help button home button Endocrine Society JCEM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a related Letter to the Editor
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hunt, P. J.
Right arrow Articles by Chatterjee, V. K. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hunt, P. J.
Right arrow Articles by Chatterjee, V. K. K.
The Journal of Clinical Endocrinology & Metabolism Vol. 85, No. 12 4650-4656
Copyright © 2000 by The Endocrine Society

Original Studies

Improvement in Mood and Fatigue after Dehydroepiandrosterone Replacement in Addison’s Disease in a Randomized, Double Blind Trial

Penelope J. Hunt1,2, Eleanor M. Gurnell1,3, Felicia A. Huppert, Christine Richards, A. Toby Prevost, John A. H. Wass, Joseph Herbert and V. Krishna K. Chatterjee4

Department of Endocrinology, University of Oxford, Radcliffe Infirmary (P.J.H., J.A.H.W.), Oxford, United Kingdom OX2 7JS; and Departments of Medicine (E.M.G., C.R., V.K.K.C.), Psychiatry (F.A.H.), Community Medicine (A.T.P.), and Anatomy (J.H.), University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom CB2 2QQ

Address all correspondence and requests for reprints to: Prof. Krishna Chatterjee, Department of Medicine, Level 5, Addenbrooke’s Hospital, Hills Road, Cambridge, United Kingdom CB2 2QQ. E-mail: kkc1{at}mole.bio.cam.ac.uk

Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are adrenal precursors of steroid biosynthesis and centrally acting neurosteroids. Glucocorticoid and mineralocorticoid deficiencies in Addison’s disease require life-long hormone replacement, but the associated failure of DHEA synthesis is not corrected. We conducted a randomized, double blind study in which 39 patients with Addison’s disease received either 50 mg oral DHEA daily for 12 weeks, followed by a 4-week washout period, then 12 weeks of placebo, or vice versa. After DHEA treatment, levels of DHEAS and {Delta}4-androstenedione rose from subnormal to within the adult physiological range. Total testosterone increased from subnormal to low normal with a fall in serum sex hormone-binding globulin in females, but with no change in either parameter in males. In both sexes, psychological assessment showed significant enhancement of self-esteem with a tendency for improved overall well-being. Mood and fatigue also improved significantly, with benefit being evident in the evenings. No effects on cognitive or sexual function, body composition, lipids, or bone mineral density were observed. Our results indicate that DHEA replacement corrects this steroid deficiency effectively and improves some aspects of psychological function. Beneficial effects in males, independent of circulating testosterone levels, suggest that it may act directly on the central nervous system rather than by augmenting peripheral androgen biosynthesis. These positive effects, in the absence of significant adverse events, suggest a role for DHEA replacement therapy in the treatment of Addison’s disease.




This article has been cited by other articles:


Home page
 Arch Intern MedHome page
K. Dhatariya
Dehydroepiandrosterone Sulfate Has Not Been Substantiated as an Anabolic Hormone
Arch Intern Med, July 14, 2008; 168(13): 1470 - 1470.
[Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
Z Hochberg
Juvenility in the context of life history theory
Arch. Dis. Child., June 1, 2008; 93(6): 534 - 539.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
E. M. Gurnell, P. J. Hunt, S. E. Curran, C. L. Conway, E. M. Pullenayegum, F. A. Huppert, J. E. Compston, J. Herbert, and V. K. K. Chatterjee
Long-Term DHEA Replacement in Primary Adrenal Insufficiency: A Randomized, Controlled Trial
J. Clin. Endocrinol. Metab., February 1, 2008; 93(2): 400 - 409.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
S. Hahner, M. Loeffler, M. Fassnacht, D. Weismann, A.-C. Koschker, M. Quinkler, O. Decker, W. Arlt, and B. Allolio
Impaired Subjective Health Status in 256 Patients with Adrenal Insufficiency on Standard Therapy Based on Cross-Sectional Analysis
J. Clin. Endocrinol. Metab., October 1, 2007; 92(10): 3912 - 3922.
[Abstract] [Full Text] [PDF]

Home page
 Eur J EndocrinolHome page
K. Lovas and E. S Husebye
Continuous subcutaneous hydrocortisone infusion in Addison's disease
Eur. J. Endocrinol., July 1, 2007; 157(1): 109 - 112.
[Abstract] [Full Text] [PDF]

Home page
 Hum Reprod UpdateHome page
M. Panjari and S. R. Davis
DHEA therapy for women: effect on sexual function and wellbeing
Hum. Reprod. Update, May 1, 2007; 13(3): 239 - 248.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
R. Bergthorsdottir, M. Leonsson-Zachrisson, A. Oden, and G. Johannsson
Premature Mortality in Patients with Addison's Disease: A Population-Based Study
J. Clin. Endocrinol. Metab., December 1, 2006; 91(12): 4849 - 4853.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
A. M. Brooke, L. A. Kalingag, F. Miraki-Moud, C. Camacho-Hubner, K. T. Maher, D. M. Walker, J. P. Hinson, and J. P. Monson
Dehydroepiandrosterone Improves Psychological Well-Being in Male and Female Hypopituitary Patients on Maintenance Growth Hormone Replacement
J. Clin. Endocrinol. Metab., October 1, 2006; 91(10): 3773 - 3779.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
M. E. Wierman, R. Basson, S. R. Davis, S. Khosla, K. K. Miller, W. Rosner, and N. Santoro
Androgen Therapy in Women: An Endocrine Society Clinical Practice Guideline
J. Clin. Endocrinol. Metab., October 1, 2006; 91(10): 3697 - 3710.
[Abstract] [Full Text] [PDF]

Home page
 Mult SclerHome page
N. Tellez, M. Comabella, E v. Julia, J. Rio, M a. Tintore, L. Brieva, C. Nos, and X. Montalban
Fatigue in progressive multiple sclerosis is associated with low levels of dehydroepiandrosterone
Multiple Sclerosis, August 1, 2006; 12(4): 487 - 494.
[Abstract] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
K. K. Miller, B. M. K. Biller, C. Beauregard, J. G. Lipman, J. Jones, D. Schoenfeld, J. C. Sherman, B. Swearingen, J. Loeffler, and A. Klibanski
Effects of Testosterone Replacement in Androgen-Deficient Women with Hypopituitarism: A Randomized, Double-Blind, Placebo-Controlled Study
J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1683 - 1690.
[Abstract] [Full Text] [PDF]

Home page
 Eur J EndocrinolHome page
W. Arlt
Androgen therapy in women
Eur. J. Endocrinol., January 1, 2006; 154(1): 1 - 11.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. PsychiatryHome page
J. G. Rabkin, M. C. McElhiney, R. Rabkin, P. J. McGrath, and S. J. Ferrando
Placebo-Controlled Trial of Dehydroepiandrosterone (DHEA) for Treatment of Nonmajor Depression in Patients With HIV/AIDS
Am J Psychiatry, January 1, 2006; 163(1): 59 - 66.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
Dehydroepiandrosterone (DHEA)
Obstet. Gynecol., November 1, 2005; 106(5): 1096 - 1097.
[Full Text] [PDF]

Home page
 Endocr. Rev.Home page
J. M. Kaufman and A. Vermeulen
The Decline of Androgen Levels in Elderly Men and Its Clinical and Therapeutic Implications
Endocr. Rev., October 1, 2005; 26(6): 833 - 876.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
A. Shafqat, L. H. Einhorn, N. Hanna, G. W. Sledge, A. Hanna, B. E. Juliar, P. Monahan, and S. Bhatia
Screening studies for fatigue and laboratory correlates in cancer patients undergoing treatment{dagger}
Ann. Onc., September 1, 2005; 16(9): 1545 - 1550.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
S. W. van Thiel, J. A. Romijn, A. M. Pereira, N. R. Biermasz, F. Roelfsema, A. van Hemert, B. Ballieux, and J. W. A. Smit
Effects of Dehydroepiandrostenedione, Superimposed on Growth Hormone Substitution, on Quality of Life and Insulin-Like Growth Factor I in Patients with Secondary Adrenal Insufficiency: A Randomized, Placebo-Controlled, Cross-Over Trial
J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3295 - 3303.
[Abstract] [Full Text] [PDF]

Home page
 Am J Health Syst PharmHome page
S. A. Boone and K. M. Shields
Dietary supplements for female sexual dysfunction
Am. J. Health Syst. Pharm., March 15, 2005; 62(6): 574 - 580.
[Full Text] [PDF]

Home page
 DiabetesHome page
K. Dhatariya, M. L. Bigelow, and K. S. Nair
Effect of Dehydroepiandrosterone Replacement on Insulin Sensitivity and Lipids in Hypoadrenal Women
Diabetes, March 1, 2005; 54(3): 765 - 769.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
D. J. Handelsman
Andro and the Prosteroids: Bolting the Stable Door
J. Clin. Endocrinol. Metab., February 1, 2005; 90(2): 1249 - 1251.
[Full Text] [PDF]

Home page
 Arch Gen PsychiatryHome page
P. J. Schmidt, R. C. Daly, M. Bloch, M. J. Smith, M. A. Danaceau, L. Simpson St. Clair, J. H. Murphy, N. Haq, and D. R. Rubinow
Dehydroepiandrosterone Monotherapy in Midlife-Onset Major and Minor Depression
Arch Gen Psychiatry, February 1, 2005; 62(2): 154 - 162.
[Abstract] [Full Text] [PDF]

Home page
 Eur J EndocrinolHome page
J. J. Christiansen, C. H. Gravholt, S. Fisker, N. Moller, M. Andersen, B. Svenstrup, P. Bennett, P. Ivarsen, J. S. Christiansen, and J. O. L. Jorgensen
Very short term dehydroepiandrosterone treatment in female adrenal failure: impact on carbohydrate, lipid and protein metabolism
Eur. J. Endocrinol., January 1, 2005; 152(1): 77 - 85.
[Abstract] [Full Text] [PDF]

Home page
 J. Gerontol. A Biol. Sci. Med. Sci.Home page
G. Valenti, L. Denti, M. Maggio, G. Ceda, S. Volpato, S. Bandinelli, G. Ceresini, A. Cappola, J. M. Guralnik, and L. Ferrucci
Effect of DHEAS on Skeletal Muscle Over the Life Span: The InCHIANTI Study
J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2004; 59(5): M466 - M472.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
P. W. Speiser and P. C. White
Congenital Adrenal Hyperplasia
N. Engl. J. Med., August 21, 2003; 349(8): 776 - 788.
[Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
W. Arlt and B. Allolio
DHEA Replacement in Adrenal Insufficiency
J. Clin. Endocrinol. Metab., August 1, 2003; 88(8): 4001 - 4001.
[Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
K. Lovas, O. Kampe, and E. S. Husebye
Authors' Response: DHEA Replacement in Adrenal Insufficiency
J. Clin. Endocrinol. Metab., August 1, 2003; 88(8): 4001 - 4002.
[Full Text]

Home page
 QJMHome page
R. Baschetti
Assessing chronic fatigue
QJM, June 1, 2003; 96(6): 454 - 454.
[Full Text] [PDF]

Home page
 Endocr. Rev.Home page
F. Labrie, V. Luu-The, C. Labrie, A. Belanger, J. Simard, S.-X. Lin, and G. Pelletier
Endocrine and Intracrine Sources of Androgens in Women: Inhibition of Breast Cancer and Other Roles of Androgens and Their Precursor Dehydroepiandrosterone
Endocr. Rev., April 1, 2003; 24(2): 152 - 182.
[Abstract] [Full Text] [PDF]

Home page
 Endocr. Rev.Home page
F. C. W. Wu and A. von Eckardstein
Androgens and Coronary Artery Disease
Endocr. Rev., April 1, 2003; 24(2): 183 - 217.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
R. Baschetti
Organic vs Cultural Explanations of Chronic Fatigue Syndrome and Fibromyalgia
JAMA, March 19, 2003; 289(11): 1385 - 1385.
[Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
K. Lovas, G. Gebre-Medhin, T. S. Trovik, K. J. Fougner, S. Uhlving, B. G. Nedrebo, O. L. Myking, O. Kampe, and E. S. Husebye
Replacement of Dehydroepiandrosterone in Adrenal Failure: No Benefit for Subjective Health Status and Sexuality in a 9-Month, Randomized, Parallel Group Clinical Trial
J. Clin. Endocrinol. Metab., March 1, 2003; 88(3): 1112 - 1118.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
R Baschetti
Phantom lymphadenopathy. An association with chronic fatigue syndrome
Postgrad. Med. J., March 1, 2003; 79(929): 185 - 185.
[Full Text]

Home page
 NEJMHome page
M. S. Cooper and P. M. Stewart
Corticosteroid Insufficiency in Acutely Ill Patients
N. Engl. J. Med., February 20, 2003; 348(8): 727 - 734.
[Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
C. M. Gordon, E. Grace, S. J. Emans, H. A. Feldman, E. Goodman, K. A. Becker, C. J. Rosen, C. M. Gundberg, and M. S. LeBoff
Effects of Oral Dehydroepiandrosterone on Bone Density in Young Women with Anorexia Nervosa: A Randomized Trial
J. Clin. Endocrinol. Metab., November 1, 2002; 87(11): 4935 - 4941.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
G. Johannsson, P. Burman, L. Wiren, B. E. Engstrom, A. G. Nilsson, M. Ottosson, B. Jonsson, B.-A. Bengtsson, and F. A. Karlsson
Low Dose Dehydroepiandrosterone Affects Behavior in Hypopituitary Androgen-Deficient Women: A Placebo-Controlled Trial
J. Clin. Endocrinol. Metab., May 1, 2002; 87(5): 2046 - 2052.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
W. Arlt, F. Callies, I. Koehler, J. C. van Vlijmen, M. Fassnacht, C. J. Strasburger, M. J. Seibel, D. Huebler, M. Ernst, M. Oettel, et al.
Dehydroepiandrosterone Supplementation in Healthy Men with an Age-Related Decline of Dehydroepiandrosterone Secretion
J. Clin. Endocrinol. Metab., October 1, 2001; 86(10): 4686 - 4692.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
A. Vermeulen
Androgen Replacement Therapy in the Aging Male--A Critical Evaluation
J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2380 - 2390.
[Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
K. K. Miller
Androgen Deficiency in Women
J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2395 - 2401.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Endocrinology Endocrine Reviews J. Clin. End. & Metab.
Molecular Endocrinology Recent Prog. Horm. Res. All Endocrine Journals
Copyright © 2000 by The Endocrine Society