DHEA Supplementation in Primary Adrenal Insufficiency
Clinical Applications
- In primary adrenal insufficiency, patients are deficient in adrenal androgen secretion, including DHEA, which can result in androgen deficiency, particularly in female patients 1, 2
- Clinical guidelines recommend DHEA replacement only for specific situations in primary adrenal insufficiency, such as for female patients with persistent lack of libido and/or low energy levels despite optimized glucocorticoid and mineralocorticoid replacement 1, 3
- DHEA replacement is typically administered as oral DHEA tablets, often 25 mg as a single daily dose, with dosing guided by serum DHEA sulphate, androstenedione, and testosterone levels 1, 3
Limitations and Cautions
- There is only limited objective evidence of clinical benefit from large studies regarding DHEA supplementation 1, 3
- Guidelines recommend a cautious approach, offering a 6-month trial of DHEA replacement that can be continued if clinically effective 1, 3
- Long-term effects of DHEA replacement therapy in patients are not well established, warranting caution in its use 1, 3