Trendy Hormone Treatments No Passage to Graceful Aging
They did little to improve quality of life, study of seniors finds
WEDNESDAY, Oct. 18, 2006 (HealthDay News) -- Forget the fountain of youth, at least for now, and at least in the form of hormone supplements.
Neither DHEA (dehydroepiandrosterone) nor low-dose testosterone replacement had any beneficial effect in elderly people, including quality of life, new research has found.
"I don't find any reason for older people to take DHEA based on this study and no reason to do any extensive studies on it," said study author Dr. K. Sreekumaran Nair, a professor of medicine at the Mayo Clinic in Rochester, Minn. His report is published in the Oct. 19 issue of the New England Journal of Medicine.
Others, however, feel differently.
"This particular study is a small study, and it's only over two years, so I don't think it's the end of the story. We have to wait for more," said Dr. Barbara Paris, vice chairwoman of medicine and director of geriatrics at Maimonides Medical Center in New York City.
That being said, Paris also warned that people need to be careful of taking DHEA, in particular, as it is sold as a dietary supplement without need of a prescription.
"You don't know what you're getting with the pill," she said. "I don't think they're benign even though they're available without a prescription."
Both DHEA and testosterone have become celebrity hormones and are widely touted as anti-aging remedies. Best-selling author Gail Sheehy (Passages) profiled DHEA as a possible anti-aging miracle in Vanity Fair in 1996.
In 2002, however, gerontology experts issued a statement essentially calling supplements such as DHEA a waste of money.
The idea is simple: Because levels of growth hormones decline starting at about age 30, researchers have speculated that hormone replacement would have a slowing effect on aging. Long-living humans are also known to have relatively high levels of DHEA, but the bulk of research has been done in animals, and it's unclear how the findings might apply to humans.
The new study reports on a two-year-long, randomized, double-blind study involving 87 elderly men with low levels of DHEA and testosterone and 57 elderly women with low levels of DHEA. All participants had to be at least 60 years of age.
The men were randomly assigned to receive DHEA, testosterone or a placebo. The women were randomly assigned to receive either DHEA or a placebo.
Although DHEA and testosterone levels were increased to what would be considered the "high normal" range for young people, there were no appreciable changes in volume of oxygen consumed per minute, muscle strength, sensitivity to insulin or quality of life, the study reported. There were no major adverse effects, either.
Men receiving testosterone had a small increase in fat-free mass, and men receiving either testosterone or DHEA had an increase in bone mineral density at the femoral neck. Women taking DHEA had an increase in bone mineral density at the wrist but nowhere else.
Wrist bone mineral density is probably less important than other locations. "If you break your wrist, it's not the end of the world," Paris said. "The real concern in an 80-year-old is breaking your hip. That can be a death sentence, so even if I take a supplement and I don't get a wrist fracture, that's not really so significant."
Another problem, said Dr. Bernard Roos, director of the geriatric institute at the University of Miami Miller School of Medicine, is that "nobody's ever found that DHEA ever did anything that wasn't a secondary effect of either testosterone or estrogen." But, even here, the results can be highly variable. "It's unpredictable because different people convert DHEA to active hormones differently. It's almost like going to a lottery," Roos added.
In any event, experts called for more of this kind of study on anti-aging products in general.
"There are a lot of people who are buying and selling products under the banner of anti-aging medicine, and prematurely, because they haven't been evaluated in any style," said S. Jay Olshansky, professor of public health at the University of Illinois and senior research scientist at the Center on Aging at the University of Chicago. "It's important that clinical trials be done and that they make these kinds of assessments," he said.
To learn more, visit the U.S. National Institute on Aging.