Dehydroepiandrosterone (DHEA)

Part I: An Analysis Of Its Status In Present Healthcare And Practical Protocols For Use By The Practicing Physician

by Peter B. Himmel, M.D.

In this brief review I would like to share my experience with over 2,000 patents who have either taken or are currently taking DHEA in a micronized time-release format. Some of the patients under my care have been taking DHEA for as long as four years. Most of these patients had Chronic Fatigue Syndrome, but at least 30-40% had a rheumatic disease or were elderly and failing. Additionally, a few adventurous souls wanted to stay youthful and energetic in their mid 40’s and early 50’s. I must emphasize that any use of DHEA that I have been personally involved with has utilized a micronized time-release product, and there does appear to be significant differences in the tolerance and utilization of straight DHEA and the micronized time-release lipoliphized form.

In the fall of 1996 1 presented a pilot study employing Dehydroepiandrosterone (DHEA) in the treatment of Chronic Fatigue Syndrome (CFS) at the American Association for Study of Chronic Fatigue Syndrome in San Francisco. Because of the large patient base that I have cared for, my observations should be of interest to other practicing physicians. I will also review some of the previous research with DHEA wherein the work was carried out previously with pure crystalline DHEA.

Present Status of Some of the Major Health Benefits of DHEA: Part 1

Recent interest in DHEA re-emerged following the work of Yen (1994) in a paper employing replacement doses of DHEA in older men and women (over 40). In a double blind controlled study seventeen women and thirteen men were given physiological doses of DHEA (50 mg) for a period of six months. They reported an increased sense of well being as manifest by: increased energy, deeper sleep, a more relaxed feeling associated with a more joyous mood, and a better ability to handle stressful events (significant at less than 0.005 level). There was a small increase in muscle mass and the lipid profile was relatively stable, although showing a slight decrease in HDL in women. Weight and insulin sensitivity changed little. There was a remarkable increase of about 10% in Insulin Growth Factor-I (IGF1). This relatively small dose restored DHEA levels in the majority of patients to those of a young adult within two weeks. There was a doubling of serum level of androgens in women, and a very small rise in men. There was no effect on libido in either sex.

At about this time one of the initial pioneer of DHEA research (some 27 years of experience) Etienive-Emile Balieu of France was being interviewed in the press with the patients he had placed on DHEA supplements exhibiting their vitality and potential increase in longevity with one woman still active at 120 years of age. In the Fall of 1996 DHEA was allowed into food stores (now considered a food supplement by the FDA), and made available to the general public. While I’m sure the rational for the removal of DHEA from health food stores in 1986 is a matter of public record, members of the FDA I contacted gave me a number of reasons, ranging from androgenic effects and potential misuse by body builders to anti-obesity and anti-viral effects. DHEA is also associated with an increased sense of well being and strength, and the promotion of its use in patients with AIDS led to its being considered as a drug. The passage of the Hatch amendment in 1994 negated the above reasoning.

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