Replacement causes no significant improvements in overall physical performance, study shows


Neither dehydroepiandrosterone (DHEA) nor testosterone supplements confer any health benefits, according to a study.

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K. Sreekumaran Nair, MD, PhD, of the Mayo Clinic in Rochester, Minn., and his colleagues studied 87 men aged 62-72 years with low DHEA and testosterone levels and 57 women aged 65-71 years with low DHEA levels. The researchers randomized 29 men to receive DHEA 75 mg/day, 22 to receive testosterone 5 mg day via a skin patch, and 31 men to receive placebo. They randomized 27 women to receive DHEA 50 mg a day and 30 to receive placebo.


At the end of the two-year trial, the supplements had raised the subjects’ levels of DHEA to values that would be considered in the high-normal range for young people, and significantly increased the levels of testosterone in men, according to a report in the New England Journal of Medicine (2006;355:1647-1659). But there were no detectable beneficial effects in any of the treatment groups regarding physical performance, insulin sensitivity, or the physical and mental components of quality of life.


Testosterone replacement increased fat-free mass but caused no significant improvement in muscle strength. DHEA had no effect on fat-free mass in either men or women. “The lack of a significant effect on thigh muscle area, strength, or fitness largely discounts the relevance of the change in fat-free mass,” the investigators said. They also pointed out that testosterone supplements may be linked to prostate cancer.


Women in the DHEA group had a small but significant increase in bone mineral density (BMD) of the ultradistal radius, and men in the femoral neck. But there were no increases at other sites. Since other pharmacologic agents result in a far greater increase in BMD, the value of DHEA for this purpose “is probably limited,” the researchers concluded.


In an editorial, Paul M. Stewart, MD, of the University of Birmingham in England, said, “The search for youth continues, but the reversal of age-related decreases in the secretion of DHEA and testosterone through physiologic replacement regimens is no answer.”