Some DHEA Pills Don't Live Up to Label

A Double Warning for Lupus Patients

From the WebMD Archives

Dec. 11, 2002 -- Several brands of an over-the-counter supplement don't live up to their labels. Bottles of at least three brands of DHEA contain less of the potent synthetic hormone than they say they do, an independent laboratory says.

Researchers at looked at 17 commonly available DHEA products. Three of them had less DHEA than their labels indicated. One of these products contained less than a fifth as much DHEA as advertised. Two others had 79% and 84% of the DHEA they claimed to have.

"We don't release the names of the failures we find -- when we do we get hit with so much litigation," Tod Cooperman, MD, president of CL, tells WebMD. "We can say that the one with least DHEA says on the bottle 'pharmaceutical quality' and it says it is 'produced and packaged in OTC approved facility.' So if people see those statements on a bottle they should be alarmed.

DHEA -- short for dehyroepiandrosterone -- is a hormone naturally made by the adrenal glands. The body turns it into other steroidal hormones such as estrogen and testosterone. DHEA sold as a supplement is made from plant chemicals.

Natural DHEA levels peak when people are in their 20s and go down as they age. For this reason -- but with little solid evidence -- DHEA has been touted as an anti-aging treatment and as a treatment for sexual dysfunction in both men and women. Some doctors are very worried that taking DHEA supplements can have dangerous side effects.

It's lupus patients, however, who are most interested in DHEA. Clinical trials with pharmaceutical-grade DHEA suggest that it can let some lupus patients take lower doses of steroid drugs, thereby reducing steroid side effects. The drug company Genelabs Technologies Inc. is testing its own version of DHEA -- called Prestara -- in clinical trials with lupus patients. FDA approval is expected.

Duane Peters, vice president of advocacy and communications, Lupus Foundation of America, says the findings highlight his group's warning that DHEA supplements aren't for every patient.

"Lupus patients need to understand the difference between unregulated over-the-counter preparations of DHEA versus the true pharmaceutical-grade DHEA now in clinical trials," Peters tells WebMD. "The danger here is that individuals with lupus will see these preparations as safe and effective alternatives to regular medical treatment. We want to make sure people understand this isn't the case."


DHEA won't help everyone with lupus. And even those who might benefit need exactly the right amount, Peters says. Moreover, he warns, supplements often contain other compounds that might actually be harmful.

"Unregulated nutritional supplements often have other compounds that are counterproductive," he says. "For example, we know that alfalfa sometimes stimulates an autoimmune reaction in lupus patients, and alfalfa is sometimes used as a filler in vitamins and other supplements. These could cause a lupus flare-up in some people."

Indeed, the tests showed that some of the DHEA supplements intentionally add something called "bioperine" derived from black pepper. And at least one product claims to contain material from cow adrenal glands -- which Cooperman says raises concerns about mad cow disease.

Peters warns lupus patients not to take DHEA supplements without a doctor's supervision.

"We do not recommend that patients use these complimentary therapies without the full knowledge and full approval and support of their lupus doctor -- someone very familiar with the treatment of lupus, such as a rheumatologist," he says.

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SOURCES: web site, "Product Review: DHEA Supplements" • Tod Cooperman, MD, president, • Duane Peters, vice president of advocacy and communications, Lupus Foundation of America.
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