DHEA for Men: Dosage, Side Effects, the Blood Test, and Why I Take About 5 mg

DHEA for men does less than the label says. In a meta-analysis of 25 placebo-controlled trials in 1,353 older men, it gave a small drop in fat mass and no change in sexual function, blood sugar, bone or quality of life.

I still take it. I take about a tenth of the dose used in those trials, and below is why.

What a DHEA supplement is

DHEA is an adrenal steroid that your body can turn into androgens or estrogens. It falls with age. In the United States it is sold over the counter. It is still a hormone.

I covered the one-year aging trial in DHEA: 280 people took 50 mg a day. This post is about men, dose and side effects.

DHEA for men: what the trials show

• The pooled result. 25 trials, 1,353 older men, 36 weeks on average. Fat mass went down slightly. That effect disappeared once the rise in testosterone and estradiol was accounted for, so it depends on what the DHEA is converted into. (Corona 2013)
• Two years. 87 older men with low DHEA-S got DHEA, testosterone or placebo for two years. DHEA did not change body composition, strength, insulin sensitivity or quality of life. Bone density at the hip rose a little. There were no major adverse effects. (Nair 2006)
• Testosterone. A meta-analysis of 42 publications found that DHEA raised testosterone by 28 ng/dl on average. In men the rise was 21 ng/dl. Doses above 50 mg a day gave 58 ng/dl against 19 at 50 mg or less. (Li 2020)
• Young men lifting. 19 men around age 23 trained for 8 weeks on 150 mg a day or placebo. Testosterone and estrogens did not change, and strength and lean mass rose the same in both groups. (Brown 1999)
• Blood vessels. 24 men with high cholesterol took 25 mg a day or placebo for 12 weeks. Flow-mediated dilation, a measure of how well an artery widens, went from 3.9% to 8.4% on DHEA and did not move on placebo. A marker of insulin sensitivity improved. (Kawano 2003)
• Mood. 23 men and 23 women with midlife-onset depression took 90 mg a day for 3 weeks and then 450 mg a day for 3 weeks. 23 of them had their depression score cut in half or better, against 13 on placebo. (Schmidt 2005) Those are very high study doses, given in a clinic.

DHEA dosage for men

The trials used 25, 50 and 100 mg a day. One study was designed to find the right replacement dose.

14 men with a mean age of 58.8 took a single dose of placebo, 50 mg or 100 mg. 50 mg brought DHEA-S to the level of young adult men. 100 mg pushed it above the normal range. (Arlt 1999)

Now the part that matters to me. In that study testosterone and DHT did not change at all. Estradiol and estrone rose with the dose, to levels still inside the upper normal range for men.

That is why I keep my own dose very low, around 5 mg. This is my dose, not a studied one. I did not find a trial of 5 mg, so I cannot show you that it does anything measurable.

My view is that where DHEA ends up depends on your state. If you are estrogen dominant, with high aromatase, more of it becomes estrogen. A good metabolic rate and enough carbohydrate push it toward the androgens. If you suspect high aromatase, DHEA may not be your best option.

DHEA side effects

• Higher estrogens in men. Shown in the dose study above, at 50 and 100 mg.
• Lower HDL in women. A meta-analysis of 23 trials found HDL cholesterol fell by 3.1 mg/dl on DHEA. In women the drop was 5.1 mg/dl. In men there was no change. (Qin 2020)
• Serious harm. The two-year trial reported no major adverse effects, and a review of 23 trials in women found no significant effect on serious adverse effects. Those trials were small, so they cannot rule out rare problems.

If you have a hormone-sensitive condition, or you take hormone therapy, DHEA is a question for your doctor.

DHEA benefits for women

• Women whose adrenals make none. 24 women with adrenal insufficiency took 50 mg each morning for four months. Well-being improved, depression and anxiety scores fell, and sexual interest and satisfaction rose compared with placebo. Testosterone came up into the normal range. (Arlt 1999)
• Women with normal adrenals. A meta-analysis of 23 trials in 1,188 postmenopausal women found no significant improvement in libido or sexual function, and no effect on lipids, glucose, weight or bone density. The authors rate their confidence as low. (Elraiyah 2014)

So the clear benefit is in women who lack DHEA for a medical reason.

The DHEA blood test: DHEA sulfate

The usual test is DHEA-S, the sulfate form. DHEA and DHEA-S are the most abundant steroids in the human body. Ask for the test before you take anything, and again after a few months.

Low levels do track with worse outcomes. In 2,644 Swedish men aged 69 to 81, those in the lowest quarter for DHEA-S had a 54% higher risk of death from any cause and a 61% higher risk of cardiovascular death over 4.5 years. (Ohlsson 2010)

The honest part

That mortality study is an association. When researchers gave DHEA back to older men for two years, almost nothing they measured improved. Low DHEA-S may be a marker of poor health more than a cause of it.

The artery study had 24 men and the mood study 46 people. The big pooled analyses say the effect in men is small.

So I treat DHEA as a small tool. I fix carbs, sleep, sunlight and stress first, I keep the dose tiny, and I test.

The balance between DHEA and cortisol is in the cortisol to DHEA ratio. What Ray Peat wrote about dose is in Ray Peat on pregnenolone and DHEA.

Quick answers

Does DHEA work for men?

Only a little, according to the trials. A meta-analysis of 25 placebo-controlled trials in 1,353 older men found a small reduction in fat mass and no effect on sexual function, glucose, lipids, bone or quality of life.

What is the right DHEA dosage for men?

Trials used 25 to 100 mg a day. In one dose study, 50 mg restored DHEA-S to young adult levels and 100 mg overshot. The author of this site takes about 5 mg, a personal choice that has not been tested in a trial.

What are the side effects of DHEA?

In men, 50 and 100 mg raised estradiol and estrone while testosterone and DHT stayed the same. In women, a meta-analysis found HDL cholesterol fell by 5.1 mg/dl. Trials lasting up to two years reported no major adverse effects.

Does DHEA increase testosterone in men?

Slightly on average. A meta-analysis found a rise of about 21 ng/dl in men. In young men doing resistance training, 150 mg a day did not raise testosterone at all.

What are the benefits of DHEA for women?

In women with adrenal insufficiency, 50 mg a day improved well-being, mood and sexuality. In postmenopausal women with normal adrenal function, a meta-analysis of 23 trials found no significant benefit.

What does a DHEA sulfate blood test show?

DHEA-S is the sulfate form of DHEA measured in blood. In 2,644 older Swedish men, the lowest quarter of DHEA-S had a 54% higher risk of death over 4.5 years. That is an association, not proof of cause.