Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEAge Study to a sociobiomedical issue

The secretion and the blood levels of the adrenal steroid dehydroepiandrost erone (DHEA) and its sulfate ester (DHEAS) decrease profoundly with age, an d the question is posed whether administration of the steroid to compensate for the decline counteracts defects associated with aging. The commercial availability of DHEA outside the regular pharmaceutical-medical network in the United States creates a real public health problem that may be resolved only by appropriate long-term clinical trials in elderly men and women. Tw o hundred and eighty healthy individuals (women and men 60-79 years old) we re given DHEA, 50 mg, or placebo, orally, daily for a year in a double-blin d, placebo-controlled study. No potentially harmful accumulation of DHEAS a nd active steroids was recorded. Besides the reestablishment of a "young" c oncentration of DHEAS, a small increase of testosterone and estradiol was n oted, particularly in women, and may be involved in the significantly demon strated physiological-clinical manifestations here reported. Bone turnover improved selectively in women >70 years old, as assessed by the dual-energy x-ray absorptiometry (DEXA) technique and the decrease of osteoclastic act ivity. A significant increase in most libido parameters was also found in t hese older women. Improvement of the skin status was observed, particularly in women, in terms of hydration, epidermal thickness, sebum production, an d pigmentation. A number of biological indices confirmed the lack of harmfu l consequences of this 50 mg/day DHEA administration over one year, also in dicating that this kind of replacement therapy normalized some effects of a ging, but does not create "supermen/women" (doping).