DHEA (dehydroepiandrosterone) is most known for being a pro-hormone which in the body gets converted to testosterone and estrogen. It is a long held view that DHEA exerts all its effects via conversion to testosterone and estrogen. However, recent studies show that DHEA also has several health promoting non-hormonal actions...
DHEA is produced mainly by the adrenal cortex, and is rapidly sulfated by sulfotransferases into DHEA-S. DHEA and its sulfated form DHEA-S is the most abundant steroid (pro)hormone circulating in the blood stream. The sulfated from of DHEA has a longer half-life in the blood and its levels remain stable throughout the day, are not altered significantly by the menstrual cycle. When getting a blood test for DHEA, the fraction that is routinely measured is therefore DHEA-S. In response to metabolic demand, DHEA-S is rapidly converted back to DHEA (e.g. is hydrolyzed to DHEA by sulfatases).
DHEA levels decrease approximately 80% between ages 25 and 75 year.[2, 3] This large decline in DHEA spurred research interest in the possibility that aging related DHEA deficiency may play a role in the deterioration of physiological and metabolic functions with aging, and in the development of chronic diseases.
When it comes to health promotion and longevity, DHEA is a supplement which deserves more attention than it has been getting.
DHEA levels (the main circulating form of DHEA in the bloodstream is DHEAS) decrease approximately 80% between ages 25 and 75 year.[1, 2]This large decline in DHEA has led to interest in the possibility that aging related DHEA deficiency may play a role in the deterioration in physiological and metabolic functions with aging, and in the development of chronic diseases.
In support of this, it has been reported that DHEA level is negatively correlated with mortality and risk of developing cardiovascular disease (CVD) (i.e. lower DHEA(S) levels are associated with higher mortality and CVD risk).[3-5]More recently it has been found that a steep decline or extreme variability over time in DHEA(S) levels is associated with higher mortality, more so than baseline DHEA(S) levels.
It has been reported that DHEA levels are inversely associated with arterial stiffness (i.e. lower DHEA levels are associated with increased arterial stiffness. [7, 12, 13] Therefore, it is possible that DHEA replacement in older adults could reduce arterial stiffness, and thereby contribute to reduction in CVD and mortality...
Many studies have highlighted the importance of investigating all major hormones, and correcting deficiencies and imbalances if present.[1-8] Given the known mechanisms of testosterone and GH/IGF-1 in building muscle (and possibly also DHEA in elderly) it is reasonable that age-related low levels of anabolic hormones contribute over time to sarcopenia and frailty.[1, 2, 4, 7, 9, 10]
Thus, multiple small effects in aggregate can lead to adverse loss of muscle and disability. In this scenario, if replacement was to occur, it would require lower doses of multiple anabolic hormones. An added benefit to this approach would be fewer side effects from the use of lower hormone doses . In addition, multiple anabolic hormone replacement might also have beneficial additive or even synergistic effects.[11-13]
A notable study investigated whether supplementation with testosterone and GH together, in physiological doses, results in greater improvements in body composition and muscle performance in older men, compared to testosterone supplementation alone...
Reduced levels of anabolic hormones can contribute to aging and frailty. Most studies that have investigated this focused on the relationship between individual hormones and specific age-associated diseases. An interesting study in older women aged 70-79 years sought to examine the associations of individual anabolic hormonal deficiencies of free testosterone, IGF-1 and DHEA, and to assess their combined effects as well.
The anabolic hormones testosterone, IGF-1 and DHEA (a pre-hormone) are receiving more and more attention by health professionals because the anabolic-catabolic imbalance that favors catabolism is a key factor in accelerated physical deterioration aging.[1, 2] Anabolic impairment can speed up the age-related decline in muscle mass and physical performance, increase in fat mass, development of insulin resistance, cardiovascular risk factors, metabolic syndrome and diabetes, conditions that in turn affect mortality.[3-18]
Interestingly, low levels of multiple anabolic hormones, rather than a single one, has a stronger association with age related muscle loss and the frailty syndrome. [19, 20] In men with chronic heart failure, deficiency of more than one anabolic hormone identifies patients with higher mortality rates.
An interesting study sought to investigate the relationship between parallel deficiency of several anabolic hormones and mortality in a general population of older men, regardless of coexisting disease: