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DHEA


¿Qué es?

El DHEA es una hormona que es producida en forma natural por el cuerpo. Se puede hacer en el laboratorio a partir de sustancias químicas que se encuentran en el ñame silvestre y la soja. Sin embargo, el cuerpo humano no puede hacer DHEA a partir de estas sustancias químicas, por lo tanto simplemente comer ñame silvestre y soja no aumentará los niveles de DHEA. No se deje engañar por los productos de ñame silvestre y de soja etiquetados como “DHEA natural.”

El DHEA se utiliza para retardar o revertir el envejecimiento, para mejorar la habilidad para pensar en las personas mayores y para retardar el progreso de la enfermedad de Alzheimer.

Los atletas y otras personas usan el DHEA para aumentar la masa muscular, la fuerza y la energía. Pero el uso de DHEA está prohibido por la Asociación Atlética Colegial Nacional (NCAA).

El DHEA es utilizado por los hombres para la disfunción eréctil (DE), y es utilizado también, por mujeres sanas y mujeres que tienen bajos niveles de algunas hormonas, para mejorar el bienestar y la sexualidad.

Algunas personas usan el DHEA para el tratamiento del lupus sistémico eritematoso (LSE), de los huesos débiles (osteoporosis), de la esclerosis múltiple (EM), de los niveles bajos de las hormonas esteroidales (enfermedad de Addison), de la depresión, de la esquizofrenia, del síndrome de fatiga crónica (SFC) y para retardar la progresión de la enfermedad de Parkinson. Se utiliza también para la prevención de las enfermedades del corazón, para el cáncer de mamas, la diabetes y el síndrome metabólico.

El DHEA se usa para la pérdida de peso, para disminuir los síntomas de la menopausia y para estimular el sistema inmunológico.

Las personas con VIH a veces usan el DHEA para aliviar la fatiga y la depresión.

Las mujeres que han pasado la menopausia a veces usan DHEA en el interior de la vagina para reforzar las paredes de la vagina. También lo toman para aumentar la densidad mineral ósea.

Como muchos suplementos dietéticos, el suplemento de DHEA tiene problemas de control de calidad. Se ha encontrado que algunos productos etiquetados como que contienen DHEA no contienen nada de DHEA y otros contienen más que la cantidad indicada en la etiqueta.

El DHEA está siendo investigado y es posible que eventualmente sea aprobado por la administración de Drogas y Alimentos (FDA) como un medicamento de venta bajo receta médica para el tratamiento del lupus sistémico eritematoso (LSE) y para mejorar la densidad mineral ósea en las mujeres que tienen lupus y están bajo tratamiento con medicamentos de esteroides. La FDA está todavía estudiando la solicitud de la compañía farmacéutica para la aprobación para este uso.

¿Qué tan efectivo es?

Natural Medicines Comprehensive Database (La Base Exhaustiva de Datos de Medicamentos Naturales) clasifica la eficacia, basada en evidencia científica, de acuerdo a la siguiente escala: Eficaz, Probablemente Eficaz, Posiblemente Eficaz, Posiblemente Ineficaz, Probablemente Ineficaz, Ineficaz, e Insuficiente Evidencia para Hacer una Determinación.

La clasificación de la eficacia para este producto es la siguiente:

Posiblemente eficaz para...

  • La esquizofrenia. El DHEA puede ser más eficaz en las mujeres que en los hombres.
  • Mejorar la apariencia de la piel en las personas de más edad. El tomar DHEA por vía oral parece aumentar la humedad y el espesor de la piel y disminuir la cantidad de “manchas en la cara debido a la vejez” en los hombres y mujeres de edad avanzada.
  • Mejorar la habilidad para poder tener una erección en los hombres que sufren de disfunción eréctil. Pero no parece ser eficaz si la disfunción eréctil se debe a la diabetes o a los trastornos de los nervios.
  • Mejorar los síntomas del lupus (LSE). El tomar DHEA por vía oral junto con el tratamiento convencional podría ayudar a reducir el número de veces que se presentan los síntomas y podría permitir una reducción de la dosis necesaria de los medicamentos de venta bajo receta médica. El DHEA podría también ayudar con los síntomas del LSE tales como los dolores musculares y las úlceras en la boca. El DHEA también parece fortalecer los huesos en los pacientes con LSE que están siendo tratados con altas dosis de esteroides (corticoesteroides).
  • Los huesos débiles (osteoporosis). El tomar DHEA diariamente por vía oral parece mejorar la densidad mineral ósea (DMO) en las mujeres y hombres con osteoporosis u osteopenia (pre-osteoporosis). El DHEA también puede aumentar la DMO en las mujeres con el desorden alimenticio llamado anorexia nerviosa.

Posiblemente ineficaz para...

  • La enfermedad de Alzheimer.
  • Mejorar el deseo sexual en las mujeres sanas.

Probablemente ineficaz para...

  • Mejorar la habilidad para pensar en las personas de edad avanzada.

Insuficiente evidencia para hacer una determinación para...

  • La insuficiencia suprarrenal. Existe información contradictoria acerca de si tomar DHEA puede mejorar la sensación de bienestar, la sexualidad, la depresión, la ansiedad y otros síntomas que sufren las personas con esta deficiencia hormonal. Algunas investigaciones sugieren que el DHEA podría mejorar estos síntomas, mientras que otras sugieren que el DHEA no ofrece ningún beneficio.
  • El síndrome metabólico (un grupo de afecciones que ponen a las personas en alto riesgo de sufrir enfermedades del corazón). Hay pruebas preliminares que indican que el DHEA podría disminuir algunos de los riesgos para la salud que hacen que los hombres y mujeres con sobrepeso tengan más probabilidades de desarrollar el síndrome metabólico. Los factores de riesgo que el DHEA parece bajar son la obesidad, la grasa alrededor de la cintura y los niveles altos de insulina.
  • La pérdida de peso. Hay pruebas preliminares que sugieren que el DHEA parece ayudar a la gente de edad avanzada, con sobrepeso y mayor probabilidad de sufrir del síndrome metabólico, a bajar de peso. Pero no se sabe si el DHEA ayuda a la gente más joven a bajar de peso.
  • La depresión. Hay algunas pruebas que indican que el DHEA podría ayudar a mejorar el estado de ánimo y la depresión.
  • El envejecimiento. El tomar DHEA no parece ayudar a mejorar el estado físico, la resistencia ósea, la fuerza muscular, las sensibilidad a la insulina o la calidad de vida en las personas mayores de 60 años que tienen bajos niveles de DHEA.
  • VIH/SIDA. Estudios preliminares sugieren que el tomar DHEA podría mejorar la salud mental y calidad de vida en los pacientes con VIH. Pero el DHEA no parece tener un impacto en el proceso mismo de la enfermedad de VIH.
  • La enfermedad de Addison. Hay algunas pruebas preliminares que indican que el DHEA podría mejorar los síntomas de la enfermedad de Addison.
  • El síndrome de fatiga crónica (SFC). Hay algunas pruebas que indican que el DHEA podría mejorar los síntomas del SFC.
  • Los síntomas de la menopausia tales como los sofocos. Los estudios que se han hecho hasta el momento muestran resultados conflictivos.
  • Mejorar el crecimiento y la madurez en las niñas con deficiencia hormonal. Hay algunas pruebas que indican que el DHEA podría ayudar en el crecimiento y grado de madurez en estas niñas.
  • Rendimiento físico. Algunas investigaciones muestran una mejora en la fuerza muscular en los adultos mayores que toman DHEA. Pero otras investigaciones han encontrado que el tomar DHEA no tiene ningún efecto en la fuerza muscular.
  • Las enfermedades del corazón.
  • El cáncer de mamas.
  • La infertilidad.
  • La diabetes.
  • La enfermedad de Parkinson.
  • Otras afecciones.
Se necesita más evidencia para poder aprobar al DHEA para estos usos.

¿Cómo funciona?

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El DHEA es una “hormona madre” producida por las glándulas adrenales (suprarrenales) que están ubicadas en la parte superior de los riñones. En los hombres, el DHEA es también secretado por los testículos. Es cuerpo convierte el DHEA en la hormona llamada androstenediona. La androstenediona es luego convertida en las principales hormonas masculinas y femeninas.

Los niveles de DHEA parecen bajar a medida que la gente envejece. El nivel de DHEA también parece estar más bajo en las personas con algún trastorno como la depresión. Algunos investigadores piensan que si se reemplaza el DHEA perdido con suplementos se podrían prevenir algunas enfermedades y afecciones.

¿Hay preocupación por la seguridad de su uso?

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El DHEA es POSIBLEMENTE SEGURO para la mayoría de las personas cuando se usa por solo unos pocos meses. Puede producir algunos efectos secundarios como acne, caída de cabello, malestar estomacal y presión arterial alta. Algunas mujeres pueden sufrir cambios en el ciclo menstrual, crecimiento de pelo en la cara y una voz más profunda después de tomar DHEA.

El DHEA POSIBLEMENTE NO ES SEGURO cuando se usa en cantidades más grandes y a largo plazo. No use DHEA en dosis mayores de 50-100 mg por día o por un largo tiempo. El usar dosis mayores o a largo plazo de DHEA puede aumentar las probabilidades de sufrir efectos secundarios.

Advertencias y precauciones especiales:

Embarazo y lactancia: El DHEA POSIBLEMENTE NO ES SEGURO cuando se toma por vía oral durante el embarazo y la lactancia. Puede producir niveles más altos de lo normal de la hormona masculina llamada andrógeno. Esto podría producir daño al bebé. No use DHEA si está embarazada o amamantando.

Afecciones sensible a las hormonas tales como cáncer de mamas, cáncer del útero, cáncer de los ovarios, endometriosis o fibromas uterinos: El DHEA es una hormona que puede afectar la manera como funciona el estrógeno en el cuerpo. No use DHEA si tiene alguna afección que podría empeorar si se ve expuesta a la presencia de estrógeno.

Problemas al hígado: El DHEA podría empeorar los problemas al hígado. No use DHEA si tiene problemas hepáticos.

Diabetes: El DHEA puede afectar la manera como funciona la insulina en el cuerpo. Si tiene diabetes y está tomando DHEA controle con cuidado el nivel de azúcar en su sangre.

Depresión y trastornos del estado de ánimo: Hay cierta preocupación de que los pacientes con un historial de depresión y trastorno bipolar podrían sufrir algunos efectos secundarios que afectan la mente si usan DHEA. El DHEA puede producir manía (impulsividad y excitabilidad e), irritabilidad, y comportamiento sexual inapropiado en las personas con trastornos del estado de ánimo. Si tiene un trastorno del estado de ánimo, asegúrese de conversar con su proveedor de atención médica antes de empezar a tomarlo. Además preste atención a cualquier cambio que sienta en la manera cono se siente.

El síndrome de los ovarios poliquísticos: El tomar DHEA podría empeorar esta condición. No use DHEA si tiene el síndrome de los ovarios poliquísticos.

Problemas del colesterol: El DHEA podría disminuir el “colesterol bueno” (las lipoproteínas de alta densidad HDL). Si el nivel de su HDL ya es muy bajo, converse con su proveedor de atención médica antes de empezar a tomar DHEA.

¿Existen interacciones con medicamentos?

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Moderadas

Tenga cuidado con esta combinación

Anastrazol (Arimidex)
El cuerpo convierte el DHEA a estrógeno. El anastrazol (Arimidex) se utiliza para ayudar a bajar los niveles de estrógeno en el cuerpo. El tomar DHEA junto con anastrazol (Arimidex) podría disminuir la eficacia del anastrazol (Arimidex). No tome DHEA si está tomando anastrazol (Arimidex).

Exemestano (Aromasin)
El cuerpo convierte el DHEA a estrógeno. El exemestano (Aromasin) se utiliza para ayudar a bajar los niveles de estrógeno en el cuerpo. El tomar DHEA junto con exemestano (Aromasin) podría disminuir la eficacia del exemestano (Aromasin). No tome DHEA si está tomando exemestano (Aromasin).

Fulvestrant (Faslodex)
Algunos tipos de cáncer son afectados por las hormonas en el cuerpo. Los cánceres con sensibilidad al estrógeno son cánceres que son afectados por los niveles de estrógeno en el cuerpo. El fulvestrant (Faslodex) se utiliza para este tipo de cáncer. El DHEA podría aumentar el estrógeno en el cuerpo y disminuir la eficacia del fulvestrant (Faslodex) para el tratamiento del cáncer. No tome DHEA si está tomando fulvestrant (Faslodex).

Insulina
La insulina se usa para bajar el azúcar en la sangre. La insulina también puede bajar la cantidad de DHEA en el cuerpo. Al bajar el DHEA en el cuerpo, la insulina podría disminuir la eficacia de los suplementos de DHEA.

Letrozole (Femara)
Algunos tipos de cáncer son afectados por las hormonas en el cuerpo. Los cánceres con sensibilidad al estrógeno son cánceres que son afectados por los niveles de estrógeno en el cuerpo. El letrozole (Femara) se utiliza para este tipo de cáncer. El DHEA podría aumentar el estrógeno en el cuerpo y disminuir la eficacia del letrozole (Femara) para el tratamiento del cáncer. No tome DHEA si está tomando letrozole (Femara).

Medicamentos alterados por el cuerpo (Sustratos de citocromo P450 3A4 (CYP3A4))
Algunos medicamentos son alterados y descompuestos por el cuerpo. El DHEA podría disminuir la rapidez con la que el hígado descompone algunos medicamentos. El tomar DHEA junto con algunos medicamentos que son descompuestos por el hígado puede aumentar los efectos y efectos secundarios de estos medicamentos. Antes de tomar DHEA converse con su proveedor de atención médica si está tomando medicamentos que son modificados por el hígado.

Algunos de los medicamentos modificados por el cuerpo incluyen lovastatina (Mevacor), ketoconazol (Nizoral), itraconazol (Sporanox), fexofenadina (Allegra), triazolam (Halcion) y muchos otros.

Tamoxifeno (Nolvadex)
Ciertos tipos de cáncer son afectados por las hormonas en el cuerpo. Los cánceres sensibles al estrógeno son afectados por los niveles de estrógeno en el cuerpo. El tamoxifeno (Nolvadex) se utiliza para ayudar en el tratamiento y prevención de este tipo de cáncer. El DHEA aumenta los niveles del estrógeno en el cuerpo. Al aumentar el estrógeno en el cuerpo, el DHEA podría disminuir la eficacia del tamoxifeno (Nolvadex). No tome DHEA si está tomando tamoxifeno (Nolvadex).

Triazolam (Halcion)
El cuerpo descompone el triazolam (Halcion) para eliminarlo. El DHEA podría disminuir la rapidez con que el cuerpo descompone el triazolam (Halcion). El tomar DHEA junto con triazolam (Halcion) podría aumentar los efectos y efectos secundarios del triazolam (Halcion).

Menores

Preste atención a esta combinación

Medicamentos para la inflamación (Corticoesteroides)
El cuerpo naturalmente produce DHEA. Algunos medicamentos para la inflamación podrían disminuir la cantidad de DHEA que el cuerpo produce. El tomar medicamentos para la inflamación podría disminuir los efectos de las píldoras de DHEA.

Algunos medicamentos para la inflamación incluyen dexametasona (Decadron), hidrocortisona (Cortef), metilprednisolona (Medrol), prednisona (Deltasone) y otros.

¿Existen interacciones con hierbas y suplementos?

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Soja
La soja podría disminuir los efectos del DHEA.

¿Existen interacciones con alimentos?

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Dieta vegetariana
Los vegetarianos más estrictos tienen niveles más altos de DHEA en la sangre que los no vegetarianos. Sin embargo, esta diferencia parece que desaparece después de la menopausia. Pero los investigadores no saben cual es la importancia de estos resultados.

¿Qué dosis se utiliza?

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Las siguientes dosis han sido estudiadas en investigaciones científicas:

POR VÍA ORAL:
  • En las mujeres post menopaúsicas y en los hombres de edad: comúnmente se usan dosis de 25-50 mg al día.
  • Para el tratamiento de la esquizofrenia: se usan dosis de 25 mg al día por 2 semanas y luego se aumenta a 25 mg dos veces al día por 2 semanas y después a 50 mg dos veces al día por 2 semanas.
  • Para el reemplazo de las hormonas cuando las glándulas adrenales no están funcionando bien (deficiencia de andrógeno): se toma entre 25-50 mg al día como una sola dosis.
  • Para el lupus sistémico eritematoso (LSE): se usan 200 mg al día junto con el tratamiento médico convencional pero también se han usado dosis de hasta 600 mg al día.
  • Para mejorar la densidad mineral ósea en las personas con huesos débiles (osteoporosis): se usan entre 50-100 mg por día.
  • Para la disfunción eréctil: se usan 50 mg por día.

Otros nombres

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3b-Hydroxy-Androst-5-Ene-17-One, 3BetaHydroxy-Androst-5-Ene-17-One, Androstenolone, Dehydroepiandrosterone, Déhydroépiandrostérone, DHEA-S, GL701, Prasterone, Prastérone.

Metodología

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Para saber más sobre cómo este artículo fue escrito, refiérase a la metodología metodología (http://www.nlm.nih.gov/medlineplus/spanish/druginfo/natural/methodology-sp.html) de la Base exhaustiva de datos de medicamentos naturales.

Referencias

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Para ver todas las referencias de la página de DHEA, por favor diríjase a http://www.nlm.nih.gov/medlineplus/spanish/druginfo/natural/331.html.
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