DHEA improves bone density

Townsend Letter for Doctors and Patients, Feb-March, 2007 by Alan R. Gaby

Seventy women and 70 men (aged 60-88 years) with low serum DHEA-sulfate levels were randomly assigned to receive, in double-blind fashion, 50 mg/day of DHEA or placebo for one year. Compared with the change in the placebo group, the mean bone mineral density (BMD) increased in the group as a whole in the total hip (1.0%; p = 0.05), trochanter (1.2%; p = 0.06), and femoral shaft (1.2%; p = 0.05). Compared with placebo, the mean BMD of the lumbar spine increased significantly in women receiving DHEA (2.2%; p = 0.04) but not in men receiving DHEA. Most of these differences were due to the combination of a decrease in BMD in the placebo group and an increase in the DHEA group.

Comment: DHEA is a steroid hormone produced in the adrenal glands, ovaries, and testes. It is metabolized in part to estrogen and testosterone, both of which can help prevent bone loss. In addition, DHEA may have a separate bone-preserving effect that is unrelated to its conversion to other hormones. The results of the present study indicate that administration of DHEA to elderly individuals with low DHEAS levels improved hip BMD in men and women and lumbar BMD in women. Consequently, correcting DHEA deficiency might help prevent osteoporotic fractures.

Interestingly, a study just published in the New England Journal of Medicine concluded that DHEA has no "physiologically relevant beneficial effects on body composition, physical performance, insulin sensitivity, or quality of life." That study is the subject of my editorial on page 124 of this issue of the Townsend Letter.

Jankowski CM, et al. Effects of dehydroepiandrosterone replacement therapy on bone mineral density in older adults: A randomized, controlled trial. J Clin Endocrinol Metab. 2006;91:2986-2993.