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Dehydroepiandrosterone Supplementation in Healthy Men with an Age-Related Decline of Dehydroepiandrosterone Secretion

Department of Medicine, University Hospital Wurzburg (W.A., F.C., I.K., J.C.V., M.F., M.R., B.A.), 97080 Wurzburg; Department of Medicine, University Hospital Innenstadt (C.J.S.), 80336 Munich; Department of Internal Medicine I, University of Heidelberg (M.J.S.), 69115 Heidelberg; Jenapharm GmbH & Co. KG (D.H., M.E., M.O.), 07745 Jena; Institute for Hormone and Fertility Research (H.M.S.), 22767 Hamburg, Germany

Address all correspondence and requests for reprints to: Dr. Wiebke Arlt, Department of Medicine, Endocrine and Diabetes Unit, University of Wurzburg, Josef Schneider Strasse 2, 97080 Wurzburg, Germany. E-mail: w.arlt{at}medizin.uni-wuerzburg.de

Abstract

Serum dehydroepiandrosterone declines with age. Whether this represents a harmful deficiency or an age-related adaptation is not known. Dehydroepiandrosterone replacement in adrenal insufficiency, a state of pathological loss of dehydroepiandrosterone production, improves well-being, mood, and sexuality. To determine the effects of dehydroepiandrosterone in healthy men with a physiological, age-related decline in serum dehydroepiandrosterone sulfate, we conducted a double blind cross-over study in 22 healthy male volunteers (age range, 50–69 yr) with endogenous dehydroepiandrosterone sulfate levels below 4.1 µmol/liter (1500 ng/ml) receiving 4 months of dehydroepiandrosterone (50 mg/d) and 4 months of placebo treatment in random order, with a 1-month washout period. Dehydroepiandrosterone treatment increased serum dehydroepiandrosterone and dehydroepiandrosterone sulfate to concentrations usually found in young men. Circulating androgen levels did not change; however, androgen metabolites increased, indicating enhanced peripheral androgen synthesis. At baseline, psychometric assessment revealed normal well-being and sexuality scores. After 4 months of dehydroepiandrosterone, no effect on sexuality was observed, whereas some mood scores improved slightly, but were not significantly different from scores after placebo. Compared with placebo, dehydroepiandrosterone had no effect on serum lipids, bone markers, body composition, or exercise capacity. Thus, in contrast to previous findings in adrenal insufficiency, we found no obvious benefit of 4 months of dehydroepiandrosterone supplementation in healthy men with a physiological decline of dehydroepiandrosterone production.

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