The role of androgens in improving muscle mass and endurance is well known. Additionally, researchers know that the levels of androgens fall with aging.
However, supplementing androgens with testosterone or anabolic steroids is not an option due to a range of adverse effects.
Researchers have been looking for a novel androgen that may have some of the benefits of classical androgens and is yet safe to supplement.
DHEA appears to have some androgenic activity and is still available as an over-the-counter supplement.
In this article, we will go through whether DHEA cause hair loss and is DHEA hair loss reversible?
Watch this video of Dr Dray on hormones and hair regrowth!
What is DHEA?
Dehydroepiandrosterone (DHEA) is a hormone secreted by the adrenal cortex. It is a hormone identified more than 50 years ago. However, its role in health remains elusive as ever.
Its concentration in the body changes with disease conditions, and more importantly, with aging. It appears to play a role in regulating stress responses, immunity, insulin sensitivity, and influence cardiac health.
It is often supplemented to boost physical performance and gain muscle mass by sportspeople. Researchers are also exploring its role in other health conditions like neurodegeneration, insulin resistance, sexual function, bone metabolism, and cognitive function. Studies are also exploring its role in managing age-related decline in metabolic activity.
In recent years, DHEA has gained more attention as a supplement for postmenopausal women. Many postmenopausal women may benefit from hormone replacement therapy. However, traditional hormone replacement therapy contains estrogens and not androgens.
Thus, some believe that adding DHEA may help improve libido in postmenopausal women and may have other health benefits.
- DHEA is a hormone secreted by adrenal glands
- DHEA levels fall with aging, and thus its role in anti-aging programs
- DHEA has androgenic activity and is thus believed to boost physical performance
- DHEA may help overcome postmenopausal symptoms
What are the side effects of DHEA?
DHEA has long remained controversial. Its impact on androgenic and estrogenic receptors is still a matter of debate. It is available as an over-the-counter dietary supplement. It means that it does not appear to cause any severe side effects. Nonetheless, its long-term safety remains controversial.
DHEA is not just used by men. It is even more commonly recommended to postmenopausal women as a novel androgen for boosting bone health, libido, sexual function, and improving mood. It does not appear to cause significant adverse effects even on long-term use of 52 weeks.
Although it appears to be safe in most, there are reports of its side effects. It may precipitate hair loss in predisposed men, those with a family history of male pattern alopecia. In addition, there are sporadic reports of DHEA precipitating symptoms of bipolar disorder and even causing severe mania.
However, these effects are only reported in individuals living with bipolar disorder, and reports are sporadic, thus not definite. Some early reports also warn that DHEA may exacerbate Covid-19 infection, but these are early reports and are not supported by clinical evidence.
Does DHEA cause hair loss?
The most common fear related to DHEA use is that it may cause increased hair loss, especially in high-risk males. However, most of these reports are assumptive in nature, and clinical studies do not show that DHEA increases hair loss. There is a reason for these assumptions.
Androgenic alopecia or male pattern alopecia is the most common cause of hair loss in men. It is a genetic disorder in which testosterone metabolite DHT causes increased hair loss in genetically predisposed individuals.
Learn how to remove DHT from scalp here.
Since DHEA is a testosterone precursor and may increase its levels in some, thus theoretically, it may increase DHT levels and cause hair loss. However, male pattern baldness appears to be related to elevated sensitivity of hair follicles to DHT rather than its higher level.
Studies show that in many with early onset of male pattern baldness, serum levels of testosterone and DHEA-S were well within the normal range. Moreover, there is no evidence that DHEA may considerably boost DHT levels in the skin or scalp. There are no reports from well-designed studies that DHEA may cause hair loss. Nonetheless, such an adverse effect cannot be entirely excluded in high-risk individuals.
Thus, in a 52-week trial in postmenopausal women, 50 mg DHEA did not appear to cause any severe side effects of cause hair loss. Yet, another study with 100 mg DHEA found that women were more sensitive to metabolic effects of it, but it did not report increased hair loss in men or women.
In a four-month study in older men, who are more likely to be living with low testosterone, and at the same time with male pattern alopecia, 50 mg of DHEA did not cause severe adverse events or hair loss.
Further, things are quite different in women. In females, postmenopausal loss of insulin sensitivity appears to cause increased hair loss in some. In such women, there are generally low levels of DHEA. Thus, it is possible that DHEA may help prevent frontal fibrosing alopecia in women.
- DHEA is believed to cause hair loss due to its androgenic activity
- There is insufficient clinical evidence that DHEA contributes to hair loss, as androgenic alopecia is related to higher sensitivity to androgens rather than their higher levels.
Is hair loss reversible with DHEA?
Studies show that about 50 percent of people are at the risk of androgenic alopecia, and in some, hair loss may be severe. Although it is a benign condition, it may have a broader impact on psychological wellbeing.
Since it is believed that DHEA may boost levels of androgens, it is believed that it may contribute to increased hair loss. However, long-term studies have not shown that it causes hair loss.
Therefore, even if, in some cases, hair loss appears to be associated with DHEA supplementation, it may be good to discontinue its use. Androgenic alopecia is challenging to reverse or manage. Nonetheless, some individuals may respond to drug therapies or even some health supplements.
How can you treat DHEA hair loss?
There is a widespread belief that DHEA may cause irreversible hair loss. However, such findings are not supported by clinical studies. These beliefs are made worst by faulty and assumptive reports on various online platforms, as they are not supported by clinical data.
Studies show that DHEA does not cause hair loss in females. It does not appear to influence hair health in men. Men appear to be less sensitive to DHEA than females, even on its high dose and long-term use.
Nonetheless, if some individuals feel that their hair loss was made worse by DHEA supplementation, they may immediately discontinue its use. Hair loss with DHEA will only occur in genetically predisposed individuals, and it remains challenging to treat.
Studies show that both men and women may benefit from the application of minoxidil 5% solution. At present, it is the only topically applied drug with some proven efficacy in the early stages of androgenic alopecia.
Another treatment option for androgenic alopecia is the initiation of anti-androgenic therapy. Generally, finasteride may help (see finasteride before and after) in men, but its role in females is less clear. However, anti-androgenic therapy increases the risk of sexual dysfunction and prostate cancer.
Those who fail to respond to finasteride may benefit from Dutasteride. It is many times more potent and has a similar safety profile to finasteride.
In women, spironolactone is preferred over other medications. It is a potassium-sparing diuretic with a mild anti-androgenic effect.
Androgenic alopecia is challenging to manage and is a progressive condition. Thus, many individuals may ultimately require hair transplantation. Researchers are also exploring the role of other therapies like the use of specific natural supplements like caffeine, argan oil, biotin, collagen, pumpkin seed oil, and turmeric.
Androgenic alopecia is the leading cause of hair loss in both men and women. It is a progressive condition. It is a genetic disorder. It appears that the scalp or hair follicles of individuals living with this genetic trait are more sensitive to the influence of androgens. Since DHEA has mild androgenic action, there is a reason to believe that it may cause hair loss.
However, it appears that it does not cause any severe hair loss in men and women. Even if it appears to show signs of early hair loss, one may discontinue its use, as it is not a medication and not used to treat severe medical conditions. Further, treatment of hair loss would be similar to other cases of androgenic alopecia.
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