DHEA

What It Does

The adrenal cortex releases DHEA, and most of it is sulfated to DHEA-S, a stable reservoir and the form labs measure. Tissues convert DHEA to androstenedione and then to testosterone or, through aromatase, to estrogens, using the hormone locally before it ever appears in the blood. In women, a large share of androgen activity comes from this pathway, and after menopause nearly all of it does. In men, the testes supply most testosterone and DHEA adds relatively little. DHEA-S peaks in the 20s and falls to about 20% of that peak by the 70s and 80s (Orentreich 1984).

Dose determines what DHEA does. At 50 mg daily, it restored youthful DHEA-S levels in middle-aged and older adults and roughly doubled androgen levels in women, with little change in men (Morales 1994). In women with adrenal insufficiency, who lack adrenal androgens altogether, 50 mg daily improved well-being and sexual interest (Arlt 1999). In healthy older adults, the results were negative: two years of 75 mg in men and 50 mg in women did not improve body composition, physical performance, insulin sensitivity, or quality of life (Nair 2006). The Endocrine Society advises against routine DHEA in women because of insufficient evidence of benefit and unknown long-term safety (Wierman 2014). One route does have FDA approval: intravaginal prasterone, the drug name for DHEA, treats painful intercourse after menopause (Labrie 2016).

Replacement-range doses of 5-25 mg aim to return DHEA-S to the normal range for age. Doses of 50-100 mg push many women above the normal androgen range, with acne, oily skin, unwanted hair, and in some cases voice changes that may not reverse. In men, higher doses raise estradiol. Monitoring means DHEA-S, testosterone, estradiol, and SHBG before starting and a few weeks after; the Testosterone Metabolism Model shows how DHEA feeds into those downstream hormones.

Forms and Bioavailability

Absorption ratings are broad tiers. Head-to-head human trials rarely support a finer ranking among well-absorbed forms.

Micronized DHEA is the standard oral form, taken in the morning to mirror the natural daily rhythm. 7-keto-DHEA is a metabolite that does not convert to sex hormones; it is sold for metabolism and weight loss on minimal human evidence. Wild yam products marketed as "natural DHEA" contain diosgenin, which the human body cannot convert to DHEA. Label accuracy has been a problem: an analysis of DHEA products found contents ranging from none to well above the labeled amount (Parasrampuria 1998).

Typical Dosing

Replacement-range doses are 5-25 mg daily; adrenal insufficiency trials used 25-50 mg. Doses of 50-100 mg push androgens above the normal range in many women. Check DHEA-S and sex hormones before starting and again after 4-8 weeks.

What to Look For

Measure DHEA-S first. If it is low for age and symptoms fit, a replacement dose of 5-25 mg in the morning is the starting point, with a recheck in four to eight weeks. Choose a product with third-party verification given the history of label inaccuracy.

Do not use DHEA with breast, prostate, ovarian, or uterine cancer, in pregnancy, or with polycystic ovary syndrome, where androgens are already high. DHEA is on the World Anti-Doping Agency prohibited list, and it is prescription-only in many countries outside the US.

Red flags: wild yam "DHEA precursors," testosterone booster blends containing DHEA, and 50-100 mg doses taken without labs. Green flags: micronized DHEA, a stated dose of 25 mg or less, third-party testing, and a plan for follow-up labs.

Products on Titrate

994 of the 214,745 labels in the NIH Dietary Supplement Label Database list DHEA as an active ingredient (482 on market). 715 are sold as DHEA products by name.

Top on-market labels, ranked by label completeness and simplicity:

1. DHEA 50 mg SMNutrition · 50 mg
2. 7-Keto DHEA 25 mg HBC Hypericum Buyers Club · 25 mg as acetate
3. DHEA 25 mg Bronson Laboratories · 25 mg
4. Opti-DHEA VitaMonk · 100 mg
5. 7-Keto DHEA 25 mg Wonder Laboratories · 25 mg as acetate

Open supplement search

DHEA does not have its own search category yet. Each product above links to its full label in the NIH database.

Related Tools

• Testosterone Metabolism Model
• 7-Keto-DHEA vs DHEA
• All DHEA form comparisons
• All supplement guides

References

MedlinePlus, National Library of Medicine. DHEA.

Orentreich N, Brind JL, Rizer RL, Vogelman JH. Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood. J Clin Endocrinol Metab. 1984;59(3):551-555.

Morales AJ, Nolan JJ, Nelson JC, Yen SS. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab. 1994;78(6):1360-1367.

Parasrampuria J, Schwartz K, Petesch R. Quality control of dehydroepiandrosterone dietary supplement products. JAMA. 1998;280(18):1565.

Arlt W, Callies F, van Vlijmen JC, et al. Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med. 1999;341(14):1013-1020.

Nair KS, Rizza RA, O'Brien P, et al. DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med. 2006;355(16):1647-1659.

Wierman ME, Arlt W, Basson R, et al. Androgen therapy in women: a reappraisal: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(10):3489-3510.

Labrie F, Archer DF, Koltun W, et al. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause. 2016;23(3):243-256.