Dehydroepiandrosterone supplements: bringing sense to sensational claims.
OBJECTIVE
To summarize the current information about dehydroepiandrosterone (DHEA), a steroid hormone produced in the adrenal cortex.


METHODS
The biochemical and physiologic features of DHEA and its purported effects on overall age-related decline and on various disorders are reviewed. In addition, the potential side effects from administration of DHEA are discussed.


RESULTS
During the normal life cycle, levels of DHEA fluctuate, beginning with production of large quantities in the fetus, stopping at birth, resuming during ages 5 to 7 years, and increasing throughout puberty to maximal production in the 20s. Thereafter, DHEA levels progressively decline. This age-related decline in physiologic levels of DHEA has prompted speculation about a relationship between relative "DHEA deficiency" in older age and diseases of aging as well as the possibility of deriving benefits from administration of DHEA. Certain studies in animals (primarily rodents) have suggested anticancer effects of DHEA in pharmacologic doses and improvement in metabolism. In various studies in animals and humans, discrepant results have been found in the assessment of the association between DHEA levels and coronary artery disease. Likewise, the clinical significance of changes in immune function with DHEA treatment is unknown. Because DHEA is classified as a "nutritional supplement," it is not subjected to government regulation, and a potential exists for inaccurate dosage and impurities.


CONCLUSIONS
Studies have shown that DHEA influences multiple systems and disease processes in animals and humans; some of these effects could be considered beneficial and others detrimental. To date, no long-term health benefits from DHEA in "replacement" doses have been demonstrated.
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Division of Endocrinology, Metabolism, Nutrition, and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.