DHEA supplementation

DHEA (dehydroepiandrosterone) circulates mainly as DHEA-S and serves as precursor for peripheral synthesis of testosterone and estradiol. Serum DHEA-S peaks in early adulthood and falls by roughly 80% by age 70–80 (adrenopause). The enzyme 3β-hydroxysteroid dehydrogenase converts DHEA to androgens and estrogens in peripheral tissues, producing tissue-specific, sex-dependent effects. The DHEAge Study (Baulieu et al. 2000, n=280, age 60–79) randomised participants to 50 mg oral DHEA or placebo for one year; bone density and skin hydration improved in older women, but body composition, muscle strength, and cognition were unaffected. A meta-analysis of 10 RCTs in women with adrenal insufficiency (Alkatib et al. 2009) found only a small quality-of-life benefit (effect size 0.21). The DAWN Trial (Kritz-Silverstein et al. 2008) found no benefit on cognition or well-being in healthy older adults. A 2025 Mendelian randomisation study (Schooling & Zhao) linked genetically higher DHEA-S to shorter lifespan in men (−1.15 years per logged µmol/L) but not in women, arguing against a causally favourable longevity effect. Safety concerns include stimulation of hormone-sensitive cancers; DHEA is sold over the counter in the USA but is prescription-only in most of Europe.