In fact, it is commonly reported that decreasing DHEA levels are inevitable with aging. But I have seen healthy, active eighty year-olds with optimal DHEA levels and I have seen stressed-out thirty-year-olds with low or deficient levels of DHEA. With few exceptions, low or deficient DHEA is found in every illness. Note the frequent overlap of this discussion with that of magnesium. Most critically, DHEA blocks carcinogenesis and retards aging, cardiovascular disease, diabetes, and even obesity. Interestingly, USA Today on September 5, 1996 carried a cover story, “DHEA: Is This Hormone the Fountain of Youth?” And The Sciences in its September/October 1995 issue carried an article, “Forever Young.”

The DHEA story begins with cholesterol, the foundation chemical for brain, nerve tissue, and hormones. Of all natural bio­chemicals, cholesterol is the most essential and most common. It is unfortunate that medicine has maligned this critical and beneficial essence of life chemical. It is not cholesterol that is a problem. Metabolic errors and/or stress induced dysfunction raise cholesterol. In fact, not only can we not live without cholesterol, we make cho­lesterol even without eating it! Ten minutes of stress will cause the body to produce more cholesterol than you get from an egg. Actually eggs are one of the best of all foods as the cholesterol in eggs comes with an ideal emulsifier, lecithin.

Except in the very rare condition of familial hypercholesterolemia, the blood level of cholesterol remains normal, (that is, below 200 units) except when total stress produces blocks to the usual metabolic pathways in which cholesterol is used to make various healthy homeostatic (balancing) hormones. In general, under stress, testosterone, estrogen, and even thyroid hormones decrease while cholesterol increases. Unfortunately, one of the normal stress modulators, DHEA, is also blocked when stress exceeds the body’s ability to compensate. One of the significant factors in that normal compensatory mechanism is magnesium. As noted, magnesium is critical in stabilizing cellular membrane electrical charge. Physical inactivity, obesity, anger, anxiety, depression, pollution, electromag­netic excess, and deficiency of any essential nutrient may lead in this way to hypercholesterolemia and DHEA depletion.

DHEA is produced in the adrenal glands in both men and women; men produce about one-third more than women as they also produce DHEA in the testes. The core of the adrenals, the cortex, produces cortisol, androgens, aldosterone, and small amounts of estrogen. Interestingly, aldosterone, a major regulator of water, is regulated significantly by potassium, a primarily intra-cellular mineral, as is magnesium.

Cholesterol is connected in the adrenal cortex to preg­nenolone, which can then be converted into progesterone, DHEA, and androstenedione, the latter made famous in 1998 by baseball player, Mark McGwire. For unknown reasons, much of the DHEA is bound to a sulfate molecule, rendering it relatively inactive. DHEA and androstenedione can be converted into testosterone. Progesterone can also be converted into testosterone. Progesterone can also be converted into cortisone and aldosterone. Actually only 5 percent of total male testosterone is derived from adrenal androstenedione; the rest from the testes. On the other hand, two-thirds of female testosterone is derived from adrenal androstenedione, the rest is produced in the ovaries.

In brief summary, DHEA counterbalances the effects of cortisone; inhibits glucose-6-phosphate dehydrogenase important in glucose metabolism; inhibits the pentose shunt and ornithine decarboxylase (perhaps important in growth hormone regulation); blocks the potassium channel (perhaps important in maintaining intracellular magnesium); and inhibits cytokineses, which makes it anti-inflammatory. It lowers cholesterol and enhances immune function; it is also an antioxidant.

DHEA is a major marker for age and health. Its major effect in a coping person is anti-stress, meaning that the increased cortisone produced by stress is subsequently normally brought back down to baseline by a rise in DHEA. DHEA similarly has antidiabetic action, as cortisol raises blood sugar and either spares or enhances effects of insulin. DHEA protects against both immune and autoimmune diseases; it enhances immune function protecting against cancer. It has significant anti-obesity effects, perhaps related to its down-regulation of the stress response.

Interestingly, high animal fat diets and obesity lead to low levels of DHEA. Additionally DHEA is intimately related to thyroid function - primary thyroid disease, especially low thyroid production, leads to low DHEA levels.

Low levels Of DHEA are found in women up to nine years before development of breast cancer. And in my experience, men may have low DHEA levels for four or more years prior to development of prostate cancer.

Insulin, blood sugar, and cortisone all cause increased secretion of DHEA into urine. Prolonged stress, which may raise insulin, blood sugar and cortisol, eventually leads to low DHEA blood levels.

Many clinical studies of DHEA are suspect as most labo­ratories are notoriously inaccurate. Of the six labs where we sent three samples of the same blood from up to ten patients, only one lab was accurate. Most labs, for the same blood, gave values 50 to 300 percent different! Only Nichols Labs, now Quest Diagnostics of San Juan Capistrano, California, has an accuracy of 95 to 99 percent. Reference labs may measure DHEA sulfate levels more accurately but at least four separate reports suggest that DHEA-S is not clinically as useful as DHEA. For instance, ACTH ordi­narily increases DHEA but not necessarily DHEA-S. Similarly in 108 seropositive HIV men with low CD4 lymphocytes, DHEA was predictive of disease progression but DHEA-S was not.

Low levels of DHEA have been reported in AIDS, Alzheimer’s, many types of cancer, coronary artery disease, depression, diabetes hypertension, lupus erythematosus, multiple sclerosis, pemphigus, psoriasis, rheumatoid arthritis, and viral infections. Indeed the only illnesses in which DHEA may be normal are occasionally in schizophrenia and early in alcoholism and panic attacks.

In evaluating DHEA levels in several thousand patients, I have come to the conclusion that DHEA is the major reflector of stress reserves or overall health. It is indeed a Youth and Longevity hormone.

DHEA Levels And Stress

Blood level of DHEA measured as nanograms per deciliter       

                 SeriousDeficiency               Worrisome Low           Fair                    Good              Excellent

Male             <180                                      180-349                        350-599              600-749            750-1250

Female         <130                                      130-299                       300-449             450-549            550-980

About 50 percent of all patients seen at our ciinic nave 1ev-els in the poor to fair level and the other 50 percent are clearly deficient! Even in several hundred non-patients, students attend­ing our seminars, a majority are low or clearly deficient.

It is likely that six hours or more of airplane travel will at least temporarily deplete DHEA. One otherwise healthy young woman had a DHEA level of only 180 ng/dL two days after fly­ing to the United States from Australia. Twelve days later it had rebounded to 560 ng/dL.

When I first became interested in DHEA ten years ago, I intuited that perhaps one reason for DHEA deficiency was a block in making progesterone, which decreases so dramatically at menopause. Thus, I initially recruited seven men with low DHEA levels and had them use natural progesterone cream one teaspoon twice a day. At six weeks, DHEA levels had increased in six of seven men. By twelve weeks this increase in DHEA had stabilized at 30 to 100 percent above baseline. Most men also reported becoming more horny! When I published this material, a French professor of endocrinology wrote that there is no known pathway for progesterone to be converted to DHEA! Fortunately, hundreds of my patients do not know there is no pathway, so they have usually responded with significant increases in DHEA with the use of progesteron cream.  F

For more information on DHEA go to: http://www.life-enthusiast.com/twilight/she

Dr. Shealy

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