Supplement Performance May 05

Written by Dan Gwartney, MD
09 October 2006
 

 

New Study!

DHEA a Decade Later

 

            In the mid-‘90s, the release of two dietary supplements caused a furor that sparked controversy and raised media attention. At mention of these supplements now, a collective yawn would rise up from the masses. Bodybuilders flocked to one of these two former "miracles" with ambivalent results. Yet, in this current environment of greater restrictions on dietary supplements and pending FDA regulations, it may be time to revisit this dated product.

            Readers older than 25 may remember the front windows of vitamin stores being covered with signs stating "We have Melatonin" and "DHEA now in stock." These two supplements were so popular at one time, that production could not meet demand and people would line up to get rain checks. Melatonin continues to sell, though at a more modest pace, as a sleep aid.1 DHEA is still on the shelf, also no longer the marketing powerhouse it once was. It's rare to find it as a stand-alone product, unless it's being sold as hormonal support for post-menopausal women. However, recent changes and research would advise a closer inspection of this currently ignored product.

DHEA was king of the product sales, but it was a short-lived reign. In part, this was because it was over-hyped and in part it was because it was marketed to the wrong group. By now, most people are aware of androgen pro-hormones thanks to the record-breaking season of baseball player Mark McGwire several years ago.2 Bodybuilders are familiar with the expansive menu of related prohormones, including: 1-testosterone, 1-AD, norandriol and boldenone precursors. Unfortunately for those who are interested in the topic, federal legislation has removed all effective prohormones from public access.2

 

            Promoted as T-Booster, Fat Fighter

            The story of prohormones began in the mid-‘90s with the introduction of DHEA as a dietary supplement. DHEA is an active steroid hormone in its own right in the body, but sports nutrition companies were quick to promote DHEA as a means to increase testosterone levels. Inappropriately, DHEA was advertised as a potent means of raising testosterone to anabolic levels. Overeager bodybuilders quickly learned this was not the case.

            Another property assigned to DHEA is an ability to reduce body fat, a hot topic to both bodybuilders and the hordes who obsess over a growing midline. The basis for this claim is very impressive upon first glance. Numerous animal studies have shown that rats (a popular animal to study to determine drug effect in the laboratory) lost body fat and resisted obesity when DHEA was administered. This, of course, inspired further research in human subjects.3-5

            DHEA investigation in humans was supported by the findings of numerous scientists, as it was clearly demonstrated that DHEA levels decreased with age, coincident with a loss of muscle and an increase in abdominal and visceral fat.6 Aging studies have determined that many hormones decrease as people age, including DHEA. Of the hormones studied, DHEA appears to decrease most rapidly, decreasing at a rate of approximately three percent every year after the age of 30.7,8

            DHEA is a significant steroid. It's considered an androgen, and is the steroid present in highest concentration in the blood.8 Unlike testosterone, which is produced in the testes, DHEA is produced in a pair of glands called the adrenal glands. The adrenals produce a number of hormones, including DHEA, cortisol, aldosterone and epinephrine. Directly or as a precursor, DHEA accounts for 30 to 50 percent of androgens in males; 75 percent in pre-menopausal females; and nearly 100 percent in post-menopausal females.9 Given these figures, it's easy to understand how a rapid decrease in DHEA could affect the metabolism, particularly among the aging. Considering that this age-related deficit can be measured as early as 30, this hormone suddenly becomes a topic of interest to many athletes and bodybuilders.10 Unfortunately, the reputation of DHEA was soiled by the marketing and hype directed at young adults and adolescents during its introduction in the ‘90s.

            As mentioned, many animal studies demonstrated a potent effect in terms of fat loss or protecting against obesity. However, it's inappropriate to extrapolate the findings of animal studies to human use, because lower animals (like rats, mice, etc.) do not secrete DHEA.11 Despite this, DHEA administration initially showed some promise as an anti-obesity agent. There were many reasons supporting this assumption; DHEA affects many pathways involved with energy storage and utilization. In the lab, DHEA affects a long list of systems, including lipogenesis, substrate cycling, peroxisome proliferation, mitochondrial respiration, protein synthesis and thyroid hormone function.12 However, the proof of efficacy remains the realm of the clinical study.

            DHEA has been successful at reducing body fat in some human clinical studies, yet had no effect in others.13 The reasons for the inconsistency among studies seems to have more to do with differences in study design as much as any scientific invalidity. DHEA has been studied at various doses, for various durations and in various groups (obese, lean, elderly, young, male, female). Without a uniform study design, it's impossible to compare the effects of DHEA across studies. Further, it appears certain groups may be more sensitive to DHEA, while others are resistant or require a higher dose. This may explain why many studies concluded DHEA is ineffective in young adults and the lean.

 

            New Study, New Interest

One recent study examined the effects of DHEA on abdominal fat and insulin action in elderly women and men.14 Though this study evaluated the effect of DHEA on subjects 65 to 78 years of age with an age-related decline in DHEA, it still holds value for bodybuilders in that it confirms several effects of DHEA that support fat loss.

            This study was performed at Washington University in St. Louis, a well- respected academic center. Using a randomized, double blind, placebo controlled design, the investigators recruited subjects and assigned them to one of two groups. The control group received a placebo, whereas the test group received 50 milligrams of DHEA at night for six months. Magnetic resonance imaging (MRI) was used to measure body fat stores, both visceral (around organs) and subcutaneous (under the skin). Additionally, blood was drawn and measured for several key hormones prior to, during and at the end of the study. The hormones measured included DHEA-S, testosterone, estradiol, sex-hormone binding globulin, IGF-1, IGF binding protein 3, prostate specific antigen (PSA) and an oral glucose tolerance test.

            MRI scans demonstrated a clear and significant loss of both visceral and subcutaneous body fat. Females showed a more vigorous response, losing over 10 percent of visceral fat, compared to slightly more than seven percent in men; both group lost approximately six percent from subcutaneous fat stores. This loss in fat occurred with no changes in diet or exercise.

            The mechanism for this fat loss may be explained in part by examining the effects of DHEA on the hormones examined. Not surprisingly, some of the effects were gender-specific, meaning effects seen in women were different from those seen in men. Both men and women exhibited significantly elevated DHEA concentration in the blood, as well as IGF-1 and estradiol. With DHEA supplementation, women experienced a rise in serum testosterone, but no change in testosterone concentration was noted in male subjects. DHEA supplementation had no effect on sex hormone binding globulin or IGF binding protein 3. These findings would be expected, as DHEA is the primary precursor for testosterone in post-menopausal women, whereas men form testosterone independent of peripheral blood levels in the testes. Further, estradiol is a known metabolite of DHEA in men and women, accounting for the increase seen in both sexes.

            PSA is a protein formed in the prostate, an organ found only in men. DHEA supplementation, at a dose of 50 milligrams per day, did not affect PSA levels. In fact, the DHEA group actually displayed a slight decrease in PSA, while the control group receiving the placebo had a slight rise in PSA. This suggests DHEA does not induce prostatic hypertrophy at the dose used in the study in the short term.

Insulin is a key hormone in substrate utilization and fat storage. Insulin levels rise when glucose (sugar) levels rise, such as after a meal. Compared to lean subjects who are very sensitive to insulin, obese individuals often have a relative resistance to insulin.15 This resistance causes the obese to release higher concentrations of insulin to control blood sugar levels. A higher insulin concentration promotes fat storage and may negatively affect cardiovascular health and other conditions. DHEA supplementation improved the insulin sensitivity of the test subjects, allowing the subjects to better manage blood sugar and lower insulin concentrations.14

 

What the Results Mean to Bodybuilders

            Reviewing the results and the data from previous studies, the researchers concluded that the study confirmed the effectiveness of DHEA in improving insulin sensitivity and reducing body fat in the elderly (65 to 78 years of age). Though this group has little relevance to a bodybuilder, the study further explained potential mechanisms of action for DHEA that would apply to bodybuilders nearing mid-life. Many bodybuilders continue to pursue the sport as a lifestyle well past their teens and twenties. Though some may quit competition, a fit and muscular body remains the goal in their thirties, forties, fifties and beyond. Considering that the drop in DHEA may be experienced by the age of 30, this makes DHEA a topic of interest to this subgroup of athletes.

            DHEA affects several hormones. As a precursor, it can be metabolized into testosterone or estradiol.16 For women, supplementation with DHEA has greater impact, increasing both hormones. Increasing testosterone supports lean body mass. Increasing estradiol increases bone mass and may reduce abdominal fat in post-menopausal women.17 Yet, in men the increase in estrogen may be a negative. Many bodybuilders used extremely high doses of DHEA in the ‘90s, as much as 2,000 milligrams per day. At this level, estrogenic side effects were experienced, including gynecomastia.18

            It's likely that for a younger user of DHEA, little benefit would be received at levels that did not lead to an accumulation of estradiol. For those in their thirties and forties who may be tempted to use higher doses than that used in the above study (50 milligrams per day), close monitoring of estrogen excess should be initiated. It would be interesting to see what impact an aromatase inhibitor (e.g., Arimidex) has on the fat reduction effect of DHEA in males. It is possible that the addition of an aromatase inhibitor, along with DHEA, may augment the fat reducing effect.

            DHEA is associated with an increase in IGF-1, an anabolic hormone. It's possible the increase in IGF-1 supports lean mass and accounts for a small degree of the fat loss.

            A more interesting point was made in the comments of the study. DHEA is a PPAR-A agonist, similar to OEA, a fatty acid amide.19 PPAR-A activation stimulates the expression of certain enzymes in mitochondria involved with burning fats for calories.20 At the same time, PPAR-A suppresses other enzymes that are involved in forming new fat for storage.21 It's possible DHEA's greatest impact on body fat stores may take place due to its role in activating PPAR-A receptors.

            DHEA, an outdated promise that did not seem to deliver a decade ago, may have a place in today's fat loss programs. Originally, DHEA was inappropriately advertised as a prohormone that would boost testosterone levels in young men to anabolic levels. This was not the case and many experienced estrogenic side effects. However, for athletes in mid-life or beyond, DHEA may have a place in controlling body fat. Given that DHEA has also been shown to alleviate the symptoms of mid-life onset depression, there are many reasons to support DHEA use in adults over 35.22

            The fat-reducing effect of DHEA is particularly prominent in current times, now that the most effective fat loss products are no longer available (ephedrine, phenylpropanolamine, tiratricol). The role of DHEA as an androgen or hormone precursor is central to its importance in normal metabolism, but for fat loss, a separate system may be involved. PPAR-A is a receptor that's involved with several energy balance systems. When PPAR-A receptors are activated, fat burning is stimulated and fat storage is inhibited. It is unlikely that DHEA is potent enough in any single pathway to affect fat loss, but the net result of all the myriad effects of the hormone seemingly provide a significant reduction in body fat in individuals who are chronologically past their prime, but still interested in maximizing performance, appearance and quality of life.

            To experience a more powerful fat loss effect, ancillary products may be necessary. DHEA supplementation will increase estradiol levels, so those who are sensitive to easily aromatized drugs or supplements will need to monitor possible side effects. DHEA is most commonly marketed in combination products and is available in a modified form which does not convert to sex hormones (testosterone or estradiol) called 7-keto DHEA.23

            DHEA was a product that had seen its day, but with the recent restrictions and legislation, many of the more potent alternatives no longer exist. As the fitness and bodybuilding population ages, it's entirely possible that this hormone may offer benefits that would not be seen in a younger group.

 

References 

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