Twenty patients (aged 18-45 years) with chronic active inflammatory bowel disease (7 with Crohn's disease, 13 with ulcerative colitis) that had failed to respond to various medications were treated with 200 mg/day of dehydroepiandrosterone (DHEA) for eight weeks. Six patients with Crohn's disease (83%) and six with ulcerative colitis (46%) went into remission (i.e., Crohn's disease activity index < 150; clinical activity index 4 or lower for ulcerative colitis). Two other patients (15%) with ulcerative colitis were considered treatment responders (i.e., a decrease in the clinical activity index of more than 4 points). No patient discontinued treatment because of side effects.

Comment: DHEA, a steroid hormone produced by the adrenal glands, testes and ovaries, has a wide range of effects on immune function. Blood levels of DHEA-sulfate, the predominant circulating form of DHEA, are low in patients with ulcerative colitis and Crohn's disease. In previous studies, administration of DHEA reduced disease activity in patients with systemic lupus erythematosus (SLE). As both SLE and inflammatory bowel disease are autoimmune diseases, DHEA has been used by some practitioners to treat inflammatory bowel disease, with apparently good results. The results of the present study suggest that DHEA is an effective treatment for both ulcerative colitis and Crohn's disease.

The dose used in this study was considerably larger than the amount the human body normally secretes. Although no adverse effects were seen, it is possible that long-term administration of high doses of DHEA would cause problems, such as the development of hormone-dependent cancers. For that reason, the lowest effective dose of DHEA should be used. I have observed that when DHEA is used as part of a comprehensive treatment program that includes allergen avoidance and nutritional supplementation, doses of DHEA closer to the physiological range (such as 15-30 mg/day) are helpful for some patients with inflammatory bowel disease.

Andus T, et al. Patients with refractory Crohn's disease or ulcerative colitis respond to dehydroepiandrosterone: a pilot study. Aliment Pharmacol Ther 2003;17:409-414.