DHEA therapy in aging: possibilities and pitfalls

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The adrenal androgens dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) decline with age in a fashion some consider analogous to menopause. On the basis of promising animal data, it has been postulated that replacement of the adrenal androgen deficiency of age may restitute a more “youthful” immune system as well as potentiate cognitive function, maintain bone mass, and enhance insulin sensitivity. Unfortunately, the clinical data regarding DHEA replacement is very preliminary. Additionally, the hormone is available over the counter, marketed aggressively as a “food supplement,” and is subject to widespread and unregulated use. This review addresses the rationale for DHEA replacement and the data on the subject generated to date. The possible adverse effects of DHEA are discussed. We believe at present, DHEA replacement, while it should be the subject of continuing scientific investigation, is not warranted for widespread clinical use.

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