DHEA effective against osteoporosis

Townsend Letter for Doctors and Patients,  Feb, 2001  by Alan R. Gaby

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Seventy women and 70 men between the ages of 60 and 69 years, and an additional 70 women and 70 men between the ages of 70 and 79 years, were randomly assigned to receive, in double-blind fashion, 50mg/day of DHEA or placebo for 1 year. At the end of the study, bone mineral density (BMD) was significantly greater at the femoral neck, Ward's triangle, and the upper and total radius, in women receiving DHEA than in those given placebo. BMD typically increased in women treated with DHEA and decreased in those given placebo (data not shown). In women over age 70 who received DHEA, serum telopeptide of type 1 collagen, a marker of bone resorption, decreased by 11% after 6 months and by 26% after 1 year. Serum osteocalcin and bone alkaline phosphatase, markers of bone formation, did not change significantly. DHEA had no significant effect on BMD or biochemical markers in men, with the exception of a 32% increase in bone alkaline phosphatase after 12 months in the older men.

Comment: This study demonstrated that supplementation with DHEA can prevent and apparently reverse bone loss in elderly women, but not in men. The benefit appeared to be due to a reduction in bone resorption. However, there is evidence from other studies that DHEA may also increase bone formation. Although biochemical markers of bone formation did not increase in the women in the new study, the reliability of these markers has been questioned. A previous epidemiological study suggested that DHEA is even more important than estrogen for osteoporosis prevention in women. That possibility is supported by the fact that estrogen therapy does not typically increase BMD, whereas such an increase did occur with DHEA in the present study. Considering the recent evidence that estrogen does not prevent heart disease, DHEA should be considered as an adjunct or alternative to estrogen replacement therapy in selected women. Additional research should be done to clarify the role of DHEA replacement therapy for postmenopaus al women.

Baker B. DHEA increases bone mineral density in woman. Fam Pract News, Nov. 1, 2000, p. 24.

COPYRIGHT 2001 The Townsend Letter Group
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