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DHEA in Men: Clinical Overview, Benefits, and Usage Guide



1. What Is DHEA?

  • Dehydroepiandrosterone (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



2. 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



3. 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



4. Causes of Low DHEA

  • Aging
  • Chronic stress or adrenal fatigue
  • Use of corticosteroids
  • Pituitary or adrenal insufficiency
  • Chronic illness or inflammation



5. Symptoms of Low DHEA in Men

  • Fatigue, low stamina
  • Mood swings, anxiety, or depression
  • Decreased libido
  • Loss of muscle tone
  • Poor stress tolerance



6. 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



7. 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



8. 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



9. 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)



10. 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



11. 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



12. 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.

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