The natural steroid hormone dehydroepiandrosterone (DHEA) was first introduced to Life Extension members four decades ago at a time when the medical community was largely unaware of the scientific data supporting this hormone’s multifaceted benefits. Fast forward to today, when more than 3700 papers have evaluated the scientific effects of DHEA upon many different cells and tissues of the body. This multifunctional hormone and its metabolite dehydroepiandrosterone sulfate (DHEA-S) provide critical hormonal benefits in both men and women (Traish 2011; Savineau 2013). As a precursor to androgens (male hormones) and estrogens (female hormones), DHEA plays a fundamental role in the maintenance of hormonal balance and youthful vitality. It also modulates a variety of pathways throughout the body involved in various aspects of health and disease via direct actions independent of its role as a precursor to androgens and estrogens (Samaras 2013; Traish 2011; Savineau 2013).
Aging disrupts hormonal balance, with the levels of several critical hormones dramatically reduced in comparison with youthful levels, and DHEA is no exception. By age 80, levels of DHEA fall by as much as 80%–90% compared to what they were during young adulthood (Samaras 2013). The gravity of this becomes clear after understanding the roles DHEA plays in supporting healthy, youthful physiology across several body systems. Studies have shown that reduced levels of DHEA-S are linked with the pathophysiology underlying numerous age-associated disease states, including cognitive decline, cardiovascular disease, bone loss, cancer, depression, sexual dysfunction, and various inflammatory disorders (Samaras 2013; Traish 2011; Savineau 2013; Dong 2012; Zaluska 2009; Labrie 2009; Straub 2000; Krysiak 2008; Lopez-Marure 2011).
Restoring youthful DHEA levels provides a unique opportunity to mitigate the consequences of dwindling hormones. Unlike direct administration of androgens (ie, testosterone replacement therapy) or estrogens (ie, estrogen replacement therapy), bolstering DHEA levels provides a “reservoir” of this hormone precursor that various tissues can convert into androgens and estrogens (Traish 2011; Arlt 1998; Morales 1994; Aldred 2010; Samaras 2013; Panjari 2007). However, DHEA administration cannot supplant the need to measure and restore other hormones because the rate at which it is converted to androgens and estrogens varies among individuals and with gender (Samaras 2013; Arlt 1999; Schulze 2013; Fitzpatrick 2001; Miller 2004). Therefore, restoring DHEA levels should be viewed as an integral part of a comprehensive hormone restoration regimen rather than an alternative to testosterone replacement in men and estrogen replacement in women.
In addition to its role as a hormone precursor, DHEA also modulates inflammation, which is a driving force in many diseases. This multifunctional hormone also promotes the production of the cell-signaling molecule nitric oxide within the delicate lining of blood vessels by activating an enzyme called endothelial nitric oxide synthase (eNOS). Nitric oxide is a pivotal regulator of blood flow via its ability to stimulate blood vessel dilation. Thus, it is not surprising that low DHEA levels have been linked to cardiovascular disease in the medical literature (Samaras 2013; Traish 2011).
Upon oral administration, DHEA is mostly converted to DHEA-S, which circulates in the blood far longer than DHEA. Circulating DHEA-S acts as a reserve upon which tissues can draw. Once taken up by tissues, DHEA-S is converted back to DHEA, which can then be locally converted to androgens and estrogens or exert direct action (Samaras 2013; Traish 2011).
Since DHEA-S is more abundant in the bloodstream than DHEA (Traish 2011; Savineau 2013), simple blood tests to measure DHEA-S concentrations can be integrated into any healthy aging strategy for both men and women. With regular monitoring of blood levels of DHEA-S and other hormones, individuals are provided with specific feedback about the state of their hormonal milieu (Traish 2011). This allows for development, implementation, and optimization of individualized regimens that can help maturing individuals lead full, active, healthy lives (Samaras 2013).
Bioidentical hormone replacement therapy is a method of administering hormones that are structurally identical to those produced by the human body. Treatment with DHEA, which is also bioidentical, is an integral component of any comprehensive hormone restoration regimen. On the other hand, some forms of conventional hormone replacement therapy utilize hormones that are not identical to those produced by humans and are either derived from animals or synthesized. Evidence suggests that bioidentical hormone replacement therapy may be safer and associated with greater patient satisfaction than conventional hormone replacement therapy (Holtorf 2009). Life Extension’s Male Hormone Restoration and Female Hormone Restoration protocols provide a thorough overview of bioidentical hormone replacement therapy and should be referred to in conjunction with this protocol.