Dehydroepiandrosterone (DHEA) is an endogenous steroid hormone produced primarily in the adrenal glands, with smaller amounts coming from the liver and gonads. In the United States, DHEA is widely available as an over-the-counter dietary supplement, often marketed with claims related to its hormonal properties. Many individuals seek information on the expected results of supplementation to understand what can realistically be anticipated before and after incorporating this hormone precursor into a wellness regimen.
DHEA’s Natural Role in the Body
DHEA functions primarily as a precursor, converting into other hormones. Its most significant role is serving as the raw material for the production of more potent sex hormones, specifically testosterone and estrogen. This conversion is highly localized, occurring within peripheral tissues like fat, skin, and bone, a concept known as intracrinology.
The adrenal glands are the main site of DHEA synthesis, which is then released into the bloodstream, largely as DHEA-S (sulfated DHEA). Circulating levels of DHEA peak naturally in early adulthood, typically around the mid-twenties. Levels then begin a gradual, significant decline with age, potentially falling by 80% to 90% from their peak by the time a person reaches their 70s or 80s.
Supplementation Goals and Research Outcomes
Individuals often supplement DHEA hoping to restore hormone levels to those of a younger person and combat age-related decline. Common goals include improving body composition, boosting libido, increasing bone density, and enhancing overall mood. Supplementation effectively increases circulating DHEA levels, and it can also raise testosterone and estrogen levels, particularly in older individuals with low baseline levels.
The scientific evidence supporting DHEA benefits is mixed and highly dependent on the population studied. In older women, DHEA supplementation has shown modest effectiveness in preserving or increasing bone mineral density (BMD). This effect is likely due to the local conversion of DHEA into estrogen, which protects bone tissue.
Evidence for DHEA universally improving body composition, such as increasing muscle mass or reducing fat mass, is largely conflicting or weak, especially in generally healthy people. Studies indicate that DHEA does not consistently improve muscle strength or physical performance in older or younger adults. While some studies suggest DHEA may improve symptoms of depression in those with low baseline levels, widespread anti-aging effects are not yet proven.
Libido and sexual function may see some improvement, especially in postmenopausal women, where DHEA can increase sex hormone levels. A prescription vaginal form of DHEA is recognized as an effective treatment for symptoms of vulvovaginal atrophy and painful intercourse in menopausal women. The effects on men are less clear, as DHEA supplementation does not reliably increase serum testosterone levels in men who already have normal ranges.
Safety Concerns and Potential Side Effects
Since DHEA is a precursor to sex hormones, most adverse effects relate to the resulting increase in androgen and estrogen levels. These side effects are often dose-dependent, meaning they become more pronounced with higher amounts of the supplement. Common androgenic side effects include oily skin, acne, and male-pattern hair loss.
Women may experience hirsutism (unwanted facial or body hair growth) and a possible deepening of the voice. In men, the conversion of DHEA into estrogen can potentially lead to gynecomastia (breast tissue enlargement). DHEA use has also been associated with mood changes, including increased aggression or irritability, and a possible reduction in HDL (“good”) cholesterol levels.
DHEA is generally contraindicated for individuals with hormone-sensitive cancers (e.g., breast, ovarian, or prostate cancer), as increased sex hormones could stimulate tumor growth. People with existing endocrine disorders, liver problems, or those who are pregnant or breastfeeding should also avoid DHEA. The long-term safety of DHEA supplementation has not been definitively established.
Regulatory Status and Medical Guidance
In the United States, DHEA is classified as a dietary supplement under the Dietary Supplement Health and Education Act. This means DHEA is not regulated as a prescription drug by the Food and Drug Administration (FDA). Consequently, there is less oversight on the quality, purity, and actual dosage contained within over-the-counter products, and the amount can vary significantly between brands.
Due to its hormonal activity and potential for serious side effects and drug interactions, DHEA supplementation should only be initiated under the supervision of a healthcare provider. Dosage is highly individualized based on a person’s existing hormone levels and health status. Blood work to establish baseline levels of DHEA and its metabolites, as well as follow-up testing, is recommended to ensure safe and effective dosing. A medical professional must evaluate the individual risk-benefit profile and check for potential interactions with other medications.