Evidence supporting the use of: DHEA (dehydroepiandrosterone)
For the health condition: Testosterone (low)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

DHEA (dehydroepiandrosterone) is an endogenous steroid hormone produced mainly by the adrenal glands, and it serves as a precursor to both androgens (including testosterone) and estrogens. The rationale for using DHEA to support or treat low testosterone is based on its role as a biochemical precursor in the steroidogenesis pathway: supplemental DHEA can be converted into testosterone in peripheral tissues. This has led to its use, particularly in aging men and women with low DHEA or testosterone levels. Several small clinical studies have investigated DHEA supplementation's effect on serum testosterone. In older men, the effect is generally modest, with some studies showing slight increases in testosterone levels, while others find little to no effect. The increases are more consistent and significant in women and individuals with adrenal insufficiency. Meta-analyses and systematic reviews conclude that while DHEA may slightly raise testosterone levels, especially in women, the clinical significance of these changes is unclear, and improvements in symptoms of hypogonadism (such as libido, mood, or muscle mass) are inconsistent or unproven. DHEA is sometimes used off-label in men with low testosterone, but major guidelines (such as those from the Endocrine Society) do not recommend it as a primary treatment for hypogonadism, citing insufficient evidence of benefit and potential safety concerns. In summary, while there is a scientific rationale and some supporting evidence, its efficacy is limited, and it is not a first-line treatment.

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