Twin study shows low Epiandrosterone, a metabolite of dehydroepiandrosterone (DHEA). Could supplementation help?
PAIN Publish Ahead of Print 2015
An omics investigation into chronic widespread musculoskeletal pain reveals epiandrosterone sulfate as a potential biomarker
Gregory Livshits et al
- Adult female twins (n=2,444) from TwinsUK registry; KORA = 1231 men and 1252 from German study
- screened 324 metabolites
- BMI (Fat mass/height) most strongly related to chronic musculosketal pain
- “epiandrosterone sulphate (EAS) was highly associated [in being low] with both CWP (p=1.05 x 10 in TwinsUK and p=3.70×10 in KORA)”
- Cortisol was only marginally related when obesity taken into account:
CWP [chronic widespread pain] was associated with cortisone levels on metabolomic screen (p=0.00069), the association was only marginally statistically significant when adjustment was made for FMI [fat mass index](p= 0.052)’
– however who is to say, that part of the effect of obesity on chronic pain, is not mediated through low cortisone
Comment – I use DHEA in the treatment of depression in older patients with low levels:
Wolkowitz, Owen M., et al.
Dehydroepiandrosterone (DHEA) treatment of depression.
Biological psychiatry 41.3 (1997): 311-318.
– gave 30-90 mg/day X 4 wks 6 older pateints, some treatment resistant
– got improvment though 1 case took 6 months so don’t know it related
Wolkowitz, Owen M., et al.
Double-blind treatment of major depression with dehydroepiandrosterone. American Journal of Psychiatry 156.4 (1999): 646-649.
-gave up to 90 mg/day DHEA X 6 wk
– “Five of the 11 patients treated with DHEA, compared with none of the 11 given placebo, showed a 50% decrease or greater in depressive symptoms.”
Rabkin, Judith G., et al.
Placebo-controlled trial of dehydroepiandrosterone (DHEA) for treatment of nonmajor depression in patients with HIV/AIDS.
American Journal of Psychiatry 163.1 (2006): 59-66.
-100-400 mg/day for 8 wks
– response rate was 56% for the DHEA vs 31% placebo group
Schmidt, Peter J., et al.
Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression.
Archives of general psychiatry 62.2 (2005): 154-162.
-DHEA 90 mg/d for 3 weeks and 450 mg/d for 3 weeks
-BDI (beck depression inventory) dropped from 17.2(mild) to 10.1 vs 13.3 in placebo (p<0.01)
Unfortunately, a trial of 50 mg tid in Fibromyalgia failed to help
Finckh, Axel, et al.
A randomized controlled trial of dehydroepiandrosterone in postmenopausal women with fibromyalgia.
The Journal of rheumatology 32.7 (2005): 1336-1340.
- “After 3 months of treatment with 50 mg of DHEA, median DHEA sulfate blood levels had tripled, but there was no improvement in well-being, pain, fatigue, cognitive dysfunction, functional impairment, depression, or anxiety, nor in objective measurements made by physicians. “
- “Androgenic side effects (greasy skin, acne, and increased growth of body hair) were more common during the DHEA treatment period (p = 0.02)”
So it might be more useful; in depressed cases for the mood. People in US can just order it. In Canada, I have people order it in through ebay from the US but have it sent c/o my office otherwise it will be rejected. I use 100 mg tid and find it helpful with no side effects I have seen. So it is possible it could help the depression in chronic pain patients; whether it helps the pain, someone will have to study…