From the Guidelines
DHEA (Dehydroepiandrosterone) in serum is a steroid hormone that serves as a precursor to sex hormones, with its levels and replacement guided by serum DHEA sulphate (DHEAS) levels, particularly in patients with primary adrenal insufficiency (PAI) 1. When considering DHEA in serum, it's essential to understand its role and measurement. DHEA is primarily produced by the adrenal glands and plays a crucial role in the production of sex hormones. In patients with PAI, DHEA replacement is considered, especially in women, to alleviate symptoms such as lack of libido and low energy levels.
- The replacement dose is typically guided by serum DHEA sulphate (DHEAS), androstenedione, and testosterone levels, aiming to maintain these within the normal range 1.
- A common approach is to offer a 6-month trial of DHEA replacement, often starting with a dose of 25 mg daily, which can be adjusted based on clinical response and serum hormone levels 1.
- It's critical to note that while DHEA replacement may offer clinical benefits, the long-term effects, especially in patients with PAI, are not well understood, necessitating cautious use 1.
- Measuring DHEA in serum, particularly its sulfated form DHEA-S, provides valuable insights into adrenal function, with low levels potentially indicating adrenal insufficiency and high levels associated with various adrenal and gonadal disorders.
- The interpretation of DHEA levels must consider the patient's age, sex, and clinical context, as reference ranges vary and symptoms of hormone imbalance or adrenal disorders may prompt testing 1.
From the FDA Drug Label
ACTIVE INGREDIENTS Dehydroepiandrosterone (DHEA) The FDA drug label does not answer the question.
From the Research
Definition and Production of DHEA
- Dehydroepiandrosterone (DHEA) is an androgen produced by the zona reticularis of the adrenal gland 2.
- It is a very important prohormone secreted in large amounts by the adrenals in humans and other primates, but not in lower species 3.
- DHEA is secreted in larger quantities than cortisol and is present in the blood at concentrations only second to cholesterol 3.
Role and Effects of DHEA
- DHEA has been shown to exert its effects via downstream conversion to sex steroid hormones, neuromodulation, improvement in endothelial cell function, and possibly by acting on a cell membrane-bound receptor 4.
- It indirectly exerts effects on bone formation, adiposity, muscle, insulin and glucose metabolism, skin, libido, and well-being 3.
- DHEA supplementation has been shown to produce beneficial effects in women with adrenal insufficiency, including improved sexual function, metabolism, and overall well-being 4.
DHEA in Serum
- DHEA is the most abundant circulating steroid hormone in humans, along with its sulfated form dehydroepiandrosterone sulfate (DHEAS) 5.
- Low levels of DHEA in serum have been associated with age-related involuntary changes, including reduced lifespan, and various diseases such as adrenal insufficiency, hypogonadism, and systemic lupus erythematosus 2, 6, 5.
- DHEA levels in serum decline with age, and this decline has been termed 'adrenopause' 6.
Potential Therapeutic Uses of DHEA
- DHEA supplementation has been proposed as a potential therapeutic approach for various conditions, including adrenal insufficiency, hypogonadism, menopause, and aging-related diseases 2, 4, 6, 5.
- It has been shown to exert beneficial effects on physical and psychological well-being, muscle strength, bone density, and immune function, and may have anti-inflammatory and anti-aging properties 5.