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DHEA is produced
by a range of organs in the body including testicles, ovaries,
and the brain.
Peak production occurs in the mid 20s.
From age 30, there is a steady decline in the DHEA production.
By the age 75, a person typically has one fifth of DHEA circulating
in their body, in comparison to fifty years earlier.
Still, we
have not found the actual mechanism of action of DHEA.
It has not been accepted for FDA or TGA approval and has been
classified as a “dietary supplement”.
It is illegal to import DHEA, and an importing licence for DHEA
is required to supply it.
There are several companies within Australia that have such qualification,
limiting its distribution.
DHEA levels
can be measured in the body, which is used by physicians to determine
doses required. DHEA has the benefits that it can be made into
troches, cream, or capsules due to its physicochemical properties.
Studies in rats and mice have shown that DHEA has been effective
to prevent or delay the onset of cancer, hardening of the arteries,
lethal viral infections, lowered immunity, obesity, and diabetes.
Studies in
humans have shown that males with high DHEA levels were far less
likely to die from heart disease.
Also, taking DHEA supplements have shown to increase lean body
mass, muscle strength, and immune function.
The main, and promoted benefit of taking DHEA is the significant
increase in the sense of “well being”. Yet, its other
uses may prove to be beneficial in the future.
One study currently underway has shown that DHEA may be effective
in the treatment of the autoimmune disease, lupus.
DHEA does
have some serious side effects that can be irreversible.
For females, it can cause growth of body or facial hair, and even
to stop menstruation.
Effects in men include the growth of tiny prostate tumours, or
difficulty in urination.
Other noted side effects include heart rhythm disturbances, acne,
irritability, and aggression.
After thorough
consideration of this information, there must be some doubt in
the use of DHEA at this stage.
Although it has been shown to have some great benefits, there
are some significant side effects as well.
I believe it is vital that great discussion is done with the patient
to ensure they know the possible risks of taking such medication.
This puts pharmacists into a very difficult situation because
we do not want to scare the patient, or insult the doctor by questioning
their choice of medication.
Still, we must allow the patient to make in informed decision
on what they are doing to their body.
Such medication
is obviously not listed on the PBS, and this allows patients to
claim such medication with their private health fund, if they
have selected pharmaceutical cover.
Due to the great increase in the sale of these pharmaceutical
items, there has been an influx of customers returning to the
pharmacy, explaining that they could not claim.
The reasoning was that products such as DHEA are classified as
dietary supplements, and that they are not essential.
This has frustrated customers, and I believe customers have every
right.
It appears that private health insurance companies are suiting
themselves, covering only items that they choose, otherwise it
would cost them too much money.
This appears to be more of an issue as time has passed, and may
result in many people reducing their cover with private health
insurance companies.
Therefore,
such new age medication such as DHEA needs to be looked at from
a range of perspectives.
This includes the benefits versus the risks involved, and the
overall cost of treatment.
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