How many times have you had DHEA pulled by your physician? Probably never. That should be no surprise, considering that the great majority of physicians do not believe in DHEA Replacement Therapy. However, in my opinion DRT (DHEA Replacement Therapy) should be almost as common as TRT (Testosterone Replacement Therapy). (I made up DRT, but I think it’s a good acronym.) The reason is simple: it is quite common for men to be very low in DHEA. What is the difference between this and hypogonadism in men?
In addition, there are very powerful arguments for DHEA Replacement Therapy: hormones that are good candidates for replacement are ones that commonly decrease with aging. DHEA definitely fits in this category and, in fact, drops more as a percentage than any other hormone. If you check out my page on DHEA Levels in Men by Age, you will see just how dramatically levels fall from the age of 30-40 to 80.
And, as is so often the case with these kind of hormonal drops with aging, low levels have been linked to a great many chronic disease conditions. So are we really supposed to believe that low DHEA levels are good for you? Isn’t it more logical to believe that this is just an unfortunate (but correctable) part of aging, such as is encountered with collapsing levels of testosterone, SOD, CoQ10, etc.?
And I would argue that we should handle DHEA in a manner very similar to testosterone:
a) Test to see if ayou are “deficient” or very low in DHEA, actually DHEA-S in this case.
NOTE: Testing is inexpensive and you do not need a doctor’s orders with these labs: Cheap Men’s Lab Testing. It is always better to work with a doctor, naturopath or Life Extension Foundation when it comes to hormones in my opinion.
b) Treat if and only if you are low on the range or below the lab’s range.
c) Raise DHEA-S levels to physiological levels – perhaps upper mid in the lab range – using low dose DHEA, usually 15-50 mg/day.
d) Monitor symptoms and DHEA-S levels afterward. (Occasional side effects are poor sleep, increased estradiol or PSA, etc.)
Again, this is exactly what any decent physician does with with testosterone and there is no reason to divert from this procedure with DHEA either. I would add that my experience to date with DHEA has been excellent. DHEA Replacement Therapy got rid of my lifelong struggle with anxiety. TRT got rid of about half of it and the addition of DHEA the other 50%, and you can read about it here if you are interested: Lee Myer’s Experience with DHEA and Pregnenolone.
WHY DON’T DOCTORS TREAT LOW DHEA? DHEA is not even on the radar of most physicians. They are so busy with acute care that they cannot possibly test your for DHEA. If they do, DHEA has a huge lab range and, if you fall in that range, 99% of physicians will ignore the result – case closed. Doctors are just now being trained in the most rudimentary knowledge regarding testosterone. Expecting them to understand the pros and cons of DHEA is just unrealistic at this point. Most of them will hand you some Cialis or Prozac and send you on your way.
This is very unfortunate, because they are completely ignoring a flood of pro-DHEA research that has come out in the last ten years. For example, there are risks with being deficient: The Risks of Low DHEA. I cover the many huge benefits of DHEA for men here. But let me give you a few teasers points and, again, these only apply to men that are low in DHEA (as measured by DHEA-S):
1. Nitric Oxide. Men, take note: DHEA stimulates nitric oxide production and has a receptor in endothelial (arterial lining) tissue, something I discuss in page on the The Benefits of DHEA. DHEA also generally boosts free testosterone (but not total) in men. See my page on Testosterone and DHEA for more information.
So DHEA clearly seems appropriate from the aging standpoint, but, of course, the real test is whether or not DHEA Replacement Therapy has done well in the studies. The answer is ‘yes,’ of course, and I document some key examples below. I also want to mention that DHEA got rid of my lifelong anxiety, something I discuss in my page on DHEA and Pregnenolone.
2. Lowers Inflammatory Cytokines. Cytokines are the inflammatory messengers associated with a host of chronic disease: cancer, heart disease, autoimmune disease and Alzheimers. The most potent and well-known cytokines are IL-6 and TNF alpha. A recent study gave a group of seniors between the ages of 65 and 75 50 mg of DHEA daily and observed that “there were significant decreases in the plasma concentrations of TNFa and IL-6 in response to 1 year of DHEA replacement.” 
3. Improved Insulin Resistance. One of the struggles for many of middle and senior age is an increase in insulin resistance. The same study above found that “it was evident on evaluation of the data, that improvements in glucose tolerance in response to DHEA occurred only in those participants who had abnormal glucose tolerance. We, therefore, did a separate analysis on the glucose tolerance data of the participants who had abnormal glucose tolerance initially. The improvements in glucose tolerance and AUC after one year of DHEA replacement was considerably greater when the results are not diluted by the values obtained on the participants with normal glucose tolerance.”  A 2007 study found that DHEA helped lower advanced glycemic end produts and oxidative stress in diabetic patients, and it’s no wonder of course. 
4. Lowered Body Fat. DHEA supplementation was found in one study to lower BOTH kinds of body fat: subcutaneous and visceral (belly or stomach).  This same study found that insulin sensitivity was improved as well and also included only senior patients (between the ages of 65 and 78).
You’re right – it doesn’t get much better than that! Inflammation, insulin resistance and weight gain our biggest enemies as men age and DHEA is clearly a powerful weapon in our arsenal against all three of them.
1) N Engl J Med, 2006; 355:1647-1659, “DHEA in Elderly Women and DHEA or Testosterone in Elderly Men”
2) New England Journal of Medicine, 1986, 315:1519-1524, “A prospective study of dehydroepiandrosterone sulfate, mortality and cardiovascular disease”
3) Diabetes Care, Nov 2007, 30(11):2922-2927, “Dehydroepiandrosterone Administration Counteracts Oxidative Imbalance and Advanced Glycation End Product Formation in Type 2 Diabetic Patients”
4) JAMA, Nov 10 2004, 292(18), “Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men”
6) Aging (Albany NY), 2011 May, 3(5):533 542, “Dehydroepiandrosterone (DHEA) replacement decreases insulin resistance and lowers inflammatory cytokines in aging humans”