Nutrition Action Healthletter
March 1997 — U.S. Edition

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DHEA: Not Ready for Prime Time

BY DAVID SCHARDT & STEPHEN SCHMIDT

"Look younger, live longer, feel better." -- The DHEA Breakthrough, by Stephen Cherniske.

"Invigorate your sex life." -- The Superhormone Promise, by William Regelson.

"Many diseases just melt away." -- Dr. Julian Whitaker, as quoted on the DHEA Connection's home page (www.tucsonlink.com/dheaconn).

"The anti-aging miracle of the 21st century." -- Dr. Earl Mindell, as quoted on the DHEA Center's home page (www.dheacenter.com).

DHEA is a miracle drug, all right -- for the companies that make it, the authors who plug it, and the doctors and multi-level marketers who hawk it on the World Wide Web.

If you're trying to stave off a debilitating disease, on the other hand, or long to recapture the energy of your youth, there is little evidence-at least in humans-that DHEA will do anything except lighten your wallet ... and perhaps raise your risk of prostate or endometrial cancer. If you've already got one of those cancers, DHEA could even make it grow faster.

HORMONING AROUND

It's not nice to play with hormones. But that's just what people who take dehydroepiandrosterone (DHEA) are doing.

Each morning, the adrenal glands (which sit atop the kidneys) release a form of DHEA into the bloodstream, from where it works its way to the body's tissues and is converted into small amounts of the sex hormones testosterone and estrogen.

What has scientists intrigued-and supplement-makers drooling-is that DHEA levels decline steadily as we age. In fact, an average 25-year-old produces about four times the DHEA of an average 70-year-old.

Bingo! Could a drop in DHEA be what causes us to age, get sick, and die?

The evidence in humans is scanty. But that hasn't stopped a band of DHEA boosters -- and an army of salespeople-from flooding bookstores and the Internet with extraordinary claims.

CLAIM: DHEA LENGTHENS LIVES

"Add Decades to Your Life." The jacket to The Superhormone Promise, by DHEA proponent William Regelson, isn't what you'd call subtle.

"The good news," writes the cancer specialist at the Medical College of Virginia in Richmond, "is that some exciting research being done at the University of Wisconsin in Madison suggests that DHEA may also help extend life." Regelson is talking about the work of Richard Weindruch, who is studying the life spans of mice given DHEA.

"We have heard from colleagues of Dr. Weindruch's," writes Regelson, "that the DHEA mice are actually doing much better than the control mice [on identical diets but with no DHEA], and they are very optimistic that DHEA will prove to be a tool which will extend life."

"Not true," says Weindruch. "DHEA does not prolong the lives of my laboratory mice, and may even shorten their life span."

Weindruch's study, which has not yet been published, is the largest to look at DHEA and longevity. And it's the only one to test the hormone on healthy animals with normal life spans.

"We found that 75 mice given DHEA each day starting in midlife lived no longer than 75 similar mice who were not given DHEA," says Weindruch, whose study was financed by the American Cancer Society.

But what's troubling, he adds, are preliminary results from an unfinished part of his study that looked at 150 mice fed restricted-calorie diets (which do cause them to live longer).

"The 75 that were also given DHEA seemed to be dying earlier than the 75 that weren't given DHEA," he says.

CLAIM: DHEA PREVENTS HEART DISEASE

In a study of 242 men in a Rancho Bernardo, California, retirement community, those who had naturally higher-than-average levels of DHEA were 70 percent less likely to die of heart disease during the next 12 years than those with lower-than-average DHEA.'

While this 1986 research -- by Elizabeth Barrett-Connor of the University of California, San Diego -- is often cited by DHEA enthusiasts, her 1995 follow up study seldom is. When she returned to Rancho Bernardo for a more-comprehensive look at 1,971 men and women-including the surviving men from the first study-the results, she wrote, were "strikingly different. "I

Men with higher-than-average DHEA were 15 per-cent-not 70 percent-less likely to die of heart disease. And DHEA didn't seem to 11 offer women any benefit.

What's more, says Barrett-on Connor, "until intervention our trials with DHEA are done, we can't conclude that DHEA was the cause of the small benefit we found in men."

IS DHEA SAFE?

So DHEA may not be a miracle drug. But what's wrong with taking it anyway, just to hedge your bets?

"Prostate cancer and endometrial cancer, for starters," says Richard Sprott of the National Institute on Aging. "The testosterone and estrogen into which our bodies convert DHEA can stimulate the growth of these cancers. We don't know how much DHEA, in what formulation, for how long, and in which people it's safe."

When estrogen was first used as hormone replacement therapy, Sprott points out, "we saw an upswing in endometrial cancer cases until we learned to combine the estrogen with progesterone. We don't know what the case is with DHEA."

Arlene Morales of the University of California, San Diego, School of Medicine, is co-author of the two largest DHEA trials. She has stopped working with the hormone, in part because of its potential hazards.

"It's crazy that people can walk into a store and buy DHEA without a prescription," she says. "The levels we were using, 50 to 100 milligrams a day, produced higher-than-normal levels of male hormones in the women, and we don't know what that does to women over long periods of time."

What's more, anything that increases testosterone levels could increase the risk of prostate cancer in men, or could make a man's prostate cancer worse.

"Many men probably have prostate cancer and don't know it," says researcher Arthur Schwartz of Temple University. "if they take DHEA, it could make the cancer grow more quickly."

CLAIM: DHEA PREVENTS CANCER

"In a large population study conducted by British researchers on the island of Guernsey, it was discovered that women with DHEA blood levels less than IO% of the normally expected amount for their age group all developed breast cancer and died of the disease."

So says NaturePlus's World Wide Web site (wvvw.natureplus.com). NaturePlus, which sells DHEA, was one of dozens to publish the "news."

There's only one problem: It isn't true.

"I can't think of anything that we did that would lead someone to that conclusion," says Dennis Wang, who helped direct the Guernsey study for the Imperial Cancer Research Fund in London.

"As far as I'm aware," he adds, "there's no good evidence that DHEA affects the development or prognosis of breast cancer."

Things on this side of the Atlantic aren't any more promising.

In three studies in Maryland and California, researchers looked at blood samples that were taken years ago from healthy people. In each case, women who subsequently got breast cancer were no more likely to have had lower DHEA levels than similar women who remained free of the disease.3,' And in two studies, women who got ovarian cancer and postmenopausal women with breast cancer were more likely to have had higher DHEA levels years earlier.

CLAIM: DHEA MELTS FAT

DHEA's power to burn fat "may become one of the most significant finds in weight control of this century," says Amy's Health and Nutrition Store (healthstore.simplenet.com). "No matter what you eat," it adds, "DHEA still provides benefits of weight loss."

"That's totally false," says Arthur Schwartz of the Fels Institute for Cancer Research and Molecular Biology at the Temple University School of Medicine in Philadelphia. Schwartz's research on weight is often cited on the Internet by DHEA proponents. "No human data exist whatsoever that show that DHEA can help a person lose weight. I wish they wouldn't use my name."

One small study did show that eight older men taking 100 mg a day of DHEA for six months lost fat and gained muscle. But six other studies -- using from 50 to 1,600 mg a day for three weeks to six months on a total of more than 60 men and women -- saw no change in body fat.

OTHER CLAIMS

"If you want to stay sexually active, I have good news," says writer Stephen Cherniske in The DHEA Breakthrough.

Good news for him, maybe; he's sold another book. As for your sex life: Volunteers reported no change in sexual desire while taking 50 mg a day of DHEA for three months, in the only study to ask.9 No well-designed study has looked at DHEA and sexual activity.

"Not proven," says researcher Elizabeth Barrett-Connor of the University of California, San Diego. In her 1993 study of 400 older men and women, more DHEA in the blood didn't mean denser bones 16 years later."

"There is very little research in humans," says Richard Sprott of the National Institute on Aging.

In one study, 64 volunteers aged 65 or older were given tetanus or influenza vaccines. Those who took 50 to 100 milligrams a day of DHEA for two days did not produce more (diseasefighting) antibodies than other seniors, as animal studies had suggested.

And 31 men with HIV had no higher levels of CD4 after taking 750 to 2,250 milligrams a day of DHEA for four months. CD4 is a measure of the immune system's ability to fight the AIDS virus.

In a small three-month study, people were more likely to report "improved physical and psychological wellbeing" when on 50 mg a day of DHEA than when on a placebo.

But in a follow up study (not yet fully published) of 16 different men and women given 100 mg of DHEA or a placebo every day for six months, "we didn't get the same positive reports of well-being," says Arlene Morales of the University of California, San Diego. "So it's not clear what effect, if any, DHEA has on energy or mood."

Pssst! Wanna Hormone?

"There is little evidence," says Lon S. Schneider of the University of California School of Medicine, Los Angeles. "Most studies have not found that blood levels of DHEA are lower in Alzheimer's patients."

A clinical trial is currently testing DHEA on Alzheimer's patients in California. But even the neurobiochemist who holds the patent for the use of DHEA to treat the disease, Eugene Roberts of the Beckman Research Institute of the City of Hope in Duarte, California, isn't optimistic. "At the moment," he says, "there is no evidence that it helps."

This one may turn out to be true. In a small, well-designed study, 14 women who were given 200 mg a day of DHEA for three months had less joint pain and other symptoms -- and had less need for medication -- than 14 similar women who were taking a placebo. Lupus is an autoimmune disease, which means the body attacks itself. The first results from studies on DHEA and lupus are expected later this year.


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