DHEA in Elderly Women and DHEA or Testosterone in Elderly Men

Abstract

One common approach to preventing or delaying age-related disorders is to supplement falling hormone levels. Animal studies give some evidence that dehydroepiandrosterone (DHEA) lessens age-related changes in body composition and has beneficial effects on diabetes and cardiovascular disease, but rodents—unlike humans—have very low DHEA levels. Whether or not to give supplemental testosterone to elderly men also is unsettled. This randomized 2-year placebo-controlled, double-blind study enrolled 87 men aged 60 years and older having low levels of sulfated DHEA and bioavailable testosterone, and 57 elderly women with low levels of sulfated DHEA. The men received 75 mg of DHEA daily in tablet form, 5 mg of testosterone daily via transdermal patch, or an appropriate placebo for 2 years. The women received either a 50-mg DHEA tablet daily or a placebo tablet. There were no major group differences at baseline. DHEA recipients had significant increases in levels of sulfated DHEA and estradiol, and treated women had increased total testosterone levels. Both bioavailable and total testosterone increased significantly in testosterone-treated men compared with placebo recipients. DHEA did not significantly alter gonadotropin levels in men or women, but lower levels were found in testosterone-treated men. Neither treatment significantly altered fasting plasma glucose levels or insulin sensitivity. Both men and women given DHEA had significant reductions in levels of high-density lipoprotein cholesterol. In men and women combined, those given DHEA had a slight but significant rise in fat-free mass and a reduction in proportion of body fat. Fat-free mass also increased in men given testosterone. Measures of muscle strength remained unchanged. Small increases in bone mineral density were noted at some but not all sites with both active treatments. Neither treatment significantly altered quality of life as reflected by scores on the Physical Component and Mental Component scales of the Health Status Questionnaire. Neither treatment altered prostate volume, liver function, or levels of electrolytes or hemoglobin. In this study, neither DHEA nor low-dose testosterone had physiologically meaningful beneficial effects on body composition, physical performance, or quality of life in elderly men or women. The investigators strongly recommend that these treatments not be used as anti-aging measures.