DHEA the Antiaging Hormone

Everything we do, feel, think – it all starts with the brain. A balanced, healthy brain helps lay the essential foundation for optimal wellbeing. A small but significant aspect of brain health is regulated by a specific class of steroid molecules that refer to cholesterol-derived steroid compounds that play critical roles in the nervous system – its development, maintenance and survival. This is better know as DHEA. As the levels of DHEA and DHEA-S decline with age, the brain loses their protective properties and becomes more sensitive to the ravages of neurological decline.

Dehydroepiandrosterone (DHEA) is plentiful in the human body – together with its sulfated form (DHEA-S), DHEA comprises the most abundant form of steroid hormones. In fact, the average concentration of DHEA-S in the bloodstream is about 10,000 times higher than the most potent estrogen – estradiol. Derived from cholesterol, DHEA is produced by the adrenal glands, brain, ovaries and testes, and is a precursor for the major sex steroids (estrogen, progesterone, and testosterone). Sometimes called the “anti-aging hormone” or even the “fountain of youth,” it is no wonder that supplementation with DHEA to its mid-normal physiologically youthful levels appears to engender a sense of wellbeing and reestablish the drive for life.

DHEA antiaging hormones androgens

DHEA-S levels peak around mid-twenties and gradually decrease to around 20% by age 70. Unfortunately, once DHEA levels begin to wind down, there are no feedback mechanisms to help restore it. As DHEA and downstream metabolites decrease, the brain loses the protective effects of sex steroids and becomes increasingly vulnerable to neurotoxic effects of cortisol and other potentially damaging factors. With declining DHEA-S levels, cortisol levels remain constant, resulting in an increased cortisol/DHEA-S ratio. The unbalanced relationship between the too high cortisol and not enough DHEA-S is serious enough that it can create potentially harmful conditions for the hippocampus and contribute to neurodegenerative disease pathology.

This is why I commonly prescribe DHEA (both to female and male patients) presenting with low androgen symptoms in combination with low circulating DHEA-S and/or low testosterone levels. DHEA replacement therapy can certainly impede the ravages of aging – adequate levels help ramp up the levels of downstream sex steroids, enhance the ability to adapt to stress, increase libido, improve the body fat ratio, and boost the immune system. However, it is important to monitor the levels of the sex steroid hormones as well as DHEA-S during supplementation – just like with too little DHEA, too much DHEA (and/or DHEA-S) can have its own set of distressing symptoms.

Low Androgen Symptoms
  • Fatigue
  • Foggy thinking
  • Decreased stamina
  • Decreased muscle size
  • Decreased libido
  • Rapid aging
High Androgen Symptoms
  • Irritability
  • Weight gain (hip and/or breast area)
  • Acne
  • Oily skin
  • Scalp hair loss
  • Growth of facial hair

Treatment Considerations

While DHEA is available over the counter in health food stores, it is best used under medical supervision with the goal of restoring low levels to the physiological range. When administered topically, DHEA restores skin elasticity, relieves symptoms of vaginal dryness and atrophy (with vaginal application), and generally improves many low-androgen symptoms. The caveat with topical DHEA administration is that it does not undergo first-pass metabolism through the liver (no liver passage – no sulfation), so although a subsequent increase in salivary and blood spot DHEA is observed, DHEA-S levels can remain unchanged. With oral DHEA administration we see a substantial spike in DHEA-S levels in all commonly tested body fluids (saliva, blood, or urine) (undergoes first-pass metabolism and gets sulfated), and a marked improvement in symptoms as well.  However, once DHEA becomes sulfated to DHEA-S, it is unable to cross the blood-brain barrier to nourish the brain. How you take DHEA definitely impacts how much gets into the brain and how fast. For example, troche (sublingual) DHEA goes directly into the bloodstream and because it’s not sulfated, it crosses directly into the brain and other tissues.

Know how much of which type is imperative when it comes to treating hormones. If you’re interested in measuring your DHEA levels for maintaining and enhancing your youth, contact the office to schedule your appointment today.