Natural Products

DHEA

Dehydroepiandrosterone

Efficacy

• Indications with proven efficacy:
  None
• Indications with possible, but poorly documented efficacy - the use of this product cannot be recommended:
  Depression
  Hormonal deficiency
  Sexual dysfunction
  Systemic lupus erythematosus
  To improve skin in elderly
  Vaginal atrophy and increasing bone density (vaginaly)
• Also used for these other indications, but with no proof of efficacy:
  Alzheimer's disease
  Multiple sclerosis
  To enhance immunity
  To improve cognitive functions
  To increase strength, energy and muscle mass
  To slow normal aging process
  Weight loss

Security

• Risk of Drug Interactions: Low
• Adverse Effects: Frequent

What is it?

DHEA is a steroid hormone with androgenic (masculinizing) properties, which is naturally synthesized by the human body. It reaches its maximum levels around the age of 25 and then decreases quite rapidly until 50 to 60 years of age. DHEA levels continue to decrease, but more slowly, until the age of 70 to 80 when they represent only about 20% of what they were at age 20. Because DHEA level reduction is age-related, some think that DHEA may be in cause in several diseases associated with aging.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) or homeopathic medicine number (DIN-HM) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plants content varies naturally from plant to plant – just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

Does it work?

Even though this product has many claims, there is no evidence that DHEA is effective in any indication. However, it is used to treat some medical conditions where it could be of some benefit:

• Depression:
  DHEA may be used alone or in combination with antidepressant drug: 30 to 90 mg per day.
• Sexual dysfunction:
  A typical dose is 50 mg per day.
• Systemic lupus erythematosus:
  As an adjunct to appropriate medical treatment. May help reduce corticosteroid doses needed. Doses used are 200 to 600 mg daily.
• Vaginal atrophy and increasing bone density:
  A 10% DHEA vaginal cream applied daily.

There is insufficient reliable information to conclude that DHEA is effective in any other indication

Is it safe?

• The risks associated with DHEA use, especially long term use, are not clearly established. DHEA use may cause acne, hair loss, hirsutism, deepening of the voice in women, insulin resistance, decreased "good" cholesterol, changes in menstrual pattern, liver problems, abdominal pain, hypertension and psychiatric events. High levels of DHEA are thought to be associated with an increased risk of prostate or breast cancer. DHEA is contraindicated in people with prostate or breast cancer.
• Since there is no safety data available concerning its use during pregnancy and breast-feeding, pregnant and lactating women should avoid DHEA.

Clinical notes

• Experts agree that for most indications, the risks associated with DHEA outweigh the benefits. This product should probably be used only under medical supervision. DHEA has been banned from the market in Canada.

References

1. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2007
2. Peirce, Andrea. Practical Guide to Natural Medicines, APha, 1999
3. Chandler, Frank. Herbs – Everyday Reference for Health Professionals, CphA – CMA, 2000
4. Passeportsanté.net. DHEA. http://www.passeportsante.net