Natural Standard® Patient Monograph, Copyright © 2014 (www.naturalstandard.com). All Rights Reserved. Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Common Brand Name(s)
DHEA-25

Background

Dehydroepiandrosterone (DHEA) is a hormone that comes from the adrenal gland. It is also made in the brain. DHEA leads to the production of androgens and estrogens (male and female sex hormones). DHEA levels in the body begin to decrease after age 30. Levels decrease more quickly in women. Low DHEA levels may lead to hormonal disorders, AIDS, Alzheimer’s disease, heart disease, depression, diabetes, inflammation, immune disorders, and osteoporosis. Corticosteroids, birth control taken by mouth, and agents that treat psychiatric disorders may reduce DHEA levels.

Evidence suggests that DHEA may help treat depression, obesity, and osteoporosis. However, more research is needed to support its use for hormonal disorders, sexual function, and lupus (an autoimmune disorder that affects the skin and organs). DHEA has been studied for the treatment of HIV, schizophrenia, and severe injury.
DHEA may cause side effects related to other hormones. Women may experience symptoms such as oily skin, increased unnatural hair growth, a deep voice, irregular periods, smaller breast size, and increased genital size. Men may experience breast tenderness, urinary urgency, aggression, or reduced size of the testes. Other side effects that may occur in either sex include acne, sleep problems, headache, nausea, skin itching, and mood changes. DHEA may also affect levels of other hormones, insulin, and cholesterol. Safety information is lacking on the long-term effects of DHEA. DHEA may increase the risk of prostate, breast, and ovarian cancers. It is not suggested for regular use without a health professional’s care.

Related terms

3Beta-methyl-delta5-androsten-17-one, 5-androsten-3beta-ol-17-one, 5-androstene-3beta,7alpha,17beta-triol, 5-androstene-3beta,7beta,17beta-triol, 7alpha-hydroxy-dehydroepiandrosterone, 7beta-hydroxy-dehydroepiandrosterone, 7-Keto (3-acetyl-7-oxo-dehydroepiandros-terone), 7-oxo-DHEA, 16alpha-hydroxy-DHEA, 17beta-spiro[5-androstene-17,2′-oxiran]-3beta-ol, 19-norandrostenediol, 19-norandrostenedione, (20R)-3beta,21-dihydroxy-17alpha,20-epoxy-5-pregnene, (20S)-3beta,21-dihydroxy-17beta,20-epoxy-5-pregnene, ADIOL, androst-5-ene-3beta,17beta-diol, androstenediol, androstenedione, androsterone, C19 steroid, clenbuterol, clostebol, dehydroepiandrosterone, dehydroepiandrosterone sulfate, dehydroepiandrosterone sulphate, dehydroepiandrosterone-3-sulphate, dehydroepiandrosterone-sulfate, dehydroepiandrosterone-sulphate, delta5-androstene-3beta,17beta-diol, DHA, DHAS, DHEA sulfate, DHEA sulphate, DHEA-Bodipy, DHEA-enanthate, DHEA-FA, DHEA-S, DHEAS, DHEA-sulfate, DHEA-sulphate, DS, etiocholanolone, fenoterol, fluoxymesterone, mesterolone, metandienone, metenolone (metheneolone), methandriol, methyltestosterone, mother steroid, nandrolone, norethandrolone, oxandrolone, oxymesterone, oxymetholone, prasterone, pregnenolone, SDHEA, stanozolol, testosterone, trenbolone.

Select product examples: DHEA-5 Pharmaceutical Grade (Enzymatic Therapy); Nature Bounty® DHEA (Nature’s Bounty, Inc.); PatentLEAN® (PatentHealth, LLC); Prestara™ (GL701; oral prasterone [DHEA]); Puritan’s Pride® Inspired by Nature™ DHEA (Puritan’s Pride, Inc.); Twinlab® 7-Keto DHEA Fuel™ (Twin Laboratories, Inc.); Vaginorm™ (intravaginal prasterone [DHEA]; EndoCeutics).

Note: Dehydroepiandrosterone (DHEA) may be made in a laboratory using wild yam extract. However, it is believed that wild yam may not be converted into DHEA by the body. Therefore, information that markets wild yam as a “natural DHEA” may be inaccurate.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)

To treat symptoms of adrenal insufficiency (hormone production problems), 20-200 milligrams of DHEA has been taken by mouth daily for up to 12 months.
To treat AIDS/HIV, 50-2,250 milligrams of DHEA has been taken by mouth for up to sixteen weeks.

To improve bone density, doses of 50-200 milligrams of DHEA have been taken by mouth daily for up to two years.
To treat cervical cancer, 150 milligrams of DHEA has been applied to the vagina daily for up to six months.

To treat chronic fatigue syndrome, up to 500 milligrams of DHEA has been taken by mouth daily for up to six months.
To treat chronic obstructive pulmonary disease (COPD), 200 milligrams of DHEA has been taken by mouth daily for three months.
To treat cognitive disorders, 25-400 milligrams of DHEA has been taken by mouth daily for up to six months. A dose of 200 milligrams of DHEA-S has been injected into the vein daily for four weeks.

To treat depression, 5-450 milligrams of DHEA has been taken by mouth daily for up to six weeks, alone or in addition to antidepressants. DHEA has been taken by mouth starting at a dose of 100 milligrams up to 500 milligrams daily for eight weeks (increasing by 100 milligrams each week).

To treat diabetes, 25-75 milligrams of DHEA has been taken by mouth daily for up to one year. Higher doses of 1,600 milligrams of DHEA have also been taken by mouth daily for 28 days. An infusion of 1 milligram of DHEA has been injected into the blood hourly for a total of 17 hours.

To treat drug withdrawal, 100 milligrams of DHEA has been taken daily by mouth for 12 weeks and 12 months.
To treat fibromyalgia, 50 milligrams of DHEA has been taken by mouth daily for three months.

To treat heart disease, 25-150 milligrams of DHEA has been taken by mouth daily for up to two years.
As an immune system stimulant, 50 milligrams of DHEA has been taken by mouth daily for 20 weeks.

To treat infertility, 25-80 milligrams of DHEA has been taken by mouth daily for at least six weeks and up to four months.
To treat inflammatory bowel disease, 200 milligrams of DHEA has been taken by mouth daily for 56 days.

To induce labor, 10 milligrams of DHEA-S dissolved in 10 milliliters of 5% glucose solution has been injected into the blood twice weekly after 38 weeks gestation. A dosage of 100 milligrams of DHEA-S in 250 milliliters of 5% levulose solution has been injected into the blood daily for three days. Additionally, 200 milligrams of DHEA-S has been injected into the blood once or twice weekly beginning at 37 weeks gestation. Multiple doses of 50 milligrams or 100 milligrams of DHEA-S have been injected during weeks 38-42 of pregnancy.

To treat lupus, 20-200 milligrams of DHEA has been taken daily for up to two years.
To treat menopause, 10-50 milligrams of DHEA has been taken by mouth daily for up to 12 months. Additionally, 100 milligrams of DHEA-S has been taken by mouth daily for three months.

To prevent miscarriage, 25 milligrams of DHEA has been taken by mouth three times daily for at least two months.
To improve muscle strength, 50-150 milligrams of DHEA has been taken by mouth daily for up to 12 months.

To treat myotonic dystrophy (muscle wasting and weakness), 100 milligrams and 400 milligrams of DHEA have been taken by mouth daily for 12 weeks. Additionally, 200 milligrams of DHEA-S has been injected into a vein for eight weeks.

To treat obesity, 50-200 milligrams of DHEA, 7-oxo-DHEA or 7-Keto has been taken by mouth daily for up to 12 months. Additionally, 400 milligrams of DHEA has been taken by mouth four times daily for 28 days. A dosage of 40 milligrams of DHEA placed under the tongue has been taken twice daily for eight weeks.

To treat partial androgen deficiency, 25 milligrams of DHEA has been taken by mouth daily for one year.
To treat psoriasis, 300 milligrams of DHEA-enanthate has been injected into the muscle daily.
To treat rheumatoid arthritis, 200 milligrams of DHEA has been taken by mouth daily for 16 weeks.

To treat schizophrenia, DHEA has been taken by mouth at a starting dose of 25 milligrams by mouth daily for two weeks, then 50 milligrams daily in divided doses for two weeks, and then 100 milligrams daily in divided doses for a final two weeks. Additionally, 200 or 400 milligrams of DHEA has been taken by mouth daily for up to eight weeks.

To treat sexual dysfunction/libido/erectile dysfunction, 20-75 milligrams of DHEA has been taken by mouth for up to six months. A single dose of 300 milligrams of DHEA has been taken by mouth. Additionally, 90 milligrams of DHEA has been taken by mouth daily for three weeks followed by 450 milligrams daily for three weeks. A dose escalation of DHEA from 100 milligrams to 400 milligrams daily for eight weeks (increasing by 100 milligrams at weekly intervals) has been taken by mouth.

To treat Sjögren’s syndrome, 50-200 milligrams of DHEA has been taken by mouth daily for up to one year.
To treat skin aging, 0.1-2% DHEA has been applied once or twice daily to the face, hands, upper chest, and thighs for up to four months.

To treat vaginal atrophy, daily doses of 0.25%, 0.5%, and 1.0% DHEA (prasterone; Vaginorm™) have been applied to the vagina for 12 weeks.
Children (younger than 18 years)
There is no proven safe or effective dose for DHEA in children. DHEA may interfere with hormonal development.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
Avoid if allergic or sensitive to DHEA or DHEA-containing products.

Side Effects and Warnings

DHEA is likely safe when taken by mouth in doses that restore normal DHEA and DHEA-S levels and under the care of a health professional. Doses of up to 1,600 milligrams of DHEA taken by mouth daily for one month have been well tolerated. A dose of 50 milligrams of DHEA taken by mouth daily has been shown to be safe for up to six months.

DHEA is possibly safe when applied to the skin of postmenopausal women for up to one year.
In women, DHEA may cause decreased breast size, a deep voice, increased genital size, irregular periods, oily skin, and unnatural hair growth. In men, DHEA may cause aggression, breast tenderness or enlargement, decreased testes size, and urinary urgency.
Use cautiously in people with hormone-sensitive conditions and those using hormonal agents.

DHEA may interfere with the way the body processes certain agents using the liver’s cytochrome P450 enzyme system. As a result, the levels of these agents may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
DHEA may cause low blood pressure. Caution is advised in people taking drugs or herbs and supplements that lower blood pressure.

Use cautiously with agents that may affect DHEA or DHEA-S levels (including angiotensin-converting enzyme (ACE) inhibitors, metformin, and thiazolidinediones), agents that may affect blood vessels, alcohol, anastrozole, antidepressants (such as selective serotonin reuptake inhibitors [SSRIs], mirtazapine, venlafaxine, or bupropion), antiestrogens (such as tamoxifen or fulvestrant), antipsychotic agents, Bacillus Calmette-Guérin (BCG) vaccine, benfluorex, birth control taken by mouth, calcium channel blockers, canrenoate, cardiac glycosides, corticosteroids, fiber, gamma-aminobutyric acid (GABA)-binding agents (alprazolam), gefitinib, glycyrrhetinic acid, licorice, metyrapone, morphine, opioid antagonists, propranolol, and soy.

Use cautiously in women who have premenstrual syndrome (PMS).
Use cautiously in people who are at risk for prostate, liver, breast, and ovarian cancer. DHEA may increase the risk of these cancers.
Use cautiously in people who are at risk for urinary tract infections. DHEA may cause urinary symptoms or urinary tract infection.
Use cautiously in people with thyroid disorders or those using thyroid hormone therapy. DHEA may affect hormone levels.

DHEA may affect insulin sensitivity. Caution is advised in people with diabetes or blood sugar disorders, and in those taking drugs, herbs, or supplements for these conditions. Blood sugar and insulin levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Use cautiously in people with a history of eating disorders, heart disease, or stroke, or those at risk for stroke. High DHEA and DHEA-S have been linked to increased risk of heart attack, heart disease, and, metabolic syndrome.

Use cautiously in people who have low levels of high-density lipoprotein (HDL, or “good”) cholesterol and/or high triglycerides. DHEA may decrease HDL cholesterol levels and increase triglyceride levels.
DHEA may increase the risk of bleeding. Caution is advised in people with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Use cautiously in people who are prone to acne. DHEA may cause acne.
Use cautiously in people who have benign prostatic hypertrophy (BPH). DHEA may cause prostate swelling.

Use cautiously in people who have sweating disorders. DHEA may cause increased odor and sweating. Use cautiously in people with muscle pain or joint pain.
Use cautiously in people who have anxiety, depression, muscle or joint pain, post-traumatic stress disorder (PTSD), or sleep disorders. Use cautiously in people taking weight loss agents.

Use cautiously in people who have seizures or those taking agents that may increase seizure risk. There have been reports of seizures following DHEA intake.
Use cautiously in people who have immune disorders or those taking agents that may affect the immune system. DHEA may stimulate the immune system.

Avoid if allergic or sensitive to DHEA or DHEA-containing products.
Avoid in children and in pregnant or breastfeeding women, due to lack of safety information. DHEA may affect hormone levels in the body and put pregnancy at risk.
Avoid in people who have mania-associated psychiatric disorders.

DHEA may also cause side effects such as abnormal menstruation, acute respiratory failure (a lack of oxygen in blood), altered cholesterol, anxiety, blocked blood flow to the brain, blood in the urine, changes in abnormal heart rhythms, changes in adrenal or thyroid hormones, changes in blood vessel width, changes in insulin, chest pain, cough, crawling sensation of the scalp, depressive symptoms, diarrhea, dizziness, elevated liver enzymes and creatine concentration, emotional change, eye problems (dryness or pain), fatigue, headache, heart palpitations, high blood pressure, increased discharge, increased dreaming, increased risk of cataract, insomnia, irritability, joint and muscle pain, labor induction, lack of energy, mania, mood changes, nasal congestion, nausea, nervousness, night sweats, psychiatric problems, restlessness, skin allergic reactions (bumps under the skin, greasy hair and skin, itching, rashes, spots, and wart-like growths), sleep problems, streptococcal infection, upset stomach, and weight gain.

Pregnancy and Breastfeeding

Avoid DHEA during pregnancy and breastfeeding without the supervision of a healthcare professional. DHEA may affect hormone levels in the body and put pregnancy or infant development at risk.

DHEA has been used in late pregnancy to induce labor, without serious side effects or complications. DHEA has been used with in vitro fertilization (IVF) to improve fertility.
DHEA injected into the blood has triggered the onset of labor.

Interactions

Interactions with Drugs

DHEA may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

DHEA may interfere with the way the body processes certain drugs using the liver’s cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
DHEA may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Because DHEA contains estrogen like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

DHEA may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.
DHEA may interact with agents for Alzheimer’s and arthritis; agents for the brain, heart, skin or urinary tract; agents that improve mental function; agents that may affect blood vessel width; agents that may affect GABA; agents that may affect the immune system; agents that may be toxic to the liver; agents that may lower seizure threshold; alcohol; androgens; angiotensin-converting enzyme (ACE) inhibitors; anticancer agents; antidepressants; antiestrogens; anti-inflammatories; antiobesity agents; antipsychotic agents; antiseptics; antiviral agents; aphrodisiacs; aromatase inhibitors; Bacillus Calmette-Guérin vaccine; benzodiazepines; beta-blockers; birth control; bronchodilators (increase air flow to lungs); bupropion; calcium channel blockers; calcium salts; canrenoate; cardiac glycosides; cholesterol-lowering agents; cocaine; corticosteroids; danazol; estrogens; fertility agents; gefitinib; gonadotropin-releasing hormone (GnRH) antagonists; growth hormones; hormonal agents or hormone replacement therapy (HRT); human chorionic gonadotropin; methylphenidate; metyrapone; morphine; NMDA receptor antagonists; opiate antagonists; osteoporosis agents; oxytocics; stimulants; tadalafil; thyroid hormones; vaccines; and vitamin D analogs.

Interactions with Herbs and Dietary Supplements

DHEA may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

DHEA may interfere with the way the body processes certain herbs or supplements using the liver’s cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

DHEA may alter blood sugar levels. Caution is advised when using herbs or supplements that may also alter blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Because DHEA contains estrogen like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
DHEA may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

DHEA may also interact with anticancer herbs and supplements; antidepressants; anti-inflammatories; antiobesity herbs and supplements; antioxidants; antipsychotics; antiseptics; antivirals; aphrodisiacs; bronchodilators (increase air flow to lungs); calcium; cardiac glycosides; carnitine; cholesterol-lowering herbs and supplements; chromium; contraceptives; digitalis; fertility herbs and supplements; fiber; flavonoids; flaxseed and flaxseed oil; herbs and supplements for Alzheimer’s and arthritis; herbs and supplements for the brain, heart, skin, and urinary tract; herbs and supplements that improve mental function; herbs and supplements that may affect blood vessel width; herbs and supplements that may affect GABA receptors; herbs and supplements that may affect the immune system; herbs and supplements that may be toxic to the liver; hormonal herbs and supplements; isoflavones; licorice; melatonin; opiate antagonists; osteoporosis herbs and supplements; oxytocics; phytoestrogens; polyunsaturated fatty acids; probiotics; seizure threshold-lowering herbs and supplements; soy; steroids; stimulants; thyroid herbs and supplements; vitamin D; vitamin E; yam.

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