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Dehydroepiandrosterone (DHEA), is a natural steroid hormone produced from cholesterol by the adrenal glands, the gonads, adipose tissue and the brain. DHEA is the precursor of, androstenedione, testosterone and estrogen. It is the most abundant hormone in the human body. Synonyms and brand names Synonyms for Dehydroepiandrosterone are: Dehydroisoandrosterone; 3β-Hydroxy-5-androsten-17-one; 3β-Hydroxyandrost-5-en-17-one; Androstenol; Androstenolone; Dehydroisoandrosterone; Hydroxyandrost-5-en-17-one; Prasterone; trans-Dehydroandrosterone. Brand names for DHEA include Prastera® and Fidelin®. DHEAS (Dehydroepiandrosterone sulfate) Dehydroepiandrosterone sulfate (DHEAS, ) is the sulfated version of DHEA, - this conversion is reversibly catalyzed by sulfotransferase (SULT2A1) primarily in the adrenals, the liver, and small intestines. In blood, most DHEA is found as DHEAS with levels that are about 300 times higher than free DHEA. Orally ingested DHEA is converted to its sulfate when passing through intestines and liver. While DHEA levels reach their peak in the early morning hours, DHEAS levels show no diurnal variation. From a practical point measurement of DHEAS is preferable to DHEA as levels are more stable. Production
Role In a simple view DHEA can be understood as a prohormone for the sex steroids. Its DHEAS variation may be looked at as buffer and reservoir. Its production in the brain suggests that is also has a role as a neurosteroid. As most DHEA is produced by the zona reticularis of the adrenal, it is argued that there is a role in the immune and stress response. DHEA may have more biologic roles. As almost all DHEA is derived from the adrenal glands, blood measurements of DHEAS/DHEA are useful to detect excess adrenal activity as seen in adrenal cancer or hyperplasia, including certain forms of congenital adrenal hyperplasia. Women with polycystic ovary syndrome tend to have normal or mildly elevated levels of DHEAS. Effects Studies have shown that DHEA is useful in patients with systemic lupus erythematosus. An application of the evidence was reviewed by the FDA in 2001 and is available online. This review also shows that cholesterol and other serum lipids decrease with the use of DHEA. Supplementation with DHEA has been shown to decrease insulin resistance. Long term supplementation has been shown to improve mood and relieve depression. Disputed effects The significance of the hormone in health and disease is not fully established. It is postulated that DHEA supplements are beneficial in alleviating: It is also commercially advertised that DHEA: 7-Keto™ DHEA, a recently identified natural metabolite of dehydroepiandrosterone (DHEA) is claimed to be both more effective and safer than DHEA because it does not convert itself into testosterone or estrogens in the body. DHEA and DHEAS are readily available in the United States, but not in many other countries. Precautions Some assert that DHEA should not be supplemented outside specialist centres under careful observation of experts in the field of endocrinology. Side effects may include: Contraindication As DHEAS and DHEA are converted to sex steroids, their use is contraindicated in patients with any cancer that is estrogen or testosterone dependent. Increasing endogenous production Regular exercise is known to increase DHEA production in the body. Caloric restriction has also been shown to increase DHEA in primates. Further reading | |||||||||
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