By Dr. Steven Long, DO, MHA, CPT
Beyond Health | Precision Medicine for High-Performance Living

What Is DHEA-S?

Dehydroepiandrosterone sulfate (DHEA-S) is the sulfated form of DHEA, an adrenal hormone that serves as a precursor to both androgens and estrogens. DHEA-S levels peak in early adulthood and decline steadily with age, sometimes dropping by more than 80% by the time someone reaches their 70s. Because of this decline, DHEA has been marketed as an “anti-aging hormone” with claims ranging from improved vitality to better sexual function and cognition.

But as with many hormones, the reality is more nuanced: physiologic decline may not always need “correction,” and supplementation outcomes depend heavily on context.

Commonly Claimed Benefits of DHEA-S

DHEA supplements (usually sold over-the-counter in the U.S.) are promoted for:

• Anti-aging and longevity: Marketed as a way to “restore youthful hormone levels.”
• Improved energy and well-being: Suggested to fight fatigue and mood decline.
• Sexual function: Promoted for both men and women as a natural libido enhancer.
• Cognitive performance: Marketed for sharper thinking and memory.
• Muscle mass and fat loss: Claimed to support anabolic processes and aid weight control.
• Bone health: Promoted for osteoporosis prevention.
• Immune support: Sometimes marketed as an immune-boosting hormone.

The question is: how much of this is supported by science?

What the Evidence Actually Shows

1. Aging and Longevity

   • While DHEA-S levels decline with age, supplementing has not been shown to extend lifespan or prevent age-related diseases in randomized controlled trials.
   • In fact, meta-analyses suggest only modest improvements in well-being in specific populations, particularly adrenal insufficiency and some perimenopausal women .

2. Energy, Mood, and Depression

   • Some small trials show DHEA supplementation can improve mood in people with major depression resistant to conventional therapy, but effects are inconsistent .
   • In healthy adults, evidence for energy or mood improvement is weak.

3. Sexual Function

   • Evidence is mixed. In women with adrenal insufficiency or postmenopausal women with low libido, DHEA may modestly improve sexual function .
   • In men, effects on erectile function or libido are minimal unless DHEA deficiency is present.

4. Cognition

   • Human trials show no consistent cognitive benefit in healthy older adults .
   • Any effects seem population-specific (possibly in those with adrenal insufficiency).

5. Muscle Mass and Fat Loss

   • Despite anabolic claims, most RCTs show minimal to no impact on lean body mass, fat mass, or strength in healthy adults .
   • Some benefit may exist in older men and women with low baseline DHEA-S levels.

6. Bone Health

   • Some studies show small improvements in bone mineral density in postmenopausal women, particularly when combined with calcium and vitamin D .
   • Effects are modest compared to standard osteoporosis therapies.

7. Immune Function

   • Preclinical studies suggest DHEA may modulate immune responses, but human evidence is weak and not clinically actionable.

Safety and Risks

• Androgenic side effects: Acne, hair loss, hirsutism in women.
• Hormone-sensitive cancers: Theoretical risk in breast, ovarian, or prostate cancer due to androgen/estrogen conversion.
• Cardiovascular risk: Long-term safety is unclear; some trials suggest possible HDL reduction in men.
• Supplement variability: OTC DHEA products often have inconsistent dosing and purity.

Where DHEA-S Fits in Precision Medicine

At Beyond Health, we rarely use DHEA as a first-line intervention. For most healthy individuals, lifestyle interventions (exercise, sleep, stress reduction, nutrition) are far more powerful for energy, mood, bone, and metabolic health.

Where DHEA may have a role:

• Adrenal insufficiency (with physician monitoring).
• Select postmenopausal women with sexual dysfunction not responsive to other interventions.
• Research settings for treatment-resistant depression.

In other cases, the risks, variability, and lack of clear long-term benefit make supplementation less compelling.

The Bottom Line

DHEA-S is an important biomarker of adrenal function and aging, but supplementing it is not a magic bullet. While marketed as an “anti-aging” hormone, robust evidence only supports niche roles—particularly in adrenal insufficiency, certain postmenopausal women, and possibly treatment-resistant depression.

For everyone else, targeting the fundamentals—strength training, Zone 2 exercise, nutrition, sleep, and stress management—provides far more reliable improvements in longevity and performance.

References

1. Corona G, et al. “DHEA supplementation in elderly men: meta-analysis of randomized controlled trials.” J Clin Endocrinol Metab. 2013;98(9):3615-3626.
2. Schmidt PJ, et al. “DHEA monotherapy for midlife-onset major and minor depression.” Arch Gen Psychiatry. 2005;62(2):154-162.
3. Davis SR, et al. “Dehydroepiandrosterone sulfate: a biomarker of human aging.” Endocr Rev. 2011;32(5):421-446.
4. Panjari M, Davis SR. “DHEA for postmenopausal women: a review of the evidence.” Maturitas. 2010;66(3):172-179.
5. von Mühlen D, et al. “The effect of DHEA supplementation on bone mineral density in older adults.” N Engl J Med. 2006;355:1647-1659.
6. Baulieu EE, et al. “Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue.” Proc Natl Acad Sci USA. 2000;97(8):4279-4284.