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World J Meta-Anal. Apr 18, 2023; 11(4): 102-111
Published online Apr 18, 2023. doi: 10.13105/wjma.v11.i4.102
Dehydroepiandrosterone sulfate supplementation in health and diseases
Parth Jethwani, Ashu Rastogi, Ravindra Shukla
Parth Jethwani, Ravindra Shukla, Department of Endocrinology & Metabolism, All India Institute of Medical Sciences Jodhpur, Jodhpur 342001, Rajasthan, India
Ashu Rastogi, Department of Endocrinology, Postgraduate Institution of Medical education and Research Chandigarh, Chandigarh 160017, Chandigarh, India
Author contributions: Shukla R conceptualized the topic and formulated the search strategy; Jethwani P performed the search, curated the data, and wrote the preliminary draft; Rastogi A critically reviewed the manuscript and added figures and tables; all three authors approved the manuscript.
Conflict-of-interest statement: All the authors declare no conflict of interest pertaining to the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ravindra Shukla, MD, Additional Professor, Department of Endocrinology & Metabolism, All India Institute of Medical Sciences Jodhpur, Room No. 3001, Jodhpur 342001, Rajasthan, India. ravindrashukla2@rediffmail.com
Received: December 28, 2022
Peer-review started: December 28, 2022
First decision: January 30, 2023
Revised: February 9, 2023
Accepted: April 10, 2023
Article in press: April 10, 2023
Published online: April 18, 2023
Processing time: 106 Days and 17.9 Hours
Abstract

Dehydroepiandrosterone sulfate (DHEAS) is a hormone produced by the zona reticularis of the adrenal gland and the ovaries. Initially considered as an inert compound merely serving as an intermediate in the conversion of cholesterol to androgens, interest in DHEA began to grow in the 1960s when it was found that DHEAS is the most abundant steroid hormone in human plasma and that its levels decline with age. In many countries, DHEA is considered a nutritional supplement. It has been used for a multitude of conditions which include sexual dysfunction, infertility, genitourinary syndrome of menopause, musculoskeletal disorders, cardiovascular diseases, ageing, neurological diseases, autoimmune conditions, adrenal insufficiency, and anorexia nervosa. We describe an overview of the historical evolution of DHEA, its physiology, and the disease states where it has been evaluated as a supplement.

Keywords: Dehydroepiandrosterone; Adrenal; Health supplements; Hypothyroidism; Autoimmunity; Depression; Cardiovascular disease

Core Tip: In this review we discuss the current evidence for the nutraceutical utility of dehydroepiandrosterone sulfate (DHEAS). Initially regarded as a panacea for a multitude of human diseases, studies conducted with DHEA supplementation have yielded largely inconclusive results, with the possible exception as an alternative agent in adrenal insufficiency patients with low energy and low libido (in affected females), and genitourinary syndrome of menopause (vaginal preparation). However, with its easy availability as a relatively inexpensive over-the-counter supplement in many countries, DHEA, like vitamin D, has continued to evoke curiosity in the scientific community. Hence, the subject of DHEA supplementation requires a pragmatic approach, backed by robust evidence, with careful weighing of potential benefits (or lack thereof) and possible adverse effects.