Jefferson Physician Warns Further Study Of DHEA's Safety Needed

September 10, 1998

An endocrinologist at Jefferson Medical College cautions that a natural hormone and popular food supplement believed by many to have anti-aging properties may actually increase men's risk of prostate cancer. Marshall Goldberg, M.D., professor of medicine and psychiatry at Jefferson Medical College of Thomas Jefferson University in Philadelphia, says that dehydroepiandrosterone (DHEA) may stimulate the production of other hormones in the body, resulting in increased levels of insulin-like growth factor-1 (IGF-1). IGF-1 can cause abnormal growth of prostate cells.

DHEA is a popular item sold in health food stores for its purported protective properties against such age-related diseases as cancer, heart disease, Alzheimer's disease and diabetes. Blood levels of DHEA, the most abundant hormone in the body, rise after puberty, peak between the ages 25-30, then decline throughout the rest of life by as much as 80 percent from its peak.

Earlier this year, researchers reported in Science, a four- to seven-fold increase in the risk of developing prostate cancer, particularly those over 60, whose blood levels of IGF-1 were higher than normal. And Dr. Goldberg reports supplements of DHEA, even as small as 25 milligrams a day, significantly raise IGF-1 levels.

Writing in the August issue of the journal Emergency Medicine, Dr. Goldberg suggests that if the link among high blood levels of DHEA, IGF-1, and the risk of prostate cancer can be confirmed, "regulation of DHEA makes sense.

"This is a real risk factor for prostate cancer," he says. He worries that the unregulated and medically-unsupervised use of this hormone may eventually prove dangerous to some people, while its beneficial effects are at best unproved. Many people over 50 take DHEA, thinking that a little won't hurt, and it could possibly help to improve their sense of well-being. He estimates that more than 1 million people in this country are currently taking DHEA supplements.

Dr. Goldberg also worries about potential hormone abuse among adolescents, particularly in light of St. Louis Cardinal slugger Mark McGwire's recent admission of using androstenedione, a steroid hormone related to DHEA, to bolster his hitting power. The recent controversy over this steroid's properties, and its possible connection to McGwire's success, may move some teenagers from contemplating to actually taking such over-the-counter drugs in the unproved belief that it will enhance their strength.

DHEA can produce unpleasant side-effects in women as well. A 1994 study showed that blood testosterone measurements rose in most females given DHEA, and in some cases, doubled their male hormone levels. This, in turn, can result in acne, unsightly facial hair, irregular menstruation and loss of scalp hair. Dr. Goldberg strongly recommends that men taking DHEA supplements have their serum DHEA, PSA (prostate-specific antigen, a marker in the blood indicating the possible presence of prostate cancer) and IGF-1 levels checked periodically. Women taking DHEA should have their testosterone levels monitored.

"Whether or not DHEA proves to slow the aging process, as it may well do," he writes, "it is not without its potential dangers." Much more needs to be learned about the actions, applications and misapplications of this powerful and all too easily available hormone.Dr. Goldberg also cautions that like any drug, there may be drug-drug interactions. He is, however, encouraged that much more research is being done on DHEA. "Now, the National Institutes of Health are conducting studies on it," he reports in his article.

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Thomas Jefferson University

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