DHEA reverses increases bone mass in women.

Fifty-five men and 58 women (aged 65-75 years) were randomly assigned to receive, in double-blind fashion, 50 mg per day of dehydroepiandrosterone (DHEA) or placebo for one year. Thereafter, all participants received 50 mg per day of DHEA for an additional year. All participants received daily 640 IU of vitamin D and 700 mg of calcium. In women, mean lumbar spine bone mineral density (BMD) increased by 1.9% (p = 0.0003 compared with baseline) during the first year in the DHEA group and increased by 0.8% in the placebo group (p = 0.03 for the difference in the change between groups). After two years, mean spine BMD increased by a total of 3.6% in the DHEA group. Hip BMD did not change. In men, there were no differences in BMD between DHEA and placebo.

Comment: DHEA is an androgen produced in women primarily by the adrenal glands and to a lesser extent by the ovaries. It is metabolized in part to estrogen and testosterone. In addition, DHEA appears to have physiological actions that are unrelated to its function as a precursor hormone, including stimulation of osteoblasts. The results of the present study indicate that DHEA can increase bone mass in elderly women, although it was not effective in men.

Weiss EP et al. Dehydroepiandrosterone replacement therapy in older adults: 1- and 2-y effects on bone. Am J Clin Nutr. 2009;89:1459-1467.

by Alan R. Gaby, MD

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