DHEA (Dehydroepiandrosterone)

  What Is DHEA?

DHEA is an endogenous steroid hormone synthesized primarily by the adrenal glands.

It serves as a precursor to both androgens (testosterone, DHT) and estrogens (estradiol, estrone).

 DHEA circulates in two main forms:

       DHEA-S (sulfated) – stable, storage form

Free DHEA – bioactive form, fluctuates throughout the day

Normal DHEA Levels in Men

  Peak levels occur around age 20–30, then decline ~2% per year.

Reference ranges:

   DHEA-S: ~180–750 µg/dL (lab dependent)

    Low DHEA-S: often <200 µg/dL in men >45

Benefits of DHEA in Men

   Supports testosterone and estrogen balance

   Enhances mood, resilience, and cognition

   Aids in libido and sexual function

   Helps maintain muscle mass and bone density

   Modulates immune function and inflammation

   May support adrenal recovery and HPA axis resilience

    Causes of Low DHEA

  Aging

   Chronic stress or adrenal fatigue

   Use of corticosteroids

   Pituitary or adrenal insufficiency

   Chronic illness or inflammation

 Symptoms of Low DHEA in Men

 Fatigue, low stamina

 Mood swings, anxiety, or depression

 Decreased libido

 Loss of muscle tone

 Poor stress tolerance

   Clinical Use of DHEA

  Form: Oral DHEA (micronized), topical cream (less common)

Starting dose: 10–25 mg daily (morning)

Max typical dose: 50 mg/day in men

 Monitor for side effects: oily skin, acne, hair loss, estrogen elevation

 When to Test DHEA

  Persistent fatigue

  Suspected adrenal insufficiency

  Early signs of andropause

  Mood disorders, poor libido, or cognitive decline

Recommended Labs:

  DHEA-S

  Total and free testosterone

 Estradiol (E2)

  Cortisol (AM and PM)

  SHBG, LH/FSH

    DHEA and Hormonal Balance

  DHEA helps buffer cortisol and supports HPA axis

  Converts into either testosterone or estrogens depending on enzyme activity

  Excess DHEA can lead to elevated estradiol or DHT, especially in insulin-resistant or obese patients

   Safety and Side Effects

   Generally well tolerated at low doses (10–30 mg)

  High doses (>50 mg) may increase risk of:

  Acne, oily skin

   Mood changes or irritability

    Gynecomastia (via aromatization)

 Hair loss (via DHT)

   Alternatives and Adjuncts

Adaptogens: Rhodiola, ashwagandha, licorice (for HPA axis)

   Pregnenolone: upstream steroid with milder hormonal effects

   Vitamin C, B5, zinc, magnesium: support adrenal function

   Lifestyle: resistance training, sleep, blood sugar balance

    Special Populations & Caution

  Avoid in men with hormone-sensitive cancers (prostate)

   Caution in men with high estradiol or DHT

  Not FDA-approved for any condition; use is off-label

 Summary

DHEA plays a vital role in male hormonal and adrenal health. Used appropriately, it may support mood, sexual function, and resilience to stress. It should be dosed conservatively and monitored to avoid unwanted androgenic or estrogenic side effects.