DHEA Boosts Well-Being in Adrenal Burnout
Noel Peterson, N.D.
A pair of small adrenal glands, one on top of each kidney, release that are so essential to life we could not survive very long without them. Without your little adrenals, the body would fall into potentially fatal hypoglycemic shock, lose its ability to fight recurrent infections, and be left without any natural resistance to stress.
Although corticoid therapy has long been used to prevent many of the severe, life-threatening complications of chronic adrenal insufficiency (or adrenal burnout), patients sometimes have debilitating psychological effects that remain. The well-being of these patients may be improved significantly by addressing severe deficiencies of the adrenal hormone dehydroepiandrosterone (DHEA) as well.
In a double-blind study appearing in the New England Journal of Medicine, German researchers reported that when women with adrenal insufficiency were administered a daily dose of 50 mg DHEA (in addition to their corticoid therapy), their DHEA levels returned within the normal range. As a result, the women felt less depressed and anxious, more energetic, and a greater degree of sexual interest and satisfaction, based on a clinical psychological evaluation.
This drastic improvement in well-being was not present at the first check-up one month after starting DHEA therapy, but appeared at the second evaluation three months later, suggesting that long-term treatment is necessary to improve mood and well-being. For women with primary adrenal insufficiency, DHEA therapy also appeared to mildly stimulate growth hormone production, spurring higher levels of IGF-1.
Although reported side effects in this study were minimal - and even favorable for women who previously had dry skin and loss of axillary and pubic hair - researchers noted that some women with adrenal insufficiency might need a smaller daily dose (5-25 mg) to avoid androgen excess. Women with a history/risk of breast cancer or other sex hormone-dependent diseases may need to avoid therapy altogether. DHEA is a precursor to sex hormones such as testosterone and estrogen.
In an accompanying editorial, Wolfgang Oelkers, M.D., says the findings usher in "a new phase of replacement therapy for patients with adrenal insufficiency." While cautioning against DHEA supplementation for healthy patients, Dr. Oelkers observes that establishing optimal levels of DHEA may be important for effectively treating clinical conditions such as depression and postmenopausal osteoporosis, as well as inflammatory disorders such as rheumatoid arthritis. Adequate DHEA levels can reduce the amount of catabolic "wear-and-tear" on the body, such as bone loss that often arises after long-term glucocorticoid therapy.
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Sources: Arlt W, Callies F, van Vlijmen JC, Koehler I, Reincke M, Bidlingmaier M, Huebler D, Oettel M, Ernst M, Schulte HM, Allolio B. Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med 1999;341(14):1013-20.
Oelkers W. Dehydroepiandrosterone for adrenal insufficiency [editorial]. N Engl J Med 1999;341(14):1073-74.