DHEA for depression and dementia. (Alternative Medicine).

* The supplement DHEA is touted as a "superhormone" that can slow aging, "melt away ease," and improve strength.

* Investigational medical uses include depression and dementia; the data thus far have been mixed, and long-term effects are unknown.

History of Use

Few items on pharmacy or health food store shelves have been associated with as much hype and controversy as has DHEA (dehydroepiandrosterone). Popularly termed "andro when professional baseball player Mark McGwire admitted using it while batting his record-breaking 70 home runs in 1998, DHEA is said to increase longevity, "melt away disease," and improve strength, mood, cognition, and sexuality. Many athletes use it in expectation of increased muscle mass and strength, but it has now been banned by many organizations including the International Olympic Committee and the National Football League.

DHEA, the predominant steroid hormone secreted by the reticular zone of the adrenal cortex, is a precursor of both testosterone and estrogens. Researchers have suggested that the relative androgenic or estrogenic properties of the hormone vary with the ambient hormonal milieu, so that DHEA would have predominantly estrogenic effects in men with normal testosterone levels and androgen effects in premenopausal women (Ageing Res. Rev. 1[1]:2941,2002). The Endocrine Society has cautioned against its use, particularly by young people, because of potentially harmful effects on normal sex steroid secretion and absorption.

The Food and Drug Administration banned over-the-counter sale of DHEA in 1985, when it was being marketed for weight loss, and classified it as an unapproved new drug available only by prescription. A 1994 reversal once again permitted OTC marketing. It remains popular among consumers who use it for conditions ranging from obesity to sexual dysfunction.

It is popular as an antiaging remedy; the rationale is that serum DHEA levels peak in the third decade of life, the decrease at about 2% per year. Aging--and associated diseases-- could reflect DHEA deficiency, advocates say, and its replacement could restore normal, youthful hormone status. Research on whether age-related lowering of DHEA levels is linked to disease states and whether supplementation is beneficial has yet to yield clear answers.