DHEA In Older Men

Because blood levels of dehydroepiandrosterone (DHEA) and testosterone decline with age, some people believe that DHEA and testosterone supplementation can reverse the effects of aging. This hypothesis was examined in a double-blind, placebo-controlled, randomized trial that included 87 men and 57 women aged 60 or older. Baseline levels of DHEA-S (the sulfated form of DHEA) in both sexes, and baseline levels of bioavailable testosterone in men, were required to be below the 15th percentile for normal young adults. Men received a DHEA tablet (75 mg) daily, a transdermal testosterone patch (5 mg daily), or double placebo; women received a DHEA tablet (50 mg) or placebo. After about 2 years of follow-up, no differences were noted between the active-drug and placebo groups in physical performance (i.e., aerobic capacity and muscle strength) or in quality of life as measured on a validated questionnaire. In the active-drug groups, small increases in bone density were noted only at the femoral neck in men and at the distal radius in women. These changes were much smaller than those typically seen with bisphosphonate drugs. No significant adverse events occurred. Comment In this well-done randomized trial, supplementation with DHEA or low-dose testosterone conferred no obvious benefits to older adults. Based on these and previous results, the authors and an editorialist conclude that DHEA and testosterone should not be used as anti-aging supplements. The editorialist also believes that DHEA should be treated as a regulated drug and not as a dietary supplement. — Allan S. Brett, MD