Dehydroepiandrosterone

Proposed uses DHEA with insufficient evidence:

• Vasodilation, anti-inflammatory, antiatherosclerotic, antiaging

• Physical performance: Increase muscle mass, strength, and energy

• SLE, multiple sclerosis, osteoporosis, adrenal insufficiency, Crohn disease, COPD

• Alzheimer disease, Parkinson disease, fibromyalgia

• Depression, schizophrenia, chronic fatigue, anorexia nervosa, sleep disorders

• CV disease, diabetes, obesity, metabolic syndrome

• Improve menopausal symptoms, bone mineral density, and vaginal atrophy

• Improve erectile dysfunction in men; cervical dysplasia, atrichia pubis, sexual dysfunction, and well-being in healthy women

May cause hirsutism, acne, headache, insomnia, wt gain, alopecia, deepening of voice, and abnormal menses in women, or gynecomastia in men.

Cardiac arrhythmias occur rarely, even with large doses.

May worsen liver diseases and polycystic ovary syndrome and lower HDL levels. (It also decreases total cholesterol, LDL, and triglycerides.)

Associated with cases of mania and palpitations.

Diabetics may be prone to hyperglycemia.

Unknown coagulation and vasoconstriction/dilation effects.

Use contraindicated in pregnancy, endometriosis, leiomyoma; breast, ovarian, uterine, and prostate cancers.

Possibly unsafe with more side effects if used long term and in larger doses (higher than 50–100 mg/d).

Single case report associated DHEA with cardiac arrhythmias and immune suppression.

High DHEA levels can be associated with insulin resistance.

Unknown effects on periop stress response, adrenal, and cardiac function.