WHAT IS DHEA? 

Dehydroepiandrosterone (DHEA)  is a steroid produced  by the adrenal glands. DHEA acts like a hormone, so it is called a steroid hormone. A hormone is a chemical produced  in one part of  the body that is carried  to another part of the body where it has a specific effect. The adrenal glands  are located on top of  the kidneys. 
DHEA is the most common steroid in humans. It can be transformed in  the body into testosterone (the primary male sex hormone), estrogen (an important female sex hormone), or other steroids. 

DHEA has not demonstrated  the same effects as anabolic (muscle-building) steroids, but  the Food and Drug Administration has already examined  the possibility of classifying  DHEA as  a Schedule III drug. If this happens, it will  be extremely difficult to get DHEA. 

In normal adults,  DHEA levels are highest at about age 20, and then decrease steadily. HIV patients with lipodystrophy have very low levels of DHEA. 

WHAT ARE THE BENEFITS OF DHEA? 

People with various diseases  have levels of DHEA that are unusually low. DHEA has  been used in the last thirty years  or so to treat obesity, diabetes,  and lupus. It has also been found to improve sleep. Many people who  have taken DHEA report improved energy levels  and a better sense of well being. 

WHY DO PEOPLE WITH HIV USE DHEA? 

Some people with HIV take DHEA in amounts designed to restore normal levels. This might help improve their energy levels.  Several studies have found  that DHEA increases the  levels of IL-2, a chemical messenger that increases  the production of CD4 (T-helper) cells. See Fact Sheet 482 for more information  on IL-2. DHEA also improves  the ability of CD8 (T-killer) cells  to destroy infected cells.  DHEA may help normalize  the immune system. A recent  study shows  that DHEA can reduce depression  in people with HIV. 

HOW IS  DHEA USED? 

DHEA is available  in “regular” form  or as DHEA-S (DHEA sulfate). The body can convert DHEA into DHEA-S and back again. 

A doctor  in San Francisco who uses  DHEA with his HIV-positive patients tries to maintain blood levels that are typical  for young adults. This usually means taking 200 milligrams  of DHEA either once or twice  a day. 

A blood or saliva test  can measure  the amount  of DHEA in your blood. This can help determine how much  DHEA to take and whether your level  is where you want it to be.  DHEA levels vary during the day, so you should  do each test at the same time  of day.

We do  not know  the best doses  of DHEA for women.  DHEA is not recommended for children  or adolescents  with HIV. 

WHAT ARE THE SIDE EFFECTS? 

There are no documented side effects  of DHEA at doses up to 2,500 mg per day, except  for an increase in acne, especially in women. 

Some studies  suggest that people  with HIV and Kaposi’s Sarcoma have very high levels of DHEA. Taking more  DHEA might  be harmful  for these people. Check your blood or urine levels  before you take DHEA. 

HOW DOES DHEA INTERACT WITH OTHER THERAPIES? 

There  are no documented interactions  of DHEA with other therapies. Because  DHEA occurs naturally  in the body, interactions are unlikely.  It is possible  that DHEA could affect the processing  of drugs by  the liver, but  this has not been studied. 

HOW DO WE KNOW IT WORKS? 

There  is increasing  scientific interest in DHEA, with well over 100 scientific articles written in each of the last four years. However, there  have not been many studies that document health benefits  in humans, and some initial good results  have not been confirmed  in follow-up studies. 

There is little scientific support for taking DHEA  supplements (that is, getting more than normal amounts in your body). However, some health care providers recommend DHEA replacement, which means taking enough DHEA to bring your levels back into  the normal range. A Phase II clinical trial  is studying the effects  of DHEA supplementation  in people with HIV disease. 

THE BOTTOM LINE 

DHEA is a steroid hormone produced by the body. DHEA levels go down with age,  and go down even faster with some illnesses including HIV. DHEA may help with immune function, increasing energy levels,  and reducing depression. 

It may be helpful to take enough  DHEA to bring levels up to the  normal range. This  is called “replacement” therapy. Before  you take DHEA, check your blood  or saliva levels. 

At this point, there  are no research studies which support the use of DHEA supplements (in amounts that would give  you higher than normal levels).