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    DHEA

    Uses

    DHEA (dehydroepiandrosterone) is one of the hormones produced by the adrenal glands. After being secreted by the adrenal glands, it circulates in the bloodstream as DHEA-sulfate (DHEAS) and is converted as needed into other hormones.

    What Are Star Ratings?

    Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

    For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

    3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

    2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

    1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

    This supplement has been used in connection with the following health conditions:

    Used for Why
    3 Stars
    Addison's Disease
    Refer to label instructions
    DHEA is largely produced by the adrenal glands, and people with Addison's disease often have subnormal levels. Some, though not all, research indicates DHEA supplements may relieve some Addison's disease symptoms.
    Because a large proportion of the DHEA in the body is produced by the adrenal glands, people with Addison's disease often have subnormal DHEA levels. Several double-blind trials have shown that supplementing with DHEA improves energy levels, mood, well-being, and sexual function in people with Addison's disease.However, not all studies have demonstrated a beneficial effect.
    2 Stars
    Athletic Performance and Improved Strength in Older Men
    100 mg daily
    DHEA is a hormone that is used by the body to make the male sex hormone testosterone. In one double-blind trial, DHEA was effective for improving strength in older men.
    Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal glands that is used by the body to make the male sex hormone testosterone. In one double-blind trial, 100 mg per day of DHEA was effective for improving strength in older men, but 50 mg per day was ineffective in a similar study of elderly men and women. DHEA has not been effective for women or younger men in other studies.
    2 Stars
    Crohn's Disease
    Take under medical supervision: 200 mg daily
    In a preliminary trial, six of seven people with Crohn's disease went into remission after taking DHEA for eight weeks.

    In a preliminary trial, six of seven people with Crohn's disease went into remission after taking 200 mg per day of DHEA for eight weeks. This large amount of DHEA has the potential to cause adverse side effects and should only be used under the supervision of a doctor.

    2 Stars
    Depression
    Consult a qualified healthcare practitioner
    Some studies have reported lower DHEA levels in depressed people. However, DHEA appears to be effective for only a minority of depressed people.

    Some studies have reported lower DHEA levels in groups of depressed patients. However, this finding has not been consistent, and in one trial, severely depressed people were reported to show increases in blood levels of DHEA.

    Despite confusion regarding which depressed people might be DHEA-deficient, most double-blind trials lasting at least six weeks have reported some success in treating people with depression. After six months using 50 mg DHEA per day, "a remarkable increase in perceived physical and psychological well-being" was reported in both men and women in one double-blind trial. After only six weeks, taking DHEA in levels up to 90 mg per day led to at least a 50% reduction in depression in five of 11 patients in another double-blind trial.

    Other researchers have reported dramatic reductions in depression at extremely high amounts of DHEA (90-450 mg per day) given for six weeks to adults who first became depressed after age 40 (in men) or at the time of menopause (in women) in a double-blind trial. Other double-blind research has shown that limiting supplementation to only two weeks is inadequate in treating people with depression. Despite the somewhat dramatic results reported in clinical trials lasting at least six weeks, some experts claim that in clinical practice, DHEA appears to be effective for only a minority of depressed people. Moreover, due to fears of potential side effects, most healthcare professionals remain concerned about the use of DHEA. Depressed people considering taking DHEA should consult a doctor well versed in the use of DHEA.

    2 Stars
    Erectile Dysfunction
    Take under medical supervision: 50 mg daily
    Some men with erectile dysfunction have been reported to have low blood levels of DHEA. Supplementing with DHEA may improve erectile function and libido.

    Low blood levels of the hormone DHEA (dehydroepiandrosterone) have been reported in some men with ED. In one double-blind trial, 40 men with low DHEA levels and ED were given 50 mg DHEA per day for six months. Significant improvement in both erectile function and interest in sex occurred in the men assigned to take DHEA, but not in those assigned to take placebo. No significant change occurred in testosterone levels or in factors that could affect the prostate gland. Experts have concerns about the safe use of DHEA, particularly because long-term safety data do not exist.

    2 Stars
    HIV and AIDS Support
    200 to 500 mg daily
    Large amounts of supplemental DHEA may alleviate fatigue in HIV-positive people.

    A deficient level of dehydroepiandrosterone sulfate (DHEAS) in the blood is associated with poor outcomes in people with HIV. Large amounts of supplemental DHEA (dehydroepiandrosterone) may alleviate fatigue and depression in HIV-positive men and women. In a preliminary trial, men and women with HIV infection took 200-500 mg of DHEA per day for eight weeks. All participants initially had both low mood and low energy. After eight weeks of DHEA supplementation, 72% of the participants reported their mood to be "much improved" or "very much improved," and 81% reported having significant improvements in energy level. DHEA supplementation had no effect on CD4 cell (helper T-cell) counts or testosterone levels.

    2 Stars
    Lupus
    Take under medical supervision: 50 to 200 mg daily
    Treatment with DHEA may improve symptoms and decrease disease activity.

    Low blood levels of the hormone DHEA and the related compound DHEA-sulfate have been associated with more severe symptoms in people with SLE. Preliminary trials have suggested that 50 to 200 mg per day DHEA improved symptoms in people with SLE. One double-blind trial of women with mild to moderate SLE found that 200 mg of DHEA per day improved symptoms and allowed a greater decrease in prednisone use, but a similar trial in women with severe SLE found only insignificant benefits.

    Experts have concerns about the use of DHEA, particularly because there are no long-term safety data. Side effects at high intakes (50 to 200 mg per day) in one 12-month trial included acne (in over 50% of people), increased facial hair (18%), and increased perspiration (8%). Less common problems reported with DHEA supplementation were breast tenderness, weight gain, mood alteration, headache, oily skin, and menstrual irregularity.

    High amounts of DHEA have caused cancer in animals. Although anticancer effects of DHEA have also been reported, they involve trials using animals that do not process DHEA the way humans do, so these positive effects may have no relevance for people. Links have begun to appear between higher DHEA levels and risks of prostate cancer in humans. At least one person with prostate cancer has been reported to have had a worsening of his cancer despite feeling better while taking very high amounts (up to 700 mg per day) of DHEA. While younger women with breast cancer may have low levels of DHEA, postmenopausal women with breast cancer appear to have high levels of DHEA, which has researchers concerned. These cancer concerns make sense because DHEA is a precursor to testosterone (linked to prostate cancer) and estrogen (linked to breast cancer). Until more is known, it would be prudent for people with breast or prostate cancer or a family history of these conditions to avoid supplementing with DHEA. Preliminary evidence has also linked higher DHEA levels to ovarian cancer in women.

    Some doctors recommend that people taking DHEA have liver enzymes measured routinely. Anecdotes of DHEA supplementation (of at least 25 mg per day) leading to heart arrhythmias have appeared. At only 25 mg per day, DHEA has lowered HDL cholesterol while increasing insulin-like growth factor (IGF). Decreasing HDL could increase the risk of heart disease . Increasing IGF might increase the risk of breast cancer.

    2 Stars
    Osteoporosis
    Take under medical supervision: 5 to 50 mg per day
    DHEA may be helpful in preventing osteoporosis. In one trial, bone mineral density increased among healthy elderly women and men who were given DHEA.
    In a preliminary trial, bone mineral density increased among healthy elderly women and men who were given 50 mg per day of DHEA as a supplement. Similar results were found in two one-year double-blind trials that used 50 mg of DHEA per day. It is not known if supplementation would have the same effect in people with established osteoporosis. DHEA is a steroid hormone, and should be used only under the supervision of a doctor.
    2 Stars
    Ulcerative Colitis
    Take under medical supervision: 200 mg daily
    In one trial, 6 of 13 people with ulcerative colitis went into remission after taking supplementing with DHEA.

    In a preliminary trial, 6 of 13 people with ulcerative colitis went into remission after taking 200 mg per day of DHEA for eight weeks. This large amount of DHEA has the potential to cause adverse side effects and should only be used under the supervision of a doctor.

    1 Star
    Alzheimer's Disease
    Refer to label instructions
    People with Alzheimer's disease may have low DHEA (dehydroepiandrosterone) levels, and supplementation may improve mental performance.

    Most, but not all, studies have found that people with Alzheimer's disease have lower blood DHEA (dehydroepiandrosterone) levels than do people without the condition. Emerging evidence suggests a possible benefit of DHEA supplementation in people with Alzheimer's disease. In one double-blind trial, participants who took 50 mg twice daily for six months had significantly better mental performance at the three-month mark than those taking placebo. At six months, statistically significant differences between the two groups were not seen, but results still favored DHEA. In another clinical trial, massive amounts of DHEA (1,600 mg per day for four weeks) failed to improve mental function or mood in elderly people with or without Alzheimer's disease. It is likely that the amount of DHEA used in this trial was far in excess of an appropriate amount, illustrating that more is not always better.

    1 Star
    Chronic Fatigue Syndrome
    Refer to label instructions
    DHEA is a hormone that has been found to be low in some people with chronic fatigue syndrome.

    DHEA (dehydroepiandrosterone) is a hormone now available as a supplement. In one report, DHEA levels were found to be low in people with CFS. Another research group reported that, while DHEA levels were normal in a group of CFS patients, the ability of these people to increase their DHEA level in response to hormonal stimulation was impaired. Whether supplementation with DHEA might help CFS patients remains unknown due to the lack of controlled research. DHEA should not be used without the supervision of a healthcare professional.

    1 Star
    Immune Function
    Refer to label instructions
    Supplementing with the hormone DHEA may improve immune functioning.
    The hormone DHEA affects immunity. In a controlled trial, a group of elderly men with low DHEA levels who were given a high level of DHEA (50 mg per day) for 20 weeks, experienced a significant activation of immune function. Postmenopausal women have also shown increased immune functioning in just three weeks when given DHEA in double-blind research.
    1 Star
    Menopause
    Refer to label instructions
    DHEA improves the response of brain chemicals (endorphins), which are involved in sensations of pleasure and pain. Supplementing with it may improve mood symptoms.

    Aging in women is characterized by a progressive decline in blood DHEA (dehydroepiandrosterone) and DHEA-sulfate (DHEAS) levels. These levels can be restored with DHEA supplementation. This process also improves the response of some brain chemicals, called endorphins, to certain drugs. These endorphins are involved in sensations of pleasure and pain ; improving their response may explain why DHEA has an effect on mood symptoms associated with menopause. In one double-blind trial, however, menopausal women who took 50 mg of DHEA per day for three months had no improvement in symptoms compared with women taking placebo. Further study is needed to validate a role for DHEA in the management of menopausal symptoms.

    1 Star
    Multi-Infarct Dementia
    Refer to label instructions
    People with deterioration of mental functions resulting from multiple small strokes (multi-infarct dementia) may have lower than normal DHEAS (dehydroepiandrosterone sulfate) levels.
    People with deterioration of mental functions resulting from multiple small strokes (multi-infarct dementia) may have lower than normal DHEAS (dehydroepiandrosterone sulfate) levels, according to a preliminary trial. In this trial, intravenous injection of 200 mg per day of DHEAS for four weeks increased DHEAS levels and improved some aspects of mental function and performance of daily activities.
    1 Star
    Obesity
    Refer to label instructions
    DHEA has been shown to help decrease body fat in men.

    One double-blind trial found 100 mg per day of DHEA was effective for decreasing body fat in older men, and another double-blind trial found 1,600 mg per day decreased body fat and increased muscle mass in younger men,. However, DHEA has not been effective for improving body composition in women or in other studies of men.

    How It Works

    How to Use It

    Most people do not need to supplement DHEA. The question of who should take this hormone remains controversial. Some experts believe that daily intakes of 5-15 mg of DHEA for women and 10-30 mg for men are appropriate amounts for people with deficient blood levels of DHEA or DHEAS.1 While a few researchers suggest supplementation with as much as 50 mg per day in postmenopausal women,2 others consider this level excessive.3 People should consult a doctor to have DHEA levels monitored before and during supplementation. Healthy people with normal blood levels of DHEA or DHEAS should not take this hormone until more is known about its effects. However, some doctors recommend DHEA supplementation for selected people with depression , autoimmune diseases, or other problems, even if their blood levels are normal.

    People with systemic lupus erythematosus (SLE) have been shown to improve after taking 100-200 mg per day of DHEA. Such large amounts should never be taken without medical supervision.

    Discrepancies between label claims and actual DHEA content of DHEA supplements have been reported.4 Regrettably, the authors of this report failed to identify which brands were properly labeled and which were not.

    Where to Find It

    DHEA is produced by the adrenal glands. A synthetic form of this hormone is also available as a supplement in tablet, capsule, liquid, and sublingual form. Some products claim to contain "natural" DHEA precursors from wild yam . However, the body cannot convert these substances into DHEA5 (although a series of reactions in a laboratory can make the conversion).

    Possible Deficiencies

    Meaningful levels of DHEA do not appear in food, and therefore dietary deficiency does not exist. Some people, however, may not synthesize enough DHEA. DHEA levels peak in early adulthood and then start a lifelong descent. By the age of 60, DHEA levels are only about 5-15% of what they were at their peak at younger ages.6 Whether the lower level associated with age represents a deficiency or a normal part of aging that should not be tampered with remains unknown.

    People with true adrenal insufficiency (i.e., Addison's Disease; not the hypothetical adrenal "fatigue" or "burnout" that is sometimes incorrectly referred to as "insufficiency") have below normal levels of DHEA. When women with adrenal insufficiency were treated with 50 mg of DHEA every morning for three or four months, their DHEA and DHEAS levels returned to normal, with a simultaneous improvement in well-being and sexuality.7 , 8

    Some studies have reported lower DHEA levels in groups of depressed patients.9 , 10 However, in one trial, severely depressed people were reported to show increases in blood levels of DHEA.11 Despite these contradictory findings, a few clinical trials suggest that at least some people who are depressed may benefit from DHEA supplementation. (See "What does it do?" above for more information about use of DHEA supplements in the treatment of depression.)

    People with multi-infarct dementia (deterioration of mental functions resulting from multiple small strokes) may have lower than normal DHEAS levels, according to a preliminary trial.12 In this trial, intravenous injection of 200 mg per day of DHEAS for four weeks increased DHEAS levels and improved some aspects of mental function and performance of daily activities.

    People infected with HIV 13 and those with insulin-dependent diabetes ,14 congestive heart failure,15 multiple sclerosis , 16 asthma ,17 , 18 chronic fatigue syndrome ,19 , 20 rheumatoid arthritis ,21 , 22 , 23 osteoporosis , and a host of other conditions have been reported to have low levels of DHEA in most,24 but not all, studies.25 , 26 In most cases, the meaning of this apparent deficiency is not well understood.

    Men under 60 years of age with erectile dysfunction have been found to have lower DHEAS levels than men without the condition.27 (See "What does it do?" above for more information about use of DHEA supplements in the treatment of men with erectile dysfunction.)

    Most,28 , 29 , 30 , 31 but not all, 32 , 33 studies have found that people with Alzheimer's disease have lower blood DHEAS levels than do people without the condition.

    Interactions

    Interactions with Supplements, Foods, & Other Compounds

    At the time of writing, there were no well-known supplement or food interactions with this supplement.

    Interactions with Medicines

    Certain medicines interact with this supplement.

    Types of interactions: Beneficial Adverse Check

    Replenish Depleted Nutrients

    • Beclomethasone

      A group of women with asthma who had been taking inhaled beclomethasone were shown to have low levels of DHEA compared to women with asthma who were not taking beclomethasone. The authors speculated that this effect may partially explain how corticosteroids can cause osteoporosis . However, more research is needed to confirm these suspicions and to evaluate whether supplemental DHEA is beneficial to patients taking inhaled corticosteroids.

    • Budesonide

      A group of women with asthma who had been taking inhaled beclomethasone were shown to have low levels of DHEA compared to women with asthma who were not taking beclomethasone. The authors speculated that this effect may partially explain how corticosteroids can cause osteoporosis . However, more research is needed to confirm these suspicions and to evaluate whether supplemental DHEA is beneficial to patients taking inhaled corticosteroids.

    • Flunisolide

      A group of women with asthma who had been taking inhaled beclomethasone were shown to have low levels of DHEA compared to women with asthma who were not taking beclomethasone. The authors speculated that this effect may partially explain how corticosteroids can cause osteoporosis . However, more research is needed to confirm these suspicions and to evaluate whether supplemental DHEA is beneficial to patients taking inhaled corticosteroids.

    • Fluticasone

      A group of women with asthma who had been taking inhaled beclomethasone were shown to have low levels of DHEA compared to women with asthma who were not taking beclomethasone. The authors speculated that this effect may partially explain how corticosteroids can cause osteoporosis . However, more research is needed to confirm these suspicions and to evaluate whether supplemental DHEA is beneficial to patients taking inhaled corticosteroids.

    • Insulin

      Insulin has been shown to decrease the levels of DHEA and DHEA-sulfate in the blood. More research is needed to determine the significance of this finding.

    • Levalbuterol

      A group of women with asthma who had been taking inhaled beclomethasone were shown to have low levels of DHEA compared to women with asthma who were not taking beclomethasone. The authors speculated that this effect may partially explain how corticosteroids can cause osteoporosis . However, more research is needed to confirm these suspicions and to evaluate whether supplemental DHEA is beneficial to patients taking inhaled corticosteroids.

    Reduce Side Effects

    • none

    Support Medicine

    • Clonidine

      DHEA (Dehydroepiandrosterone) supplementation (50 mg per day) has been shown to restore the response of beta-endorphin (a brain chemical involved in pain and pleasure sensations) to clonidine.

    • Fluoxetine

      DHEA (Dehydroepiandrosterone) supplementation (50 mg per day) has been shown to restore the response of beta-endorphin, a brain chemical involved in pain and pleasure sensations, to fluoxetine. Further research is needed to determine if this drug combination is safe for long-term use.

    Reduces Effectiveness

    • Diltiazem

      Diltiazem has been shown to raise blood levels of DHEA and DHEA-sulfate in insulin-resistant, obese men with high blood pressure.

    Potential Negative Interaction

    • none

    Explanation Required

    • Amlodipine

      Amlodipine has been shown to raise blood levels of DHEA-sulfate in insulin-resistant, obese men with high blood pressure.

    • Amlodipine-Benazepril

      Amlodipine has been shown to raise blood levels of DHEA-sulfate in insulin-resistant, obese men with high blood pressure.

    • Metformin

      Metformin has been reported to increase blood levels of DHEA-sulfate in at least two studies.

    • Methyltestosterone

      DHEA (Dehydroepiandrosterone) supplementation has been shown to increase blood levels of testosterone, as does methyltestosterone. No studies have investigated the possible additive effects of taking DHEA and methyltestosterone, but either increased drug effectiveness or more severe side effects are possible. Until more is known, these agents should be combined only under the supervision of a doctor.

    The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers' package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

    Side Effects

    Side Effects

    Experts have concerns about the use of DHEA, particularly because long-term safety data do not exist.

    Side effects at high intakes (50-200 mg per day) appear to be acne (in over 50% of people), increased facial hair (18%), and increased perspiration (8%). In a preliminary trial, DHEA was also reported to induce less common side effects, including breast tenderness, weight gain, mood alteration, headache, oily skin, and menstrual irregularity in some people.34 Since this trial was not controlled, some of these less common "side effects" might have occurred even with a placebo. A case of mania has been reported in an older man who took 200-300 mg of DHEA per day for six months.35 However, in that case report, other causes of mania could not be ruled out.

    Significant increases in testosterone levels in both men and women have been reported in some trials.36 , 37 Other reports have found this change in women but not in men.38 An increase in testosterone might increase the risk of several cancers, and high amounts of DHEA have caused cancer in animals.39 , 40 Moreover, a possible link between higher DHEA levels and risks of prostate cancer in humans has been reported.41 At least one person with prostate cancer has been reported to have had a worsening of his cancer, despite feeling better, while taking very high amounts (up to 700 mg per day) of DHEA.42

    While younger women with breast cancer may have low levels of DHEA, postmenopausal women with breast cancer appear to have high levels of DHEA, which has researchers concerned.43 , 44 Most,45 , 46 , 47 , 48 , 49 but not all, studies50 , 51 , 52 have found that as DHEA blood levels increase, so does the risk of breast cancer.

    Supplementation with high levels of DHEA (100 mg per day) has adversely affected other indicators of cancer risk in both women and men.53 , 54 Elevated DHEA levels have been reported to be associated with both higher,55 and lower risk for ovarian cancer.56 The reason for this discrepancy is unknown.

    The lack of knowledge about how DHEA supplementation might affect cancer risks provides a reason for caution. Until more is known, people with breast or prostate cancer or a family history of these conditions should avoid supplementing with DHEA.

    Although anticancer effects of DHEA have also been reported,57 they involve trials using animals that do not process DHEA the way humans do. Therefore, these positive effects may have no relevance for people.

    Some doctors recommend that people taking DHEA have liver enzymes measured routinely. Anecdotes of DHEA supplementation (of at least 25 mg per day) leading to heart arrhythmias have appeared.58

    The relationship between DHEA, blood pressure, and heart disease is poorly understood. Increased blood levels of DHEAS have been associated with increased blood pressure59 and other cardiovascular risk factors in some,60 but not all,61 studies. One study found that people with hypertension had significantly decreased blood levels of DHEA.62 Until clinical trials clear up these inconsistencies and confirm its safety, people with hypertension should avoid using DHEA, except under the close supervision of a doctor.

    At only 25 mg per day, DHEA has lowered HDL cholesterol while increasing insulin-like growth factor (IGF).63 Decreasing HDL could increase the risk of heart disease. Increasing IGF might increase the risk of breast cancer.

    References

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    2. Casson PR, Buster JE. DHEA replacement after menopause: HRT 200 or nostrum of the '90s? Contemporary OB/GYN 1997;Apr:119-33.

    3. Arlt W, Justl HG, Callies F, et al. Oral dehydroepiandrosterone for adrenal androgen replacement: pharmacokinetics and peripheral conversion to androgens and estrogens in healthy young females after dexamethasone suppression. J Clin Endocrinol Metab 1998;83:1928-34.

    4. Parasrampuria J, Schwartz K, Petesch R. Quality control of dehydroepiandrosterone dietary supplement products. JAMA 1998;280:1565 [letter].

    5. Araghiniknam M, Chung S, Nelson-White T, et al. Antioxidant activity of dioscorea and dehydroepiandrosterone (DHEA) in older humans. Life Sci 1996;11:147-57.

    6. Ebeling P, Koivisto VA. Physiological importance of dehydroepiandrosterone. Lancet 1994;343:1479-81.

    7. Arlt W, Callies F, van Vlijmen JC, et al. Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med 1999;341:1013-20.

    8. Gebre-Medhin G, Husebye ES, Mallmin H, et al. Oral dehydroepiandrosterone (DHEA) replacement therapy in women with Addison's disease. Clin Endocrinol (Oxf) 2000;52:775-80.

    9. Barrett-Connor E, von Mühlen D, Laughlin GA, Kripke A. Endogenous levels of dehydroepiandrosterone sulfate, but not other sex hormones, are associated with depressed mood in older women: The Rancho Bernardo Study. J Am Geriatr Soc 1999;47:685-91.

    10. Heinz A, Weingartner H, George D, et al. Severity of depression in abstinent alcoholics is associated with monoamine metabolites and dehydroepiandrosterone-sulfate concentrations. Psychiatry Res 1999;89:97-106.

    11. Heuser I, Deuschle M, Luppa P, et al. Increased diurnal plasma concentrations of dehydroepiandrosterone in depressed patients. J Clin Endocrinol Metab 1998;83:3130-3.

    12. Azuma T, Nagai Y, Saito T, et al. The effect of dehydroepiandrosterone sulfate administration to patients with multi-infarct dementia. J Neurol Sci 1999;162:69-73.

    13. Ferrando SJ, Rabkin JG, Poretsky L. Dehydroepiandrosterone sulfate (DHEAS) and testosterone: relation to HIV illness stage and progression over one year. J Acquir Immune Defic Syndr 1999;22:146-54.

    14. Louviselli A, Pisanu P, Cossu E, et al. Low levels of dehydroepiandrosterone sulfate in adult males with insulin-dependent diabetes mellitus. Minerva Endocrinol 1994;19:113-9.

    15. Moriyama Y, Yasue H, Yoshimura M, et al. The plasma levels of dehydroepiandrosterone sulfate are decreased in patients with chronic heart failure in proportion to the severity. J Clin Endocrinol Metab 2000;85:1834-40.

    16. Kümpfel T, Then Bergh F, Friess E, et al. Dehydroepiandrosterone response to the adrenocorticotropin test and the combined dexamethasone and corticotropin-releasing hormone test in patients with multiple sclerosis. Neuroendocrinology 1999;70:431-8.

    17. Weinstein RE, Lobocki CA, Gravett S, et al. Decreased adrenal sex steroid in the absence of glucocorticoid suppression in postmenopausal asthmatic women. J Allergy Clin Immunol 1996;97:1-8.

    18. Dunn PJ; Mahood CB; Speed JF; Jury DR. Dehydroepiandrosterone sulphate concentrations in asthmatic patients: pilot study. N Z Med J 1984;97:805-8.

    19. Kuratsune H, Yamaguti K, Sawada M, et al. Dehydroepiandrosterone sulfate deficiency in chronic fatigue syndrome. Int J Mol Med 1998;1:143-6.

    20. De Becker P, De Meirleir K, Joos E, et al. Dehydroepiandorsterone (DHEA) response to i.v. ACTH in patients with chronic fatigue syndrome. Horm Metab Res 1999;31:18-21.

    21. Khalkhali-Ellis Z, Moore TL, Hendrix MJ. Clin Exp Rheumatol 1998;16:753-6.

    22. Hall GM, Perry LA, Spector TD. Depressed levels of dehydroepiandrosterone sulphate in postmenopausal women with rheumatoid arthritis but no relation with axial bone density. Ann Rheum Dis 1993;52:211-4.

    23. Mateo L, Nolla JM, Bonnin MR, et al. Sex hormone status and bone mineral density in men with rheumatoid arthritis. J Rheumatol 1995;22:1455-60.

    24. Gaby AR. Dehydroepiandrosterone: biological effects and clinical significance. Altern Med Rev 1996;1:60-9 [review].

    25. Heikkila R, Aho K, Heliovaara M, et al. Serum androgen-anabolic hormones and the risk of rheumatoid arthritis. Ann Rheum Dis 1998;57:281-5.

    26. Mileva Zh, Maleeva A, Khristov G. Androstenedione, DHEA sulfate, cortisol, aldosterone and testosterone in bronchial asthma patients. Vutr Boles. 1990;29:84-7 [in Bulgarian].

    27. Reiter WJ, Pycha A, Schatzl G, et al. Serum dehydroepiandrosterone sulfate concentrations in men with erectile dysfunction. Urology 2000;55:755-8.

    28. Hillen T, Lun A, Reischies FM, et al. DHEA-S plasma levels and incidence of Alzheimer's disease. Biol Psychiatry 2000;47:161-3.

    29. Nasman B, Olsson T, Backstrom T, et al. Serum dehydroepiandrosterone sulfate in Alzheimer's disease and in multi-infarct dementia. Biol Psychiatry 1991;30:684-90.

    30. Sunderland T, Merril CR, Harrington MG, et al. Reduced plasma dehydroepiandrosterone concentrations in Alzheimer's disease. Lancet 1989;2:570.

    31. Yanase T, Fukahori M, Taniguchi S, et al. Serum dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEA-S) in Alzheimer's disease and in cerebrovascular dementia. Endocr J 1996;43:119-23.

    32. Birkenhager-Gillesse EG, Derksen J, Lagaay AM. Dehydroepiandrosterone sulphate (DHEAS) in the oldest old, aged 85 and over. Ann N Y Acad Sci 1994;719:543-52.

    33. Schneider LS, Hinsey M, Lyness S. Plasma dehydroepiandrosterone sulfate in Alzheimer's disease. Biol Psychiatry 1992;31:205-8.

    34. Van Vollenhoven RF, Morabito LM, Engleman EG, McGuire JL. Treatment of systemic lupus erythematosus with dehyroepiandrosterone: 50 patients treated up to 12 months. J Rheumatol 1998;25:285-9.

    35. Markowitz JS, Carson WH, Jackson CW. Possible dihydroepiandrosterone-induced mania. Biol Psychiatry 1999;45:241-2.

    36. Wolf OT, Neumann O, Hellhammer DH, et al. Effects of a two-week physiological dehydroepiandrosterone substitution on cognitive performance and well-being in healthy elderly women and men. J Clin Endocrinol Metab 1997;82:2263-7.

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