Dr. Smith with Your Health - DHEA: Treatment or Hype?

DHEA: TREATMENT OR HYPE?
by Dr. Brian A. Smith

DHEA (Dehydroepiandosterone) is a steroid secreted by the adrenal glands. Its precise role is not yet fully understood. It is related to testosterone, and, in fact, can be converted to testosterone in small quantities. In the HIV+ asymptomatic person, DHEA has been found to be 30% lower in plasma. Progression of illness is associated with further depressed DHEA levels. In other severe illnesses, lower DHEA levels, coupled with high cortisol levels, is found and could be partially responsible for the immunosuppression of AIDS. (Cortisol is another adrenal secretion which is commonly found elevated in the HIV+ person). Low DHEA levels have been correlated with lowered production of Il-2 (Interleukin-2). Further, this adrenal derangement could explain a number of symptoms such as weight loss, general fatigue, diarrhea, dizziness upon rising and loss of appetite. As early as 1984, reports of adrenal gland damage in HIV+ persons was reported.

The cause of these abnormalities is not yet fully known but infections with CMV, MAI and cryptococcus have been reported as has Kaposi's sarcoma in the gland. Drugs including rifampin, ketaconazole, opiate derivatives and phenytoin can produce or contribute to adrenal damage.

Many hormones, DHEA included, have a daily rhythm (called a circadian rhythm) in which it is present at different concentrations at different times. It is highest in the morning and decreases throughout the day. To accurately check for DHEA and/or cortisol problems, it is necessary to take multiple readings throughout the day and compare them with "normal" levels. The patients age also determines the concentration as levels begin to decline after the age of 25.

The simplest way to measure your levels is to have a serum DHEA-sulfate level measured. This is an inexpensive test, usually less than $40.00.

What to do if you are found to have abnormal adrenal gland function? From a nutritional approach, the vitamins B-5 (pantothenic acid) and B-6 (pyridoxine) are intricately linked to the production of adrenal secretions. Deficiencies of either can interfere with proper function. Magnesium levels must also be adequate for proper functioning. I have also used adrenal gland extracts in some patients with success. While not completely understood, it appears that glandular supplements assist by providing the necessary "ingredients" to restore the gland to normal function as well as providing small quantities of the chemicals made by the gland.

DHEA supplementation has also been used in some patients with varying degrees of success. High dosages, 500 mg. per day, have shown some benefits in increasing T4 cell counts and lessening fungal infections. This amount is much too high to supplement on a regular basis. In some research it has been shown that the virus does not multiply when DHEA is used. DHEA can not be combined with AZT as it will decrease AZT activity and/or increase viral replication.

When I have had the occasion to use DHEA in my patients, it is always after receiving lab results showing a true deficiency exists. If the results are very low, that is below normal, I have usually recommended 50 mg. daily for 4 weeks. At that time the serum level is rechecked. In most of my patients, by the 30 day point, levels have returned to the high end of normal. My lab uses the reference range of 70 - 510 ng/dl. as normal. I am satisfied if the value is at least 380 ng/dl. At that point, supplementation is discontinued and after 4 more weeks the level is rechecked to see if the body has been able to resume maintenance of normal levels. Some patients need low level supplementation on a long term basis, such as 5 mg. three times a week; others need no further supplementation.

As with all hormones, there are times when DHEA is not appropriate or the patient must be monitored more closely. The two main problems occur in people who have had a history of prostate problems and those with a history of heart problems.

If you are bothered by unexplained symptoms of fatigue, weight loss, dizziness upon rising or loss of appetite, you may have an adrenal abnormality that is treatable by conservative means. You must first, identify the problem; second, take corrective measures; and third, verify the results with confirmatory testing.

As always, consult with a qualified health care provider before beginning any new treatments.

Dr. Brian A. Smith is a chiropractic doctor and naturopathic physician who has specialized in the treatment of immune-suppressed individuals since 1987. He is a scientific advisory board member of AIDS ReSEARCH Alliance.

He maintains a private practice in Los Angeles and can be reached at (323) 306-4909. Questions from readers are welcome as are suggestions for future articles. You can also contact him via E-mail at: Send e-mail to Dr. Smith

Back to the Article List

Articles by Dr. Brian A. Smith:

HIV and CHIRO † VITAMIN C † BETA-CAROTENE † MINERALS † DMG † PROTEIN † DIET & HIV † MORE ON PROTEIN † NUTRITION † DHEA † LIVER † CHIRO † NAC † SILVER † ALT THERAPIES †