DHEA-The Marker of Longevity and Lifespan
DHEA (dehydroepiandrosterone) is a hormone unto itself as well as a hormone precursor that has the ability to convert into estrogen, progesterone, and testosterone. DHEA is formed in the adrenal gland and has the effect of shifting catabolic (breakdown) processes to anabolic (building) activities. DHEA is the most abundant hormone in the body with multiple health benefits. The most interesting fact associated with this hormone and the primary reason for monitoring levels lies in the fact that it is the best biochemical marker of age. A New England Journal of Medicine article from 1986 concluded that DHEA levels were inversely related to death from any cause and death from cardiovascular disease in men over 50. Thus, higher levels of DHEA are associated with increased longevity whereas lower levels are predictive of early mortality. Therefore, overall morbidity and mortality are directly related to DHEA levels. To quote Dr Rouzier, “What do you want your levels to be?” The answer would be optimal.
DHEA has multiple positive effects on the body for overall health, healthy aging and longevity. It serves to increase lipolysis (fat breakdown) thus reducing visceral fat. This effect is common with many of the hormones as we have seen in previous discussions, and one of the major reasons that chronic disease is significantly reduced with hormone optimization (see above and below). DHEA has a profound effect on immune function thus reducing the risk of acute and chronic illness. For this reason, the risk of cancer is also reduced with optimal levels of DHEA. It works as an anti-inflammatory and therefore has indications for treating autoimmune disorders such as lupus and rheumatoid arthritis. It also has benefits for patients suffering from osteoarthritis. It reduces IL-6 which is a pro-inflammatory cytokine which has many deleterious effects on the body. This list of conditions where IL-6 is elevated includes diabetes, atherosclerosis, multiple myeloma, prostate cancer, and Behcet’s disease, and DHEA thus is beneficial for these conditions via this dampening effect. It improves mood, energy levels, and memory and helps to guard against Alzheimer’s dementia. DHEA improves bone health and is part of the comprehensive treatment plan for patients with osteopenia/osteoporosis (including estrogen, progesterone, testosterone, growth hormone, vitamin D, Vitamin K, magnesium, and strength training). DHEA also has the effect of controlling cortisol levels thus reducing the stress and other negative effects hypothalamic-pituitary-adrenal axis (HPA axis) disorders.
DHEA is typically taken twice a day in both men and women. Side effects include acne and hirsutism (hairiness). Both of these effects may be reduced and/or resolved via dose reduction. Levels are assessed via bloodwork and typically adjusted up or down after six weeks of initiating therapy. After optimal levels are obtained, DHEA will then typically be checked at six-month intervals. In summary, DHEA treatment helps reduce the risk of cancer, cardiovascular disease, Alzheimer’s dementia, osteoporosis, autoimmune disorders, osteoarthritis, and HPA axis disorders.