Are there any side effects or interactions?
Experts have concerns about the use of DHEA, particularly because long-term safety data do
not exist.
Side effects at high intakes (50–200 mg per day) appear to be acne (in over 50% of people), increased facial hair
(18%), and increased perspiration (8%). In a preliminary trial, DHEA was also reported to
induce less common side effects, including breast tenderness, weight gain, mood alteration,
headache, oily skin, and menstrual irregularity in some people.6 Since this trial
was not controlled, some of these less common “side effects” might have occurred
even with a placebo. A case of mania has been reported in an older man who took 200–300
mg of DHEA per day for six months.7 However, in that case report, other causes of
mania could not be ruled out.
Significant increases in testosterone levels in both men and women have been reported in
some trials.8 9 Other reports have found this change in women but not in
men.10 An increase in testosterone might increase the risk of several cancers, and high amounts of DHEA have caused cancer
in animals.11 12 Moreover, a possible link between higher DHEA levels
and risks of prostate cancer in humans has
been reported.13 At least one person with prostate cancer has been reported to have
had a worsening of his cancer, despite feeling better, while taking very high amounts (up to
700 mg per day) of DHEA.14
While younger women with breast cancer may
have low levels of DHEA, postmenopausal women with breast cancer appear to have high levels of
DHEA, which has researchers concerned.15 16 Most,17
18 19 20 21 but not all, studies22
23 24 have found that as DHEA blood levels increase, so does the risk of
breast cancer.
Supplementation with high levels of DHEA (100 mg per day) has adversely affected other
indicators of cancer risk in both women and men.25 26 Elevated DHEA
levels have been reported to be associated with both higher,27 and lower risk for
ovarian cancer.28 The reason for this discrepancy is unknown.
The lack of knowledge about how DHEA supplementation might affect cancer risks provides a
reason for caution. Until more is known, people with breast or
prostate cancer or a family history of these conditions should avoid supplementing with
DHEA.
Although anticancer effects of DHEA have also been reported,29 they
involve trials using animals that do not process DHEA the way humans do. Therefore, these
positive effects may have no relevance for people.
Some doctors recommend that people taking DHEA have liver enzymes measured routinely.
Anecdotes of DHEA supplementation (of at least 25 mg per day) leading to heart arrhythmias have appeared.30
The relationship between DHEA, blood pressure, and heart disease is poorly understood.
Increased blood levels of DHEAS have been associated with increased blood
pressure31 and other cardiovascular
risk factors in some,32 but not all,33 studies. One study found that
people with hypertension had significantly decreased blood levels of
DHEA.34 Until clinical trials clear up these inconsistencies and confirm its
safety, people with hypertension should avoid
using DHEA, except under the close supervision of a doctor.
At only 25 mg per day, DHEA has lowered HDL cholesterol while increasing insulin-like
growth factor (IGF).35 Decreasing HDL could increase the risk of heart disease.
Increasing IGF might increase the risk of breast cancer.
Are there any drug
interactions?
Certain medicines may interact with dehydroepiandrosterone. Refer to drug interactions for a list of those medicines.
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2. Morales AJ, Haubrich RH, Hwang JY, et al. The effect of six months
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3. Percheron G, Hogrel JY, Denot-Ledunois S, et al. Effect of 1-year oral
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systemic lupus erythematosus with dehydroepiandrosterone: 50 patients treated up to 12 months.
J Rheumatol 1998;25:285–9.
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11. Orner GA, Mathews C, Hendricks JD, et al. Dehydroepiandrosterone is a
complete hepatocarcinogen and potent tumor promoter in the absence of peroxisome proliferation
in rainbow trout. Carcinogenesis 1995;16:2893–8.
12. Metzger C, Mayer D, Hoffmann H, et al. Sequential appearance and
ultrastructure of amphophilic cell foci, adenomas, and carcinomas in the liver of male and
female rats treated with dehydroepiandrosterone. Toxicol Pathol
1995;23:591–605.
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advanced prostate cancer: a case report and review. Urology 1997;50:784–8.
15. Zumoff B, Levin J, Rosenfeld RS, et al. Abnormal 24-hr mean plasma
concentrations of dehydroisoandrosterone and dehydroisoandrosterone sulfate in women with
primary operable breast cancer. Cancer Res 1981;41:3360–3.
16. Helzlsouer KJ, Gordon GB, Alberg AJ, et al. Relationship of
prediagnostic serum levels of dehydroepiandrosterone and dehydroepiandrosterone sulfate to the
risk of developing premenopausal breast cancer. Cancer Res 1992;52:1–4.
17. Dorgan JF, Longcope C, Stephenson HE, et al. Relation of
prediagnostic serum estrogen and androgen levels to breast cancer risk. Cancer Epidemiol
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18. Gordon GB, Bush TL, Helzlsouer KJ, et al. Relationship of serum
levels of dehydroepiandrosterone and dehydroepiandrosterone sulfate to the risk of developing
postmenopausal breast cancer. Cancer Res 1990;50:3859–62.
19. Berrino F, Muti P, Micheli A, et al. Serum sex hormone levels after
menopause and subsequent breast cancer. J Natl Cancer Inst 1996;88:291–6.
20. Hankinson SE, Willett WC, Manson JE, et al. Plasma sex steroid
hormone levels and risk of breast cancer in postmenopausal women. J Natl Cancer Inst
1998;90:1292–9.
21. Zumoff B, Levin J, Rosenfeld RS, et al. Abnormal 24-hr mean plasma
concentrations of dehydroisoandrosterone and dehydroisoandrosterone sulfate in women with
primary operable breast cancer. Cancer Res 1981;41:3360–3.
22. Zeleniuch-Jacquotte A, Bruning PF, Bonfrer JM, et al. Relation of
serum levels of testosterone and dehydroepiandrosterone sulfate to risk of breast cancer in
postmenopausal women. Am J Epidemiol 1997;145:1030–8.
23. Barrett-Connor E, Friedlander NJ, Khaw KT. Dehydroepiandrosterone
sulfate and breast cancer risk. Cancer Res 1990;50:6571–4.
24. Bernstein L, Ross RK, Pike MC, et al. Hormone levels in older women:
a study of post-menopausal breast cancer patients and healthy population controls. Br J
Cancer 1990;61:298–302.
25. Johannes CB, Stellato RK, Feldman HA, et al. Relation of
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factors in women: longitudinal results from the Massachusetts Women’s Health Study.
J Clin Epidemiol 1999;52:95–103.
26. Morales AJ, Haubrich RH, Hwang JY, et al. The effect of six months
treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex
steroids, body composition and muscle strength in age-advanced men and women. Clin
Endocrinol (Oxf) 1998;49:421–32.
27. Helzlsouer KJ, Alberg AJ, Gordon GB, et al. Serum gonadotropins and
steroid hormones and the development of ovarian cancer. JAMA
1995;274:1926–30.
28. Heinonen PK, Koivula T, Pystynen P. Decreased serum level of
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Invest 1987;23:271–4.
29. Schwartz AG. Inhibition of spontaneous breast cancer formation in
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32. Hautanen A, Manttari M, Manninen V, et al. Adrenal androgens and
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34. Suzuki M, Kanazawa A, Hasegawa M, et al. A close association between
insulin resistance and dehydroepiandrosterone sulfate in subjects with essential hypertension.
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35. Casson PR, Santoro N, Elkind-Hirsch K, et al. Postmenopausal
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