DHEA cuts abdominal fat and beats depression...

Researchers at Washington University School of Medicine in St. Louis have found the hormone dehydroepiandrosterone (DHEA) may be able to offset the increase in abdominal fat and accompanying increased risk for diabetes that often occur with advancing age.

Just about everyone adds inches round their middle as they get older, and some scientists have linked this to lessened production of the adrenal hormone dehydroepiandrosterone (DHEA).

Blood levels of DHEA peak at about 20, and then decline quite rapidly after 25 years of age.

By the time we are 70, we have only about 20 percent of the peak amount circulating in the body, which has been associated with the harmful effects of aging.

In animals, giving DHEA reduces the accumulation of abdominal fat and protects against insulin resistance. What effect does it have in aging people?

A publication in the Journal of the American Medical Association has some preliminary results.

Dennis T. Villareal, M.D., and John O. Holloszy, M.D., set out to examine whether complications of aging could be reversed if DHEA levels in elderly people were returned to the levels of their youth.

"Earlier human studies indicated DHEA supplementation improved bone density and a sense of well-being," Villareal says. "In this study, we wanted to test whether our findings in the rat studies would hold true in people. We investigated whether DHEA could reverse some of the metabolic complications of aging if DHEA levels in elderly people were returned to the levels of their youth."

The study included 56 people with an average age of 71. For six months, half of the group was randomly assigned to receive a placebo while the other half received 50 milligrams of DHEA daily.

Using highly sensitive MRI measurements of the amount of abdominal fat, the researchers found that compared with placebo, DHEA supplementation resulted in a decrease in visceral fat (within the abdomen) of 10.2 percent in the women and 7.4 percent in the men.

DHEA therapy also resulted in a decrease in subcutaneous abdominal fat (below the skin surface) averaging 6 percent in both the women and the men. The researchers found no adverse effects from DHEA therapy.

"Among the different fat stores, visceral [abdominal] fat is specifically considered potent and metabolically active because its blood drains directly to the liver," the authors say. "Fatty acids from visceral fat get deposited in the liver and other organs and then mediate the decrease in insulin action that leads to an increased risk for diabetes."

In addition, patients receiving DHEA showed an improvement in insulin action. This shows a protective effect of DHEA against insulin resistance caused by a high-fat diet and the natural decrease in insulin responsiveness that occurs with older age.

DHEA increased serum testosterone levels in women, but not in men. It increased estradiol and IGF-1 levels in both sexes. (DHEA is, in fact, a forerunner of testosterone and estrogens.)

There were no significant side effects of DHEA supplementation. In particular, prostate specific antigen (PSA) levels in the men were unchanged - 1.7 ng/mL at baseline and 1.6 ng/mL after 6 months. In the placebo group, PSA levels were 1.4 ng/mL at baseline and 1.8 ng/mL 6 months later.

Depression

DHEA may also be an effective treatment for mild to moderately severe midlife-onset depression.

In the study - published in the Archives of General Psychiatry - 46 subjects were randomly divided into two groups. One group received 90 mg per day of DHEA for three weeks, followed by three additional weeks with the dosage increased to 450 milligrams per day. The other group received a placebo for six weeks.

Before the trial period, at three weeks, and again at the end, researchers evaluated depression with three assessment tools: the Hamilton Depression Rating Scale, the Center for Epidemiologic Studies Depression Scale and the Derogatis Interview (to determine sexual function).

When scores from these evaluations were analyzed, the DHEA group showed significant improvement in all three assessments. Every subject in the DHEA group had a 50 percent or greater improvement in the Hamilton scale, while only 13 subjects in the placebo group improved on this scale.

DHEA levels can be measured with a simple saliva test, which can also be used to monitor the effects of DHEA supplementation on an ongoing basis.

DHEA is certainly not for everyone. Your body can convert DHEA into both estrogen and testosterone, so doses of DHEA that are too high can lead to unpredictable imbalances in sex hormone profiles.

It would be foolish to embark on long-term DHEA supplementation without a better idea of the potential risks involved.

Reference
Dennis T. Villareal, MD; John O. Holloszy, MD Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men A Randomized Controlled Trial. JAMA. 2004;292:2243-2248
Schmidt PJ, Daly RC, Bloch M, Smith MJ, Danaceau MA, St Clair LS, Murphy JH, Haq N, Rubinow DR. Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression. Arch Gen Psychiatry. 2005 Feb;62(2):154-62