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DHEA

Author: Dr. George Shanlikian, M.D.  |   Last Updated: February 5th, 2024

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Dehydroepiandrosterone (DHEA), also known as androstenolone, is one of the most abundant circulating steroids in humans. Once secreted into the blood stream, the body converts DHEA into several other hormones such as testosterone and estrogen. Because of this vital function, DHEA is sometimes referred to as the “mother of all hormones” or “parent hormone”. DHEA is produced in the adrenal glands (small glands located on top of each kidney), the gonads (sex glands), and the brain.

Potential Health Benefits of DHEA

Aside from being a precursor to other important hormones, DHEA plays the following important functions:

  • Boosts immune function [1-16]
  • Decreases cholesterol [17-22]
  • Decreases formation of fatty deposits in the brain and blood vessels [23-30]
  • Enhances mood [31-54]
  • Improves cognitive function [55-60]
  • Improves quality of life [61-68]
  • Improves stress response [69-77]
  • Increases libido [78-83]
  • Lowers blood sugar [84-87]
  • Maintains healthy bones and prevents osteoporosis [88-97]
  • Maintains healthy heart [98-104]
  • Promotes weight loss [105-107]

DHEA in Women

Touted as the “super hormone”, DHEA plays several important functions in women:

  • Improves menopausal symptoms [108-117]
  • Improves fertility [118-132]
  • Treats low libido [133-138]
  • Improves skin quality [139-141]

DHEA in Men

In men, this powerful hormone works in numerous ways:

  • Increases muscle mass and strength [142-146]
  • Reduces fat mass [147-148]
  • Helps with addressing erectile dysfunction [149-153]

DHEA Deficiency

The levels of DHEA tend to gradually deteriorate with age. In addition, certain factors such as lifestyle, diet, emotional health, and stress levels can affect DHEA levels. It is a known fact that the level of this hormone start to decline after the age of 30, causing a wide array of negative health implications. Typical symptoms of DHEA deficiency (adrenal insufficiency) include:

  • Allergies
  • Decreased bone mineral density
  • Decreased sex drive
  • Depression
  • Dry eyes, skin, and hair
  • Elevated anxiety and stress levels
  • Erectile dysfunction
  • Extreme fatigue
  • Heightened sound sensitivity
  • Joint pain
  • Loss of muscle mass
  • Loss of pubic hair
  • Low immunity
  • Memory problems
  • Mood swings
  • Painful sexual intercourse
  • Sleeping difficulties
  • Weight gain/Obesity

If you are experiencing one or more of these symptoms, consult immediately with a qualified hormone replacement therapy doctor to assess your DHEA levels and come up with an appropriate medical management that is tailored to your needs.

Proven Health Benefits of DHEA Replacement Therapy

DHEA replacement therapy has gained worldwide attention over recent years. An overwhelming body of clinical research supports the significant beneficial effects of DHEA administration in patients with complete DHEA deficiency. Whether taken orally in the form of tablets or capsules, or given in the form of injections or applied directly to the skin, studies show that this “super hormone” can benefit almost every organ system in the body and can help combat a wide array of fatal diseases.

Fights Inflammation

Inflammation is the root cause of most diseases and is strongly linked with almost all age-related health problems. DHEA’s potent anti-inflammatory properties can help ward off various inflammatory disorders associated with advancing age and improve overall quality of life. Several research studies confirm the anti-inflammatory effects of DHEA:

  1. DHEA protects human neurons (nerve cells) from HIV-associated inflammation and prevents degeneration. [154-155]
  2. In patients with chronic inflammatory diseases, DHEA replacement therapy reduces the levels of inflammatory markers. [156]
  3. In patients with asthma and allergies, DHEA attenuates T helper 2 allergic inflammation and reduces airway hyperreactivity. [157]
  4. In patients with inflammatory bowel disease, DHEA restrains intestinal inflammation by modifying white blood cell activity and balancing the exacerbated immune responses. [158]
  5. In patients with Crohn’s disease and ulcerative colitis, DHEA decreases disease activity without any adverse side effects. [159]
  6. In patients with systemic lupus erythematosus (SLE), a chronic inflammatory disease, DHEA administration reduces dose of prednisone (thus avoiding its adverse effects) while also improving symptoms. [160]
  7. DHEA stops inflammation and restores normal colon length in mouse models of inflammatory bowel disease. [161]
  8. In mice, DHEA administration decreases the systemic inflammatory response induced by bilateral femoral fracture. [162]
  9. In animal models, DHEA suppresses experimental brain inflammation by reducing the levels of inflammatory substances. [163-168]

Improves Bone Strength and Quality

DHEA possesses potent anti-aging properties that help protect against loss of bone mineral density and strength, thereby reducing the risk of fractures and osteoporosis. Apart from aging, bone loss occur at higher rates in people with hormonal imbalances, poor eating habits, unhealthy lifestyle, and those with medical conditions that affect bone quality. As the “mother of all hormones”, evidence suggests that DHEA replacement therapy improves bone production and quality by boosting the production of other hormones necessary for bone production:

  1. In elderly men and women, DHEA replacement therapy significantly increases bone mineral density and the levels of the bone-boosting hormones insulin-like growth factor 1 and testosterone. [169-172]
  2. In women, 12 months of DHEA treatment increases bone mineral density of the lumbar spine as well as estrogen levels. [173-174]
  3. In men and women with low levels of DHEA due to disease, short duration of DHEA treatment improves bone mineral density and bone metabolism. [175-180]
  4. In older healthy individuals, DHEA prevents bone loss and osteoporosis. [181-182]
  5. DHEA acts protectively against osteoporosis by increasing bone-forming cells known as osteoblasts. [183]
  6. In older women, DHEA supplementation improves bone mineral density when co-administered with vitamin D and calcium. [184]
  7. In older adults, long-term (12–24 months) DHEA replacement therapy significantly increases or preserves bone mineral density while preventing bone breakdown. [185-188]
  8. In young adults, DHEA decreases bone breakdown and increases bone formation without any adverse side effects. [189]
  9. In young women with anorexia nervosa (eating disorder characterized by fear of gaining weight and strong desire to be thin), DHEA treatment significantly increases bone mineral density of both hip and spine. [190]
  10. In postmenopausal women, higher DHEA levels are associated with lesser bone loss. [191]
  11. In postmenopausal women, DHEA treatment significantly increases bone mineral density as well as blood levels of osteocalcin, a marker of bone formation. [192]

Maintains Heart Health

DHEA appears to play a major role in cardiovascular function and deficiency in this vital hormone may compromise heart health. In fact several high quality studies found a strong link between DHEA deficiency and higher incidence of heart diseases in both men and women. [193-207] This suggests that replacing DHEA to youthful levels can help boost heart health and prevent various fatal heart diseases. A number of clinical trials support the beneficial effects of DHEA replacement therapy on the cardiovascular system:

  1. In patients with coronary heart disease, DHEA inhibits human platelet aggregation and dissolves blood clots. [208]
  2. In patients with cardiovascular disease, DHEA relaxes the blood vessels of the heart, thereby improving blood flow and function. [209]
  3. In patients with coronary heart disease, DHEA replacement therapy significantly decreases the levels of fibrinogen, a protein associated with blood clotting. [210]
  4. In patients with cardiovascular disease, higher DHEA levels are associated with better prognosis. [211]
  5. In postmenopausal women, long-term treatment with DHEA lowers cardiovascular risk by improving insulin sensitivity and cholesterol levels. [212-213]

Improves Brain Function

As a nootropic agent or cognitive-enhancer, DHEA is among the most important neurosteroids. Neurosteroids are steroids synthesized within the brain that help maintain the functions of nerve cells. There is strong scientific evidence that DHEA supplementation can help boost brain function in the elderly as well as those with cognitive impairments related to various brain problems:

  1. In women, DHEA supplementation improves memory by stimulating neurons and inhibiting the stress hormone cortisol. [214]
  2. In patients with depression and anxiety, DHEA enhances emotional regulation of memory by improving the function of the hippocampus (memory center of the brain). [215-216]
  3. In young adults, DHEA improves visual processing. [217]
  4. In women, DHEA supplementation improves working memory, attention and verbal fluency. [218]
  5. In elderly men and women, DHEA supplementation significantly improves executive function and memory. [219]
  6. In men, DHEA replacement therapy at a dose of 300 mg daily improves memory recollection and mood and decreases cortisol levels. [220]
  7. In older women with mild to moderate cognitive impairment, oral DHEA supplementation at a dose of 25 mg daily for 6 months improves cognition and activities of daily living. [221]
  8. In rat models of Alzheimer’s disease, DHEA supplementation reduces symptoms and improves memory. [222]

Increases Pregnancy Rate

For women who want to increase their chances of getting pregnant, DHEA supplementation can help. In fact, DHEA supplements are actually prescribed by doctors in women with diminished ovarian reserve (DOR), a condition in which the ovaries lose their reproductive potential. Several clinical trials assessing the beneficial effects of DHEA replacement therapy on pregnancy rate have shown positive outcomes for many women:

  1. In young women who do not respond well to in vitro fertilization (IVF), DHEA supplementation at dose of 25 mg three times daily for at least 12 weeks significantly increases spontaneous pregnancy rate. [223]
  2. In women with lower fertility rates, DHEA improves ovarian function, increases pregnancy chances and lowers miscarriage rates. [224]
  3. DHEA significantly reduces miscarriages in women by preventing aneuploidy (presence of an abnormal number of chromosomes in a cell). [225-229]
  4. In women with lower fertility rates, DHEA supplementation improves pregnancy rate by increasing the number and quality of oocyte (egg cell) and embryo. [230-232]
  5. In women with hormonal imbalances, DHEA supplementation for at least 3 months is associated with spontaneous and treatment-induced pregnancies. [233-234]
  6. In women with DOR, DHEA replacement therapy increases the levels of Anti-Mullerian Hormone (AMH), an indicator of good ovarian reserve. [235]

Promotes Weight Loss

While proper diet and regular exercise are important factors involved in maintaining a healthy weight, hormones like DHEA play an important role too. This “super hormone” boosts the body’s natural ability to utilize energy reserves and burn fat, two metabolic processes that gradually decline with advancing age. Studies show that DHEA replacement therapy promotes weight loss, thus reducing one’s risk of developing obesity-related diseases:

  1. In obese men, DHEA supplementation reduces body mass index (BMI). [236]
  2. In overweight men and women, DHEA supplementation promotes weight loss by increasing metabolic rate. [237]
  3. In overweight adults, DHEA supplementation is associated with a three-fold decrease in body weight and fat mass. [238]
  4. In young athletes, DHEA reduces BMI, waist-to-hip ratio (WHR) and body fat while increasing testosterone and estrogen levels. [239]
  5. In age-advanced men, 100 mg daily dose of DHEA decreases fat body mass. [240]

Lowers Blood Sugar Levels

Acquiring more DHEA can help combat diabetes and other diseases linked with high blood sugar levels. Results of human studies assessing the anti-diabetic effects of DHEA suggest that it can protect against insulin resistance induced by aging and unhealthy lifestyle:

  1. In older men and women, 6 months of DHEA replacement therapy improves insulin action, thereby reducing blood sugar levels. [241]
  2. In women with stress hormone deficiency, DHEA replacement therapy lowers blood sugar levels by improving the body’s response to insulin. [242]
  3. In older men and women, DHEA treatment at a dose of 50 mg daily for 6 months reduces adiposity while improving blood sugar levels. [243]
  4. In middle-aged and elderly men and women, higher DHEA levels are associated with a lower risk of type 2 diabetes. [244]
  5. In older men and women, DHEA prevents insulin resistance by reducing the levels of inflammatory cytokines such as IL-6 and TNFα. [245-250]
  6. DHEA reverses insulin resistance by activating peroxisome proliferator-activated receptor (PPARα), a group of proteins that play a role in the metabolism of carbohydrates, lipids, and proteins. [251-261]
  7. Another mechanism by which DHEA improves insulin action is by improving the activation of phosphatidyl inositol 3-kinase and Akt/PkB pathway, both of which play a key role in blood sugar metabolism. [262-264]

Improves Sleep Quality

Troublesome and frustrating, sleeping problems associated with aging can negatively impact one’s quality of life. Hormonal imbalance during this stage is thought to affect sleep quality, resulting in lack of sleep and extreme fatigue. Specifically, the age-related decline in various hormones such as testosterone, estrogen, and DHEA contributes to insomnia. Because DHEA is a precursor to several other important hormones in the body, researchers believe that restoring DHEA to youthful levels can help improve sleep quality. A number of clinical trials support the beneficial effects of DHEA on sleep:

  1. In men, a single dose of DHEA (500 mg) induces a significant increase in rapid eye movement (REM), one of the deepest stages of sleep. [265]
  2. In healthy postmenopausal women, oral DHEA administration at a dose of 50 mg daily for 3 weeks enhances sleep quality. [266]

Improves Muscle Mass and Strength

Regular exercises along with proper diet are known to increase muscle mass and strength. However, not all older individuals may benefit from these strategies due to reduced activity levels and slower metabolism. Interestingly, there is increasing evidence that DHEA supplementation can aid in improving muscle mass and strength especially in the older population. Studies show that DHEA replacement therapy is beneficial in both older men and women:

  1. In elderly men and women, DHEA replacement therapy enhances the effect of weightlifting training on muscle strength. [267]
  2. In postmenopausal women, DHEA supplementation improves muscle strength and function. [268]
  3. In elderly men and women, DHEA supplementation improves muscle mass and strength as well as gait speed. [269]
  4. In healthy non-obese age-advanced (50-65 years of age) men, a daily oral 100 mg dose of DHEA for 6 months increases knee muscle strength as well as lumbar back strength. [270]
  5. DHEA also helps protect against muscle wasting by preventing cell oxidation and cell death. [271]
  6. In frail older women, DHEA supplementation improves lower extremity strength and physical function. [272]

Relieves Menopausal Symptoms

Menopausal women often experience debilitating symptoms that ruin their quality of life, including hot flushes, sleeping difficulties, fatigue, sexual dysfunction, headaches, body pains, and mood swings.  Researchers believe that menopause and low DHEA levels go hand in hand, and by restoring DHEA to youthful levels through hormone replacement therapy, menopausal women can significantly experience relief from these unpleasant symptoms. A number of high quality studies conducted in menopausal women support the benefits of DHEA:

  1. Intravaginal administration of DHEA improves vaginal health and lessens pain during sexual intercourse. [273]
  2. In postmenopausal women, intravaginal administration of DHEA prevents vaginal atrophy (thinning, drying and inflammation of the vaginal walls). [274]
  3. Daily intravaginal administration of DHEA causes highly statistically significant improvements in vaginal dryness, vaginal pH acidity, and pain during sexual activity. [275-277]
  4. In menopausal women, four weeks of DHEA therapy decreases hot flushes by 50%. [278]
  5. In early and late postmenopausal women, DHEA replacement therapy for 3-6 months improves hot flushes and night sweats. [279]
  6. In early postmenopausal women, DHEA replacement therapy improves sexual function and frequency of sexual intercourse. [280]

Treats Erectile Dysfunction (ED)

DHEA doesn’t only treat sexual dysfunction in women, but also in men with ED. As a building block for testosterone, the key male sex hormone, DHEA may be able to ramp up sexual power in men with ED. Strong scientific evidence supports the beneficial effects of DHEA on this condition:

  1. In men with ED, DHEA therapy at an oral dose of 50 mg daily for 6 months improves scores in International Index of Erectile Function (IIEF). [281]
  2. In patients with ED who have hypertension, DHEA treatment is associated with statistically higher mean scores in IIEF. [282]
  3. In men with ED, DHEA supplementation improves sexual interest, arousal, orgasm and sexual frequency. [283]
  4. In men with ED caused by chronic prostate inflammation, DHEA supplementation significantly improves sexual function. [284]

Fights Cancer

DHEA does not only have anti-aging capability but it also has potent anti-cancer properties. There is strong scientific evidence that this hormone is capable of destroying various cancer cell types, thereby preventing its spread in different body parts (metastasis). Results from numerous studies show that DHEA fights cancer through various mechanisms:

  1. In patients with colon cancer, DHEA prevents the metastatic progression of colon cancer cells by targeting the prenylation pathway, a process that contributes to the spread of cancer cells. [285]
  2. In cancer patients, DHEA administration at a dose of 25-50 mg daily induces significant normalization of abnormal cancer parameters. [286]
  3. DHEA inhibits the growth and reproduction of different human breast cancer cell lines by inhibiting the production of inflammatory substances and proteins related with cell migration and metastasis. [287-288]
  4. In postmenopausal women, DHEA inhibits the growth of breast cancer cells. [289]
  5. In patients with advanced prostate cancer who are unresponsive to chemotherapy and other standard treatment regimens, DHEA significantly improves symptoms. [290]
  6. Dietary supplementation with 0.6% DHEA significantly inhibits pancreatic cancer cell growth. [291]
  7. DHEA inhibits the growth, reproduction, and migration of human uterine cervical cancers by inducing programmed cell death. [292-293]

Boosts Immune Function

The age-related decline in DHEA levels is believed to contribute to various medical conditions, including impairment of immune function. This predisposes older individuals to a wide array of fatal diseases like autoimmune disorders and inflammatory conditions. Research suggests that DHEA supplementation may help improve symptoms and even prevent immune system-related disorders by boosting immune function via several different mechanisms:

  1. In patients with systemic lupus erythematosus (SLE), DHEA significantly reduces symptoms and improves health related quality of life. [294-306]
  2. In patients with tuberculosis, DHEA helps relieve symptoms by clearing bacteria and preventing tissue damage. [307]
  3. DHEA improves immune function by reducing the levels of the stress hormone cortisol. [308]
  4. DHEA has strong antiviral, antibacterial, and anti-parasitic properties capable of protecting against a variety of lethal infections. [309-310]
  5. In age-advanced men with low DHEA levels, administration of oral DHEA at a daily dose of 50 mg significantly activates immune function by increasing the levels of insulin-like growth factor 1 (IGF-1), a hormone that has immune-modulating effects. [311]
  6. DHEA improves immune function by regulating the production of pro-inflammatory cytokines such as IL-2, IL-1, IL-6 and TNFα. [312-319]
  7. DHEA is metabolized to other sex hormones such as estrogen and testosterone, both of which regulate immune cell development and function. [320-324]
  8. In elderly men and women, DHEA boosts immune function by increasing the production of immune system cells such as CD4+ T cells. [325-332]
  9. DHEA mediates its immune-boosting effects by suppressing the mitogen-activated protein kinases (MAPK) pathway in activated lymphocytes (white blood cells). [333] An increase in this pathway is associated with compromised immune function. [334]
  10. DHEA improves immune function by enhancing natural killer cell activity. [335]
  11. DHEA supplementation is used to enhance the antibody response to tetanus and influenza vaccines. [336-338]
  12. In patients with asthma, DHEA reduces allergic inflammatory airway reactions, thereby improving symptoms. [339]

Wards off Depression and Improves Mood

Low mood and depression are among the most common psychological symptoms associated with old age. There is increasing evidence that age-related DHEA deficiency is strongly linked with depression, [340-341] suggesting that DHEA replacement therapy can be beneficial in improving depressive symptoms as well as quality of life. Results from various human studies assessing the beneficial effects of DHEA on mood show that this hormone can help maintain a positive outlook, energy and motivation:

  1. In older men and women (40-70 years), DHEA administration at 50 mg daily improves energy levels and ability to handle stress. [342]
  2. In patients with depression that is mild or resistant to conventional therapy, DHEA supplementation improves depressive symptoms. [343]
  3. In middle-aged and elderly patients with major depression and low DHEA levels, treatment with DHEA at 30-90 mg daily for 6 months significantly improves depression ratings and memory performance while increasing DHEA levels. [344]
  4. In men, DHEA administration reduces activity in brain regions associated with generation of negative emotion, thereby improving mood. [345]
  5. In patients with major depressive disorder, DHEA administration is associated with significant reduction in depressive symptoms. [346-348]
  6. In men, DHEA administration increases activity in the anterior cingulate cortex, a region in the brain involved with emotion formation. [349]
  7. DHEA also modulates dopamine and serotonin release in the brain, both of which play a key role in emotion regulation and episodic memory. [350]
  8. In patients with anxiety disorder, DHEA administration improves the function of the amygdala, a brain region that plays a key role in the processing of emotions. [351]
  9. In patients with post-traumatic stress disorder (PTSD), DHEA administration is positively associated with adaptive responses to stress and symptom improvement and coping. [352-353]
  10. In depressed and nondepressed men and women, DHEA administration has mood-elevating effects. [354-357]
  11. In women with adrenal insufficiency (lack of steroid hormones, primarily cortisol), DHEA significantly improves overall well-being as well as scores for depression and anxiety. [358-360]
  12. In patients with depression, low-dose topical DHEA treatment improves subjective measures of fatigue, depression, and vitality. [361]

Improves Cholesterol Levels

Cholesterol is required for DHEA production. In fact, the process by which DHEA is produced starts when cholesterol enters the “powerhouse” of cells known as mitochondria. [362] Researchers believe that this process may help lower cholesterol and increase DHEA levels in the body, thereby boosting overall health. Results from several studies support the beneficial effects of DHEA supplementation on cholesterol levels:

  1. In overweight individuals, higher DHEA levels are associated with lower cholesterol levels. [363]
  2. In older women with frailty characteristics, DHEA supplementation improves total cholesterol and low-density lipoprotein (LDL) levels. [364]
  3. In men aged 41-60 years, DHEA therapy at a dose of 150 mg daily for 40 days reduces total cholesterol levels. [365]
  4. In postmenopausal women, DHEA supplementation has favourable effect on cholesterol levels. [366]

Reduces Wrinkles and other Signs of Skin Aging

DHEA can reduce wrinkles and other skin imperfections associated with aging. Studies show that this hormone exerts its anti-aging effect through various mechanisms:

  1. In postmenopausal women aged 60-65 years, skin application of DHEA cream twice daily for 13 weeks improves skin health and appearance by increasing the levels of collagen, a protein that makes the skin radiant and younger-looking. [367]
  2. In postmenopausal women, skin application of DHEA cream is associated with greater procollagen and collagen production. [368-370]
  3. In older women, oral DHEA supplementation at a dose of 50 mg daily for 1 year improves skin hydration, skin thickness and oil production, and reduces skin pigmentation. [371]
  4. In patients with skin atrophy (skin thinning), oral DHEA prevents frequent skin tearing. [372]
  5. In postmenopausal women, skin application of DHEA cream reduces wrinkles and blemishes. [373]
  6. In postmenopausal women, DHEA decreases the production of the collagenase enzymes that destroy collagen. [374]
  7. DHEA also decreases the production of genes associated with the formation of calluses and rough skin in postmenopausal women. [375]

Prevents Stroke

Stroke is one of the most deadly diseases worldwide. Interestingly, aside from diet and lifestyle, studies show that low DHEA levels are strongly associated with increased risk of stroke and related death. [376] Fortunately, increasing DHEA levels through replacement therapy can significantly prevent stroke, according to studies:

  1. DHEA prevents the death of healthy cells in the brain by inhibiting inflammatory processes. [377]
  2. In post-stroke patients, DHEA supplementation can improve functional outcome. [378]
  3. DHEA protects nerve cells in the brain from injury. [379]
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  286. Omura Y. Beneficial effects and side effects of DHEA: true anti-aging and age-promoting effects, as well as anti-cancer and cancer-promoting effects of DHEA evaluated from the effects on the normal and cancer cell telomeres and other parameters. Acupuncture & electro-therapeutics research. 2005; 30(3-4):219-61.

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  290. Jones JA, Nguyen A, Straub M, Leidich RB, Veech RL, Wolf S. Use of DHEA in a patient with advanced prostate cancer: a case report and review. Urology. 1997; 50(5):784-8.

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  332. Casson PR, Andersen RN, Herrod HG, et al. Oral dehydroepiandrosterone in physiologic doses modulates immune function in postmenopausal women. American journal of obstetrics and gynecology. 1993; 169(6):1536-9.

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  335. Solerte SB, Fioravanti M, Vignati G, Giustina A, Cravello L, Ferrari E. Dehydroepiandrosterone sulfate enhances natural killer cell cytotoxicity in humans via locally generated immunoreactive insulin-like growth factor I. The Journal of clinical endocrinology and metabolism. 1999; 84(9):3260-7.

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  338. Degelau J, Guay D, Hallgren H. The effect of DHEAS on influenza vaccination in aging adults. Journal of the American Geriatrics Society. 1997; 45(6):747-51

  339. Choi IS, Cui Y, Koh Y-A, Lee H-C, Cho Y-B, Won Y-H. Effects of dehydroepiandrosterone on Th2 cytokine production in peripheral blood mononuclear cells from asthmatics. The Korean Journal of Internal Medicine. 2008;23(4):176-181. doi:10.3904/kjim.2008.23.4.176.

     

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  341. Barrett-Connor E, von Muhlen DG, Kritz-Silverstein D. Bioavailable testosterone and depressed mood in older men: the Rancho Bernardo study. J Clin Endocrinol Metab. 1999;84:573–7.

  342. Morales AJ, Nolan JJ, Nelson JC, Yen SS. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. The Journal of clinical endocrinology and metabolism. 1994; 78(6):1360-7.

  343. Peixoto C, Devicari Cheda JN, Nardi AE, Veras AB, Cardoso A. The effects of dehydroepiandrosterone (DHEA) in the treatment of depression and depressive symptoms in other psychiatric and medical illnesses: a systematic review. Current drug targets. 2014; 15(9):901-14.

  344. Wolkowitz OM, Reus VI, Roberts E, et al. Dehydroepiandrosterone (DHEA) treatment of depression. Biological psychiatry. 1997; 41(3):311-8.

  345. Sripada RK, Marx CE, King AP, et al. DHEA Enhances Emotion Regulation Neurocircuits and Modulates Memory for Emotional Stimuli. Neuropsychopharmacology. 2013;38(9):1798-1807. doi:10.1038/npp.2013.79.

  346. Bloch M, Schmidt PJ, Danaceau MA, Adams LF, Rubinow DR. Dehydroepiandrosterone treatment of midlife dysthymia. Biol Psychiatry. 1999;45:1533–1541.

  347. Schmidt PJ, Daly RC, Bloch M, Smith MJ, Danaceau MA, St, Clair LS, et al. Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression. Arch Gen Psychiatry. 2005;62:154–162.

  348. Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L, et al. Double-blind treatment of major depression with dehydroepiandrosterone. Am J Psychiatry. 1999;156:646–649.

  349. Alhaj HA, Massey AE, McAllister-Williams RH. Effects of DHEA administration on episodic memory, cortisol and mood in healthy young men: a double-blind, placebo-controlled study. Psychopharmacology (Berl) 2006;188:541–551.

  350. Hofmann SG, Ellard KK, Siegle GJ. Neurobiological correlates of cognitions in fear and anxiety: a cognitive-neurobiological information-processing model. Cogn Emot. 2012;26:282–299.

  351. Etkin A, Wager TD. Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. Am J Psychiatry. 2007;164:1476–1488.

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  353. Sageman S, Brown RP. 3-acetyl-7-oxo-dehydroepiandrosterone for healing treatment-resistant posttraumatic stress disorder in women: 5 case reports. J Clin Psychiatry. 2006;67:493–496.

  354. Berr C, Lafont S, Debuire B, Dartigues JF, Baulieu EE. Relationships of dehydroepiandrosterone sulfate in the elderly with functional, psychological, and mental status, and short-term mortality: a French community-based study. Proceedings of the National Academy of Sciences of the United States of America. 1996; 93(23):13410-5.

  355. Morales AJ, Nolan JJ, Nelson JC, Yen SS. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. The Journal of clinical endocrinology and metabolism. 1994; 78(6):1360-7.

  356. Wolkowitz OM, Reus VI, Roberts E, et al. Dehydroepiandrosterone (DHEA) treatment of depression. Biological psychiatry. 1997; 41(3):311-8.

  357. Bloch M, Schmidt PJ, Danaceau MA, Adams LF, Rubinow DR. Dehydroepiandrosterone treatment of midlife dysthymia. Biological psychiatry. 1999; 45(12):1533-41.

  358. Rabkin JG, Ferrando SJ, Wagner GJ, Rabkin R. DHEA treatment for HIV+ patients: effects on mood, androgenic and anabolic parameters. Psychoneuroendocrinology. 2000; 25(1):53-68.

  359. Arlt W, Callies F, van Vlijmen JC, et al. Dehydroepiandrosterone replacement in women with adrenal insufficiency. The New England journal of medicine. 1999; 341(14):1013-20.

  360. Johannsson G, Burman P, Wirén L, et al. Low dose dehydroepiandrosterone affects behavior in hypopituitary androgen-deficient women: a placebo-controlled trial. The Journal of clinical endocrinology and metabolism. 2002; 87(5):2046-52.

  361. Glick R, Jimenez X. P02.62. DHEA augmentation strategy for treatment of fatigue and depression: a case presentation. BMC Complementary and Alternative Medicine. 2012;12(Suppl 1):P118. doi:10.1186/1472-6882-12-S1-P118.

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  364. Boxer RS, Kleppinger A, Brindisi J, Feinn R, Burleson JA, Kenny AM. Effects of dehydroepiandrosterone (DHEA) on cardiovascular risk factors in older women with frailty characteristics. Age and Ageing. 2010;39(4):451-458. doi:10.1093/ageing/afq043.

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