title: Is DHEA replacement beneficial in chronic adrenal failure?
abstract: Although dehydroepiandrosterone (DHEA) and its sulphate ester dehydroepiandrosterone sulphate (DHEAS) are the most abundant steroid hormones in the human circulation, its exact physiological role is not yet fully understood. In patients with adrenal insufficiency, secretion of DHEA is impaired, leading to decreased circulating DHEA and DHEAS levels, and to androgen deficiency in women. Replacement of DHEA in patients with adrenal insufficiency positively influence mood, sexuality and subjective health status. These effects are generally moderate and show high inter-individual variability. Limited evidence exists for immunomodulatory effects of DHEA. Although an increase of IGF-I levels has been documented, relevant effects on body composition, metabolic or cardiovascular parameters has not been observed in patients with adrenal insufficiency receiving DHEA. Larger-scale phase III studies are still lacking; therefore, initiation of DHEA replacement is decided on an individual basis, focussing on those patients with impaired well-being associated with signs and symptoms of androgen deficiency.
authors.affiliation: Endocrinology and Diabetes Unit, Department of Internal Medicine I, University Hospital of Wuerzburg, Oberduerrbacher Strasse 6, D-97080 Wuerzburg, Germany. Electronic address: Lang_k@ukw.de.
authors.forename: Katharina
authors.initials: K
authors.lastname: Lang
authors.affiliation: Endocrinology and Diabetes Unit, Department of Internal Medicine I, University Hospital of Wuerzburg, Oberduerrbacher Strasse 6, D-97080 Wuerzburg, Germany. Electronic address: Burger_s1@ukw.de.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Burger-Stritt
authors.affiliation: Endocrinology and Diabetes Unit, Department of Internal Medicine I, University Hospital of Wuerzburg, Oberduerrbacher Strasse 6, D-97080 Wuerzburg, Germany. Electronic address: Hahner_s@ukw.de.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Hahner
mesh_terms: D000309:Adrenal Insufficiency / Q000188:drug therapy*; D000728:Androgens / Q000627:therapeutic use*; D003687:Dehydroepiandrosterone / Q000627:therapeutic use*; D006304:Health Status; D020249:Hormone Replacement Therapy; D006801:Humans; D012725:Sexual Behavior; D016896:Treatment Outcome
chemical_list: D000728:Androgens; D003687:Dehydroepiandrosterone
keywords: DHEA; androgen deficiency; anxiety; cardiovascular effects; dehydroepiandrosterone; depression; immune modulation; intracrinology; quality of life; sexual function