If you have lost your zest for life, are constantly fatigued and prone to autoimmunity – then take heed. You might be DHEA deficient. Dubbed the ‘youth hormone’, DHEA has many potential benefits – but also carries with it some noted contraindications. Therefore it’s best to consult with a healthcare or anti-ageing practitioner… and do your own due diligence. By Dr Sly Nedic
DHEA… Say What?
DHEA (Dehidroepiandrosterona) is a steroid hormone that is secreted mainly by the adrenal cortex, and in smaller amounts by ovaries in women. Production of this hormone increases in pre-puberty, picks up during adulthood, declines as we age and finally by the age of 70, diminishes to 10% of its adulthood level. DHEA transforms into male or female hormones (estrogen and testosterone) in various degrees from person to person, which is genetically determined. There has been numerous scientific papers about anti-ageing properties, which plays a role in the immune response throughout life, as well as the general well-being of the ageing person. This has made DHEA one of the essential hormones in anti-ageing therapies and integrative management of auto-immune diseases. DHEA is an essential hormone in my anti-ageing protocols, and majority of my patients report that in as early as two months after undergo-ing DHEA replacement, there is a major difference in their sense of well-being, energy, increased libido, improved memory and mood. Since the above signs and symptoms are often considered as part of the inevitable ageing process, majority of patients never complain or ask for help. They might also get treated symptomatically without their DHEA levels being checked. It is suggested by numerous anti-ageing societies that DHEA should be replaced to carry on with the patient’s well-being. Studies also reported an increase in the psychological and physical wellbeing when compared to a placebo – as well as an increase in IGF1 levels (simulating effect of growth hormone). In addition, prevention of osteoporosis has been reported in women, libido improvement and mood stabilization.
The Danger of Low DHEA
There has been a remarkable consistency in scientific papers showing the correlation between significantly low DHEA and various cancers, diabetes type II, inflammatory diseases and cardiovascular diseases (mainly heart attacks). In fact, two recent studies (Feldman et al.1998) and (Jansson et al. 1998) showed a higher mortality rate from myocardial infarction in the case of low DHEA, and independently from other factors
DHEA and Autoimmunity
The physiological response to stress is regulated by the adrenocortical system, in which the DHEA and Cortisol have opposing effects on the innate immune response (DHEA enhances while Cortisol suppresses immunity). During the period of intense stress (which we see more and more in the younger population and in ageing populations respectively), molar ratio of Cortisol to DHEA increases, leaving the organism more susceptible to autoimmunity. It has been shown that patients suffering from lupus (SLE) and rheumatoid arthritis (RA) have low DHEA. It has also been reported that pre-menopausal women with a low level of DHEA may develop rheumatoid arthritis later in life. There has been great resistance and non-acceptance by conventional physicians to use DHEA in treating autoimmune diseases, despite extensive scientific evidence. DHEA appears to have a major beneficial effect in SLE, helping to reduce concurrent corticosteroid dose, while protecting against osteoporosis with a high dose of corticosteroids (van Vollenhoven et al. 1998, Barryet al. 1998). DHEA as a part of the integrative medical approach is used in autoimmune thyroiditis (the most common cause of low thyroid function), RA, inflammatory bowel diseases and other autoimmune problems.
DHEA and Cortisol Ratio
An inverse relationship between the DHEA and Cortisol concentration appears to be a predictor of inflammatory activity. A low DHEA /Cortisol ratio is an alarming sign of extensive stress – and therefore needs to be addressed. This should be done by thoroughly modifying Cortisol secretion… and not just replacing the DHEA. In an ageing population, it is found that a low DHEA/Cortisol ratio is associated with great cognitive impairment. I have seen a tremendous improvement in cognition in my ageing patients after a couple of months of administering oral DHEA.
Side Effects and Contraindications
Side effects (which often stop women from continuing DHEA therapy) comes from the transformation of DHEA into androgens, testosterone or DHT (male hormones). These target the cells that lead to hirsutism (increased body hair), male patterned baldness and acne. However, this activity is mainly genetically determined (gene CYP17A1 T34C) and can be prevented by modifying a dose – and knowing which pathway DHEA takes in the body. The same gene is responsible for DHEA being transformed into estrogen, which makes this hormone contraindicated in breast & prostate cancers in patients who are carriers of this gene. Genetic testing prior to DHEA treatment should be done routinely in order to find out which metabolic pathway DHEA is mainly involved in: estrogen or testosterone? DHEA is available on a prescription from integrative physicians (and compounding pharmacies) as a integral part of an anti-ageing treatment (or according to indications).