Dehydroepiandrosterone (DHEA), DHEA Sulfate, and Aging: Contribution of the DHEAge Study to a Sociobiomedical Issue

Abstract

Studies showing that blood levels of dehydroepiandrosterone (DHEA) and its sulfate ester (DHEAS) drop markedly with advancing age led to the concept of an “adrenopause” that might conceivably impair health. One implication is that administering DHEA may confer benefit, as does administration of estrogen to postmenopausal women. Wide interest in this possibility promoted a randomized, double-blind, placebo-controlled, year-long trial of orally administered DHEA in 280 men and women aged 60 to 79 years, the DHEAge Study. Participants were seen for various reasons at a geriatric clinic but had no severe or evolving disease. Subjects took 50 mg of DHEA daily or a placebo for 1 year and were followed up at 3-month intervals. Young adult DHEAS levels were present in men after 6 months of receiving DHEA. After 1 year of treatment the levels fell significantly compared with 6-month values in men less than 70 years of age but not in older men. Estradiol levels increased significantly during the treatment year. Women had higher DHEAS levels after 6 months of treatment, exceeding young adult values, but nearly all of them had a secondary reduction after 1 year of treatment, and this was highly significant in those younger than 70 years. There were no changes in levels of gonadotropins, thyrotropin, or triiodothyronine. Testosterone levels increased to a limited extent. Bone turnover, as measured by dual-energy x-ray absorptiometry, improved in women older than 70 years. Older women also had significantly increased libido, and skin hydration improved at the same time. In addition, pigmentation of the facial skin decreased significantly, sebum production increased, and epidermal thickness was greater than in placebo recipients. Treatment for 1 year with 50 mg daily of DHEA seems to normalize some of the effects of aging without obvious harmful consequences. It does not, however, in any sense create “supermen” or “superwomen.” Those who take DHEA at this dose level, or even in smaller amounts, require appropriate follow-up at reasonable intervals. Proc Natl Acad Sci U S A 2000;97:4279–4284