Aging: Can Hormones Prevent Aging? (cont.)
Heed The Warnings
The NIA recognizes that some hormone-like products are available over the counter and can be used without consulting a physician. The Institute discourages individuals from self-medicating with these products for a number of reasons. First, these products are marketed as "dietary supplements", and therefore are not regulated by the Food and Drug Administration (FDA) in the same way as drugs. This is an important distinction because the requirements for marketing a dietary supplement are very different from those that apply to hormones marketed as drugs. Unlike drug manufacturers, a firm selling dietary supplements doesn't need FDA approval of its products and doesn't need to prove that its products are safe and effective before marketing. Also, there is no specific guarantee that the substance in the container is authentic or that the indicated dosage is accurate. Because of these differing standards, hormone-like substances that are sold as dietary supplements may not be as thoroughly studied as drug products, and, therefore, the potential consequences of their use are not well understood or defined. In addition, these over-the-counter products may interfere with other medications you are taking.
Therefore, the NIA does not recommend taking any supplement, including DHEA and melatonin, that is touted as an "anti-aging" remedy because no supplement has been proven to serve this purpose. The influence of these supplements on a person's health is unknown, particularly when taken over a long period of time.
Talk to your doctor if you are interested in any form of hormone supplementation. In fact, you might want to show this fact sheet to your doctor to help explain your concerns.
How Hormones Work
Most hormones exist in very low concentrations in the bloodstream. Each hormone molecule travels through the blood until it reaches a cell with a receptor that it matches. Then, the hormone molecule latches onto the receptor and sends a signal into the cell. These signals may instruct the cell to multiply, to make proteins or enzymes, or to perform other vital tasks. Some hormones can even stimulate a cell to release other hormones. However, no single hormone affects all cells in the same way. One hormone, for example, may stimulate a cell to perform one task, while the same hormone can have an entirely different influence over another cell. The response of some cells to hormonal stimulation also may change throughout life.
Hormone supplements, particularly if taken without medical supervision, may adversely affect this complex system. These supplements, for instance, may not behave exactly the same way as our own naturally produced hormones have because the body may process them differently. In addition, natural hormone production isn't constant, so circulating blood levels may vary significantly over a 24-hour period. Hormone supplements can't replicate these fluctuations. As a result, high doses of supplements, whether pills, shots, gels, or skin patches, may result in excessive and unhealthy amounts of hormones in the blood. Hormone supplements also may compound any negative effects caused by hormones naturally produced by the body.
Finally, most of the processes in the body are tightly controlled and regulated. Too much stimulation can elicit natural responses to inhibit a hormone's action. The body's system of checks and balances is complicated and the notion that hormone supplements can improve function may be an oversimplification.
Dehydroepiandrosterone or DHEA is made from cholesterol by the adrenal glands, which sit on top of each kidney. Production of this substance peaks in the mid-20s, and gradually declines with age in most people. What this drop means or how it affects the aging process, if at all, is unclear. In fact, scientists are somewhat mystified by DHEA and have not fully sorted out what it does in the body. However, researchers do know that the body converts DHEA into two hormones that are known to affect us in many ways: estrogen and testosterone (see below).
Supplements of DHEA can be bought without a prescription and are sold as "anti-aging remedies." Some proponents of these products claim that DHEA supplements improve energy, strength, and immunity. DHEA is also said to increase muscle and decrease fat. Right now there is no consistent evidence that DHEA supplements do any of these things in people, and there is little scientific evidence to support the use of DHEA as a "rejuvenating" hormone. Although the long-term (over 1 year) effects of DHEA supplements have not been studied, there are early signs that these supplements, even when taken briefly, may have several detrimental effects on the body including liver damage.
In addition, some people's bodies make more estrogen and testosterone from DHEA than others. There is no way to predict who will make more and who will make less. Researchers are concerned that DHEA supplements may cause high levels of estrogen or testosterone in some people. This is important because testosterone may play a role in prostate cancer, and higher levels of estrogen are associated with an increased risk of breast cancer. It is not yet known for certain if supplements of estrogen and testosterone, or supplements of DHEA, also increase the risk of developing these types of cancer. In women, high testosterone levels can cause acne and growth of facial hair.
Overall, the studies that have been done so far do not provide a clear picture of the risks and benefits of DHEA. For example, some studies in older people show that DHEA helps build muscle and reduce fat, but other studies do not. Researchers are working to find more definite answers about DHEA's effects on aging, muscles, and the immune system. In the meantime, people who are thinking about taking supplements of this hormone should understand that its effects are not fully known. Some of these unknown effects might turn out to be harmful.