DHEA has been an enigma to the public and to most physicians. I never once heard about this hormone in four years of medical school, seven years of residency or in any endocrinology lecture I heard in my training. This is why when I mention it to my patients, I am not surprised that they have never heard about it. The general public did not learn about DHEA until 1996, when its benefits were mentioned in the media and several popular books that showed up on daytime TV shows. Most in mainstream medicine continued to ignore the science these books contained because they were not found in the usual ways via journals and continuing education classes. You actually had to be on the lookout for this information if you wanted to help your patients directly. With a busy medical practice this is no easy task, to be sure. DHEA became credible to the medical establishment when the New York Academy of Sciences published a book called DHEA and Aging. That book provided scientific validation for the many life-extending effects of DHEA. DHEA Hormone Review: DHEA (dehydroepiandrosterone) is a steroid hormone produced by the adrenal glands. It’s a precursor to both testosterone and estrogen in the body, although it may play other physiological roles as well. In post menopausal women, the only way they make sex steroid hormones is from adrenal enzymes and the aromatase enzyme in fat cells. There are many studies of oral and IV routes that have given us all conflicting reports of efficacy. Topical DHEA use may be another story for women, however. Recent studies have demonstrated that intra-vaginal application of DHEA cream could alleviate age and menopause-associated vaginal atrophy. It also can improve sexual function without altering serum hormone levels significantly, and is the most potent way to stimulate sleep when some one is sleep deprived because of its effects on the IL- 6 cytokine. In 2012, even modern healthcare is beginning to realize that chronic inflammation is linked to just about every neolithic and aging disease known to mankind. Both of these disease processes have rising inflammatory cytokines as the main causes of their progression. These chemicals are destructive to cell membrane signaling, cellular nuclear processessing signaling, and cytosolic signaling. They have particularly devastating affects on the steroid hormone receptors and the receptors of both arms of the immune system. These errors in signaling lead to disease progression. Some examples of these cytokines are TNF-alpha, IL-6, IL1b, and LTB4 on the inflammatory cascade. We have known from Cutolo’s 2000 study that most adrenal hormones (like DHEA) are very low prior development of the full blown disease. This is true in all autoimmine diseases, especially rheumatoid arthritis. DHEA has been shown to prevent chronic inflammation and it slows the abberant signaling that is commonly found in the immune system when it is turned on by any pathogen, self or foreign. DHEA is particularly helpful in limiting IL-6 and TNF alpha in both disease propagation and in normal human aging. DHEA has been shown to have dramatic affects on those infected with serious viral illness like HIV and Hepatitis C. Part of the reason for this affect is because in both of these diseases we see a loss of Type 1 cytokines from cell mediated immunity (gamma Interferon and IL-2) and an excess of Type 2 cytokines like IL-6. This steep rise in Il-6 is fought back by the available DHEA until its production falls and causes dramatic rises in cortisol. The drugs used to treat both conditions are called protease inhibitors and when they are used in either disease DHEA levels dramatically rise to help stimulate the immune system. Many physicians are completely unaware of the the effects of the hormone on immunity. In my practice as a neurosurgeon, I use DHEA replacement often in post trauma cases or post brain tumor cases to improve cognitive function and memory. Replacement of proper DHEA levels actually improves EEG recordings in these patients. A study done at UCSD by Dr. S.S.C. Yen showed the remarkable effect of a low dose of DHEA (50 mgs a day for 6 months) restoring DHEA levels in men and women while dramatically improving their perceived physical and psychological well being for both sexes. I have found in many trauma and brain tumor cases that DHEA was the easiest way to elevate IGF 1 levels to improve growth hormone secretion without expensive replacement. When IGF 1 levels are in the upper quartile, we see massive improvements in lean muscle mass, decreased abdominal fat, improved immune function, and improvement of cognition and memory. DHEA also improves cardiac function and atherosclerosis. You can review the 1996 journal article Drugs and Aging by Dr. Watson that correlated low DHEA with several human cancers, loss of sleep, decreased sense of well being, and increased feeling of death. DHEA also improved bone cell function, lymphocyte function, improved cardiac function, and helped T2D as well. The study also reported no toxic doses when used to restore humans back to youthful levels and production. The study appeared to show a link between low DHEA and all diseases of aging in humans, poignant because the neolithic disease we are seeing today are occurring earlier– DHEA levels may be a very earlier marker for poor metabolic functioning of many systems. This study caught my eye years ago, inspiring me to test DHEA levels to help me assess patients when I work them up in my clinic. DHEA is abundant in the human brain, which manufactures it in high quantities. DHEA levels are a great clinical proxy for depression. The DHEA levels in many of our troops returning from the Middle East’s wars are horrendous when tested. It is no wonder we are seeing a massive spike up in PTSD and suicide in these troops–they are the first generation of soldiers feed an exclusively neolithic diet their entire lives before combat. Their risks would be expected to be the highest because they likely had the highest cortisol and lowest DHEA levels before entering the theatre of combat. DHEA and cortisol are the two most common hormones linked to depression in most studies who look at hormones and these diseases (Goodyear et al 1996, and Barrett-Connor in 1999). http://jackkruse.com/hormone-cpc-1-dhea/ more info in the link. cfs not directly mentioned but dhea's effects on cytokines and immune system will be of interest to cfsers. cheers!!!