Dehydroepiandrosterone or DHEA is a hormone that originates from the adrenal glands. There are a lot of controversies regarding the use of DHEA in sports competition as The World Anti-Doping Agency has banned its use for it is thought to give the user an unfair performance advantage. But does it really enhance the athletes performance? And are the other health claims true?

DHEA supplements are created by extracting the hormone from soy and or wild yams. There are a lot of things that researchers still don’t know about DHEA. What is clear though is that this is a precursor hormone to male and female reproductive hormones. Which means that for the body to create reproductive hormones like testosterone and estrogen; it needs to create DHEA first and then process it further to create the reproductive hormones. Interestingly, DHEA levels decrease with age leading to claims that it can prevent conditions that are associated with advanced age. Several other health claims such as bone durability improvement, muscle strength improvement, mood regulation, memory enhancements, energy boost, slowing down of advanced-age-related conditions, immune boost, and adrenal wellness have been associated with DHEA intake. However, these health claims either lack the research to back them up or it needs further studies.

DHEA and Athletic Performance

This is where DHEA sparks a lot of controversy. In a review of the Doping Status of DHEA which was published in the Clinical Journal of Sports Medicine, researchers noted that DHEA administration is of primary importance in female athletes rather than in male athletes. The reason behind this is that DHEA increases testosterone levels in women but, strangely, it does not have the same effect in men. That is why The World Anti-Doping Agency is more stringent in testing DHEA in women than men. But nonetheless, it is prohibited in athletes of both sexes. Is the World Anti-Doping Agency just too paranoid or is their paranoia justified?

In a research paper entitled “Androgens and athletic performance of Elite Female athletes”, researchers reviewed clinical findings in the laboratory and observations from the field to try and see whether DHEA and other frequently abused hormones does in fact improve performance or not. Through their extensive review they found out that female athletes who have high androgen levels, be it through a health condition or through supplementation, performed 2-5% better than those who have normal androgen levels. In a study that included 106 Swedish female olympic athletes which had significantly higher DHEA levels, researchers revealed that women with higher than normal levels of DHEA had greater bone density, lower levels of estrone, and had more lean mass. Furthermore, increased DHEA levels and lean mass was shown to afford a huge advantage to those who have it in comparison to those who do not. This review also compiled several performance and hormonal data from athletes that competed in the IAAF World Championships. From the 1332 females and 795 males that took part in the competition, there were hypoandrogenic males, hyperandrogenic females, and doped male or female athletes among them. When the researchers related the performance of the athletes and their hormone levels they discovered that the hyperandrogenic females and those females who raised their hormone androgen levels through doping performed significantly better in the 400-meter hurdles, pole vault, 800-meter hammer throw, and 400 meter run. Males on the other hand showed no significant advantage in their performance. 

DHEA and Weight Loss

There are some studies that claim that DHEA can improve weight loss by increasing fat burning and by raising our metabolism. Earlier studies investigated DHEA’s effects on laboratory rats. One study in particular discovered that DHEA increases the speed of which glucose is broken down in rats that were fed a high fat diet. In this study they grouped the rats into different groups so that each group would be given a different DHEA dosage. Some rats, the ones in the control group, were not given any DHEA at all. All rats in the study were fed a high fat diet. Their results showed that the higher the amount of DHEA given to the rat the faster their bodies broke down glucose or stored the glucose as glycogen. This and other animal studies encouraged other researchers to investigate DHEA’s effect on humans. One study in particular wanted to find out whether DHEA can have an effect on abdominal fat and insulin in elderly men and women. In this study, the researchers were able to recruit 28 men and women aged between 65 to 78 years old. These participants were then randomly assigned to the experimental group, the group that would receive 50 mg of DHEA, and the placebo group, the group who would receive a pill that supposedly contains DHEA but do not. The participants took their assigned pills everyday for 6 months. After 6 months was done, the researchers then measured the visceral and subcutaneous abdominal fat of their participants. They also measured insulin levels and tested the participants oral glucose tolerance or OGTT. The participants in the experimental group exhibited a greater loss in abdominal fat, had better insulin levels, and showed better response to the oral glucose tolerance test. Due to the rising number of studies which indicated that DHEA may promote weight loss, supplements like the 7-Ketodehydroepiandrosterone, or 7-Keto, for short have been marketed for weight loss promotion. A study was then conducted to test the claims of 7-Keto Naturalean™, a 7-Keto supplement. This supplement supposedly contains 3-acetyl-7-oxo-dehydroepiandrosterone which the manufacturer claims would aid in weight loss when paired with proper diet and regular exercise. 35 overweight but otherwise healthy adults were recruited for this research. All of them went through the same exercise and diet program for 8 weeks but some were given 200 mg of 7-Keto Naturalean, while the others, those in the placebo group, were given maltodextrin everyday. Basal metabolic rate, body weight, and body composition were measured before they started the experiment, in the middle part of the experiment or after 4 weeks, and at the end of the experiment or after 8 weeks. Results of this study showed that those who took 7-Keto Naturalean lost significantly more weight after 8 weeks of treatment when paired with diet and exercise compared to those who did not.

Other health claims for DHEA

Depression

There are studies that claim that DHEA might be an effective hormonal drug for depression. In a double-blind clinical trial for the usage of DHEA in treating Major Depression, researchers sought to find out if DHEA has some possible antidepressant effects. They recruited twenty-two patients with major depression to be the participants of their study. The patients were separated into two groups at random, one group will receive 90 milligrams of DHEA, the experimental group, while the other will receive a pill that’s supposed to DHEA but does not contain any, the control group. They will take their assigned pills each day for 6 weeks. To determine the participants’ level of depression before and after the treatment regimen, they were assessed using a Hamilton Depression Rating Scale before and after the experiment. Their results showed that the patients who were given DHEA showed a 50% reduction in depressive symptoms. However, the researchers noted that further trials may be needed involving a bigger sample size. Another study wanted to find out whether DHEA can treat or prevent a mid-life crisis. So the researchers invited 23 men and women aging 45 to 65 years old with midlife-onset major or minor depression to be their participants. After comparing their data before and after the intervention was given, researchers concluded that DHEA is an effective midlife onset depression treatment. Still, this study is not conclusive enough to support the claim that DHEA can treat depression because their sample size was still too small. Further studies involving a greater number of test subjects is needed.

Osteoporosis

As mentioned previously, athletes who took DHEA showed significantly denser bones. This has sparked interest in some researchers looking for ways to combat osteoporosis. One study tackled this and investigated the effects of DHEA supplementation on body composition, bone markers, and bone mineral density in adults. The researchers of this study further justified the reasoning behind their experiment by mentioning that osteoporosis comes with age, as does DHEA decline; so it must be that DHEA may help treat osteoporosis. 225 healthy adults with ages ranging from 55 to 85 years were invited for this research. They were then separated into two groups at random, an experimental group, the group that would be given 50 mg of DHEA, and a placebo group, the group that would be given a fake DHEA pill. Each participant would then take their assigned pills each day for a year. Results of this research showed that DHEA has a selective positive effect on the bones of women but not on men.

Aging

Since DHEA decreases with age some researchers theorized that DHEA supplements might slow down the negative effects of aging such as overall decline in health, body composition, and cognitive function. Although some clinical trials have been conducted and gave positive results these were still not conclusive enough to support the claims. There are a lot of things that scientists do not know about DHEA and its long term use. Thus, if studies say that there is no sufficient evidence that shows DHEA’s positive effect on aging then its better to be on the safe side and avoid its use for such purpose.

Vaginal Atrophy

Another condition that comes with age, specifically for women, is vaginal atrophy. This is a general term that encompasses several harmful changes in a female’s reproductive system. There are only a few research studies regarding DHEA’s effect on the female’s reproductive tract, one study in particular investigated DHEA’s effect on Dyspareunia, vaginal dryness, symptoms of vulvovaginal atrophy, and Genitourinary Syndrome of Menopause. 157 women were recruited to be part of the placebo group while 325 women were placed in the experimental group. The researchers noted sexual pain, the vaginal parabasal cells and percentage of superficial cells, and the vaginal pH of the participants. They took note of these before the experimental group were given 6.5 mg of DHEA everyday for 12 weeks and after when the experiment was done. At the end of the experiment, the data revealed that the experimental group had less vaginal dryness, their vaginal parabasal cells and the percentage of superficial cells were better, and they experienced less pain during sexual activity compared to the placebo group.They concluded that DHEA is a viable treatment for vaginal atrophy.

Are DHEA Supplements safe?

Even though it is banned in sporting events, reasonable DHEA intake is considered safe. However, due to the fact that information regarding the detailed effect of DHEA to the body is still unavailable health professionals have placed certain precautions to be on the safe side. 

DHEA is a precursor hormone to a number of other hormones, meaning if you increase the amount of DHEA in a person’s body it is highly likely that you would increase other hormones aside from DHEA. This poses several concerns, one of them is the danger of exacerbating hormone-sensitive cancers like prostate, ovarian, and breast cancers. Another one would be on hormonal imbalances, those who have excessively oily skin, prone to acne, and for women, have unwanted male-pattern hair growth. DHEA could potentially cause harm in these cases; thus, its use is prohibited. 

Pregnancy, child-rearing, and breast-feeding is a delicate time for both mother and child. Since DHEA is still not fully understood yet, their use is also prohibited if the female is pregnant or breast-feeding. 

There is some evidence that DHEA can lower a person’s High Density Lipoprotein (HDL), also known as the good cholesterol. Although the evidence is not substantial, it is still best to practice precaution and avoid DHEA usage if you have a poor blood lipid profile. 

Although DHEA might have a positive effect on Depression, there has been some research that mentions its negative effect on select mental conditions.

Drug Interactions

DHEA when taken with certain drugs could lead to undesirable effects. Some of the drugs you need to be wary of includes Clozapine, Carbamazepine, Estrogen, Testosterone, Lithium, Valproic acid, Triazolam, Selective Serotonin Reuptake Inhibitors, and Phenothiazines. 

DHEA can reduce the efficacy of the mood-regulating drug Phenothiazine, antimanic drug lithium, anticonvulsant Valproic Acid, the antibipolar drug Carbamazepine, and the antipsychotic Clozapine. 

DHEA is a precursor to both Estrogen and Testosterone, taking them together can lead to abnormally high levels of Estrogen and Testosterone which could have the following undesirable effects; nausea, headaches, and insomnia in estrogen excess, and low sperm count, enlarged breast in men, and development of male characteristics in women in testosterone excess.

There are reports that DHEA can cause manic symptoms in individuals who are taking Selective Serotonin Reuptake Inhibitors.

The use of Triazolam, a sedative used for various purposes, along with DHEA can lead to undesirable effects on the Central Nervous System which leads to irregular breathing and arrhythmia. 

Side-effects

DHEA like any other drug has some reported side effects. Those who took it regularly have reported the following unfavorable effects; oily skin, acne, hair loss, gastric distress, hypertension, insomnia, unhealthy changes in cholesterol levels, nasal congestion, headache, fatigue, arrhythmia, changes in menstrual cycle, and development of masculine features in women such as deepening of the voice and facial hair.

Sources:

https://www.worldathletics.org/download/download?filename=4eaf68f3-91bb-4016-9747-99116e1a9956.pdf&urlSlug=bermon-current-opinion-2017

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943648/

https://jamanetwork.com/journals/jama/fullarticle/199765

https://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.156.4.646

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2435090/

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/208294

https://pubmed.ncbi.nlm.nih.gov/26731686/

https://www.sciencedirect.com/science/article/pii/S0011393X02800315

https://journals.lww.com/cjsportsmed/FullText/2017/01000/Doping_Status_of_DHEA_Treatment_for_Female.12.aspx