Myths About DHEA

Over recent decades a whole mythology has grown around DHEA: from an "elixir of youth" to a "legal anabolic." Part of these notions was born from real observations that were later not confirmed in randomized studies, part — simply from marketing. The editorial team has examined the seven most common claims and compared them with what is known from clinical science.

Myths 1–2: the "hormone of youth" and a low level as a diagnosis

The popularity of DHEA began with an observation that is true in itself: the level of DHEA-S in the blood peaks in young adulthood and then gradually declines, so that in old age it is only a small fraction of the peak. From this arose the idea that returning the "young" level would return youth as well.

However, correlation does not mean causation. A decline in DHEA-S is a marker of aging, but this does not prove that it causes aging. To test the hypothesis, randomized studies were needed, and the most famous of them — the two-year study by Nair and colleagues in the New England Journal of Medicine — found no clinically significant effect of 50 mg of DHEA on body composition, physical performance, insulin sensitivity, or quality of life in older people.

The European DHEAge study showed some effects, for example on skin condition and certain bone tissue indicators in women over 70, but this is far from "rejuvenation" of the body. Meta-analyses on postmenopausal women and older men concluded that the benefit is either absent or modest.

The second related myth is that any low DHEA-S reading requires "correction." An age-related decline is the norm, and laboratories' reference intervals depend on age and sex. Use makes medical sense only in specific clinical situations, for example in adrenal insufficiency, and even then not always.

Myth 3: DHEA raises testosterone and builds muscle

On sports forums DHEA is still called a "prohormone" and a "natural testosterone booster." The logic is simple: if DHEA is a precursor of testosterone, then more DHEA means more testosterone. But a man's body regulates testosterone levels through the hypothalamic-pituitary axis, and its main part is produced in the testes, not from adrenal DHEA.

In a controlled study by Brown and colleagues, young men took 100 mg of DHEA per day for eight weeks of strength training. The level of androstenedione increased, but testosterone did not change, and the gain in strength and muscle mass did not differ from the placebo group. Similar results were obtained by Wallace's group for DHEA and androstenedione.

In women DHEA does indeed raise testosterone levels, because their own testosterone largely comes from the peripheral conversion of precursors. But this is precisely why women more often experience androgenic side effects, while there is no convincing effect on strength or muscle in studies.

Thus, for men DHEA is not an effective anabolic, and for women — not an effective way to get acne and unwanted hair growth without proven athletic benefit.

Myth 4: DHEA burns fat

The idea of DHEA's "fat-burning" action arose from experiments on rodents, in which DHEA reduced obesity. However, rodents have a very low level of their own DHEA, and their physiology differs substantially from human, so transferring the results is incorrect.

In humans the data are ambiguous. In a small randomized study by Villareal and Holloszy (JAMA, 2004), older men and women taking DHEA showed a moderate reduction in visceral fat and improved insulin sensitivity. At the same time, the larger and longer study by Nair and colleagues did not confirm such effects.

For young people with a normal DHEA-S level, there are no data on a reduction in fat mass. Products that combine DHEA with "thermogenics" have no evidence of effectiveness specifically due to DHEA.

Confusion often arises from 7-keto-DHEA as well, which is advertised for weight loss. This is a different molecule, the evidence base for which is also limited to small studies.

Myths 5–6: natural means safe, yam as a source

DHEA is indeed identical to the hormone the body produces. But "natural" does not mean "harmless in any amount": insulin and cortisol are also natural. When the DHEA-S level goes beyond physiological limits, the formation of androgens and estrogens increases, and with it the risks for skin, hair, hormone-dependent tissues, and the lipid profile.

This is exactly why in the European Union and in Ukraine systemic DHEA is not sold as an ordinary dietary supplement, and the only widely registered preparation based on it is prescription vaginal prasterone with clear contraindications.

Another persistent myth is that Mexican wild yam extract is "plant DHEA." Yam contains diosgenin, from which steroids are synthesized in the chemical industry. However, the human body has no enzymes for such a conversion, so consuming yam does not raise DHEA.

Be attentive to advertising phrases such as:

• "a natural precursor of all hormones" — sounds convincing but says nothing about benefit;
• "without side effects" — contradicts clinical trial data;
• "plant DHEA from yam" — biochemically incorrect;
• "rejuvenation by 10 years" — not confirmed by any RCT.

Myth 7: DHEA is not detected in doping control

Some athletes believe that since DHEA is produced in the body, it cannot be distinguished from the endogenous one. This is a false assumption. DHEA is included on the WADA Prohibited List as an endogenous anabolic androgenic steroid, and laboratories have methods for its detection.

First, DHEA use changes the steroid profile of the urine, which is tracked in the athlete's biological passport. Second, isotope mass spectrometry (IRMS) makes it possible to establish that a steroid is of synthetic origin, by the ratio of carbon isotopes.

A review by Collomp and colleagues devoted to DHEA in sport emphasizes that even a single intake may affect test results, and the absence of a proven ergogenic effect makes such a risk especially senseless.

A reference to a "supplement bought in a store" does not exempt from responsibility: under anti-doping rules, an athlete is responsible for any substance detected in their sample.

Editorial conclusions

Most popular notions about DHEA do not withstand testing by randomized studies: it does not rejuvenate, does not raise testosterone in men, and does not build muscle.

The data on the effect on fat mass are contradictory and concern mainly older people. The "naturalness" of DHEA does not make it safe, and wild yam is not its source.

For athletes DHEA is a prohibited substance that laboratories are able to detect.

To understand more deeply, read our articles "Side Effects of DHEA," "Who Should Not Take DHEA," and "Pregnenolone: What It Is and How It Works."

References

1. Nair KS, Rizza RA, O'Brien P, et al. DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med. 2006;355(16):1647–1659.
2. Baulieu EE, Thomas G, Legrain S, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci USA. 2000;97(8):4279–4284.
3. Brown GA, Vukovich MD, Sharp RL, et al. Effect of oral DHEA on serum testosterone and adaptations to resistance training in young men. J Appl Physiol. 1999;87(6):2274–2283.
4. Wallace MB, Lim J, Cutler A, Bucci L. Effects of dehydroepiandrosterone vs androstenedione supplementation in men. Med Sci Sports Exerc. 1999;31(12):1788–1792.
5. Villareal DT, Holloszy JO. Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial. JAMA. 2004;292(18):2243–2248.
6. Corona G, Rastrelli G, Giagulli VA, et al. Dehydroepiandrosterone supplementation in elderly men: a meta-analysis study of placebo-controlled trials. J Clin Endocrinol Metab. 2013;98(9):3615–3626.
7. Collomp K, Buisson C, Lasne F, Collomp R. DHEA, physical exercise and doping. J Steroid Biochem Mol Biol. 2015;145:206–212.
8. World Anti-Doping Agency. Prohibited List. Montreal: WADA; чинна редакція.