Eating Disorders and Bone Health

DHEA may help young women with eating disorders fend off bone decline.

Young women who battle eating disorders open the door to a number of associated complications. One of these major complications is bone mass loss, especially as seen in anorexia nervosa.1

Unfortunately, a side effect of this eating disorder is declining estrogen levels and insulin-like growth factor (IGF-1) as well as high cortisol levels, which can all contribute to accelerated bone loss. To counteract these effects, physicians often recommend nutritional rehabilitation, weight gain and hormone replacement therapy as a front-line defense to recover bone mass. However, research shows dehydroepiandosterone (DHEA) can restore the bone matrix as well.1

In fact, doses of DHEA (in 50 mg, 100 mg, 200 mg/d) dramatically decreased markers for bone resorption in 15 anorexic young women-as well significantly increasing markers related to bone formation, in one Harvard study.2

In addition, researchers at the Children's Hospital in Boston compared a one year course of oral DHEA treatment to conventional hormonal replacement therapy (HRT) in young women with anorexia nervosa.3  In this trial, 61 young women were randomly administered 50 mg/d of DHEA or 20 micrograms of the HRT drug ethinylestradio/0.1 mg levonorgestrel. Both therapies significantly decreased bone resorption. And hip bone mass density were positively correlated with increases in insulin growth factor (IGF-1), bone formation markers and bone-specific alkaline phosphatase (bone ALP),3 an enzyme immunoassay that measures active bone formation.4,5

The increase in IGF-1 associated with DHEA intake is also of great importance since IGF-1 plays a critical role in bone metabolism. Based on the current body of knowledge surrounding exercise and the maintenance of bone health , and DHEA's regulatory actions within the bone matrix, researchers suggest restoring and maintaining youthful levels of DHEA heightens this osteotrophic effect, in which bone builds during physical activity.6

While hormone replacement therapy can preserve bone health, mounting evidence shows that DHEA has a more profound effect in increasing bone formation markers, anabolic factors such as IGF-1, as well as balancing hormone activity. Current data also indicates that DHEA has a positive influence on the psychological and emotional status of these women. Thus, DHEA could be a possible an alternative for preserving bone health effectively and safely.


1. Rivera-Gallardo, M.T., Madel Socorro, P.C., Barriguete-Melendez, J.A.  Eating disorders as risk factors for osteoporosis.  Salud Publica de Mexico.  2005 July-August; 47(4): 308-318.

2. Gordon, C. , Grace, E., Emans, S.J. , Goodman, E., Crawford, M. H., Leboff, M.S. Changes in bone turnover markers and menstral function after short - term oral DHEA in young women with anorexia nervosa. Journal of Bone and Mineral Research. 1999; 14:136:145.

3. Gordon, C.M., Grace, E. , Emans, S.J. , Feldman, H.A. , Becker, K.A. et.al. Effects of oral dehydroepiandrosterone on bone density in young women with anorexia nervosa: a randomized trial. Journal of Clinical Endocrinology and metabolism. 2002 Nov; 87(11): 4935-4991.

4. Specialty Laboritories.  Osteoporosis and Metabolic Bone Disease: Osteoporosis COL1A1 GEnotypRTM.  Found online at:  www.specialtylabs.com/education/download_PDF/TN_1026  Accessed on 05/22/09.

5. Vasikaran, S.D., Glendenning, P., Morris, H.A.  The role of biochemical markers of bone turnover in osteoporosis management in clinical practice.  The Clinical Biochemist Reviews.  2006 Aug; 27(3): 119-121.

6. O'Brien, M.  Protection for bones: adolescent exercise offers best long-term protection for bones.  Ireland Journal of Medical Science.  2001 Jan; 170(1): 58-62.

George L. Redmon, PhD, ND, is a leading expert on nutritional supplements, herbal botanicals and holistic health care. He has authored six books on alternative ways to manage arthritis, chronic fatigue, sexual dysfunction, obesity and prostate disturbances.




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