Mood elevation 
      The studies by Morales, Yen, and Labrie all suggest that DHEA is able to provide a sense of well-being and improved energy levels in the majority of the users. My clinical experience matches the research findings. 
      Owen Wolkowitz, M.D., from the Department of Psychiatry at the University of San Francisco, has been researching the role of DHEA as an antidepressant in middle-aged and older individuals. He tells me, "Our research has consistently shown that DHEA supplementation improves mood [in these groups]." 
      Pregnenolone, "the grandmother of all adrenal hormones," became more available over the counter in 1996. My clinical experience suggests that this hormone also has mood-elevating properties, which is supported by research presented in the book,  Pregnenoione: Nature's Feel Good Hormone (Avery, 1997). (See pregnenolone sidebar,) 
 

Weight loss/muscle gain 
      At the end of the 12-month study completed by Labrie, et al., there was no change in weight in the women receiving DHEA. However, this study found that DHEA supplementation led to a 10 percent decrease in body fat while leading to a 10 percent increase in muscle mass. This happens since DHEA is converted into androgens, which have some anabolic (constructive, or synthesizing, metabolic) properties. 

Libido enhancement 
      DHEA is converted in the body into testosterone and estrogen. It is known that testosterone increases sexual drive. A three-month study done by Morales, et al., showed that DHEA did increase libido, but the improvement was similar to that of the placebo group, and thus was not statistically significant. In my clinical experience, most men and women who take DHEA have reported a noticeable increase in libido. 

Improves bone formation. 
      Labrie found that DHEA supplementation led to stronger bones. Levels of serum osteocalcin, a marker for bone formation, increased, while the urinary hydroxyproline/creatinine ratio, a marker of bone resorptlon, decreased. This makes sense in that both of the metabolites of DHEA -- androgens and estrogens -- are known to have a positive influence on bone formation. 

Circulatory system effects 
      Animal-model studies (Haffa, et al, 1994; Jesse, et al, 1995; Rich, et al, 1993) have shown that DHEA administration has beneficial effects on the circulatory system, specifically a prevention of plaque formation and a slight thinning of the blood. The long-term effects of DHEA on the human circulatory system are not known. Anecdotal information suggests some people experience heart palpitations or arrhythmias on dosages greater than 20 mag. 

Influence on tumor formation 
      Animal studies, conducted by A. Schwartz, et al., in 1979 and 1995, have shown that DHEA has powerful anti-cancer abilities, and the administration of this hormone has decreased the incidence of a variety of cancers, including breast, colon, pancreas, and brain. However, the influence of long-term DHEA supplementation on human tumor initiation, promotion, or inhibition is not known at this time. 

Influence on prostate gland 
     DHEA may increase the risk for benign (non-cancerous) prostatic enlargement. There are several factors that influence the growth of the prostate gland, one of the most important of which is the hormone, dihydrotestosterone (DHT). DHEA can be converted into DHT and, consequently, can increase the size of the prostate gland. There is a possibility that high doses can also increase the risk for prostate cancer (becoming more common). 

Potential side effects 
      Side effects can readily occur with the misuse of DHEA. These side effects depend on how much is taken, and generally begin at about 10 mg. The following are some of the side effects that have been either mentioned in the medical literature or that have been observed clinically. 

Acne. 
      Pimples can occur even on the very first day of use, if a high dose is taken. Individuals prone to acne can get pimples on a dose as low as 5 mg. Acne has been reported by the subjects in all three of the long-term clinical trials. Stop the use of DHEA when pimples occur, and then discontinue taking the hormone for a few days. Thereafter, restart at a lower dose. 

Hair growth and loss 
      This is common in women, and can occur in unwanted places such as the face and       chin. Facial hair growth has been observed in both clinical trials and in the office setting. As one would expect, this side effect is not popular with most women. As with acne, hair growth is dose-dependent, and generally occurs in women who take more than 10 mg. 
      On the other hand, high doses of DHEA could potentially lead to accelerated scalp hair loss in certain sensitive individuals due to this hormone's conversion into dihydrotestosterone (DHT), the hormone associated with hair loss. 

Overstimulation, insomnia, and other effects 
      Anecdotal information indicates that high dosages of DHEA can lead to overstimulation, occasional nervousness, irritability, and aggresiveness. Some users experience difficulty sleeping, since DHEA can cause alertness.Headaches, mood changes and fatigue have also been reported anecdotally. 

Caution: Heart irregularites (palpitations or arrhythmias) have not been reported in the medical literature, although I have come across at least two dozen cases over the past year. The possible mechanisms include a direct effect of DHEA on the nerve conduction system of the heart or possibly through DHEA stimulating the thyroid gland to release excess levels of thyroid hormones. 

Fountain of youth 
      There is no doubt that the majority of people who take the appropriate dosage of DHEA notice an improvement in mood, energy, and mental functions, such as better memory and thinking abilities. Whether regular supplementation with DHEA for years, and decades, will increase life span is currently not known. My opinion is that, just as estrogen replacement has been shown to increase life span in women, as found through studies done by Ettinger, et al., we may eventually find DHEA to do the same. However, it will take decades to find the right dosages and the ideal form of administration (i.e., pills, cream, sublingual, timed-release pills, or micronized). It will also take a long time to find out which population groups would most benefit. 

More is not better 
      In the meantime, I urge anyone who is currently taking DHEA, or plans to do so, to take small amounts. It's quite possible that low doses could be beneficial while high dosages could be counterproductive, or harnfiul, as indicated. 
      For most individuals, the maximum daily dose I recommend is no more than 10 mg. I also advise individuals to take, what I call, 'hormone holidays." This means that you should occasionally give yourself a break and go off the DHEA. There are many ways to do this. You could take the pills every other day, take 5 days on, two days off, or take off one or two weeks a month. 
 

Ray Sahelian,M.D., is the bestselling author of books on DHEA, creatine pregnenolone, melatonin, saw palmetto, glucosamine, St. John's Wort, Co-Q10, kava, stevia, 5-HTP, and lipoic acid. To inquire about Dr. Sahelian's hormone books, including DHEA: A Practical Guide and Pregnenolone: Nature's Feel Good Hormone, ask your retailer to call (310) 821-2409. 
 

Pregnenolone: the 'grandmother of the adrenal hormones' 

      Pregnenolone (Preg) is primarily made in the adrenal glands from cholesterol, but it can also be made in other tissues, including the brain. I call it the "grandmother of all adrenal hormones," since the body uses it to convert DHEA, progesterone, and at least 150 different steroidal hormones. Preg has functions that overlap with progesterone and DHEA. 
      Availability: Pills are sold in 5, 10, 25, and 50 mg. Sublingual tablets are sold in 5, 10, and 25 mg. 

Indications: 
      Research with Preg is limited. It may have a roleto play as an additional hormaone to replace as we get older. It has powerful memory-enhancing capabilities as demonstrated in rodent studies. Users report enhanced wisual and auditory perception, a sense of well-being, and increased alertness and awareness of environment. Women with premenstral syndrome often report improvement of symptoms. 

Dosage: 
      Maximum regular, daily dosage should not exceed 10 mg. I recomend "hormone holidays," similar to those recomended when taking DHEA. Both Preg and DHEA have some overlapping functions; therefore, if you plan to add Preg to your DHEA regimen, you need to reduce your dosage of DHEA. Preg should be taken in the morning, or no later than noon. Long-term hormone replacement dosages range from 2 to 5 mg. with "hormone holidays." 

Side effects: 
      High doses can lead to similar androgenic side effects as seen with high doses of DHEA, including acne and accelerated hair loss. Irritability, aggressiveness, insomnia, anxiety, headaches, and menstrual irregularities are also frequently reported in dosages greater than 10 or 25 mg. Heart palpitations can also occur in dosages greater than 25 mg. or even at 10 mg in individuals with hearts prone to irregular rhythms. 

Future potential: 
      Preg is a fascinating hormone; there's still a great deal we need to learn about its potential. It could eventually be found to play a role, either by itself or with other natual supplements, in easing arthritis, controlling seizures, enhancing itelligence, and a number of medical and psychiatric conditions. 

Better Nutrition May 1998