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Dehydroepiandrosterone (DHEA) is a steroid hormone with many biological roles. DHEA is a precursor to the sex hormones (androgens and estrogens) as well as having many functions independent of sex hormones. DHEA levels tend to decline with age, and loss of youthful hormone balance—and DHEA in particular—is linked with many age-associated diseases. Restoring youthful DHEA levels may help prevent or improve outcomes of several conditions.
DHEA levels (usually measured as the metabolite DHEA-S) should be monitored as part of a healthy aging strategy for both men and women. DHEA can be an integral part of a comprehensive hormone replacement regimen.
What are Risks of Low DHEA Levels?
- • Cognitive decline
- • Cardiovascular disease
- • Bone loss
- • Cancer
- • Depression
- • Sexual dysfunction
- • Inflammation and inflammatory disorders
What are the Potential Benefits of DHEA Restoration?
- • Improved cognitive function and mood
- • Increased bone mineral density
- • Enhanced cardiovascular health
- • Improved insulin sensitivity
- • Enhanced immune function
- • Youthful skin restoration
- • Improved sexual function in men and women
- • Decreased levels of inflammatory markers
- • Increased longevity
- • A metabolite of DHEA, 7-Keto DHEA, has been linked with improved metabolism
Note: Concerns have been raised regarding DHEA supplementation and hormone-sensitive cancers. To date, no study has convincingly shown an increased risk of hormone-dependent cancer in people supplementing with DHEA. As always, anyone with a medical condition should consult their doctor before beginning a new supplement or medication.
Introduction
The natural steroid hormone dehydroepiandrosterone (DHEA) was first introduced to Life Extension supporters four decades ago at a time when the medical community was largely unaware of the scientific data supporting this hormone’s multifaceted benefits. Fast forward to today, when more than 3700 papers have evaluated the scientific effects of DHEA upon many different cells and tissues of the body. This multifunctional hormone and its metabolite dehydroepiandrosterone sulfate (DHEA-S) provide critical hormonal benefits in both men and women. As a precursor to androgens (male hormones) and estrogens (female hormones), DHEA plays a fundamental role in the maintenance of hormonal balance and youthful vitality. It also modulates a variety of pathways throughout the body involved in various aspects of health and disease via direct actions independent of its role as a precursor to androgens and estrogens.
Aging disrupts hormonal balance, with the levels of several critical hormones dramatically reduced in comparison with youthful levels, and DHEA is no exception. By age 80, levels of DHEA fall by as much as 80%–90% compared to what they were during young adulthood. The gravity of this becomes clear after understanding the roles DHEA plays in supporting healthy, youthful physiology across several body systems. Studies have shown that reduced levels of DHEA-S are linked with the pathophysiology underlying numerous age-associated disease states, including cognitive decline, cardiovascular disease, bone loss, cancer, depression, sexual dysfunction, and various inflammatory disorders.
Restoring youthful DHEA levels provides a unique opportunity to mitigate the consequences of dwindling hormones. Unlike direct administration of androgens (ie, testosterone replacement therapy) or estrogens (ie, estrogen replacement therapy), bolstering DHEA levels provides a “reservoir” of this hormone precursor that various tissues can convert into androgens and estrogens. However, DHEA administration cannot supplant the need to measure and restore other hormones because the rate at which it is converted to androgens and estrogens varies among individuals and with gender. Therefore, restoring DHEA levels should be viewed as an integral part of a comprehensive hormone restoration regimen rather than an alternative to testosterone replacement in men and estrogen replacement in women.
In addition to its role as a hormone precursor, DHEA also modulates inflammation, which is a driving force in many diseases. This multifunctional hormone also promotes the production of the cell-signaling molecule nitric oxide within the delicate lining of blood vessels by activating an enzyme called endothelial nitric oxide synthase (eNOS). Nitric oxide is a pivotal regulator of blood flow via its ability to stimulate blood vessel dilation. Thus, it is not surprising that low DHEA levels have been linked to cardiovascular disease in the medical literature.
Upon oral administration, DHEA is mostly converted to DHEA-S, which circulates in the blood far longer than DHEA. Circulating DHEA-S acts as a reserve upon which tissues can draw. Once taken up by tissues, DHEA-S is converted back to DHEA, which can then be locally converted to androgens and estrogens or exert direct action.
Since DHEA-S is more abundant in the bloodstream than DHEA, simple blood tests to measure DHEA-S concentrations can be integrated into any healthy aging strategy for both men and women. With regular monitoring of blood levels of DHEA-S and other hormones, individuals are provided with specific feedback about the state of their hormonal milieu. This allows for development, implementation, and optimization of individualized regimens that can help maturing individuals lead full, active, healthy lives.
Bioidentical hormone replacement therapy is a method of administering hormones that are structurally identical to those produced by the human body. Treatment with DHEA, which is also bioidentical, is an integral component of any comprehensive hormone restoration regimen. On the other hand, some forms of conventional hormone replacement therapy utilize hormones that are not identical to those produced by humans and are either derived from animals or synthesized. Evidence suggests that bioidentical hormone replacement therapy may be safer and associated with greater patient satisfaction than conventional hormone replacement therapy.
DHEA: Background and Biology
The human body derives DHEA from cholesterol via two enzymatic reactions. First, cholesterol is converted into pregnenolone, which is sometimes referred to as “the master hormone” due to its role as a precursor to the hormonal cascade that eventually gives rise to the primary sex hormones testosterone and estrogen. Next, pregnenolone is converted into DHEA.
The primary location for DHEA production is the outer layer of the adrenal glands, called the adrenal cortex; some other tissues such as the testes in men and ovaries in premenopausal women also produce DHEA, but to a much lesser extent. Production of DHEA peaks in the 2nd to 3rd decade of life. Thereafter, levels decline steadily with age.
Up to the early 2000s, much of the research on DHEA focused on its role as a precursor to androgens and estrogens. However, more recent investigations revealed several biological actions mediated directly by DHEA. Studies have shown that specialized receptors on cellular membranes in the blood vessel lining (endothelium), heart, kidney, and liver interact directly with DHEA. For example, one significant androgen- and estrogen-independent action of DHEA is the activation of an enzyme in blood vessels called endothelial nitric oxide synthase (eNOS), which produces the potent vasodilator nitric oxide (NO) that is important for healthy vascular function.
Effects of DHEA
DHEA in Mood and Brain Health
Although adrenal glands produce the majority of DHEA, it can also be produced by the brain. Moreover, levels of DHEA in the central nervous system (CNS) are 6–8 times higher than in the blood. This has led several researchers to classify DHEA as a “neurosteroid”. DHEA has been shown to modulate the release and signaling of neurotransmitters in various brain regions. It is therefore not surprising that DHEA has garnered interest for certain health conditions involving the brain, such as depression and anxiety.
As humans age, cognitive function and memory typically become impaired. This corresponds with an age-related reduction in levels of brain neurosteroids. Likewise, some neurodegenerative diseases such as Alzheimer’s disease have been linked to declining neurosteroid levels. It is thought that age-related decline in DHEA may compromise neuronal function and integrity.
Several studies have revealed a relationship between DHEA and cognitive function in a variety of settings. A study that followed 755 older individuals for 3 years found that DHEA-S levels declined in tandem with cognitive function as measured by the Mini Mental State Examination (MMSE), a standardized assessment of cognition. Moreover, subjects who scored better on their baseline MMSE were more likely to have higher DHEA-S levels than their counterparts who scored more poorly, and having a lower DHEA-S level at baseline was predictive of larger declines in cognitive function over the study period. In another study on 24 healthy young men, DHEA dosed at 150 mg twice daily for 7 days resulted in an improvement in mood and memory. This study also found that DHEA supplementation reduced evening levels of cortisol, which is a hormone released in response to stress. A separate double-blind, placebo-controlled study that enrolled 24 postmenopausal women found that 50 mg of DHEA daily led to improved visual-spatial performance as measured by several standardized tests. The researchers also found that higher levels of DHEA and its metabolites correlated with better performance on visual-spatial tasks. A study conducted on 27 women aged 65–90 living at an assisted-care facility in Japan found that supplementation with 25 mg of DHEA daily for 6 months led to improved cognitive scores in the subjects allocated to active treatment, whereas cognitive function deteriorated in those who received a placebo.
One way DHEA may modulate cognitive function in certain populations is by preserving the production of several neuroprotective factors such as IGF-1 (insulin-like growth factor-1), VEGF (vascular endothelial growth factor), and TGF-β (transforming growth factor-beta). A laboratory study measured levels of these neuroprotective factors produced by cells taken from subjects with mild to moderate Alzheimer’s disease and compared the results to samples taken from healthy, age-matched controls. The scientists found that Alzheimer’s patients’ cells produced significantly diminished amounts of these neuroprotective growth factors compared to healthy cells. However, when the Alzheimer’s patients’ cells were incubated with DHEA-S, the production of growth factors returned to levels similar to those seen in healthy control cells. The authors remarked “These data suggested that DHEA-S is able to increase the … production of neuroprotective growth factors … suggesting a new approach in the treatment of dementia” .
In addition, DHEA may exert neuroprotective action by countering the deleterious effects of glucocorticoids (eg, cortisol) in neurons. This is an important consideration in the context of mood disorders since elevated glucocorticoids are associated with psychiatric conditions such as social anxiety and depression. Indeed, research has linked depression with a low serum DHEA concentration in adult, senior, and adolescent populations. DHEA supplementation is also associated with reduced anxiety and improved response to anti-psychotic medications in schizophrenics. In middle-aged adults, DHEA (90 mg daily for 3 weeks and then 450 mg daily for 3 weeks) improved dysthymia, a chronic, low-grade depressed mood. Supplementation with 50 mg of DHEA daily for 6 months in advanced-aged men and women improved psychological well-being. Another study found that DHEA, dosed at 100–400 mg daily for 8 weeks, alleviated non-major, persistent depression in HIV/AIDS patients. Restoration of DHEA levels may also support mood when pituitary function is suboptimal. DHEA replacement at 50 mg daily led to long-term improvements in psychological well-being in both male and female hypopituitary patients on growth hormone replacement therapy.
DHEA and Bone Health
Although often thought of as only affecting women, osteoporosis affects the lives of men. Millions of men in the United States are affected by osteoporosis or low bone mass, and that number is likely to grow as the population ages. In addition, evidence suggests that postmenopausal women with low bone-mineral density have lower DHEA-S levels compared to postmenopausal women with normal DHEA-S levels. In fact, a Czech study found low bone-mineral density to be present in 86% of women whose DHEA-S levels fell into the lower quarter of distribution, whereas a rate of about 30% was predicted for healthy postmenopausal women. Bone-mineral density is largely regulated by 2 cell types: osteoblasts, which build bone, and osteoclasts, which break down or resorb bone. DHEA promotes osteoblast activity and suppresses osteoclast-mediated bone breakdown. It appears to accomplish this both by being converted into estrogen, which stimulates osteoblastic activity, and via androgen- and estrogen-independent mechanisms.
Bone tissue is especially responsive to hormonal modulation. Therefore, age-related decline in hormone levels, including DHEA, has considerable implications for both men and women with regard to bone health. DHEA and other androgen hormones play a pivotal role in the bone building process; thus, declining DHEA levels may compromise bone metabolism and promote osteoporosis. DHEA has been shown effective for treating osteoporosis at a dose of 50 mg daily over the course of 1 year in otherwise healthy older women by increasing bone mineral density of the lumbar spine. DHEA was also shown to decrease serum C-terminal telopeptide of type-1 collagen, a marker for bone turnover. In another study, women aged 65–75 who were given 50 mg of DHEA daily along with 650 IU of vitamin D and 700 mg of calcium displayed a 3.6% increase in spinal bone-mineral density after 2 years of treatment.
DHEA and Cardiovascular Health
The decline of DHEA-S associated with aging may contribute to vascular disease and the risk of cardiac events, especially among post-menopausal women. In men, decreased DHEA-S levels appear to be associated with a higher risk of diabetes and coronary heart disease. Observational studies have also shown that as DHEA-S levels decline, cardiovascular disease rates rise.
DHEA supplementation has been shown to improve cardiovascular health. Short-term treatment with DHEA in healthy elderly subjects appears to increase the production of NO, decrease low-density lipoprotein (LDL) cholesterol, and increase testosterone levels. DHEA was also found to inhibit the inflammatory process in the innermost cell layer of blood vessels (the endothelium). Obese women given 100 mg of DHEA-S over 3 months saw a shift in fatty acid balance whereby saturated fats in their blood were decreased, thus indicating a healthier metabolic profile.
Additionally, DHEA may support the healthy remodeling of vascular tissue following injury. Among women undergoing a cardiovascular procedure (ie, coronary angiography), those whose DHEA-S levels fell into the bottom one-third of distribution were more likely to die from any cause than women whose DHEA-S levels were in the upper two-thirds of the distribution over 6-years of follow up time. Specifically, while 21% of the women whose DHEA-S levels were in the bottom one-third of distribution died during follow up, only 10% of women in the top two-thirds of the distribution for DHEA-S levels died. This evidence suggests a further protective role of DHEA in heart disease. Animal studies further suggest that DHEA exerts a favorable effect on vascular remodeling.
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DHEA and Blood Sugar Regulation
DHEA appears to increase insulin sensitivity and combat insulin resistance. Insulin resistance is an early indicator of type-2 diabetes and is closely linked with obesity, both of which are major risk factors for heart disease. DHEA has been shown to have a protective role against diabetes. In fact, one study showed that taking 50 mg of DHEA for 1 year improved insulin response, as seen by the oral glucose tolerance test, with further improvement after 2 years among participants whose glucose tolerance was impaired at the beginning of the study. Another study showed that 50 mg of DHEA daily taken over 6 months led to a trend toward reduced insulin resistance. The combined results of these studies may suggest that longer-term administration may be required to see significant changes in insulin resistance.
Another group of researchers found that women with potentially impaired adrenal function exhibited improved insulin sensitivity after daily supplementation with 50 mg of DHEA over 12 weeks. A separate study found low DHEA-S levels in 77% of type-2 diabetic men with coronary artery disease. When low DHEA-S were combined with three other risk factors (testosterone deficiency, elevated high-sensitivity C-reactive protein [hs-CRP], and high plasma N-terminal pro-B-type natriuretic peptide [NTproB]), the risk for cardiovascular mortality jumped a staggering 63-fold above healthy control subjects. Other evidence suggests that DHEA protects against blood vessel damage induced by high concentrations of glucose. Elevated blood sugar can cause damage by driving oxidative stress and the formation of dysfunctional proteins via a process called glycation. As shown by a study conducted on 20 subjects with type-2 diabetes, supplementation with 50 mg of DHEA daily for 12 weeks improved the oxidative imbalance induced by high blood sugar levels and prevented advanced glycation end-product (AGE) formation. These findings indicate that DHEA may exert a beneficial effect on the onset and/or progression of chronic complications in type-2 diabetic patients.
DHEA and Immune Function
Another important role of DHEA is to counter the actions of cortisol (the “stress hormone”) in the context of the immune system. While DHEA enhances immunity, cortisol suppresses it. This is particularly significant for aging individuals, since advancing age is associated with a decrease in the DHEA:cortisol ratio. In other words, aging individuals are exposed to more unopposed immunosuppression by cortisol than younger individuals, potentially increasing their risk of infection.
In fact, it is thought that age-associated DHEA deficiency, resulting in an imbalance between DHEA and cortisol, may be partially responsible for the decline in immune function common among the elderly. In general, the immune system decreases in function as we age. This is known as immunosenescence. Similarly, the decline of hormone production due to the loss of function of multiple glands (including the adrenal cortex) is known as endocrinosenescence. In the elderly, 50 mg of DHEA daily may enhance the immune system and potentially prevent some common infections.
DHEA and Skin
DHEA has been shown to function as an antioxidant and anti-inflammatory agent in skin, and decreases in DHEA have been linked to skin atrophy and increased skin aging. Topically administered DHEA could exert an anti-aging effect in the skin through stimulation of collagen biosynthesis and improved structural organization of the dermis, the layer of tissue directly under the surface of the skin. Through topical administration of a 1% formula of DHEA to postmenopausal women over 4 months, study participants experienced increased sebum production, which contributes to the suppleness of skin.
DHEA and Sexual Function in Men and Women
A considerable body of research has examined the relationship between DHEA and sexual health, especially among women. Aside from the increased risk of osteoporosis and heart disease as women age, sexual function and interest tends to decline as well. DHEA has been shown to improve virtually all aspects of sexual function including desire, arousal, activity, interest, and drive. One study found that DHEA administered vaginally in postmenopausal women with moderate-to-severe symptoms of vaginal atrophy exerts beneficial effects on several important aspects of sexual function including arousal/sensation, lubrication, and orgasm. Another study found that daily oral DHEA therapy at the dose of 10 mg led to a significant improvement in sexual function and frequency of sexual intercourse in healthy postmenopausal women. DHEA has been shown to benefit men’s sexual health as well. Impotent men given 50 mg of DHEA daily for 6 months experienced improved sexual function, but not increased PSA, testosterone, prolactin, or prostate volume.
DHEA and Weight Loss – Focus on 7-Keto® DHEA
7-Keto® DHEA is a metabolite of DHEA that is not converted into testosterone or estrogen but does possess prohormonal properties. 7-Keto® DHEA appears to increase basal metabolic rate and thermogenesis (ie, the conversion of stored energy into heat in the body). Greater basal metabolic rate and thermogenesis lead to reduction in energy stores (ie, body fat). In one study, resting metabolic rates were increased 3.4% in overweight adults using a combination formula containing 50 mg of 7-Keto® DHEA along with calcium citrate, green tea extract, vitamin C, chromium, and vitamin D3. Moreover, DHEA and its metabolites counteract the actions of cortisol, a catabolic stress hormone associated with greater fat accumulation. In healthy men, 7-Keto® DHEA has been shown to be safe at doses of up to 200 mg/day for 4 weeks. |
DHEA in Inflammation and Autoimmunity
As humans age, the immune system weakens. One of the possible consequences of this progressive aging of the immune system is an increased incidence of certain cancers and predisposition to infections. DHEA modulates several aspects of the immune system. In elderly men, cytokine production and the function of T-cells, B-cells, NK cells, and monocytes appear to be improved by DHEA. The inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), both of which are elevated in patients with chronic inflammation or inflammatory diseases, appear to be positively influenced by DHEA. In an experimental study, immune cells were taken from asthmatic patients and treated with DHEA. The scientists found that DHEA suppressed the release of inflammatory mediators by these cells and reduced their hyperreactivity.
In addition, research suggests restoring optimal DHEA levels may act as an immunomodulator in certain situations. One study revealed that DHEA and certain metabolites were decreased in female subjects with autoimmune hypothyroidism (Drbalová 2008). Another study found that DHEA-S was decreased in a group of female type-1 diabetics. In systemic lupus erythematosus, DHEA led to a clinically significant improvement in quality of life according to a comprehensive review of several studies. In adult women, treatment of lupus with DHEA (200 mg daily) caused a 16% decrease in the number of patients with flares, and daily doses of 50-200 mg DHEA were clinically beneficial.
DHEA and Frailty Prevention
Some studies have looked at the decline in DHEA in the elderly as a primary marker of aging. One such study found that declines in DHEA were consistent with declines in quality of life markers, such as gait speed, mental status, and neuropsychological scores in women. Fundamentally, aging women with the highest levels of DHEA-S performed best on these tests. Thus, measuring DHEA-S blood levels may represent a simple way to help determine an individual’s rate of aging.
Falling and bone fractures are a significant concern for the aging population. DHEA may be able to help in this regard. In a 6-month trial, women with low DHEA-S, low bone mineral density, and frailty were given 50 mg/day of DHEA (along with vitamin D and calcium) and performed 2 gentle exercise routines per week. At the end of the trial, lower extremity muscle strength and function were improved. In March of 2010, William Davis, MD wrote an article in Life Extension Magazine titled Don’t Fall Victim to Frailty: Evidenced-based strategies for lifelong power in aging individuals. In the article, Dr. Davis brought to light several pieces of evidence including the use of DHEA in improving aspects of physical function and well-being.
DHEA and Longevity
Numerous scientific studies have found that declining DHEA levels are associated with greater likelihood of death due to a variety of causes:
- In a study on 270 women suspected of having reduced blood flow to cardiac muscles, subjects whose DHEA-S levels fell within the bottom one-third of distribution were 11% more likely to die from any cause over a 9-year follow-up period compared to women whose DHEA levels fell into the upper two-thirds of distribution.
- In another study in which 242 men aged 50 to 79 were followed for 12 years, having a DHEA-S level below 140 µg/dL was associated with a 3.3 fold risk of death from cardiovascular disease compared to higher levels. Moreover, an increase of 100 µg/dL in DHEA-S was associated with a 36% reduction in risk of death from any cause, even after adjustments were made for a number of confounding factors.
- Researchers from the University of Cambridge followed 963 men for up to 9 years and found that as circulating DHEA-S levels increased above the lower one-fourth of distribution, the risk of death from any cause decreased by about 30%.
- In a study on men undergoing dialysis for chronic kidney disease, low plasma DHEA-S levels were associated with a roughly 2.9-fold increased risk of death due to any cause compared to higher levels after adjustment for potential confounding factors.
- A similar study on 313 men undergoing dialysis corroborates the finding that lower DHEA-S levels predict increased mortality in this population.
- In a study that followed 2644 men from Sweden for an average of 4.5 years, men whose DHEA-S levels fell within the lower one-fourth of the distribution were 54% more likely to die during follow up compared to men with higher DHEA-S levels, even after the researches adjusted the findings to account for variables that could influence the results.
- An analysis of 4255 Vietnam-era U.S. army veterans revealed that higher DHEA-S levels were associated with a 49% reduced likelihood of death over a 15-year follow-up period.
- A long-term study that followed 940 subjects for 27 years found that men whose DHEA-S levels were greater than 200 µg/dL had were significantly less likely to die during the study period than men whose levels were lower.
- A 3-year study among 963 older Taiwanese individuals revealed that having a DHEA-S level less than 54.5 µg/dL was linked to a 64% greater risk of death during the study period than having higher levels.
- French researchers studied 290 subjects over a 10-year period and found that risk of death increased 1.9 fold among men with low DHEA-S level compared to those with high levels; this was especially true among men 65 – 69 years of age, where the magnitude of the risk was 6.5 fold.
- In another study in which 123 heart-attack survivors were followed for up to 10-years, low DHEA-S levels were found to be predictive of death due to cardiovascular disease.
- In a group of 622 individuals older than 65 who participated in a French community-based study, low DHEA-S levels were strongly linked to greater risk of death over 2 and 4 years in men.
- In another study, when low DHEA-S were combined with three other risk factors (testosterone deficiency, elevated high-sensitivity C-reactive protein [hs-CRP], and high plasma N-terminal pro-B-type natriuretic peptide [NTproB]), the risk for cardiovascular mortality jumped a staggering 63-fold above healthy control subjects.
Interestingly, in addition to the overall level of DHEA-S, some evidence suggests that the rate at which it declines with age may independently influence longevity. In one study on 950 individuals 65 or older, those whose DHEA-S levels declined on a steeper trajectory were 75% more likely to die during the study period than subjects whose DHEA-S level declined more slowly. These findings were in spite of the fact that baseline DHEA-S were not associated with mortality in this study.
DHEA and Cancer Risk
Because DHEA may increase sex hormone levels, concerns have been raised about its use in people who have or had hormone-related cancers. To date, no study has convincingly shown an increase in human hormone-dependent cancer risk as a result of DHEA or pregnenolone supplementation. In July 2011, Life Extension Magazine addressed this issue in the article State of California Decrees Strong Warning Labels on DHEA and Pregnenolone as follows.
Both pregnenolone and DHEA are “parent” hormones of the sex hormones estrogen, progesterone, and testosterone. Taking pregnenolone or DHEA supplements, therefore, may indeed raise levels of those sex hormones; in fact, that is considered one of the desired effects. Mainstream physicians, however, continue to express concern about boosting sex hormone levels late in life, citing the theoretical risk of hormone-dependent malignancies such as breast and prostate cancers.
The truth, as always, is more nuanced. Important work by Harvard urologist Abraham Morgentaler and others has revealed that low testosterone levels may increase prostate cancer risk, although this is a controversial concept. Morgentaler himself has become a strong proponent of supplementation with testosterone in older men. He was also the lead researcher on a study demonstrating that DHEA supplementation in rats enhanced total testosterone levels without producing any deleterious changes in prostate tissue.
Similar theoretical risks apply for breast cancer. But no increased risk of breast cancer has been demonstrated in large studies of combinations of natural estradiol and progesterone (the natural products of DHEA and/or pregnenolone). Furthermore, natural progesterone alone may reduce cancer risk, again suggesting that boosting sex hormone levels with precursors such as DHEA and pregnenolone is safe. One recent animal study demonstrates a direct anti-cancer effect of DHEA in obese rats).
Any individual who is known to have cancer of any kind should consult with his/her physician when using any new supplement or medication.
Note 2: Dehydroepiandrosterone sulphate and mortality in middle-aged and older men and women - a J-shaped relationship
Note 3: DHEA, DHEA-S and cortisol responses to acute exercise in older adults in relation to exercise training status and sex