Long-term DHEA replacement in primary adrenal insufficiency: a randomized, controlled trial

Gurnell EM, Hunt PJ, Curran SE, Conway CL, Pullenayegum EM, Huppert FA, et al.

Published in J Clin Endocrinol Metab, Vol. 93 (2), pp. 400-9

Methodology

Double-blind randomised trial in 106 adults with Addison's disease (44 men, 62 women): 50 mg micronized DHEA or placebo daily for 12 months, measuring bone density, body composition, cognition, well-being and fatigue.

Key Findings

DHEAS and androstenedione rose in both sexes; testosterone reached low-normal levels only in women. DHEA reversed ongoing bone loss at the femoral neck (P < 0.05) but not elsewhere, and increased total body (P = 0.02) and truncal (P = 0.017) lean mass. One SF-36 subscale of well-being improved (P = 0.004); fatigue, cognition and sexual function did not.

Conclusions

The authors concluded the results support some beneficial effects of long-term DHEA in Addison's disease, and called for longer studies with dose adjustment.

Limitations

Most well-being measures did not change; some older women reached above-normal DHEAS levels and had mild androgenic side effects, suggesting 50 mg can be too much for them.