From the Guidelines
DHEA levels of 74 μg/dL in a 74-year-old individual are generally considered normal and do not require supplementation or medical intervention. When considering the management of adrenal insufficiency, which can involve DHEA replacement, it's crucial to follow guidelines that prioritize patient outcomes in terms of morbidity, mortality, and quality of life. According to the ASCO guideline update on the management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy 1, DHEA replacement is controversial but can be considered in specific cases, such as in women with low libido and/or energy who are otherwise well-replaced. However, this consideration is not directly applicable to a 74-year-old individual with a DHEA level of 74 μg/dL, as this level is age-appropriate. Key points to consider in the management of adrenal insufficiency include:
- The distinction between primary and secondary adrenal insufficiency, which can guide the approach to replacement therapy 1.
- The importance of educating patients on stress dosing, emergency injectables, and the use of a medical alert bracelet or necklace for adrenal insufficiency 1.
- The role of endocrinology consultation in planning before surgery or high-stress treatments 1. Given the information provided and the context of the question, the primary concern is whether the DHEA level of 74 μg/dL in a 74-year-old requires intervention. Based on the guideline evidence, no specific action is recommended for a DHEA level that is considered normal for the patient's age. If symptoms suggestive of adrenal insufficiency or other hormonal imbalances are present, consultation with a healthcare provider is essential to determine the appropriate course of action.
From the FDA Drug Label
INDICATIONS: Temporarily supports the body to rebalance Adrenal and DHEA output. Symptoms of imbalanced Adrenal and DHEA may include: low energy, depression, anxiety, dry eyes, skin, and hair, loss of head hair. The answer to the question about DHEA of 74 is not provided in the given text, as the text does not mention a specific value of 74 in relation to DHEA. 2
From the Research
DHEA Levels and Health Implications
- A DHEA level of 74 may be considered low, as studies have shown that low levels of DHEA are associated with adverse impacts on metabolic function, quality of life, and sexuality 3.
- DHEA deficiency is commonly seen in patients with adrenal insufficiency, and supplementation has been shown to have beneficial effects on quality of life, body composition, bone health, and metabolic markers 3, 4.
- However, the optimal dose and duration of DHEA replacement in adrenal failure are still unclear, and more research is needed to inform clinical practice 3, 5.
Reference Ranges for DHEA
- Reference ranges for serum DHEA sulfate (DHEAS) and testosterone in adult men have been established, with age-specific ranges calculated using linear regression and quantile regression 6.
- These reference ranges can be used to identify individuals with low DHEA levels, such as a level of 74, and to guide treatment decisions.
Potential Benefits and Risks of DHEA Supplementation
- DHEA supplementation has been shown to have potential benefits, including improved physical and psychological well-being, muscle strength, and bone density, as well as reduced body fat and age-related skin atrophy 4.
- However, DHEA supplementation can also have side effects, such as increased sebum production, facial acne, and changes in hair status, particularly in women 5.
- More research is needed to fully understand the potential benefits and risks of DHEA supplementation and to determine the optimal dose and duration of treatment 3, 7.