Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal glands that is available over the counter in the US. It is still a WADA-banned substance, but does it actually increase muscle mass, lowr fat mass, or significantly increase strength?
TL;DW - There might be a little, maybe something there on the body composition side. Any signal is likely coming from older individuals, and there is unlikely to be a benefit in young healthy subjects. There has not been a published meta-analysis on strength. It will very likely be null.
Below is a scorched-earth deep dive into what can and can't affect DHEA and what supplementing what else DHEA may and may not move the needle on:
Briefly, there are some very serious medical conditions that can bottom out DHEA-S. High allostatic load and fatty liver also seem to reduce it and these are inherently intertwined, as many of the allostatic load calculators subtly capture metabolic health. DHEA-S also appears to decrease with age. Sleep deprivation, fragmentation, and OSA don't seem to do much and sleep extension doesn't seem to increase it. Also, with limited data, DHEA-S doesn't appear to be a reliable marker of overtraining syndrome. Regular physical activity in older adults and mindfulness-based stress reduction may somewhat increase it.
DHEA-S / Modulators
A consolidated map of what raises, lowers, and fails to move circulating DHEA-S — and what supplementing it actually accomplishes. Magnitudes from RCTs, meta-analyses, and Mendelian randomization where available. Sex stratifies many findings dramatically.
What Lowers DHEA-S in Men
↓ SuppressorsWhat Doesn't Reliably Lower It
≈ ResilientWhat Raises Endogenous DHEA-S
↑ InterventionsDHEA Supplementation in Men
⚖ OutcomesPossibly Helpful
Mixed / Modest
Doesn't Improve
Cautions
What Lowers DHEA-S in Women
↓ SuppressorsWhat Doesn't Reliably Lower It
≈ ResilientWhat Raises Endogenous DHEA-S
↑ InterventionsDHEA Supplementation in Women
⚖ OutcomesReliably Improves
Mixed / Modest
Doesn't Improve
Adverse / Caution
REFERENCES FOR DHEA FOREST PLOTS:
1. Wang, F., et al., The effects of dehydroepiandrosterone (DHEA) supplementation on body composition and blood pressure: a meta-analysis of randomized clinical trials. Steroids, 2020. 163: p. 108710.
2. Brown, G.A., et al., Effect of oral DHEA on serum testosterone and adaptations to resistance training in young men. J Appl Physiol (1985), 1999. 87(6): p. 2274–83.
3. Dayal, M., et al., Supplementation with DHEA: effect on muscle size, strength, quality of life, and lipids. J Womens Health (Larchmt), 2005. 14(5): p. 391–400.
4. Dhatariya, K.K., et al., Dehydroepiandrosterone replacement therapy in hypoadrenal women: protein anabolism and skeletal muscle function. Mayo Clin Proc, 2008. 83(11): p. 1218–25.
5. Igwebuike, A., et al., Lack of dehydroepiandrosterone effect on a combined endurance and resistance exercise program in postmenopausal women. J Clin Endocrinol Metab, 2008. 93(2): p. 534–8.
6. Kenny, A.M., et al., Dehydroepiandrosterone combined with exercise improves muscle strength and physical function in frail older women. J Am Geriatr Soc, 2010. 58(9): p. 1707–14.
7. Morales, A.J., et al., The effect of six months treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex steroids, body composition and muscle strength in age-advanced men and women. Clin Endocrinol (Oxf), 1998. 49(4): p. 421–32.
8. Muller, M., et al., Effects of dehydroepiandrosterone and atamestane supplementation on frailty in elderly men. J Clin Endocrinol Metab, 2006. 91(10): p. 3988–91.
9. Nair, K.S., et al., DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med, 2006. 355(16): p. 1647–59.
10. Pénisson-Besnier, I., et al., Dehydroepiandrosterone for myotonic dystrophy type 1. Neurology, 2008. 71(6): p. 407–12.
11. Percheron, G., et al., Effect of 1-year oral administration of dehydroepiandrosterone to 60- to 80-year-old individuals on muscle function and cross-sectional area: a double-blind placebo-controlled trial. Arch Intern Med, 2003. 163(6): p. 720–7.
12. Villareal, D.T. and J.O. Holloszy, DHEA enhances effects of weight training on muscle mass and strength in elderly women and men. Am J Physiol Endocrinol Metab, 2006. 291(5): p. E1003–8.
13. Wallace, M.B., et al., Effects of dehydroepiandrosterone vs androstenedione supplementation in men. Med Sci Sports Exerc, 1999. 31(12): p. 1788–92.
14. Weiss, E.P., D.T. Villareal, and J.O. Holloszy, Effect of DHEA replacement therapy on muscle strength and size in sedentary older adults. Med Sci Sports Exerc, 2010. 42(5 Suppl): Abstract 590 (presented at ACSM Annual Meeting, June 2, 2010, Baltimore, MD).
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8. Nair, K.S., et al., DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med, 2006. 355(16): p. 1647–59.
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21. Brown, G.A., et al., Effect of oral DHEA on serum testosterone and adaptations to resistance training in young men. J Appl Physiol (1985), 1999. 87(6): p. 2274–83.
22. Wallace, M.B., et al., Effects of dehydroepiandrosterone vs androstenedione supplementation in men. Med Sci Sports Exerc, 1999. 31(12): p. 1788–92.
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28. Scheffers, C.S., et al., Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database Syst Rev, 2015. 1(1): p. CD011066.
29. Kritz-Silverstein, D., et al., Effects of dehydroepiandrosterone supplementation on cognitive function and quality of life: the DHEA and Well-Ness (DAWN) trial. J Am Geriatr Soc, 2008. 56(7): p. 1292–8.
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34. Villareal, D.T., et al., Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial. JAMA, 2004. 292(18): p. 2243–8.
35. Alkatib, A.A., et al., A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency. J Clin Endocrinol Metab, 2009. 94(10): p. 3676–81.
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62. Brahimaj, A., et al., Serum dehydroepiandrosterone levels are associated with lower risk of type 2 diabetes: the Rotterdam Study. Diabetologia, 2017. 60(1): p. 98–106.
63. Zhang, X., et al., Low serum dehydroepiandrosterone is associated with diabetic kidney disease in men with type 2 diabetes mellitus. Front Endocrinol (Lausanne), 2022. 13: p. 915494.
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