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Your fellow readers have been asking me about DHEA, testosterone and Stemulite following the suspension of NBA basketball player Rashard Lewis for having elevated testosterone levels which implies he was using performance enhancing drugs.
Some pundits are saying he’s trying to cover up illegal steroid use with the excuse that he took only DHEA, an over-the-counter supplement.
Not only is his story plausible, but I’ve gone through the exact same thing.
No, not the losing $1.6 million part, but the accusation of steroid-use part.
A few years ago, I read a study claiming that the supplement DHEA had anti-aging benefits for those of us over 40.
So I tried it.
And of course, I tried it the standard American male way of twice (or so) the recommended dosage.
When I went to my “annual” physical (I promise to get better at that), my internist told me I had “elevated liver enzymes” and implied – quite strongly (which is why he quickly became my EX-internist) – that he thought I was on steroids.
Obviously, a lot of people now searching for the truth about DHEA and its effects on testosterone, weight loss, fat loss, etc., so here’s a report from The New England Journal of Medicine on medical opinions on DHEA.
DHEA in Elderly Women and DHEA or Testosterone in Elderly Men
Nair KS, Rizza RA, O’Brien P, et al
N Engl J Med. 2006;355:1647-1659
Older adults are often interested in treatments that might improve physical appearance and performance as well as longevity. In this regard, much public attention has been focused on adrenal and sex steroids.
The relationship between hormones, such as dehydroepiandrosterone (DHEA) and testosterone, to the process of aging makes some intuitive sense. Testosterone levels fall gradually as men grow older, and, in one longitudinal study, levels of DHEA declined over a 13-year follow-up period in 67% of healthy men.
Variations of levels in DHEA did not appear to affect health status or subjects’ well-being. DHEA levels also decline gradually in women as they age.
DHEA may reduce the incidence of chronic disease and has demonstrated inhibition of inflammation along with associated epithelial hyperplasia, carcinogenesis, and atherosclerosis.
Results of research on the treatment effects of DHEA supplementation have been mixed, however. In one placebo-controlled trial of older adults with a reduced level of serum DHEA, supplementation of DHEA at a dose of 50 mg/day was associated with reduced levels of:
- Visceral fat;
- Subcutaneous fat; and
- Serum insulin.
Overall insulin sensitivity was improved in the DHEA group compared with those who received placebo. On the other hand, another placebo-controlled trial of the same dose of DHEA failed to demonstrate a significant difference between groups in the composition of fat vs muscle in the thigh.
This latter trial noted that handgrip strength and knee muscle strength were similar after treatment with DHEA or placebo.
Studies of testosterone supplementation have suggested multiple health and functional benefits. In one placebo-controlled trial of hypogonadal men, treatment with intramuscular testosterone over 36 months was associated with better outcomes in terms of:
- Timed physical performance;
- Handgrip strength; and
- Lean body mass.
Testosterone therapy also reduced total and low-density lipoprotein cholesterol levels without increasing high-density lipoprotein cholesterol levels. The benefits of testosterone therapy vs placebo were noted whether patients received concomitant treatment with finasteride, which was administered to reduce the possible deleterious effects of testosterone therapy on the prostate.
Summary and Viewpoint
The current study by Nair and colleagues does little to support the use of DHEA among older women or DHEA or testosterone among older men. Study participants were all over the age of 60 and had serum levels of DHEA and bioavailable testosterone below the 15th percentile. Dosages of DHEA were 75 mg/day, and testosterone was administered with a transdermal patch at a dose of 5 mg/day.
Although levels of DHEA and testosterone rose appropriately with treatment, there were no consistent benefits associated with active vs placebo therapy.
Although testosterone reduced insulin levels to a mild degree, there was no difference between testosterone therapy and placebo in terms of insulin sensitivity. DHEA reduced fat-free mass only when men and women were considered together; even this result is less clinically significant because muscle strength was similar between treatment groups.
Although DHEA and testosterone each increased bone mineral density at specific anatomic sites (namely, femoral neck for men in both treatment arms and ultradistal radius for women taking DHEA), bone mineral density did not improve at the remainder of the 5 anatomic sites tested.
An editorial by Stewart, which accompanied the current article, noted that other available treatments for osteoporosis have a much more powerful effect in increasing bone mineral density.
This study is particularly useful in that it measures multiple health and quality-of-life outcomes among a cohort of patients who would be considered for treatment with DHEA or testosterone.
Although the research demonstrated no discernible effect on prostate-specific antigen levels, higher doses and/or longer durations of treatment could be associated with higher rates of benign prostatic hypertrophy or prostate cancer.
On the basis of this possible risk and the questionable benefits of therapy, routine use of DHEA or testosterone among asymptomatic men and women with low hormone levels should not be recommended.
Of course, the follow-up question is get from readers – especially college athletes – is, “Does Stemulite contain any ingredients that could get me banned.”
The answer is unequivocally, “No.”
There is absolutely nothing in Stemulite that will get you banned in your sport.
So don’t worry. You can still get Stemulite here.