DHEA & Bone Health
By George L. Redmon, PhD, ND
June 7, 2010
The mere action of walking to our cars or to our mailboxes is a mindless and common event-unless we are among the one in four Americans who suffer from bone or joint disorders.1
These debilitating diseases, which most notably include osteoarthritis, take a toll on quality of life, and researchers expect bone and joint disorders will only escalate in the next decade and beyond as more people age.1
However, recent research has centered on a powerful hormone, DHEA (dehydroepiandrosterone), which may help increase bone density and maintain bone health. Current studies explore the possibility of using DHEA in clinical settings to help prevent bone breakdown.
The DHEA Story
DHEA is one of the most abundant hormones found in the human body. Sometimes referred to as the mother hormone, DHEA regulates the body's production of 18 other steroid hormones, including estrogen and testosterone, as well as the stress hormones cortisol and norepinephrine.2 These hormones all play a role in bone resorption and formation.
But like all hormones, DHEA levels tend to decline at an accelerated rate in a person's mid-thirties. In fact, by age 65, blood levels drop to 10 percent to 20 percent of normal levels. By 80, people's blood levels can dive to less than 5 percent compared to those between 25 to 35.3
Studies correlate this decline with reduced bone health-indicating reduced activity levels of DHEA are possible precursors to osteoporosis in aging females. Studies also show that postmenopausal women benefit from DHEA as a bone restoration agent.
Researchers believe that DHEA has regulatory mechanism of actions within the osteoblast, where DHEA is converted to estrogen through a process referred to as the aromatase activity.4 With the help of vitamin D3, these bone cells convert DHEA into estrone, the form of estrogen responsible for accelerating osteoblasts activity, the cells which actually make new bone.5
In fact, DHEA levels positively correlated with increased bone density in women over the age of 50. Thus, the higher a woman's DHEA levels were at menopause, the greater the density of the bones.6 This link was further confirmed by another study at Kyushu University in Japan, where researchers tested the bone mineral density and DHEA levels in 120 post-menopausal women.7
Interestingly, since DHEA is produced in the ovaries, these researchers also administered DHEA to experimental female rats whose ovaries had been removed (pophorectomy). In these cases, supplemental DHEA still increased the rate of bone density in these animal models.7 The results of this study further confirm the importance of administering supplemental DHEA to aging females to prevent bone loss.
Researchers at the department of obstetrics and gynecology at Jiaotong University in Japan also investigated the physiological effects of DHEA on postmenopausal women with osteoporosis. They reported that DHEA improved osteoblast or bone building activity substantially in women with osteoporosis.8 Based on their study results, DHEA inhibited the bone resorption or breakdown of bone by osteoclast at blood concentrations of 0.01 microm. This positive physiological action was even more pronounced in 0.1 microm concentrations.8
In another study appearing in the Townsend Letter for Doctors and Patients, 70 women and 70 men aged 60 to 88 in a double-blind placebo controlled study were randomly administered 50 mg/d of DHEA or a placebo for a year.9 Compared to the placebo group, BMD increased in the DHEA group by 1 percent versus 0.05 percent of the placebo group in the hip. In the femoral shaft, bone mineralization increased by 1.2 percent as compared to 0.06 percent in the placebo group.
Similar increases were also seen in BMD in the lumbar spine region of women. Those in the DHEA group experienced 2.2 percent increases compared to 0.04 percent in the placebo group.9 Although appreciable, the increases occurred at small dosage ranges of only 50 mg.
A mounting body of evidence also suggests that DHEA improves bone repair through another mechanism: by reducing levels of the stress hormone cortisol.10 Elevated cortisol levels upregulate the fight or flight response,11 where the body quickly reroutes energy sources and micronutrients involved with bone-building activities to muscle tissue.12
Researchers found increased DHEA levels at any degree of cortisol excess (as measured with blood tests) minimized the negative aspects of vertebrae fractures by actually minimizing the chances of having one. They concluded that lumbar spine bone mass density is directly related to the cortisol-to-DHEA ratio, actually being the best predictor of impending vertebral fractures.13
Considerable evidence verifies the efficacy of restoring declining DHEA levels in aging women to enhance bone mineral density.14 In fact, based on current data, improvements in bone mineral density in response to DHEA supplementation appears to occur not only as a result of the suppression of bone resorption processes but more importantly stimulation of bone formation.15,16
In practical terms, physicians should consider DHEA as a primary adjunct to current supplementation and osteoporosis prevention programs17 in pre- and postmenopausal women over the age of 35.18,19 This is especially important since studies suggest that DHEA is the only hormone that can stop bone breakdown while simultaneously stimulating bone formation.20
Based on a large body of scientific evidence, I feel comfortable recommending that patients over 35 maintain blood levels of 20-30 nmol/L of DHEA. Most patients generally could benefit from 50 mg to 200 mg a day. Physicians should check DHEA blood levels and adjust daily dose ranges to maintain and monitor blood levels.21
Risks associated with this treatment may include hormone imbalances (more specifically between estrogens and androgens), which can lend to the possibility of increased risk of hormone-driven cancers, including breast, prostate and ovarian cancers. However, no long-term studies confirm this connection.
Hormone imbalances may also affect moods and may cause surges in energy levels. Thus, physicians must closely monitor these levels, especially in larger doses.
Although vitamin D3, calcium, and vitamin k2 have received much attention when discussing bone maintenance, emerging science suggests that DHEA is the missing agent responsible for regulating many of the physiological processes that build and maintain our body's infrastructure. Physicians should routinely discuss and recommend the benefits of DHEA, especially to aging women.
George L. Redmon, PhD, ND, is an expert on nutritional supplements, herbal botanicals and holistic health care. Published in various health and alternative health care publications, he has also authored six books focusing on alternative ways to treat and manage arthritis, chronic fatigue, sexual dysfunction and prostate disturbances. Disclosure: Dr. Redmon indicates that he has no commercial affiliations, directly or indirectly referenced within this article.