Healthy Aging

DHEA for Bones, Brains, and in the Bedroom

The anti-aging perks of the dietary supplement DHEA

Dehydroepiandrosterone (DHEA) and its sulfated form, DHEA-S, are the most abundant steroid hormones in the human body.1 DHEA is produced from cholesterol in the adrenal glands, brain, ovaries, and testes, and is then converted into the major sex hormones estrogen and testosterone.

DHEA levels decline dramatically with age – and testosterone, estrogen, and other important hormone levels drop as well.2 By the time a person reaches their seventh or eighth decade of life, their DHEA levels may be a mere 10 to 20% of what they were in their mid 20’s.3 Women have been observed to have lower concentrations of DHEA than men,4 which likely plays a role in their increased risk of osteoporosis and other hormone-mediated ailments as they age.5 This age-mediated drop in DHEA may be buffered to at least some degree by DHEA supplementation.

Let’s take a closer look at how DHEA supplements may be able to help older individuals – especially older women – with bone health, brain health, and sexual function:

DHEA and bone health

DHEA may help safeguard against bone fractures, especially in older women.6

Some medications used to treat osteoporosis prevent the breakdown of bone (bone resorption) without stimulating new bone formation. DHEA, however, may do both by serving as a precursor to testosterone, estrogens, and other hormones that directly affect bone health.6

In a study assessing DHEA’s potential role in the bone health of older men, low levels of DHEA-s were associated with an increased risk of non-vertebral fractures (fractures of all body regions except for the spine). Even after the researchers controlled for such factors as age, body weight, and exercise, blood DHEA-s levels were inversely associated with osteoporosis and fracture risk.1

Blood DHEA-s levels are inversely associated with osteoporosis and fracture risk.

While high DHEA-s levels didn’t seem to protect older men from spinal fractures in this study, the results of another trial found that DHEA supplementation improved spine bone mineral density (BMD), an objective measurement of bone health, in older women – but not men.7 Whereas the spine BMD of the women who received placebo remained unchanged, the women who took DHEA (50 mg per day) plus vitamin D (16 μg, or 640 IU per day)8 and calcium (700 mg per day) had a statistical increase in spine BMD after one year, and an even greater increase after a second year of supplementation. Curiously, there was no significant difference in bone turnover markers (blood tests that screen for fracture risk) between the groups, but the women in the DHEA group were found to have higher levels of testosterone, estradiol (estrogen), and insulin-like growth factor 1 (IGF-1), a signaling factor with anabolic effects.

In another trial, 18 adults (10 women and eight men) between 72 and 74 years of age received 50 mg per day of oral DHEA supplementation for six months. As compared to the 18 members of the control group (who were a touch older: 73 to 75 years), the adults who took DHEA had improvements in both BMD and body composition. Specifically, total body and lumbar spine (low back) BMD increased, while fat mass decreased, meaning they had relatively less fat on their bodies than when they began the study – an added perk of the therapy. Again, testosterone and IGF-1 levels increased in the DHEA group, which may explain the mechanism by which DHEA improves bone health.9

While it has been demonstrated that DHEA increases bone formation in postmenopausal women, Papierska et al. performed a study to see if DHEA could also help women with osteoporosis caused by the use of steroid medications. The 19 women observed in this study all had low BMD, were between the ages of 50 and 78, and had all been on steroid drugs for at least three years before enrolling. The women were first treated with calcium, vitamin D, and a diuretic medication for one year before starting 25 to 50 mg of DHEA daily. DHEA supplementation was found to significantly increase the blood levels of DHEA-s and testosterone in all the women, and significant elevations of IGF-1 and osteocalcin (a marker of the formation of new bone) were also observed just six weeks after starting DHEA. After six months of supplementation with DHEA, these women were also found to have increased BMD of the lumbar spine and of the femoral neck (the thin part of the upper leg bone, just below the ball-and-socket joint of the hip).10

Despite the clearly positive findings of the above studies, not every trial has had the same outcomes. One study, for example, failed to find any significant changes in BMD or bone turnover markers in 88 older women (ages 70 to 82) who took 50 mg of DHEA daily for six months. It did, however, find that DHEA supplementation significantly raised the women’s DHEA, estrogen, and testosterone levels, and also increased their lower extremity strength (the strength of the muscles between their hips and toes).11

DHEA for brain health

Concentrations of both DHEA and DHEA-s are particularly high in the brain, one of the sites of their production and biological activity. DHEA and DHEA-s stimulate the growth of neurons, as well as the axons and dendrites by which they communicate. They also play a role in the synthesis of catecholamines like epinephrine and dopamine, have anti-inflammatory and antioxidant effects, and have even been implicated in the synthesis and release of endorphins.5,12 DHEA and DHEA-s are understood to be neuroprotective hormones, meaning they protect the brain and nervous system against damage and degeneration. DHEA and DHEA-s are thus sometimes referred to as “neurosteroids” for their hormonal effects on brain health and cognition.

DHEA and DHEA-s protect the brain and nervous system against damage and degeneration.

The evidence is mixed regarding the efficacy of DHEA supplements to help with cognition, however.5,13

Nevertheless, six months of DHEA supplementation (25 mg per day) was shown to be helpful in a study of older women (ages 65 to 90) with mild to moderate cognitive impairment.14 Specifically, the cognitive scores of the DHEA group improved, whereas cognition declined among the women in the control group. The women in the DHEA group also maintained their baseline ability to accomplish activities of daily living (ADLs), while the women in the placebo group declined in this area. DHEA was also associated with improvements in verbal fluency.

In a double-blind, placebo-controlled study of 24 healthy young men,15 a mere seven-day course of DHEA supplementation (150 mg twice daily) or placebo was administered. (As a note, this is a particularly high dose of DHEA which should not be taken without the guidance of a physician.) DHEA was found to reduce evening cortisol (stress hormone) levels and subjectively improve both mood and memory. Objectively, these men also performed better on episodic memory tests than those who received placebo.

DHEA for sexual health

Considering that DHEA is a precursor to the sex hormones testosterone and estrogen,13 DHEA supplements may very well improve sexual function – especially in women.

In a controlled, double-blind study of DHEA’s effects on hypoactive sexual desire disorder (HSDD), a condition marked with very low libido, 27 postmenopausal women and 21 men received either 100 mg of DHEA or a placebo daily for six weeks. (Again, high doses of DHEA such as this should only be taken under the guidance of a physician.) While the supplement increased blood levels of DHEA-s and testosterone, levels of bioavailable testosterone increased in the women only. The women reported significant benefits with sexual arousal and satisfaction (and, incidentally, brain function) in as little as six weeks.

Significant benefits with sexual arousal and satisfaction in as little as six weeks.

Higher blood levels of DHEA-s were also correlated with sexual satisfaction in the women. The study authors suggest that the sexual benefits of DHEA in women are likely due to the hormone’s metabolism to testosterone.16

In another study, one year of DHEA supplementation at a dosage of merely 10 mg per day yielded significant improvements in sexual function and frequency of sexual intercourse among women in early menopause, suggesting that this hormone may be of benefit even at low doses.12

Conclusion

DHEA may help protect older women – and, to some degree, older men – against the health ailments associate with aging. Specifically, DHEA likely reduces the risk of bone fracture, may improve cognitive function, and has been shown to improve sexual arousal and satisfaction.

References

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Managing Menopause

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