Thursday, April 14, 2005

Past the Peak...and Rising

"Treating Depression Slows Seniors' Physical Decline" That's the headline from a Reuters Health article that caught my eye last week. And there's really no big surprise here. As we've seen many times, physical health and mental health often go hand in hand. The Reuters article detailed an Indiana University study in which more than 1,800 subjects over the age of 60 with major depressive disorder received either normal care or normal care with access to a clinical depression specialist. After a one-year trial, most of the subjects who improved their depression status experienced a significant improvement in physical health. This research dovetails nicely with another study in which middle-aged subjects found relief from depression without resorting to prescription drugs. A recent study from the National Institute of Mental Health (NIMH) examined the effects of DHEA on subjects with mild to major depression that developed in middle age. DHEA is an acronym for the hormone dehydroepiandrosterone, which is secreted by the adrenal glands. Your own natural production of DHEA peaks in your twenties during your prime reproductive years. After that, it gradually declines. On average, DHEA levels in 40-year-olds are half what they are in 20-year-olds. By the time you reach your 70s or 80s, DHEA levels have declined considerably to about 10 percent of what they were at their peak. Scientists have not clearly established whether declining DHEA production is a cause or a result of the aging process, but research has shown that raising low levels with supplemental DHEA can have dramatic anti-aging effects. In addition, giving DHEA a boost may also help reduce the risk of heart attack and stroke, help control diabetes, increase energy levels, improve memory, strengthen the immune system, and alleviate depression. In the NIMH study - published in the Archives of General Psychiatry - 46 subjects were randomly divided into two groups. One group received 90 mg per day of DHEA for three weeks, followed by three additional weeks with the dosage increased to 450 mg per day. The other group received a placebo for six weeks. Before the trial period, at three weeks, and again at the end, researchers evaluated depression with three assessment tools: the Hamilton Depression Rating Scale, the Center for Epidemiologic Studies Depression Scale and the Derogatis Interview (to determine sexual function). When scores from these evaluations were analyzed, the DHEA group showed significant improvement in all three assessments. Every subject in the DHEA group had a 50 percent or greater improvement in the Hamilton scale, while only 13 subjects in the placebo group improved on this scale. In their conclusions the researchers wrote that DHEA was found to be an effective treatment for mild to moderately severe midlife-onset depression. Dr. Norman Shealy, Founder of American Holistic Medical Association and an expert on DHEA research, calls DHEA, "a measure of life force...the single most important hormone in the body." But while DHEA supplementation offers powerful health benefits, the effects must be monitored by a medical professional. As one of our panelist, Martin Milner, N.D., explains, "Even at small doses, it's relatively easy to overdose on DHEA if you don't actually have a deficiency." DHEA normally exists in a balance with other corticosteroid hormones like cortisol. If your cortisol levels are already low (often the result of constant or long-term stress), DHEA supplements can drive them even lower, leading to increased inflammation, light-headiness, and fatigue. Also, because DHEA can be converted into estrogen and testosterone, over-supplementation with DHEA may lead to unpredictable imbalances in sex hormone profiles. For men, this can increase the risk of prostate cancer. For women, it can lead to a deepened voice, excessive hair growth, and other masculinizing effects. Levels of DHEA, along with cortisol and sex hormones, can be measured with a simple saliva test to determine whether or not you would benefit from DHEA supplementation and to monitor its effects on an ongoing basis. Dr. Milner recommends that anyone using DHEA ask their doctor to monitor salivary hormone levels at least once every six months.

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