Levels of DHEA-S reflect adrenal gland function.
Dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands, is the precursor for estrogens and testosterone, and is therefore normally present in significantly greater quantities than all the other steroid hormones.
It is mostly found in the circulation in the form of its sulfate ester, DHEA sulfate (DHEA-S), levels of which in saliva are higher and more stable than those of DHEA.
Its production is highest in the late teens to early 20s and declines gradually with age in both men and women.
Low DHEA-S indicates adrenal insufficiency and/or androgen deficiency and can be associated with reduced libido and general malaise.
DHEA supplementation has been successfully used to treat adrenal insufficiency and can restore normal levels of testosterone in women with androgen deficiency, particularly as a consequence of ovary removal. Because of its conversion to potent estrogens and androgens, levels should be closely monitored during supplementation to avoid excess. DHEA is a supplement commonly used topically and orally. It is marketed as a dietary supplement for weight loss, increased metabolism, and memory enhancement.
Chronic low DHEAS may suggest HPA axis dysfunction, particularly if cortisol is also low and symptoms are indicative of low adrenal function.
High DHEA-S levels are seen in hyper-adrenal states such as CAH, and in polycystic ovarian syndrome; high levels in women are associated with masculinizing effects because of its local metabolism to testosterone.
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