Brooke AM et al. (2006) Dehydroepiandrosterone (DHEA) replacement reduces growth hormone (GH) dose requirement in female hypopituitary patients on GH replacement . Clin Endocrinol [doi:10.1111/j.1365-2265.2006.02648.x]

Growth hormone (GH) has been implicated in regulation of the adrenal androgen dehydroepiandrosterone (DHEA). Brooke et al. hypothesized that DHEA supplements might increase insulin-like growth factor 1 (IGF1) production, despite use of constant GH doses.

Their single-center trial enrolled 30 female and 21 male (26 and 18 of whom completed the study, respectively) hypopituitary patients aged 18–64 years, who were treated with full pituitary hormone-replacement therapy, including GH. In the initial, double-blind phase, patients were randomly allocated to receive either 50 mg DHEA or placebo daily for 6 months. Subsequently, all patients received open-label DHEA for 6 months, followed by a 2-month washout period. Patients were evaluated monthly during the study; if serum IGF1 levels showed a >15% change from baseline, the dose of GH was adjusted to maintain constant serum IGF1 levels.

All patients had subnormal DHEA sulfate levels at baseline that became normalized in those who received DHEA supplementation. In both the placebo-controlled and open-label phases of the trial, GH dose requirements were reduced by 15.3% on average (SD 3.6%) in DHEA-treated women, whereas GH doses increased by 2.7% (SD 4.8%) in placebo-treated women—a statistically significant difference (P <0.01). There was no change in GH dose requirements of male patients, perhaps because they were all taking testosterone-replacement therapy.

Brooke et al. concluded that close monitoring of serum IGF1 in GH-treated hypopituitary women who start DHEA-replacement therapy is necessary, as GH dose reductions might be achievable.