Hormone Supplement Boosts Quality of Life in HIV Patients

From the WebMD Archives

Jan. 24, 2000 (Eugene, Ore.) -- A study of the effects of dehydroepiandrosterone (DHEA) on HIV patients found they experienced more energy, improved mood, more interest in sex, and increased muscle mass after eight weeks of treatment. DHEA, a hormone produced in the adrenal glands, is readily available in health food stores and drugstores without a prescription.

"This is preliminary research; the results are suggestive but far from conclusive," says principal author Judith Rabkin, PhD, professor of clinical psychology in psychiatry at Columbia University in New York.

A representative of the HIV/AIDS community expressed guarded optimism about the study. "It's difficult to say how significant or important this research may be, because DHEA hasn't been widely tested, and this is only one study," says Michael Cover. He is director of communications at the Whitman-Walker Clinic in Washington, the nation's largest provider of HIV/AIDS services, with 10,000 client visits a year. "We are encouraged that the medical research community is continuing to look at alternative forms of treatment for HIV complications," he adds.

The study, published in a recent issue of the journal Psychoneuroendocrinology, looked at 45 patients (including six women) who were HIV positive. They were all experiencing mild to moderate depression, but they were not psychotic nor were they current substance abusers. Just over half had been diagnosed with AIDS, while 85% were taking three or more antiretroviral medications for the disease.

Participants in the study first received 100 mg/day of oral micronized DHEA, supplied by Belmar Pharmacy of Lakewood, Colo. During the second week, the dose was increased to 200mg/day, and at the fourth week it was increased to 300 mg/day. For those who didn't experience improvements on this dosage, and didn't have any significant side effects, the dose was gradually increased to a maximum of 500 mg/day.

Stephen Ferrando, MD, also an author of the study, says, "We observed a high response rate. Mood was improved in 72% of participants, while 81% had less fatigue. Now that may just be a high placebo effect, but there were also increases in muscle mass, which indicates a real anabolic effect of DHEA." Ferrando is an associate professor of psychiatry at Cornell University Weill Medical College in New York.

Among patients who reported low libido at the start of the study, 50% were rated much improved or very much improved after eight weeks. Men who reported improvements in mood and energy levels also reported increased strength of morning erections. By week eight, there was also a statistically significant increase in muscle mass, which stayed at the same level after four additional weeks of treatment.

Three patients dropped out of this study during the first two weeks due to side effects including acne, irritability, and headaches. An additional seven patients reported minor side effects, such as irritability, insomnia, and nasal congestion during the study. Occasionally DHEA does produce more significant side effects, which were not observed in this study, says Owen Wolkowitz, MD, a professor of psychiatry at the University of California, San Francisco Medical Center. "Sometimes a person responds to DHEA by getting manic or overaggressive; these reactions are rare but they have been reported."

DHEA is widely available without a prescription. Should the study results encourage consumers to dose themselves? "This is only a preliminary study; if someone wants definitive evidence, they need to wait," says Rabkin. "On the other hand, DHEA is a fairly benign product, so there isn't a great cost in trying it." She warns that no one should take DHEA unless they are experiencing specific indications that would make it suitable. "Consumers should only use DHEA if they have certain symptoms, such as fatigue or depressed mood. Then they need to observe themselves and see if there is a noticeable difference in those symptoms after a period of treatment."

Since this pilot study did indicate DHEA has useful effects for HIV, the next step should be a larger study with more rigorous scientific procedures. Study authors believe they will be funded for this research, and Rabkin expects to begin such a study by late spring.

"The medications used in HIV/AIDS often compromise muscle mass and the ability to maintain body weight in a healthy way," says Cover. "We are looking forward very much to further testing of this compound in people living with HIV and AIDS."

Vital Information:

  • DHEA is a hormone produced by the adrenal gland, and it is widely available as a supplement without prescription.
  • In a recent study of HIV-positive patients, those taking DHEA experienced more energy, improved mood, more interest in sex, and increased muscle mass.
  • This study is still considered preliminary, and knowledge about the supplement is limited since it hasn't been widely tested.