DHEA and Lupus

DHEA - Dehydroepiandrosterone or DHEA is made from cholesterol by the adrenal glands, which sit on top of each kidney. Production of this substance peaks in the mid-20s, and gradually declines with age in most people. What this drop means or how it affects the aging process, if at all, is unclear. In fact, scientists are somewhat mystified by DHEA and have not fully sorted out what it does in the body. However, researchers do know that the body converts DHEA into two hormones that are known to affect us in many ways: estrogen and testosterone.

Supplements of DHEA can be bought without a prescription and are sold as “anti-aging remedies.” Some proponents of these products claim that DHEA supplements improve energy, strength, and immunity. DHEA is also said to increase muscle and decrease fat. Right now there is no consistent evidence that DHEA supplements do any of these things in people, and there is little scientific evidence to support the use of DHEA as a “rejuvenating” hormone. Although the long-term (over one year) effects of DHEA supplements have not been studied, there are early signs that these supplements, even when taken briefly, may have several detrimental effects on the body including liver damage.

In addition, some people's bodies make more estrogen and testosterone from DHEA than others. There is no way to predict who will make more and who will make less. Researchers are concerned that DHEA supplements may cause high levels of estrogen or testosterone in some people. This is important because testosterone may play a role in prostate cancer, and higher levels of estrogen are associated with an increased risk of breast cancer. It is not yet known for certain if supplements of estrogen and testosterone, or supplements of DHEA, also increase the risk of developing these types of cancer. In women, high testosterone levels can cause acne and growth of facial hair.

Overall, the studies that have been done so far do not provide a clear picture of the risks and benefits of DHEA. For example, some studies in older people show that DHEA helps build muscle, but other studies do not. Researchers are working to find more definite answers about DHEA's effects on aging, muscles, and the immune system. In the meantime, people who are thinking about taking supplements of this hormone should understand that its effects are not fully known. Some of these unknown effects might turn out to be harmful.

National Institute on Aging
U. S. Department of Health and Human Services
Public Health Service
National Institutes of Health

Proposed Treatment for Lupus

A meaningful body of evidence tells us that the hormone dehydroepiandrosterone (DHEA) may be helpful for the treatment of lupus. A 12-month, double-blind, placebo-controlled trial of 381 women with mild or moderate lupus evaluated the effects of DHEA at a dose of 200 mg daily. Although many participants in both groups improved, DHEA was more effective than placebo, reducing many symptoms of the disease.

Similarly, in a double-blind, placebo-controlled study of 120 women with SLE, use of DHEA at a dose of 200 mg daily significantly decreased symptoms and reduced the frequency of disease flareups. Positive results were also seen in earlier small studies.

Resources:
Mease PJ, Merrill JT, Lahita R, et al. GL701 (prasterone, dehydroepiandrosterone) improves or stabilizes disease activity in systemic lupus erythematosus. Presented at: The Endocrine Society’s 82nd Annual Meeting; Toronto, Canada; June 21-24, 2000.

Chang DM, Lan JL, Lin HY, et al. Dehydroepiandrosterone treatment of women with mild-to-moderate systemic lupus erythematosus: A multicenter randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2002;46:2924-2927.

van Vollenhoven RF, Morabito LM, Engleman EG, et al. Treatment of systemic lupus erythematosus with dehydroepiandrosterone: 50 patients treated up to 12 months. J Rheumatol. 1998;25:285–289.
van Vollenhoven RF, Park JL, Genovese MC, et al. A double-blind, placebo-controlled, clinical trial of dehydroepiandrosterone in severe systemic lupus erythematosus. Lupus. 1999;8:181–187.

Jan. 9, 1996 - Genelabs Technologies, Inc. announced the publication of the results of a clinical study conducted by Stanford University of women with Systemic Lupus Erythematosus (SLE), treated for three months with 200 mg/day of DHEA, fared better than placebo-treated patients, in a clinical study published in December issue of "Arthritis and Rheumatism," the official journal of the American College of Rheumatology.