Oral Dehydroepiandrosterone Supplementation can Increase the Testosterone/Epitestosterone Ratio (Technical Briefs‪)‬

The availability of endogenous anabolic steroids and their precursors in the form of "dietary supplements" has become widespread in the United States. The popularity of dehydroepiandrosterone (DHEA) arose from a number of reports in the popular press that suggested that the results of a study conducted by Morales et al. (1) characterized DHEA as similar to the mythical fountain of youth. Increased use of DHEA among athletes was reported anecdotally before and during the 1996 Olympic Games, and the International Olympic Committee (IOC) Medical Commission explicitly added the compound to the list of prohibited compounds in December 1996, although it would have been considered prohibited previously under the "related compounds" provision of the list. Other groups testing for steroids have either added DHEA as an example of a prohibited compound or assumed that it did not play a role in their testing program. Some researchers have questioned whether the use of compounds that are precursors of the anabolic steroid testosterone increase testosterone and therefore impact the testosterone/epitestosterone (T/E) ratio. Two studies have reported that no increase in the T/E ratio occurred when DHEA was given (2,3). We report here on the impact of administration of two over-the-counter DHEA preparations on the excretion of several steroids, and a greater than 6:1 dose-dependent increase of the T/E ratio in one individual.