this topic
Dehydroepiandrosterone replacement administration: pharmacokinetic and pharmacodynamic studies in healthy elderly subjects.
The safety of 52 weeks of oral DHEA therapy for postmenopausal women.
Effects of dehydroepiandrosterone (DHEA) on cardiovascular risk factors in older women with frailty characteristics.
Efficacy of intravaginal dehydroepiandrosterone (DHEA) for symptomatic women in the peri- or postmenopausal phase.
DHEA on sexual function in Sheehan Syndrome: A randomized double-blind placebo-controlled cross-over trial.
Alert to US physicians: DHEA, widely used as an OTC androgen supplement, may exacerbate COVID-19.
ACP Journal Club. Review: In peri- or postmenopausal women, DHEA does not improve symptoms and increases androgenic side effects.
Dehydroepiandrosterone inhibits complex I of the mitochondrial respiratory chain and is neurotoxic in vitro and in vivo at high concentrations.
DHEA for postmenopausal women: a review of the evidence.
Dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEAS) protect hippocampal neurons against excitatory amino acid-induced neurotoxicity.
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