Honolulu Advertiser "Womanhealth" Column
Melatonin and DHEA: Miracle Cures or Snake Oil?
By David Fitz-Patrick, M.D., Endocrinologist
Melatonin and DHEA have become the dietary supplement fads du jour, and it is tempting to believe the hype that these are wondrous cure-alls. But, as is often the case when such substances are promoted through miracle stories rather than scientific fact, the truth is far less glamorous than promoters would have us believe, and many people are taking them without knowing their benefits are unproven and that they pose possible risks.
In fact, both Melatonin and DHEA are sold as dietary supplements rather than as over-the-counter medicines because this distribution route does not require approval by the Food and Drug Administration (FDA). Gaining FDA approval would require scientific proof that they are safe and effective for treating specific health problems, proof that is lacking to date. Further, DHEA’s appearance on store shelves as a dietary supplement followed its ban by the FDA as a nonprescription drug in 1985. As dietary supplements, their strength and purity is not regulated or standardized, so there is no assurance that the dose promised on the label is delivered in the pill or that harmful impurities are eliminated in the manufacturing process.
These compounds are hormones—chemicals produced by the body that help regulate specific body functions. Melatonin, produced by the pineal gland in the brain, sets the body's rhythm of sleeping and waking. Studies suggest that Melatonin supplements may help travelers decrease jet lag, older adults sleep better and shift workers adjust to changing schedules. However, taken at the wrong time, Melatonin can disrupt the sleep cycle, and more research is needed to determine under what conditions it helps rather than disturbs sleep.
The current enthusiasm for Melatonin, though, goes far beyond these possible capabilities, with promoters claiming it reverses aging, prevents cancer, enhances sex, strengthens the immune system and performs a host of other wonders. Although these claims are trumpeted as realities, they are really not much more than speculation.
At the same time, we do know the effects of Melatonin can differ from person to person, and side effects can include confusion, drowsiness and headache. Furthermore, animal research indicates possible danger to people with high blood pressure or other cardiovascular problems. The possible long-terms effects of taking Melatonin supplements remain unknown.
The story is much the same with DHEA (dehydroepiandrosterone), made by the adrenal glands, which sit on top of each kidney. DHEA is broken down into the female and male sex hormones estrogen and testosterone, and whether it also causes hormonal effects on its own is unknown. Supplements are sold as an anti-aging remedy, with claims that it not only slows aging, it also burns fat, builds muscle and strengthens the immune system. None of these benefits has been proved. Most studies so far have been on animals, with only very limited human trials--trials which have not shown any long-term benefits nor evaluated possible risks, which may include increased risk for breast cancer, menstrual irregularities and even the development of masculine characteristics in women, and aggravation of benign prostate enlargement or promotion to prostate cancer in men. There are also early signs that DHEA supplements may lead to liver damage, even with short-term use.
Until more definitive research is done, the wise consumer will be cautious. Despite grandiose claims, hormone supplements have not been proven to be either beneficial or harm-free. Those who are concerned about a medical problem they think might be helped by these supplements would be wise to consult with their personal physician rather than treating themselves.
Provided as a public service by the Queen’s/HMSA Premier Plan and the Queen’s Physician Group. This column is intended for general information only. For personal medical advice, consult your physician. Word count: 610
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