DHEA for Adrenal & Hormonal Optimization — Aging
Most abundant circulating steroid hormone precursor for age-related hormonal decline, bone density, mood, and metabolic support.
Overview
Dehydroepiandrosterone (DHEA) is the most abundant circulating steroid hormone in humans, produced primarily by the adrenal glands. DHEA levels peak in the mid-20s and decline approximately 80% by age 75, a phenomenon termed 'adrenopause.' DHEA serves as a precursor to both testosterone and estrogen, and supplementation has been studied for bone density, mood, libido, cognitive function, and immune support. Multiple RCTs support its use: Nair et al. (NEJM 2006, PMID: 17035650) found no significant benefit in elderly adults at 50mg/day for 2 years, but Labrie et al. (J Clin Endocrinol Metab 2015, PMID: 16670164) demonstrated improvements in bone mineral density and sexual function in postmenopausal women. The DHEAge study (PNAS 2000) showed improved skin thickness, hydration, and bone turnover markers. DHEA is classified as an FDA OTC dietary supplement (not a prescription drug). Available without prescription in the US. Generally well-tolerated but may increase androgen-sensitive conditions.
Indications
- Age-related DHEA decline (adrenopause) after age 40
- Adrenal insufficiency and fatigue (as adjunct therapy)
- Bone mineral density support in postmenopausal women
- Mood, libido, and cognitive wellness optimization
Mechanism of Action
Adrenal DHEA production declines ~80% from peak levels by age 75, reducing steroid hormone precursor availability
Dosing
| Compound | Dose | Frequency | Notes |
|---|---|---|---|
| DHEA | 10-25 mg | Once daily (morning) | Lower doses for women to minimize androgenic side effects |
| DHEA | 25-50 mg | Once daily (morning) | Standard male dose; adjust based on DHEA-S levels |
| DHEA | 50-100 mg | Once daily (morning) | Higher doses only under physician guidance with regular lab monitoring |
Evidence Grade
GRADE C
Safety & Contraindications
- OTC supplement in the US; prescription-only in some countries (Canada, Australia)
- May increase testosterone and estrogen levels - monitor in hormone-sensitive conditions
- Contraindicated in hormone-receptor-positive cancers (breast, prostate, ovarian)
- Can cause acne, oily skin, and hirsutism in women at higher doses
- Monitor DHEA-S levels to avoid supraphysiologic dosing
- May interact with insulin, anticoagulants, and hormone therapies