DHEA: The Measure of Our Youth
 
 It hardly seems fair. While human life expectancy has risen
from an average of 49 years in 1900 to over 76 years today, the
actual age at which one's body naturally begins to deteriorate,
typically in the middle to late twenties, has increased little.
Around this age, muscles begin to weaken, metabolism slows,
lowering the rate at which calories are burned, hair starts to
thin, and hearing begins to fade. As one's thirties roll along,
laugh lines and fine furrows appear around the mouth and eyes as
skin begins to lose elasticity, women notice the appearance of
age spots, and extra effort is required to maintain cardiovascular
fitness, an increasingly important factor for men, whose LDL count
(the bad cholesterol) continues to climb. Why, by the time we have
achieved (it is hoped) a measure of success in our careers and
personal lives, we are already sliding down the slippery slope
of physical decline, older and wiser,perhaps, but almost certainly
weaker and sicker as well.
 
 However, research into promising new treatments for
aging-related diseases, coupled with advances in our
understanding of the actual mechanisms of aging, offers the hope
that it soon may be within the means of science to preserve, or
at least to recreate, the days of our youth. Perhaps the most
exciting of these treatments centers on a hormone known as
dehydroepiandrosterone, or, more mercifully, DHEA.
 
 DHEA is the most abundant naturally occurring steroid hormone
in the body. It is produced by the adrenal gland, which secretes
many other hormones, like adrenaline. DHEA is often referred to
as a "motherlode" hormone because the body converts it into
active hormones such as testosterone and estrogen, substances
essential for, among many critical functions, regulating libido,
metabolism, and forming muscle mass.
 
 A growing body of research suggests that DHEA may have a number
of vital medical applications, including bolstering immunity in
the elderly, inhibiting certain cancers, and combating
atherosclerosis, Alzheimer's disease, lupus, diabetes, and
obesity. Moreover, there is mounting evidence that the level of
DHEA in a person's blood is a good predictor not only of the
incidence of afflictions commonly associated with aging, such as
cancer, cardiovascular disease, and memory disorders, but of
aging itself.
 
 As people age, levels of DHEA decrease so that by age 65
production of the hormone is only 10 to 20 percent of that in
the average 20-year old. Because one of DHEA's primary roles is
to protect against bacterial and viral infections, this fall in
its production has been closely correlated with a, general
weakening of the immune system. At birth, the reference range
for DHEA is 1.7-3.6 micrograms/milliliter for both males and
females and peaks at 1.4-7.9 mcg/ml for males and 0.7-4.5 for
females between age 20-29.
 
 Although many other hormones also are important in warding off
disease, DHEA has been found to confer protection against a
wider range of viruses and infections, several of which, such as
streptococcus, are potentially lethal. Researchers are
particularly excited about studies done on mice (whose response
to vaccinations is similar to old humans) in which a single dose
of DHEA administered with a vaccine stimulated a powerful
antibody response characteristic of young mice.
 
 And though it is premature to draw definitive conclusions from
these experiments alone, there is hope DHEA may stimulate a
parallel immune reaction in people, which would be critical for
delaying the onset of disease in the elderly. Indeed, the
implications of these findings, says Richard Hodes, head of the
National Institute on Aging, are "extremely interesting and
potentially important."
 
 DHEA's usefulness as a factor to forecast and assess one's risk
for cancer is equally exciting. Epidemiological studies suggest
that the risk of developing a number of cancers strongly relates
with serum or urine levels of DHEA or its chemical relative,
DHEAS (DHEAS is 300-500 higher in concentration than DHEA). A
low level of the hormone in the bloodstream has been linked with
gastric, prostate, and bladder cancer.
 
 As of today, more research is required to ascertain the
hormone's actual value in cancer treatment. To wit, there is
concern among some clinicians that DHEA, which is close in
composition to sex hormones, might cause enlargement of the
prostate, and consequently many physicians caution against its
therapeutic use in cases of prostate abnormality. Furthermore,
animal studies suggest that DHEA may both promote and suppress
the growth of mammary tumors, raising concerns that in women it
may heighten the risk for breast cancer.
 
 DHEA also exhibits promise in treating atherosclerosis, a
disease in which small deposits of fat, called plaque,
accumulate on the inner walls of the arteries. One study
stretching nearly 20 years showed DHEAS levels in men who died
of coronary heart disease to be appreciably lower than
those of men whose levels were normal.
 
 In rabbits with the disease, DHEA reduced plaque by almost 50
percent over controls whose DHEA levels were lower. And in yet
another experiment, low levels of the hormone were found in 32
men (aged 26-40 years) who had suffered myocardial infarction,
reinforcing the view that DHEA was a predictor, and quite possibly
a cause, of atherosclerosis. These and other similar findings have
the medical community abuzz regarding DHEA's value in defeating
this leading killer.
 
 While a cure for Alzheimer's disease continues to elude
researchers, evidence increasingly suggests that DHEA is
essential in maintaining the function of brain cells. Recent
studies indicate that Alzheimer's patients' DHEA levels are
uniformly lower than people without the disease; further,
DHEA and DHEAS sink to markedly low levels later in life, when
the incidence of the disorder is much higher.
 
 In vitro studies of mice show that even minimal doses of the
hormones lessen amnesia and augment long-term memory. Thus,
neurologists speculate that DHEA supplementation in humans may
be an important ingredient both in slowing the progression of
Alzheimer's and in treating the sort of degenerative memory
disorders that often arise in old age.
 
 Systemic lupus erythematosus is a chronic inflammatory disease
in which the immune system causes abnormalities in blood vessels
and connective tissues that can damage the kidney, nervous
system, joints, and skin. Moreover, because lupus is commonly
treated using large doses of steroids and cancer chemotherapy
agents, the side effects of therapy are often worse than the
disease itself.
 
 In a test of DHEA on 57 women with lupus, Stanford University
researchers say that roughtly two-thirds of the subjects
reported some alleviation of their symptoms, including a
reduction in the severity and frequency of rashes, joint pain,
headaches, and fatigue. According to Dr. James McGuire, one of
the leaders of the study, many of the women also reported a
heightened tolerance for exercise and an improvement in
concentration. These encouraging results have spurred the Food
and Drug Administration to facilitate further clinical trials to
evaluate DHEA's efficacy as an alternative to conventional
lupus therapy.
 
 In the 1980s, Dr. Arthur Schwartz of the Fells Institute for
Cancer Research and Molecular Biology at Temple University
discovered another effect of DHEA: It induced weight loss in
laboratory animals irrespective of much food they consumed. This
dramatic result has prompted researchers to study DHEA's use as
a weight-loss therapy for humans. One explanation for this
property of DHEA is that it increases the release of
cholecytokinin (CCK), a hormone responsible for signaling the
brain when the body has ingested enough food to feel satiated,
or "full."
 
 Rats fed DHEA produced higher levels of CCK, lowered their
intake of food, and showed a consonant decrease in body fat. It
is also believed that DHEA alters metabolism by causing the body
to shift glucose metabolism from the production of fat to the
production of energy. In a study where DHEA was given to five
normal weight males for 28 days (and where diet and physical
activity were controlled), 4 of the 5 subjects experienced an
average fat loss of 31 percent. Most significantly, perhaps,
none of the four exhibited an aggregate change in weight,
meaning that the loss in fat was balanced by a proportional
gain in muscle.
 
 Because weight gain in older adults is often accompanied by
mature-onset diabetes, experts suspect that this higher
incidence of the disease is a function of the steep decline in
DHEA levels associated with advancing age. DHEA has been found
to inhibit development of diabetes in rats genetically
predisposed to it, and some clinicians report that, in humans,
DHEA reduces the need for insulin. A related finding suggests
that the higher incidence of cardiovascular disease in diabetics
is caused by elevated levels of insulin that, in turn, act to
lower levels of DHEA.
 
 Anti-aging medicine specialists list the diseases mentioned in
this article-cancer, atherosclerosis, diabetes-as principal
benchmarks of aging, which is why many of these same experts
point to DHEA as perhaps the most useful indicator of aging and
longevity. Research has shown that DHEA can prolong life span in
laboratory animals by 50 percent, while mice given the hormone
actually appear to age slower, maintaining the glossiness and
coat color of their youth. Says Dr. Ronald Klatz, president of
the American Academy of Anti-Aging Medicne," DHEA is undeniably
one of the most crucial predictive factors in diagnosing
aging-related diseases, and it may turn out to be an effective
anti-aging medication as well."
 
 Also undeniable is that the outlook for DHEA research is
excellent. Once disparaged as of minor interest by the
scientific establishment, this remarkable little molecule has
become the subject of intense scrutiny. DHEA research currently
is being underwritten by the National Institute on Aging, the
National Cancer Institute, the National Institutes of Health,
the American Cancer Society, and other major scientific agencies.
 
 Moreover, it is being investigated for its possible use in a
host of other areas, including AIDS, osteoporosis, Epstein-Barr
viral infections, chronic fatigue syndrome, menopause,
depression, herpes, and even stress. Pending the results of
long-term human studies of DHEA, the FDA has yet to approve
the substance, while its proponents are lobbying hard
to make it available at least as an experimental drug. However,
what is certain is that DHEA's promise as a defense against the
scourge of aging and the degenerative diseases aging engenders
is, for all of us, enormous.
 
References
 
Bird, C.E. et al. "Dehydroepiandrosterone: Kinetics of
Metabolism in Normal Men and Women." Journal of Clinical
Endocrinology and Metabolism, 47:818-22 (1978).
 
Block, Will. "DHEA Replacement Therapy." Life Extension Report,
13, no. 9 (Sept 1993).
 
Boggs, Carl. "DHEA: The Youth Hormone Can Now be Added Back to
the Body With Full Rejuvenating Potential." Journal of Longevity
Research, 1, no. 1, (1994).
 
Braverman, Eric R. "DHEA and Adrenopause: A New Sign of Aging
and a New Treatment." Total Health, 16, no. 1, (Feb 1994).
 
Dilman, Vladimir M. and Ward Dean. The Neuroendocrine Theory of
Aging and Degenerative Disease. Pensacola, Florida: The Center
for Bio-Gerontology, 1992.
 
Ebeling, Pertti and Veikko A. Koivisto. "Physiological
Importance of Dehydroepiandrosterone." The Lancet, 343, no.
8911, (June 11 1994).
 
Fettner, Ann Guidici. "DHEA Gets Respect." Harvard Health
Letter, 19, no. 9, (July ,1994).
 
WHAT TREATMENTS ARE BEING TRIED USING DHEA?
 
Abstract # 25 . DHEA AS A MARKER OF AGING AND A THERAPEUTIC PRINCIPAL
 
Julian M. Whitaker, M.D., Medical Director, Whitaker Wellness Institute,
Newport Beach, CA.
 
Dehydrepiandrosterone (DHEA) is a steroid hormone produced by the adrenal
gland. Synthesized from cholesterol, it is produced in larger amounts
than any other adrenal steroid hormone. DHEA isboth a precursor to the sex
hormones and functions as a "buffer" hormone. It also has recently
discovered independent functions of its own.
 
DHEA has therapeutic potential for many medical conditions including:
cardiovascular disease, diabetes, hypercholesterolema, obesity, cancer,
Alzheimer's disease, memory deficits, autoimmunediseases, immune disorders
including AIDS, chronic fatigue, and osteoporosis. In addition, DHEA has a
decided effect on mortality, with studies showing that an increase in blood
levels of DHEAsulfate is associated with a 36% reduction in mortality
from any cause.
 
An individual's innate blood levels of DHEA reach a peak in his or her
mid-twenties and progressively decline from that point. Blood levels of DHEA
sulfate are a marker for manydegenerative diseases, including the
above-mentioned conditions.
 
Supplemental DHEA is being used clinically for these conditions, as well
as for physical and psychological well-being and life extension. Doses vary
but as much as 1,600 mg/day have been given for a month without side
effects. A recommended initial therapeutic dose is 25 mg/day forwomen and 50
mg/day for men, with monitoring of blood levels every three months and
adjusting thedose accordingly. The intent is to maintain levels in the
average range for a young adult, regardless of the individual's age.
 
 
 
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