Oral
DHEA administration to patients with
hypoadrenalism, in addition to
glucocorticoid and mineralcorticoid replacement, may improve both well-being and hormonal/metabolic parameters. Twenty patients (13 men, 7 women, 26-76 yr, 11 with
Addison's disease, 9 with central
hypoadrenalism) were recruited in a placebo-controlled, randomized study.
Hormone levels,
carbohydrate and
lipid parameters, bone metabolism, body composition and psychological parameters were evaluated at baseline and
after treatment with
DHEA 50 mg/day or placebo for 4 months. After 4 months of
DHEA administration, serum DHEAS levels raised both in men (from 0.71+/-0.18 to 8.28+/-1.66 micropmol/l, p<0.005) and in women (from 0.25+/-0.07 to 5.65+/-1.93 micromol/l, p<0.05). Only in hypoadrenal women an increase in
testosterone (T; from 0.4+/-0.1 to 1.45+/-0.26 nmol/l, p<0.05) and
androstenedione (A; from 0.86+/-0.34 to 2.05+/-0.29 nmol/l, p<0.05) levels was observed. In men no significant modifications in T and
17-hydroxyprogesterone (17-OHP) levels were found, whereas serum SHBG significantly decreased. As far as the metabolic parameters are concerned, only in patients with
Addison's disease a significant decrease in total
cholesterol and in
low-density lipoproteins after 4 months of
DHEA administration was found. No changes in
glucose metabolism and
insulin sensitivity were observed. In basal conditions, mean serum
osteocalcin (OC) was normal and significantly decreased after
DHEA treatment. A significant reduction in body fat mass percentage (BF%) after
DHEA administration was observed. As far as well-being is concerned,
DHEA replacement did not cause any relevant variation of subjective health scales and sexuality in both sexes. Our study confirms that
DHEA may be beneficial for female patients with
hypoadrenalism, mainly in restoring
androgen levels. Concerning the health status, more sensitive and specific instruments to measure the effects of
DHEA treatment could be necessary.