By Dr. Mercola
Before I begin this article I want to state very clearly that hormones are not my primary specialty. I have used them clinically but I found the science quite controversial, so this is a summary as I best understand it.
If you are a clinician with considerable experience in this area I invite you to present your views to update the information on DHEA.
DHEA is a hormone produced by your adrenal glands and in your brain, which was first discovered by scientists in the 1930's.
Your body's natural production of DHEA varies widely with age, with very low levels produced before puberty, peak production in your late 20's or early 30's, followed by a steady decline in production with advancing age.
This age-related pattern of production has lead many to believe that DHEA production may actually be linked to the aging process itself. DHEA supplementation (if you're deficient) may help turn back the clock, as it were, as it can help:
- Lower fat storage through improved thyroid response
- Stimulate bone deposition
- Increase muscle tone
- Improve mood (including fighting depression)
- Fight cancer
Sub-optimal levels of DHEA have also been associated with many age-related degenerative conditions, including:
Chronic inflammation Low libido Immune dysfunction Cognitive decline Rheumatoid arthritis Osteoporosis Increased risk for certain cancers Some complications of type II diabetes.[i]
Can supplementing DHEA really help you with these conditions?
What We Know About DHEA
DHEA, or more precisely DHEA sulfate (your body naturally converts DHEA-S to the DHEA that it uses) is the most abundant precursor hormone in the human body, meaning that it is the largest raw material your body uses to produce other vital hormones, including testosterone in men and estrogen in women.
One thing we know for certain about human adrenals -- besides making DHEA -- they also manufacture cortisol, which is in direct competition with DHEA for production. In other words, when cortisol production is high, especially for prolonged periods of time, your adrenals can actually wear out, and DHEA production will necessarily suffer.
So a natural question follows: what is cortisol and what causes an increase in its production?
The Stress Connection
Cortisol is the hormone your body produces in response to stress, real or imagined, which is why it's commonly referred to as "the stress hormone".
Adrenal exhaustion from coping with chronic stress means your adrenal glands are overworked from manufacturing cortisol, and they simply can't produce enough DHEA to support a healthy hormonal balance.
You feel exhausted, often depressed, and your muscle tone decreases while body fat increases (cortisol tells your body to store fat).
Symptoms of chronically elevated cortisol levels include:
Increased abdominal fat Stomach ulcers Suppressed immune response Mild memory loss
(words, names and numbers)
Accelerated aging Suppressed thyroid function Inflammation
You hear all the time about how bad stress is for your body. Well now you're looking at the actual hormone responsible for much of the damage. Clearly it pays healthy dividends to reduce stress in your life, not only to reduce cortisol production, but also to ensure that your body has adequate adrenal strength to keep your DHEA levels optimal.
When DHEA Supplementation Makes Sense
First, let me start by saying that bioidentical DHEA should ideally ONLY be supplemented under the guidance of a holistic doctor who can test your body's DHEA levels to ensure you need supplementation. I prefer to test levels using a 24-hour urine test.
Hormonal testing is a controversial area as you can also do blood and saliva test. I tend to follow Dr. Jonathon Wright's recommendation, as he's really the person who introduced bioidentical hormone therapy into the United Sates. You can review his book Stay Young and Sexy for further details.
Properly testing your levels is very important, because people who have normal hormone levels in their bodies who supplement DHEA are likely to experience side effects, such as:
- Tumor formation
- Hair loss
- Heart rhythm problems
If you've been living long stretches of your life on a poor diet, not getting adequate sleep, and overwhelmed by the daily grind -- chances are you're a good candidate for DHEA supplementation.
However, please understand that only a test will tell you for certain what your body's DHEA levels are, but if you're feeling tired and overwhelmed, have low libido, and find your mood suffering or even experience depression regularly, there is a strong chance that your body is not producing enough DHEA.
Maintaining optimal DHEA levels may also be useful for:
Athletes looking to improve performance Increasing sex drive Improving recovery time from stress and physical training Increasing sense of well being Weight loss Improving sleep Muscle gain Improving mood
Too Much DHEA is NOT a Good Thing
The conventional thinking is that if a little is good, then a lot must be better. Not so with DHEA.
Like most good things in life, too much DHEA can lead to problems.
Supplementing hormones over a long period of time can trick your body into suspending its own DHEA production, and possibly even shut down your adrenal glands, which can lead to disastrous health consequences.
Many doctors strongly advise taking "hormone holidays", meaning practice a supplementation schedule that features a few weeks on DHEA followed by a few weeks off.
Also, DHEA supplements come in doses ranging from 5 mg to 200 mg. The scientific jury is still out on the subject, but it appears normal daily DHEA production for an average person in their 20's is between 10-25 mg.
Supplementing beyond the normal peak production range of DHEA might be advisable for short periods of time to restore the effects of a badly depleted adrenal system, but maintaining mega doses of DHEA for any sustained period of time will probably lead to unwanted side effects.
Remember your body's hormone balance is a delicate mechanism that should only be supplemented after consulting a holistic doctor and testing your body's natural DHEA level to determine the appropriate level of supplementation you might need. I would advise against supplementing with this hormone without some professional guidance.
Another important co-factor when considering DHEA supplementation is that your body naturally produces DHEA in the morning and then either uses the hormone or excretes it by the end of the day. So if supplementation is undertaken, it appears that an early morning dose of DHEA is the way to go.
Why You Should AVOID All Oral Hormone Preparations
There are many ways to "naturally" address bioidentical hormone replacement but one of the most common mistakes is to use oral hormones.
But if you swallow steroid hormones you seriously distort their natural metabolism. Swallowed hormones encounter potent stomach acids, and the hormones that survive this assault then move to your liver where they will be further broken down. Your liver screens all molecules that enter your blood stream, passing some onward, modifying or detoxifying others, and rejecting a few.
This routing of orally swallowed hormones is in sharp contrast to the way nature intended them to be distributed to your tissues.
If you swallow hormones, only 10-15 percent will eventually reach the target tissues and you will need to take an oral dose that is 500 percent higher than you need.
Many different metabolites are created in your liver when you swallow a DHEA supplement and any of these can produce unwanted side effects.
So if you or anyone you know currently use an oral DHEA supplement or any other oral hormone, I encourage you to strongly consider phasing them out and instead using a DHEA cream preparation that you administer trans mucosally.
Best Way to Use DHEA Cream
The key mistake that many well-intentioned and knowledgeable doctors -- including myself -- have made is to advise using DHEA cream on your skin. While this certainly provides better results than swallowing the hormones, the method of delivery can still be improved.
The primary problem with topical skin application of the cream is that it's very difficult to determine the dose. Hormones also accumulate in fat tissue, so you may end up with far more than you need.
There is a relatively minor tweak you can make using the cream that avoids nearly all of the side effects of applying the cream on your skin.
If you apply the cream to your mucous epithelial membranes that line your vagina, you are able to obtain a virtually ideal administration system. Not only is absorption through these membranes more complete than through your skin, but hormones absorbed through your vaginal membranes also eliminate the production of unwanted metabolites of DHEA.
Men also require hormones and I myself take DHEA. Obviously men don't have a vagina to administer the cream, but we do have a rectum that has a similar mucosal epithelial surface. So for men, the ideal delivery system for DHEA is in cream form, through the rectum.
Final Thoughts on DHEA
Is DHEA the "fountain of youth" it was touted to be in the 1990's?
Perhaps it is, but with an asterisk.
Your body is designed to maintain a delicate hormonal balance that usually self-regulates naturally according to your age and the stresses you face in life. The fact is, most people do just fine with DHEA production in the prime of their life.
Progressively increasing number of people today complain of a lack of energy, unexplained weight gain, poor mood, depression and insomnia. Some of the contributing factors can be a poor diet, lack of exercise, stress that goes unchecked and adrenal glands functioning sub-optimally.
Prolonged adrenal imbalance can actually be the cause of many of the symptoms associated with a lack of optimal health -- weight gain, depression and a lack of energy that you just can't seem to shake no matter what other healthy changes you make to your lifestyle. And if you're not getting enough quality sleep (another symptom of DHEA imbalance) all of the other healthy changes you make to your lifestyle will not produce dividends you can feel.
So if you are under constant stress, or constantly feel tired, weak, depressed or have a low sex drive, please find yourself a holistic doctor and have him/her perform a 24-hour urine test to determine your DHEA levels.
Too many people suffer unnecessarily from high stress and low DHEA production, so make sure you are not one of these people.
- [i] Gaby AR. Dehydroepiandrosterone: biological effects and clinical significance. Alter Med Rev. 1996;1(2):60-9.