DHEA: Panacea or snake oil?

OBJECTIVE To review the evidence that supplementation with dehydro-3-epiand rosterone (DHEA) is beneficial in aging, cardiovascular disease, immune fun ction, and cancer. METHODS English-language literature search using MEDLINE with subject headi ngs DHEA, adrenal steroids, and androgens. QUALITY OF EVIDENCE Although some randomized, double-blind, placebo-control led trials have been conducted, most of the evidence supporting use of DHEA for any disease state is of poor quality and consists of case reports and case-control and open-label clinical trials. MAIN MESSAGE Dehydro-3-epiandrosterone is available as a health food supple ment and is touted as being beneficial for a variety of diseases. It might be beneficial for improving someone's sense of well-being; minor improvemen ts in body composition have been noted for men only No consistent relations hip has been demonstrated between levels of DHEA and risk of cardiovascular disease, breast cancer, or immune function. Insufficient evidence exists t o support using DHEA for acquired immune deficiency syndrome. High levels o f DHEA are associated with adverse effects, such as increased risk of breas t and ovarian cancer at certain ages and reduced levels of high-density lip oprotein cholesterol. CONCLUSIONS Current enthusiasm for using DHEA as a panacea for aging, heart disease, and cancer is not supported by scientific evidence in the literat ure. Given the potentially serious adverse effects, using DHEA in the clini cal setting should be restricted to well-designed clinical trials only.