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Ask the Experts about Lipodystrophy and Wasting

 

DHEA
May 31, 2002

I have read in more than one publication that DHEA (supplement form) bolsters the immune system, and has actually been shown to attack HIV. "HEALING HIV" by Dr. Kaiser has an entire chapter dedicated to support this theory.

So.... Of course I ran to GNC and bought a couple of bottles. (Now taking 25mg x 2 a day)

Is this safe? Is there any evidence to back up the claims of Dr. Kaiser & others?

Response from Ms. Fields-Gardner

DHEA (dehydroepiandrosterone) is a precursor of androgens and estrogen that has been used primarily to treat fatigue and improve mood. There have been suggestions that DHEA may be low in persons who are HIV-infected. Thus, it made sense to many to attempt replacement therapy and one study suggested improvement in fatigue and mood in that case.

There is no proven effect on CD4 count or testosterone levels, a finding suggested by an open-label trial that was reported in 1993. This trial used 750-2250 mg/day in divided doses. Most studies in immune enhancement have been completed in elderly populations. Studies suggesting any trend toward improvement in CD4 count did not show significant effects. One report suggests an ability of DHEA to influence testosterone levels if DHEA is used in excess (not just physiologic replacement doses).

There have also been claims for an improvement in body composition and many patients and clinicians swear by it. A double-blind, placebo-controlled, crossover study using 1600 mg/day did not bear that out.

And, as with any therapy, there are some potential downsides. For instance, DHEA is associated with possible insulin resistance and decreased hepatic function. A very small study of 6 obese men did not suggest additional insulin resistance, but that may be the wrong group from which to draw conclusions in this case.

The dose you are taking may or may not produce results... either way, let your doctor know if you decide to continue taking DHEA so that it can be monitored along with the rest of your health indices.

So, in conclusion, there doesn't seem to be conclusive evidence. The theory is interesting, but it will be more interesting if the theory plays out in research. Till then, it is a guess you are taking and in the risk vs. benefit decision you make, there are many factors to consider.



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