DHEA Deficiency

 

What is DHEA?

DHEA (dehydroepiandrosterone) is the most abundant steroid hormone in the human body.  DHEA starts to increase when children are about 9 or 10.  Levels peak between the ages of 20 and 35 and then start to decline.1 It is often referred to as the ‘anti-ageing hormone’, the ‘super-hormone’ or ‘the fountain of youth hormone’ due to the decline in certain functions associated with the ageing process.  DHEA plays a part in many of our bodily functions including regulating testosterone and oestrogen, memory and cognitive functions, the immune system, stress management and even vitality and wellbeing. The synthesis of DHEA is very complicated because there are several enzymes involved in the process (see graph below).  DHEA is a precursor hormone that is controlled by the brain via a negative feedback loop (similar to that of the thyroid gland).  The system starts with the hypothalamus, which produces corticotrophin-releasing hormone (CRH), which then informs the anterior pituitary gland to produce adrenocorticotropic hormone (ACTH).  Both CRH and ACTH enable the adrenal glands to produce DHEA. DHEA is also produced by the testes and ovaries as well as by the brain but in very small amounts.2  DHEA is synthesized mostly from cholesterol in the adrenal glands, which is then converted to pregnenolone.3 Once formed, pregnenolone can be converted to progesterone, which will then be converted to cortisol, or DHEA, which can be converted into other hormones including testosterone and estradiol.3,4  

What are the symptoms of a DHEA imbalance?

Depending on whether your DHEA levels are high or low for your age, symptoms could vary. Whilst DHEA production decreases with age in both men and women, a low level of DHEA can also indicate conditions like a damaged adrenal gland, Addison’s disease or hypopituitarism. Low DHEA levels often present symptoms such as memory loss, fatigue, low libido, osteoporosis and erectile dysfunction in men.  It has also been linked with a shorter lifespan in men but not in women.  Low levels are associated with an increased risk of cardiovascular disease in men with type 2 diabetes mellitus.1 Low levels of DHEA in women are associated with low libido, reduced bone mineral density and osteoporosis. High levels of DHEA have been seen in females with PCOS (polycystic ovarian syndrome) and hirsutism, children with congenital adrenal hyperplasia and people with cancer of the adrenals. Some studies have linked high levels with cardiovascular disease and death as well as a reduction in depression.5  All of these conditions would require testing and diagnosis by a specialist medical professional. High levels can cause acne, additional facial and body hair as well as hair loss, missed periods in women, fertility issues and other symptoms.6  

Testing

Your GP may be able to test your DHEA levels if you are concerned you might have an imbalance although it is more likely to be tested by an endocrinologist. If you are taking any DHEA supplements or supplements that could contain DHEA, you must advise your doctor of this ahead of your test.  The DHEA test is a straightforward blood test.7  

Treatment

Your clinician will use the results of your DHEA test to ascertain the cause of any DHEA imbalances.  There are many possible causes and solutions. Your treatment would be dependent on the root cause of the change in your DHEA levels. DHEA has been used along with gonadotropins to treat infertility.1  

What is the link between DHEA and thyroid disease?

It is common for people with Addison’s disease to have hypothyroidism and because DHEA is produced by the adrenals, problems with the adrenals can, but not always, affect its production and the levels present in the blood.8 Thyroid conditions can impact other hormone levels in the body, which can in turn also affect DHEA levels.  One study showed that DHEA, DHEA-S and PREG-S were all significantly lower in patients with hypothyroidism.  Interestingly, although DHEA levels were normal in patients with hyperthyroidism, their DHEA-S and PREG-S levels were significantly higher.9  

What about the research?

Research into DHEA is still relatively recent and producing some mixed results. It’s effectiveness is controversial with little supporting evidence.10  Most studies indicate no effect of DHEA on cognitive function or on muscle size or strength.  It’s use as a supplement carries certain side effects that should be considered.  The consistency of the quality across the supplements available is also not at a very high standard.  There are currently dosage guidance concerns too.11 Early research indicates that DHEA could be used to help people with certain conditions, such as adrenal insufficiency and lupus.  Further research into this solution is still required.  

What about 7-keto DHEA?

7-keto DHEA is produced from DHEA but is not converted to steroid hormones when taken orally.12 However, when used on the skin, it has been shown to affect hormone levels in men.13 7-keto-DHEA is often taken to speed up metabolism and weight loss as well as increase the activity of the thyroid gland, boost the immune system, enhance memory, and slow aging14 as well as to treat depression, anxiety, and post-traumatic stress disorder (PTSD).15,16 One randomized, placebo-controlled research study on dieting and exercising healthy overweight individuals found 7-keto DHEA significantly increased body-weight loss and fat-loss.17 Studies show that it was well tolerated in normal healthy men at doses up to 200 mg/d for up to 8 weeks although it might cause mild side effects such as nausea, dizziness, or low blood pressure in some people.18 Not enough is known about the use of 7-keto DHEA during pregnancy and breast-feeding so it’s best to avoid it.19 Be aware that the World Anti-Doping Association has classed 7-keto DHEA as a prohibited anabolic agent 20,21 and the UK class DHEA as a CLASS C controlled drug.22 When ordering online you may have your DHEA or 7-keto DHEA seized by customs.  

Check out what people are saying on our online community regarding DHEA:

http://www.healthunlocked.com/thyroiduk  

Thyroid UK relies on donations so that we can continue to support and campaign for people with thyroid disease and related disorders.  If you have found our information helpful, please do think about donating or becoming a member.

 

Donate Become a member

   

Glossary

Addison’s Disease – a rare disorder of the adrenal glands. The adrenal gland is damaged so it does not produce enough cortisol or aldosterone Adrenal gland – a small gland located on top of the kidney. The adrenal glands produce hormones that help control heart rate, blood pressure, the way the body uses food, the levels of minerals such as sodium and potassium in the blood, and other functions particularly involved in stress reactions Adrenocorticotropic Hormone (ACTH) – ACTH is made in the pituitary gland – it is needed for your adrenal glands to work properly and help your body react to stress Anterior – situated before or at the front Cardiovascular Disease – (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack) Cholesterol – a fatty substance in our blood, which is produced naturally in the liver Cognitive – ability of the brain to think and reason Congenital –  medical condition that is present at or before birth Corticotrophin-releasing hormone – the main element that drives the body’s response to stress Cortisol – a steroid hormone that regulates a wide range of processes throughout the body, including metabolism and the immune response. It also has a very important role in helping the body respond to stress Dehydroepiandrosterone (DHEA) – a hormone produced by the body’s adrenal glands Dysfunction – a problem or fault in a part of the body Endocrinologist – a medical practitioner qualified to diagnose and treat disorders of the endocrine glands and hormones Enzymes – proteins that creates a chemical reaction in the body Estradiol – an estrogen steroid hormone and the major female sex hormone.  Also known as oestradiol Gonadotropins – hormones synthesized and released by the anterior pituitary, which act on the gonads (testes and ovaries) to increase the production of sex hormones and stimulate production of either sperm or ova Hirsutism – abnormal growth of hair on a woman’s face and body Hyperthyroidism – a term used to describe an over-active thyroid gland Hypopituitarism – a rare disorder in which your pituitary gland fails to produce one or more hormones, or doesn’t produce enough hormones Hypothalamus –  a small area at the base of the brain where the pituitary gland is found, and helps regulate the endocrine and nervous system Hypothyroidism – a term used to describe an under-active thyroid gland Immune system – the organs and processes in the body that work together to resist infections Lupusa long-term condition causing inflammation to the joints, skin and other organs Oestrogen – the primary female sex hormone. Also known as estrogen Osteoporosis – a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D Pituitary gland – the major endocrine gland, a pea-sized body attached to the base of the brain that is important in controlling growth and development and the functioning of the other endocrine glands Pregnenolone – a hormone naturally produced in the body by the adrenal gland Progesterone – an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species Synthesis – something that is made by combining different things Testosterone – the primary male sex hormone and an anabolic steroid  

References

  1. You and your hormones Educational Resource from the Society of Endocrinology http://www.yourhormones.info/
  1. You and your hormones – Dehydroepiandrosterone Educational Resource from the Society of Endocrinology http://www.yourhormones.info/hormones/dehydroepiandrosterone/
  1. Early steps in androgen biosynthesis: from cholesterol to DHEA NCBI – Miller W L https://www.ncbi.nlm.nih.gov/pubmed/9890062
  1. DHEA and Health: More Questions that Answers Harvard Medical School https://www.health.harvard.edu/newsletter_article/dhea-and-health-more-questions-than-answers
  1. What is a DHEA Test? WebMD https://www.webmd.com/healthy-aging/aging-dhea-test#
  1. Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate University of Rochester https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=dhea
  1. Lab Tests Online UK DHEAS https://labtestsonline.org.uk/tests/dheas
  1. Addison’s Disease – Diagnosis NHS – Southend University Hospital https://www.nhs.uk/conditions/addisons-disease/diagnosis/
  1. Serum Dehydroepiandrosterone, Dehydroepiandrosterone Sulfate, and Pregnenolone Sulfate Concentrations in Patients with Hyperthyroidism and Hypothyroidism Noriko Tagawa et al American Association for Clinical Chemistry http://clinchem.aaccjnls.org/content/46/4/523
  1. How can DHEA benefit your Health? Medical News Today https://www.medicalnewstoday.com/articles/308684.php
  1. Dehydroepiandrosterone (DHEA): hypes and hopes Rutkowski K NCBI (Drugs. 2014 Jul;74(11):1195-207. doi: 10.1007/s40265-014-0259-8.) https://www.ncbi.nlm.nih.gov/pubmed/25022952
  Other Sources: https://www.sciencedirect.com/topics/neuroscience/dehydroepiandrosterone https://academic.oup.com/endo/article/145/3/1039/2877953   Date updated: 25/03/20 (V1.5) Review date: 09/10/20