Journal of Behavioral Medicine, VoL, 15, No.

4, 1992

Elevated Serum Dehydroepiandrosterone Sulfate

Levels in Practitioners of the Transcendental
Meditation (TM) and TM-Sidhi Programs
Jay L. Glaser, 1,4 Joel L. Brind, 2,3 Joseph H. Vogeiman, 2 Michael J.
Eisner, 1 Michael C. Dillbeck, 1 R. Keith Wallace, 1 Deepak Chopra, 1
and Norman Orentreich 2
Accepted for publication October 14, 1991

Serum dehydroepiandosterone sulfate (DHEA-S) levels were measured in 270

men and 153 women who were experienced practitioners of the Transcendental
Meditation (TM) and TM-Sidhi programs, mental techniques practiced twice
daily, sitting quietly with the eyes closed. These were compared according to
sex and 5-year age grouping to 799 male and 453 female nonmeditators. The
mean DHEA-S levels in the TM group were higher in all 11 of the age groups
measured in women and in 6 of 7 5-year age groups over 40 in men. There
were no systematic differences in younger men. Simple regression using
TM-group data revealed that this effect was independent of diet, body mass
index, and exercise. The mean TM-group levels measured in all women and
in the older men were generally comparable to those of nonmeditator groups
5 to 10 years younger. These findings suggest that some characteristics of TM
practitioners are modifying the age-related deterioration in DHEA-S secretion
by the adrenal cortex.
KEY WORDS: practitioners; serum dehydroepiandrosterone sulfate; transcendental medita-
tion.

1The Department of Physiological and Biological Sciences, Maharishi International University,

Fairfield, Iowa 52556.
2The Orentreich Foundation for the Advancement of Science, Inc., Cold Spring-on-Hudson,
New York 10516.
3Department of Natural Sciences, Baruch College, CUNY, New York, New York 10010.
4To whom correspondence should be addressed at Maharishi Ayur-Veda Health Center for
Behavioral Medicine and Stress Management, P.O. Box 344, Lancaster, Massachusetts 01523.

327
0160-7715/92/0800-0327506.50/0 9 1992Plenum PublishingCorporation
328 Giaser et aL

INTRODUCTION

The serum level of the adrenal androgen, dehydroepiandrosterone sul-

fate (DHEA-S), is closely correlated with age in humans and has also been
associated with measures of health and stress. Cross-sectional studies have
indicated that serum DHEA-S levels rise throughout childhood and adoles-
cence and attain peak levels during the midtwenties. Thereafter, DHEA-S
levels decline logarithmically with age to reach values in the eighth and ninth
decades that are only 20% of peak levels (Orentreich et al., 1984).
Higher levels of DHEA-S have also been associated with a reduction
in age-related disorders. In men over 50, but not in women, DHEA-S con-
centrations appear to be inversely correlated with death from both ischemic
heart disease and all cardiovascular diseases as well as with death from
any cause (Barrett-Connor et al., 1986). Subnormal plasma concentrations
of both D H E A and DHEA-S have been associated with breast cancer
(Browney et al., 1972, Wang et al., 1974) and subnormal concentrations of
urinary metabolites of DHEA-S have been associated with increased risk
of breast cancer up to 9 years prospectively (Bulbrook et al., 1971). Oral
administration of DHEA has been noted to lower serum low-density lipo-
protein levels in normal men (Nestler et al., 1988) and DHEA-S levels in
women in late menopause have been found to be positively correlated with
bone density (Deutsch et al., 1987). Delta-5 adrenal androgen levels may
also be a reflection of stress: basal unconjugated DHEA excretion de-
creases in patients with chronic illness (Parker et aL, 1985b), serum DHEA-
S levels fall following burn trauma (Parker and Baxter, 1985), and adrenal
androgens have been found to be depressed in combat troops under threat
of attack (Rose et aL, 1969). Serum DHEA levels were observed to increase
following improvement of the social environment of elderly individuals
(Arnetz et aL, 1983).
A previous report suggests that individuals over 55 practicing the
Transcendental Meditation (TM) technique have a younger physiological
age than a control population on a standardized index that estimates bio-
logical age using blood pressure, auditory threshold, and near-point vision
(Wallace et al., 1982). In a Harvard study involving 73 elderly nursing-home
residents, subjects taught TM had reduced mortality and improved cogni-
tive flexibility, learning and word fluency compared to subjects randomized
into groups receiving progressive relaxation, mindfulness therapy, or no
treatment (Alexander et al., 1989). TM practitioners have also been re-
ported to improve on other physiological and psychological parameters that
tend to deteriorate with age, such as reaction time (Appelle and Oswald,
1974), latency of brain-stem auditory evoked potentials (McEvoy et al.,
1980), systolic blood pressure (Wallace et al., 1983), and serum cholesterol
Elevated Dehydroepiandrosterone Sulfate in TM Practitioners 329

levels (Cooper and Aygen, 1979). A recent study of 2000 TM practitioners

subscribing to a major health insurance carrier found reduced medical utili-
zation rates for 16 of 17 major medical treatment categories (obstetrical
utilization was similar), including 55.4% fewer admissions for tumors and
87% fewer admissions for heart disease, compared with nonmeditating co-
horts (Orme-Johnson, 1987), implying that TM practitioners may have
lower morbidity. This lower utilization was most pronounced in the older
age groups.
We hypothesized that TM practice may be a behavior that elevates
DHEA-S levels. As a first step, a cross-sectional study was conducted in a
group of experienced TM practitioners.

METHODS

Subjects

Subjects were recruited in order to give representative samples from

all age groups in both sexes. Comparison subjects were members of a study
reported previously and comprised 799 men and 453 women (Orentreich et
al., 1984). These subjects represented a healthy fraction of the patients of
a large, well-known New York City practice specializing in cosmetic derma-
tology who visited the practice from 1980 to 1983 for cosmetic procedures
such as hair transplants, dermabrasion, and removal of warts and moles.
Criteria for exclusion included the presence of major medical disorders or
any disorder known to affect androgen levels. Comparison subjects had con-
firmation of normal serum assays for T4, T3 uptake, cortisol, testosterone,
and sex hormone binding globulin and could not be taking medications
known to affect androgen levels. Women in this group were not taking glu-
cocorticoids or estrogens and had no significant acne, alopecia or hirsutism.
Inclusion criteria for TM group subjects were identical except for hor-
mone determinations: all but 38 of the men had confirmation of normal
levels of serum cortisol and T4, and all but 55 had measurement of tes-
tosterone and sex hormone binding globulin. These determinations were
not performed with the TM women's sera. TM-group subjects were re-
cruited from any practitioners of the TM technique on the Maharishi In-
ternational University ( M I U ) campus in Fairfield, Iowa. Campus
populations were targeted for recruitment to facilitate enrollment of ade-
quate samples from all age groups (270 men age 20 to 81 and 153 women
age 20 to 74). All but 28 of the TM subjects over 45 years of age were
volunteers recruited by public announcements during conferences for ad-
vanced TM practitioners held on campus from 1983 to 1987. All TM-group
330 Giaser et al.

subjects under 45 and 28 subjects over 45 were recruited from MIU stu-
dents, faculty, and staff and from meditating members of the Fairfield com-
munity, including senior citizen groups.
Sampling of the TM group began in 1982 before the end of the sam-
piing period of the comparison group. All younger men and the majority
of men over 45 were sampled during 1982 and 1983. Sampling of women
over 45 began in 1984 and continued through 1987 due to the relative pau-
city of long-term meditators in the oldest age groups. Similarly, recruitment
of adequate numbers for the oldest male groups was completed in 1987.
All women under 45 were sampled in April 1987.
All TM subjects practiced the Transcendental Meditation technique as
taught by Maharishi Mahesh Yogi (Wallace, 1970). Most were advanced
meditators, with a mean length of regular practice of 10.3 years for men and
11.1 years for women (range, 8 months to 26 years for all subjects). Ninety-
two percent of the women and 93% of the men were also practitioners of
the more advanced TM-Sidhi program. TM is a simple, mental technique
practiced twice daily (usually in the morning and evening) for 20 min, sitting
comfortable with the eyes closed. During this period, the meditator remains
wakeful and alert, effortlessly thinking in a prescribed manner a specific
meaningless sound (mantra), and generally experiences a state of quiet inner
awareness. The TM-Sidhi program is an advanced meditation technique, simi-
larly practiced sitting with the eyes closed for an additional 20 to 30 min. In
the TM-Sidhi program, instead of a meaningless mantra, the subject of medi-
tation is a set of specific, meaningful aphorisms known as sutras (Mukerji,
1977). The physiological studies on these techniques have been reviewed in
meta-analysis elsewhere (Dillbeck and Orme-Johnson, 1987).
A comprehensive health questionnaire was administered to all TM
subjects before venipuncture and included variables of health history, medi-
cation, physiognomy, diet, tobacco and alcohol consumption, physical ex-
ercise, sleep patterns, participation in TM and other stress reduction
programs, and menstrual and endocrine parameters. This lengthy question-
naire was not given to the comparison group, who were screened from their
clinical records. It is possible that some members of the comparison group
were practitioners of the TM program, but this would not likely be much
more than 0.5% of the population, the estimated proportion of the U.S.
population practicing the technique.

Experimental Procedure

Blood was drawn on TM group subjects under 45 between 10:45 and

11:45 AM; men were sampled in September and October, and women in
Elevated Dehydroepiandrosterone Sulfate in TM Practitioners 331

April and May. For logistical reasons during the conferences, most TM
subjects over 45 were sampled between 1:00 and 2:30 PM, after they had
taken lunch; most older women were sampled in July, and men in Decem-
ber. Sera were drawn on comparison subjects at random times during medi-
cal office hours throughout the year. Serum was separated immediately
after coagulation and the specimens were stored in hermetic polyethylene
tubes at -80~ without thawing until assay. The long-term stability of
DHEA-S in frozen serum has ben documented previously (Orentreich et
al., 1984). Serum sodium was assayed on random samples to verify that
concentration of frozen aliquots due to desiccation had not occurred.

Radioimmunoassay (RIA) of Serum DHEA-S

Serum DHEA-S levels were measured by direct radioimmunoassay

(Buster and Abraham, 1972) using as the radiolabeled ligand [1,2-3H] - in-
stead of [7-3H] dehydroepiandrosterone as described by the original
authors. Duplicate aliquots of serum were diluted 1:2000 to a final volume
of 0.5 ml and incubated overnight with 12,000 dpm of tracer (in 0.1 ml)
and 0.1 ml of antiserum (Environmental and Endocrine Products, Cliffside
Park, N J). The unbound steroid was removed with dextran~ charcoal,
and an aliquot of the supernatant was counted. The cross-reactivity of the
rabbit antiserum with unconjugated (free) D H E A was 100%. The results,
therefore, represent the sum of serum D H E A and DHEA-S, although the
contribution from D H E A is negligible because of the thousandfold greater
abundance of DHEA-S in serum. Other steroids did not contribute more
than 0.02 gg/dl to the assay values. The sensitivity of the method was 0.004
p.g/assay tube, equivalent to 16.0 gg/dl serum (Abraham, 1975). Sera which
contained less than 40 ~tg/dl were reassayed at a 1:500 dilution (detection
limit, 4.0 gg/dl). The mean intraassay coefficient of variation was 10%, and
the maximum interassay coefficient of variation (n = 6) was 12% for the
range 47 to 413 gg/dl. Although sera from the comparison and TM groups
were assayed in different batches, inclusion of random samples from sub-
jects in the comparison group as well as standardized sera were included
with all assays, and there was no drift in the assay over time.

Statistical Methods

Data were analyzed by 5-year age groups, i.e., 20-24, 25-29, 30-34,
35-39, 40-44, 45--49, 50-54, 55-59, 60-64, 65-69, and 70-74 (for men the
oldest category was 70+ years, since male meditators up to 81 were in-
cluded). Analysis of variance was performed using a two-way design of age
332 G l a s e r et aL

vs. T M status (i.e., meditator or nonmeditator), with correction for multiple

comparisons. Since the distribution of D H E A - S for all age groups was
skewed toward higher values, the logarithm of the D H E A - S value was
taken as the dependent variable to normalize the distribution curve. In ad-
dition, analysis of variance was performed on nonlogarithmic, normalized
data, in which each value was expressed as a percentage of the mean. Sim-
ple regression was used to control for other life-style variables which could
have influenced D H E A - S levels. For regression, T M group D H E A - S was
expressed as a percentage of the mean for comparison subjects of the same
age to control for the observed decline of D H E A - S values with age.

RESULTS

The mean serum D H E A - S levels (i.e., ant• of mean logarithmic

D H E A - S ) in all age groups are summarized in Tables I and II and Figs.
1 and 2. Analysis of variance revealed that there were significant systematic
effects for both age and T M practice, accounting for the differences in
group mean D H E A - S levels. The effect of age was significant for both men
and women [F(10,1047) = 53.88, p < .0001, and F(10,585) = 31.67, p <
.0001, respectively]. This reflected a progressive decline of D H E A - S with
increasing age, as found in prior studies. The effect of T M practice was
also significant [F(1,1047) = 16.03, p = .0001 for men and F(1,585) =
17.55, p < .0001 for women]. T M participants showed higher levels than

Table I. Serum DHEA-S Concentrations (• SEM) in 1069 Men for Comparison and
TM Groups
Comparison group TM group
DHEA-S level DHEA-S level % Elevation in
Age group N (~g/dl) N (~g/dl) TM group
20-24 216 347• 11 350• 1
25-29 151 314• 33 341• 8
30-34 82 325• 44 317• -2
35-39 70 294• 66 249• -15
40-44 63 215_+21 8 229• 6
45-49 59 182• 27 205• 13
50-54 53 126• 20 195• 54
55-59 40 147• 25 127• -14
60-64 27 98• 15 137• 40
65-69 20 92• 11 127• 37
70+ 18 59• 10 130• 121
Total 799 270
Elevated Dehydroepiandrosterone Sulfate in TM Practitioners 333

Table II. Serum DHEA-S Concentrations (• SEM) in 606 Women for

Comparison and TM Groups
Comparison group TM group
DHEA-S DHEA-S % Elevation in
Age group N level (llg/dl) N level (gg/dl) TM group
20-24 54 2302-_27 11 269-2-42 17
25-29 65 217• 10 221• 2
30-34 52 159-+18 13 218• 37
35-39 54 137• 15 176+-21 28
40-44 44 127• 10 162• 28
45-49 51 88• 30 117• 34
50-54 39 7ffZ--12 16 108• 54
55-59 28 61• 14 78• 29
60-64 36 56_+08 11 98• 76
65-69 19 43• 18 56• 30
70-74 11 46• 5 54• 17
Total 453 153

4OO
350 ~ ~ Men

3OO
| C o m p a r i s o n Group

250

200
w
,,1-
I~ 150
E
:~ 100
i..,

50

0 20-24 25129 30'-34 35139 4o I`4`4 45149 50'-54 55159 60164 c51c,9 70,,
Age (years)

Fig. 1. Serum DHEA-S concentrations (• vs. age in men. Group mean DHEA-S
levels are displayed according to 5-year age grouping in the TM group (open circles)
and comparison group (filled circles). In both groups, DHEA-S decreases with age.
There are no systematic differences in DHEA-S levels in the younger age groups, but
TM group levels are higher in six of seven age groups over 40 years. The DHEA-S
concentrations shown represent the antilog of group mean log DHEA-S values. The
curves obtained were fitted to the data using the equation a x ~ b x 2 + cx +d.
334 Glaser et al.

400
Women

350

_ 9 Comparison Group
300
A
"0
250
::=L
v

O3
200
IM
"I-
Q 150

E
"-i 100
t,
t.~
50

0 i , i i i ~ ~ i i i i
20-24 25-29 30-34 35-39 40-,~4 z-5-49 50-54 55~59 60-64 65-69 70-74

Age (years)

Fig. 2. Serum DHEA-S concentrations (_+SEM) vs. age in women. DHEA-S declines
with age in both the TM and the comparison groups, and the TM-group values are
higher in all age groups. TM-group values are characteristic of comparison-group
women 5 to 10 years younger.

the comparison group for both men and women. Similar significance was
found using nonlogarithmic, normalized data.
For men, but not for women, there was also a significant interaction
[F(10,1047) = 4.18, p -- .0001] between TM practice and age: TM practice
had a significant effect only in older male age groups. A test of simple
main effects for each male age group was significant (F>3) for the groups
35-39, 50-54, 60-64, 65-69, and 70+ (p < .05). All four of the significant
or near-significant simple main effects for men over 40 were in the direction
of TM participants having higher values. Simple main effects were not de-
termined for women since an interaction was not observed. In all 11 of
the measured age groups in women, the mean DHEA-S levels of the TM
group were higher than for the nonmeditators.
There were several variables recorded from the TM-group subjects
that differed from the norm and that conceivably could account for the
observed differences in DHEA-S levels. A high proportion of subjects,
mostly from the younger age groups, was vegetarian (40% of women and
59% of men). In women, there was no correlation between meat consump-
tion and DHEA-S elevation (r = -.009). In men, meat consumption was
positively correlated with DHEA-S elevations (r = .20). This was attributed
to the fact that nonvegetarians were predominantly in age groups over 40,
Elevated Dehydroepiandrosterone Sulfate in TM Practitioners 335

the only male groups in which DHEA-S elevations were observed. Similarly,
exercise and indices of obesity (body mass index and deviation from ideal
weight) were not correlated with DHEA-S elevation (r < .15 for all values).
Because so few TM subjects used tobacco or alcohol, it was not pos-
sible to analyze these factors as contributing variables. Although 49% of
the male and 55% of the female members of the TM group were former
smokers, and 32% of the men and 29% of the women were smoking at
the time of instruction in TM, only 0.7% of the men and 1.9% of the
women still smoked at the time of the study. This is probably considerably
different from the nonmeditators, for whom data on smoking activity were
not collected. In the population at large, for similar age groups, the inci-
dence of smoking was 37% for men and 28% for women (National Center
for Health Statistics, 1985). Similarly, only 9% of TM practitioners con-
sumed any alcohol.

DISCUSSION

The data presented here reveal that men over 45 and women of all
age groups, who are experienced practitioners of the TM and TM-Sidhi
programs, have serum DHEA-S concentrations that are higher than those
found in a healthy, normal, nonmeditating population consulting derma-
tologists for cosmetic reasons and reported previously by the same labora-
tory. Two important questions must be addressed: first, whether the
comparison between groups is valid; and second, whether these findings
are the result of regular practice of the TM program or whether they reflect
another characteristic of the TM group or some other experimental effect.
It is unlikely that the observed differences are due to the selection
of the comparison population. Comparison subjects represented healthy cli-
ents who visited a cosmetic surgery/dermatology practice, but these values
are probably representative of North American values in general. Virtually
identical data for each age grouping were obtained from 517 normal female
participants in a multiphasic health screening program of the (Kaiser) Per-
manente Medical Group, Oakland, CA (Orentreich et al., 1984) and from
98 normal male participants in the Baltimore Longitudinal Study on Aging
(Orentreich et al., manuscript in preparation).
Although the TM-group subjects were different from normal popu-
lations in their reduced consumption of tobacco, alcohol, and meat, as
noted above, as well as of prescribed and nonprescribed drugs, the observed
results could not be attributed to any of these factors. Analysis indicated
that vegetarianism did not make a systematic contribution to the elevated
mean DHEA-S levels. This conclusion is supported by the findings of
336 G l a s e r ~ aL

Schultz and Keklem (1983), who measured DHEA-S of 159 _+ 65 Bg/dl in

vegetarian women (mean age, 32.6) vs. 176 + 48 ~tg/dl in nonvegetarians
(mean age, 32.0), and by H/im/il/iinen et al. (1984) who did not observe
any change in DHEA-S in 30 men transferred from a diet high in saturated
fat and animal protein to an experimental diet consisting mostly of fruit,
vegetables, vegetable oils, and fish. In addition, Hill et al. (1977) did not
observe any change in D H E A levels in four female nurses who were
switched to a low-fat vegetarian diet.
It is also improbable that the lack of smokers in the TM group con-
tributed to the differences, since cigarette smoking has been found to in-
crease DHEA-S as well as androstenedione levels in both women (Khaw
et al, 1988) and men (Barrett-Connor and Khaw, 1987). These findings ap-
pear, at first, to be paradoxical and to cast doubt on the validity of DHEA-S
as a marker of aging. However, it is known that the human lung has con-
siderable capacity to metabolize DHEA-S, both to other sulfoconjugates
(Menzel et al., 1970) and to unconjugated steroids (Milewich et al., 1983),
and to metabolize androstenedione (Milewich et al., 1977). Consequently,
cigarette smoking may impair normal pulmonary clearance of adrenal an-
drogens, a finding which has been demonstrated in the rat (Hartiala et al.,
1978). Thus, any aging study in which the test population has compromised
pulmonary function relative to a healthy population, including exposure to
tobacco smoke, could not rely on DHEA-S as an aging marker. In the
present study, the strong likelihood of a higher smoking incidence in the
comparison group (though not measured) than in the meditators might sim-
ply raise the "noise" level of DHEA-S in the comparison group and mask
DHEA-S elevations in the TM group due to other factors. We are not
aware of any studies indicating an influence of alcohol on DHEA-S.
We could also not explain any difference in the two populations from
the sampling methods. The DHEA-S levels used for the comparison group
norms were assayed under identical conditions in the same laboratory. Al-
though assaying of meditator sera continued 3 years longer than the com-
parison group, many assays were contemporaneous. DHEA-S, unlike D H E A
and other androgens, is secreted into a large plasma pool with a half-life
of 10-20 hr and, therefore, does not display large circadian or ultradian
rhythmic fluctuations (Rosenfeld et al., 1975). Several recent studies, how-
ever, have shown small but significant circadian rhythms in plasma DHEA-S
by cosinor analysis in young (but not old) men (Del-Ponte et al., 1990; Mon-
tanini et al., 1988) and women (Carandente et al., 1990). These studies are
remarkable for the strong agreement among them: all showed amplitudes
of 11-15% of the mesor and an acrophase between approximately 2:00 and
4:00 PM for subjects of younger ages (21-23 years). While the lack of rhyth-
micity in the older men would rule out the timing of sampling as a source
Elevated Dehydroepiandrosterone Sulfate in TM Practitioners 337

of bias in our older men, a small bias might be expected in the case of
younger women, since the comparison group was randomly sampled
throughout the workday. However, the amplitude of the circadian rhythm
is in the same range as the variability of the DHEA-S assay itself and smaller
than the daily variability (Orentreich et al., 1984). Moreover, DHEA-S re-
mains at a broad plateau about the mesor through most of the workday
hours following a 10:00 AM nadir (Carandente et al., 1990). Since the
younger meditators were all sampled between 10:45 and 11:45 AM, any sam-
pling bias due to circadian variation would tend to mask rather than exag-
gerate the observed elevations of DHEA-S in young female meditators.
Sonka suggests that fasting may increase D H E A excretion (Sonka,
1976), but we are not aware of any postprandial changes in DHEA-S which
could account for the elevated levels in the older group, who were sampled
in the early afternoon. Similarly, no significant monthly, seasonal, or annual
rhythms have been observed in men (Orentreich et al., 1984), and the 28%
circatrigintan variation in DHEA-S observed with menses (Sinkl6si et al.,
1984) would be expected to be distributed approximately uniformly across
the subjects in both groups.
One must finally consider whether the TM group represents a self-
selected group that may have had other characteristics responsible for
maintaining elevated levels of DHEA-S. If individuals who began TM
tended to be healthier than the population at large, or if only the healthiest
older meditators attended meditation conferences and volunteered for this
study, then this may have provided a skewed sample of healthier individuals
with a younger physiological age, who conceivably might have higher con-
centrations of DHEA-S. The same exclusion criteria were utilized for both
TM and comparison groups. Since data have been published indicating that
TM practitioners have lower health-care utilization (Orme-Johnson, 1978),
TM subject recruitment was designed to avoid selection bias. Nevertheless,
the possibility of selection bias remains an important confounder of these
data that cannot be dismissed.
This raises an important question that has not yet been sufficiently
investigated: whether DHEA-S levels are related not only to age, but also
to the general state of health, including the presence of chronic disorders,
debility, stressors, and other life-style variables. If chronic disease and stress
prove to be associated with subnormal DHEA-S levels, this could help ex-
plain our findings, because many of the physiological changes observed
both during and outside the practice of the TM technique are opposite to
those occurring in the acute and chronic adaption response to stressors:
decreased plasma cortisol (Jevning et al., 1978), attenuated catecholamine
production during exercise (Lang et al., 1979), increased 5-hydroxyindole-
3-acetic acid excretion (Bujatti and Riederer, 1976), reduced metabolism
338 G i a s e r a aL

in resting forearm muscle and decreased blood lactate (Jevning et al.,

1983a), and other physiological changes suggestive of decreased autonomic
and metabolic activation (Wallace et al., 1983; Jevning et al., 1983b).
The age-related decline in serum DHEA-S levels is probably due to
reduced secretion by the adrenal cell, since nearly all DHEA-S production
can be traced to the adrenal in both men and women, since DHEA-S is
not stored in the adrenal cortex, and since its metabolic clearance rate de-
clines slightly with age (Vermeulen, 1980; Laatikainen et al., 1971; Rivarola
et al., 1967). This implies that some mechanism in the TM group is pre-
venting the usual age-related reduction in those biochemical processes lead-
ing to delta-5 androgen production by the adrenal cell. If factors besides
age, such as stress, general health, and other life-style variables, modify
DHEA-S levels in normal individuals, then it would not be surprising that
DHEA-S elevations were also found in younger TM groups. It is not clear
why these elevations were found in younger women but not in younger
men.
Since TM practitioners have been shown to have an attenuated auto-
nomic response to stressors (Orme-Johnson, 1973), the higher DHEA-S
levels seen in the TM group may reflect protection against chronic over-
stimulation of the adrenal in response to stress. In support of this, Parker
et al. (1985a,b) found reduced DHEA-S/cortisol ratios in patients under
conditions of prolonged, severe illness and suggested that mineralocorticoid
and adrenal androgen synthetic mechanisms may have been shifted to glu-
cocorticoid production, which is essential to survival. The age-related de-
cline in DHEA-S, which appears to be retarded in the TM group, may be
due to decreased adrenal-cell responsiveness to ACTH (Pavlov et al., 1986)
or some other factor, due to shunting to glucocorticoid pathways, or in-
trinsic to the adrenal cell. Since delta-5 androgens have been shown to be
produced in primate brain, it is also conceivable that meditation may be
altering neurosteroid production in the central nervous system (Robel et
al., 1987).
It is still unclear whether higher DHEA-S levels significantly contrib-
ute to longevity and improved health in older individuals or whether ele-
vated D H E A - S levels simply reflect the lack of cumulative physical
deterioration due to age, chronic stress, and illness. There are many reasons
to suspect the latter in the difference between the two groups under study.
Although comparisons of general health were not made in this particular
study, the insurance study cited earlier (Orme-Johnson, 1987), showing re-
duced health-care utilization rates in TM practitioners, especially in the
oldest groups studied, used a population of meditators including many from
MIU and the surrounding community, implying that the meditators may
indeed have been healthier. Since TM practice is a behavior that has been
Elevated Dehydroepiandrosterone Sulfate in TM Practitioners 339

shown to modify numerous other physiological, psychological, and behav-

ioral parameters, we doubt that the observed elevations in DHEA-S are
primarily responsible for TM's effect on health utilization and other age-
related parameters.

ACKNOWLEDGMENTS

The authors gratefully acknowledge Clark T. Sawin, M.D., for his re-
view of the manuscript and Kiavdia Chervinsky, Despina Marinescu, Kokila
Patel, Bill Crosson, and Tom Moriarty for their skilled technical assistance.

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