DHEA supplements may exacerbate COVID-19

[Nelson Vergel]

Androgens play a fundamental role in the morbidity and mortality of COVID-19, inducing both the ACE-2 receptor to which SARS-CoV-2 binds to gain entry into the cell, and TMPRS22, the transmembrane protease that primes the viral spike protein for efficient infection. The United States stands alone among developed nations in permitting one androgen, oral dehydroepiandrosterone (DHEA), to be freely available OTC and online as a “dietary supplement.”

Alert to US physicians: DHEA, widely used as an OTC androgen supplement, may exacerbate COVID-19

Androgens play a fundamental role in the morbidity and mortality of COVID-19, inducing both the ACE-2 receptor to which SARS-CoV-2 binds to gain entry into the cell, and TMPRS22, the transmembrane protease that primes the viral spike protein for efficient infection. The United States stands...

erc.bioscientifica.com

 

[sammmy]

The whole claim that DHEA is bad during C19 infection revolves around DHEA suppressing Glucose-6-phosphate Dehydrogenase:

G6PD deficiency:

Without enough functional glucose-6-phosphate dehydrogenase, red blood cells are unable to protect themselves from the damaging effects of reactive oxygen species. The damaged cells are likely to rupture and break down prematurely (undergo hemolysis). Factors such as infections, certain drugs, and ingesting fava beans can increase the levels of reactive oxygen species, causing red blood cells to undergo hemolysis faster than the body can replace them. This loss of red blood cells causes the signs and symptoms of hemolytic anemia, which is a characteristic feature of glucose-6-phosphate dehydrogenase deficiency.

 

[Cataceous]

The whole claim that DHEA is bad during C19 infection revolves around DHEA suppressing Glucose-6-phosphate Dehydrogenase:

G6PD deficiency:

That's interesting. I wonder if the statement in this work has any relevance. "DHEA inhibition of G6PD was only found to occur at concentrations above 10 microM..." If that's microMoles per liter then it translates to around 300 mcg/dL, right at typical serum levels. This work also seems to demonstrate significant effects at 10 microM, but not at 1 microM.

 

[sammmy]

The required 10 micro-mol/L blood DHEA concentration (should be differentiated from DHEA-S concentration) does not seem reachable in older men/women with the usual oral supplementation:

Dehydroepiandrosterone Replacement Administration: Pharmacokinetic and Pharmacodynamic Studies in Healthy Elderly Subjects*

DHEA concentrations:

After 8 days with 25 or 50 mg DHEA, Cmax and AUC0–24h differed significantly from placebo (P < 0.05), with a dose-proportional response in men but not in women. In men and women, Cmax with 50 mg reached 34 ± 12 and 34 ± 10 nmol/L, respectively, just above normal values observed in young men (5.2–26.0 nmol/L) and women (4.2–27.7 nmol/L; Table 1).

DHEA-S concentrations:

The mean maximal DHEAS concentration (Cmax) was observed 2 h after DHEA ingestion. After 8 days of treatment with 25 or 50 mg DHEA, Cmax reached 8.98 ± 2.7 and 13.70 ± 3.92 μmol/L, respectively (P < 0.05) in men and 7.70 ± 2.26 and 13.10 ± 3.80 μmol/L (P < 0.05) in women. Thereafter, administration of 25 mg DHEA restored serum DHEAS to levels similar to those observed in young women in the early follicular phase (1.1–7.3 μmol/L) and in young men (4.1–13.6 μmol/L).

 

[Cataceous]

The required 10 micro-mol/L blood DHEA concentration (should be differentiated from DHEA-S concentration) does not seem reachable in older men/women with the usual oral supplementation:

Dehydroepiandrosterone Replacement Administration: Pharmacokinetic and Pharmacodynamic Studies in Healthy Elderly Subjects*
...

Thanks, I did conflate it with the sulfated version. If serum levels are normally orders of magnitude lower, even with typical supplementation, then why are they making an issue of it?

 

[sammmy]

The whole alert under discussion is based on rather stretched assumptions. The ultimate "intellectual peak" is:

DHEA is widely used by males in the US to offset the age-related decline in circulating androgens. This fact may contribute to the disparate statistics of COVID-19 morbidity and mortality in this country.

Let's "explain" the large infectious rate and mortality with arbitrary correlations, or the more recent "new strains".

 

[S1W]

Covid and androgens...are men on TRT at more/less/equal risk to men who are not on TRT in terms of covid risk, severity, etc?

 

[sammmy]

Claims that higher testosterone or "androgens" lead to higher mortality from C19 is instantly contradicted by the fact that younger men die of it much less frequently than older men, and younger men have higher testosterone levels on average.