Ah, DHEA.
It is one of those hormones that has grown on me more and more the longer I have studied it. And I want you to know something: this one is radically important for your patients, especially your more seasoned ones.
One of My Favorite Studies on DHEA
There is a randomized controlled trial from 2004 that still blows my mind.
They gave men and women DHEA at a dose of 50 mg per day for six months.
It was a small study, but it was an RCT, so the data signal is strong.
The researchers measured two key things:
- Visceral and subcutaneous abdominal fat (via MRI)
- Glucose and insulin responses (via oral glucose tolerance test)
They did this because visceral and subcutaneous fat tend to build up with age, driving the three big killers:
- Cardiovascular disease
- Type 2 diabetes
- Obesity
What They Found
The results were incredible.
Men lost an average of 10 percent visceral fat, and women lost 7 percent in six months.
And that is not all. They also saw a 34 percent improvement in insulin sensitivity.
No negative effects. None.
The average serum DHEA-S level was around 3,600 ng/mL, and everyone did fine.
That alone should challenge how we think about “optimal” lab ranges.
How DHEA Works
DHEA drops sharply after age 25 and even more rapidly after 40.
Here is how it helps.
Think of your body as a factory with two teams: one burns fat for energy, and the other stores it. PPAR is the control switch that powers up the fat-burning machinery.
DHEA acts like the key that turns that switch on, activating PPAR to boost fat burning and slow down fat storage.
That is why animal studies have consistently shown DHEA to be an incredible metabolic regulator.
The HRTU Principle in Action
This study also highlights one of my core HRTU principles:
Hormone replacement therapy is not a 1:1 match with endogenous production and metabolism.
In other words, serum levels do not always tell the full story. The body’s response matters more than the number on the page.
Clinical Takeaway for Providers
Please do not think of DHEA as a “nice-to-have” add-on for older patients.
It is foundational.
It is safe.
And it is one of the easiest ways to improve metabolism, insulin sensitivity, and overall vitality.
Of course, this does not mean we should be giving high-dose DHEA to younger patients. Context matters. But for older adults, it is a powerful and underutilized tool.
I cover all of this, and more, inside the Adjunct Hormone section of the HRTU Master Course. If you have been wondering how to dose, monitor, and integrate DHEA effectively into your practice, that is where you will learn how to do it right.
Conclusion: Do Not Overlook DHEA
DHEA is not an “extra.” It is essential.
It improves metabolic health, protects against age-related decline, and supports the same systems that start to fail with time: fat metabolism, insulin control, and overall energy.
The research has been telling us this for twenty years. It is time we start listening.
