madman
Super Moderator
Abstract
Background: Dehydroepiandrosterone (DHEA) has been aggressively sold as a dietary supplement to boost testosterone levels although the impact of DHEA supplementation on testosterone levels has not been fully established. Therefore, we performed a systematic review and meta-analysis of RCTs to investigate the effect of oral DHEA supplementation on testosterone levels.
Methods: A systematic literature search was performed in Scopus, Embase, Web of Science, and PubMed databases up to February 2020 for RCTs that investigated the effect of DHEA supplementation on testosterone levels. The estimated effect of the data was calculated using the weighted mean difference (WMD). Subgroup analysis was performed to identify the source of heterogeneity among studies.
Results: Overall results from 42 publications (comprising 55 arms) demonstrated that testosterone level was significantly increased after DHEA administration (WMD: 28.02 ng/dl, 95% CI: 21.44-34.60, p=0.00). Subgroup analyses revealed that DHEA increased testosterone level in all subgroups, but the magnitude of increment was higher in females compared to men (WMD: 30.98 ng/dl vs. 21.36 ng/dl); DHEA dosage of ˃50 mg/d compared to ≤50 mg/d (WMD: 57.96 ng/dl vs. 19.43 ng/dl); intervention duration of ≤12 weeks compared to ˃12 weeks (WMD: 44.64 ng/dl vs. 19 ng/dl); healthy participants compared to postmenopausal women, pregnant women, non-healthy participants and androgen-deficient patients (WMD: 52.17 ng/dl vs. 25.04 ng/dl, 16.44 ng/dl and 16.47 ng/dl); and participants below 60 years old compared to above 60 years old (WMD: 31.42 ng/dl vs. 23.93 ng/dl).
Conclusion: DHEA supplementation is effective for increasing testosterone levels, although the magnitude varies among different subgroups. More studies are needed for pregnant women and miscarriage.
Introduction
In humans, dehydroepiandrosterone (DHEA) is a steroid hormone that is produced mainly in the zona reticularis of the adrenal gland, apart from the testes and ovaries (Acacio and others 2004; Collomp and others 2018). It is also a neuro-steroid that is formed de novo in the brain (Strous and others 2006). DHEA can be subsequently converted to its sulfated conjugate (DHEA-S) (Buster and Casson 2000); whereby both forms represent the most abundant steroid hormone in both sexes (Hornsby 1995). Although the bona fide hormone receptors, specific target tissues and exact mechanisms of action for DHEA remains unclear (Ebeling and Koivisto 1994), DHEA is known to possess weak androgenic activity (Barnhart and others 1999) in addition to being a pro-hormone precursor that is converted to testosterone, a highly potent androgen in men; and estrogen in women (Labrie and others 1997; Longcope 1996).
In humans, serum DHEA levels have been linked to bone and muscle health, feelings of wellbeing, improvements in concentration, cognition, improve in pregnancy rate, verbal and long-term memory, lower miscarriage rates, as well as increases in vigor and libido (Barrett-Connor and Edelstein 1994; Berr and others 1996; Gleicher and others 2009; Mortola and Yen 1990; Rudman and others 1990; Wolkowitz and others 1995; Yen and others 1995). On the contrary, low concentrations of DHEA have been associated with functional limitation, anxiety disorders during pregnancy, depressed symptomatology, poor subjective perceptions of health and life satisfaction, and poor cognition (Berkman and others 1993; Leff-Gelman and others 2020; Sunderland and others 1989). Although DHEA plays such an important role in our overall health and well-being, its levels in our circulation actually decline steadily with age. Adrenal production of DHEA begins during puberty and peaks at around 20 years old. At approximately age 25, serum DHEA begins to decline rapidly, so that by age 75 DHEA level is ~80% lower than at 20 years old (Orentreich and others 1984; Orentreich and others 1992). As such, DHEA has been made available as a form of “over-the-counter” nonprescription oral dietary supplement.
Conclusion
In summary, our systematic review and meta-analysis that was based on 42 RCTs revealed that oral administration of DHEA supplement was associated fully with the increase of plasma testosterone levels in both genders. However, the increase in plasma testosterone is more prominent among females, healthy and younger subjects, and when the DHEA supplement is consumed for >50mg/day for < 12 weeks.
Highlighted
1- DHEA administration was associated with an increase in testosterone levels.
2- DHEA increased testosterone level in all subgroups, but the magnitude of increment was higher in females compared to men; DHEA dosage of ˃50 mg/d compared to ≤50 mg/d; intervention duration of ≤12 weeks compared to ˃12 weeks;
Background: Dehydroepiandrosterone (DHEA) has been aggressively sold as a dietary supplement to boost testosterone levels although the impact of DHEA supplementation on testosterone levels has not been fully established. Therefore, we performed a systematic review and meta-analysis of RCTs to investigate the effect of oral DHEA supplementation on testosterone levels.
Methods: A systematic literature search was performed in Scopus, Embase, Web of Science, and PubMed databases up to February 2020 for RCTs that investigated the effect of DHEA supplementation on testosterone levels. The estimated effect of the data was calculated using the weighted mean difference (WMD). Subgroup analysis was performed to identify the source of heterogeneity among studies.
Results: Overall results from 42 publications (comprising 55 arms) demonstrated that testosterone level was significantly increased after DHEA administration (WMD: 28.02 ng/dl, 95% CI: 21.44-34.60, p=0.00). Subgroup analyses revealed that DHEA increased testosterone level in all subgroups, but the magnitude of increment was higher in females compared to men (WMD: 30.98 ng/dl vs. 21.36 ng/dl); DHEA dosage of ˃50 mg/d compared to ≤50 mg/d (WMD: 57.96 ng/dl vs. 19.43 ng/dl); intervention duration of ≤12 weeks compared to ˃12 weeks (WMD: 44.64 ng/dl vs. 19 ng/dl); healthy participants compared to postmenopausal women, pregnant women, non-healthy participants and androgen-deficient patients (WMD: 52.17 ng/dl vs. 25.04 ng/dl, 16.44 ng/dl and 16.47 ng/dl); and participants below 60 years old compared to above 60 years old (WMD: 31.42 ng/dl vs. 23.93 ng/dl).
Conclusion: DHEA supplementation is effective for increasing testosterone levels, although the magnitude varies among different subgroups. More studies are needed for pregnant women and miscarriage.
Introduction
In humans, dehydroepiandrosterone (DHEA) is a steroid hormone that is produced mainly in the zona reticularis of the adrenal gland, apart from the testes and ovaries (Acacio and others 2004; Collomp and others 2018). It is also a neuro-steroid that is formed de novo in the brain (Strous and others 2006). DHEA can be subsequently converted to its sulfated conjugate (DHEA-S) (Buster and Casson 2000); whereby both forms represent the most abundant steroid hormone in both sexes (Hornsby 1995). Although the bona fide hormone receptors, specific target tissues and exact mechanisms of action for DHEA remains unclear (Ebeling and Koivisto 1994), DHEA is known to possess weak androgenic activity (Barnhart and others 1999) in addition to being a pro-hormone precursor that is converted to testosterone, a highly potent androgen in men; and estrogen in women (Labrie and others 1997; Longcope 1996).
In humans, serum DHEA levels have been linked to bone and muscle health, feelings of wellbeing, improvements in concentration, cognition, improve in pregnancy rate, verbal and long-term memory, lower miscarriage rates, as well as increases in vigor and libido (Barrett-Connor and Edelstein 1994; Berr and others 1996; Gleicher and others 2009; Mortola and Yen 1990; Rudman and others 1990; Wolkowitz and others 1995; Yen and others 1995). On the contrary, low concentrations of DHEA have been associated with functional limitation, anxiety disorders during pregnancy, depressed symptomatology, poor subjective perceptions of health and life satisfaction, and poor cognition (Berkman and others 1993; Leff-Gelman and others 2020; Sunderland and others 1989). Although DHEA plays such an important role in our overall health and well-being, its levels in our circulation actually decline steadily with age. Adrenal production of DHEA begins during puberty and peaks at around 20 years old. At approximately age 25, serum DHEA begins to decline rapidly, so that by age 75 DHEA level is ~80% lower than at 20 years old (Orentreich and others 1984; Orentreich and others 1992). As such, DHEA has been made available as a form of “over-the-counter” nonprescription oral dietary supplement.
Conclusion
In summary, our systematic review and meta-analysis that was based on 42 RCTs revealed that oral administration of DHEA supplement was associated fully with the increase of plasma testosterone levels in both genders. However, the increase in plasma testosterone is more prominent among females, healthy and younger subjects, and when the DHEA supplement is consumed for >50mg/day for < 12 weeks.
Highlighted
1- DHEA administration was associated with an increase in testosterone levels.
2- DHEA increased testosterone level in all subgroups, but the magnitude of increment was higher in females compared to men; DHEA dosage of ˃50 mg/d compared to ≤50 mg/d; intervention duration of ≤12 weeks compared to ˃12 weeks;
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