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One trial tested the effect of DHEA-S in patients with systemic lupus erythematosus (SLE).7 Prior studies evaluating the impact of DHEA-S in SLE patients were inconsistent in their findings. This review also failed to find evidence to substantiate or refute the benefits of DHEA-S in this patient population.
The trial demonstrated improved quality-of-life scores and a reduction in flares in the DHEA cohort, but up to 30% of participants dropped out of the study prior to conclusion. The potential negative effects in the DHEA group included a lowering of serum HDL, a known antioxidant.7
Safety, Interactions
In recommended doses, few side effects were reported when DHEA-S were administered orally. Common side effects include fatigue, headache, tachycardia, nasal congestion and acne.2 For women, the most common side effects are abnormal menses, emotional changes, headache and insomnia. Patients with a history of heart disease, abnormal heart rhythms, hypercoagulability and liver disease should avoid DHEA-S. DHEA-S is not recommended for pregnant or lactating women.2
How Supplied, Dosage
DHEA is supplied in capsules, tablets and injections. Dose-range recommendations are from 25 mg to 250 mg daily. A 5% to 10% topical cream containing DHEA is also available for daily use.
Summary
While there is the potential for substantive health benefits with DHEA-S, the lack of consistent, positive clinical trial data at present makes this a weak therapeutic choice. DHEA-S may be a star of the future, but it is not shining brightly enough for selection at this time.
Sherril Sego, FNP-C, DNP, is a staff clinician at the VA Hospital in Kansas City, Mo., where she practices adult medicine and women’s health. She also teaches at the nursing schools of the University of Missouri and the University of Kansas.
References
- About herbs, botanicals and other products: dihydroepiandrosterone page. Memorial Sloan Kettering Cancer Center website.
- DHEA page. Mayo Clinic website.
- Nachshoni T, Ebert T, Abramovitch Y et al. Improvement of extrapyramidal symptoms following dehydroepiandrosterone (DHEA) administration in antipsychotic treated schizophrenia patients: A randomized, double-blind placebo controlled trial. Schizophr Res. 2005;79:251-256.
- Parsons TD, Kratz KM, Thompson E et al. DHEA supplementation and cognition in postmenopausal women. Int J Neurosci. 2006;116:141-155.
- Baker W, Karan S, Kenny AM. Effect of dehydro- epiandrosterone on muscle strength and physical function in older adults: A systematic review. J Am Geriatr Soc. 2011;59:997-1002.
- Arnlöv, J,Pencina MJ, Amin S et al. Endogenous sex hormones and cardiovascular disease incidence in men. Ann Intern Med. 2006;145:176-184.
- Sawalha AH, Kovats S. Dehydroepiandrosterone in systemic lupus erythematosus. Curr Rheumatol Rep. 2008;10:286-291.
All electronic documents accessed on October 1, 2012.
This article originally appeared on Clinical Advisor
