Dehydroepiandrosterone Sulfate (DHEA-S)
Other names: dhea-s, dhea-sulfate, DHEA SULFATE, Dehydroepiandrosterone Sulfate (DHEA-S), dhea-sulfate, DHEAS, Dehydroepiandrosterone [DHEA-S], DHEA SULPHATE
What is DHEA?
Dehydroepiandrosterone (DHEA) is a naturally occurring steroid hormone produced mainly by the adrenal glands, with smaller amounts synthesized in the gonads (ovaries and testes) and the brain. DHEA acts primarily as a precursor for the body’s major sex hormones—testosterone and estrogen—meaning it is converted into these hormones as needed. This role is crucial for reproductive function, mood regulation, metabolism, immune function, and maintaining overall hormonal balance in both men and women.
Biological Functions of DHEA
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Hormone Precursor: DHEA is converted into androgens (like testosterone) and estrogens, supporting the development of secondary sexual characteristics and reproductive health.
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Neurosteroid: DHEA has effects in the central nervous system, acting as a neurosteroid that can influence mood, cognitive function, and memory.
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Metabolic and Immune Effects: It modulates endothelial function (essential roles in maintaining blood vessel health and regulating blood flow), reduces inflammation, improves insulin sensitivity, supports fat metabolism, and may enhance immune response.
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Antioxidant Properties: DHEA may help combat oxidative stress and inflammation.
DHEA vs. DHEA-S (DHEAS)
| Feature | DHEA (Free Form) | DHEA-S (Sulfated Form) |
|---|---|---|
| Structure | Active, free hormone | Sulfated, more stable in bloodstream |
| Production Site | Adrenal glands, gonads, brain | Primarily adrenal glands |
| Circulation Time | Shorter | Longer |
| Measurement | Less commonly measured | Preferred for blood tests |
| Clinical Use | Reflects immediate hormone status | Reflects overall DHEA production |
DHEA-S (dehydroepiandrosterone sulfate) is the sulfated, more stable form that circulates in higher concentrations in the blood and is the preferred marker for assessing DHEA production in laboratory tests. DHEA-S can be converted back to DHEA within cells as needed.
DHEA Levels Over the Lifespan
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Newborns: High levels that drop rapidly after birth.
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Puberty: Levels rise, supporting sexual development.
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Early Adulthood: Peak levels.
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After Age 30: Gradual decline, with levels decreasing by up to 80% by the 70s or 80s.
Low DHEA or DHEA-S levels are associated with aging, adrenal dysfunction, and several health conditions, while abnormally high levels may indicate hormonal imbalances or adrenal disorders.
Clinical Uses and Supplementation
DHEA is available as a dietary supplement and is sometimes used with claims of improving mood, energy, bone density, muscle strength, and sexual function, as well as slowing aging. However, scientific evidence supporting many of these uses is limited or mixed, and DHEA supplementation can have side effects and risks, especially if used without medical supervision.
Summary
DHEA is a key hormone precursor produced mainly in the adrenal glands, essential for the synthesis of testosterone and estrogen, and plays roles in metabolism, immune function, and neurological health. DHEA-S is the stable, circulating form measured in blood tests to assess adrenal and hormonal health. Both forms decline with age, and abnormal levels can indicate various health issues.
What does it mean if your Dehydroepiandrosterone Sulfate (DHEA-S) result is too high?
What Do Elevated DHEA or DHEA-S Levels Mean?
Elevated levels of DHEA (dehydroepiandrosterone) or DHEA-S (DHEA sulfate) can indicate increased androgen activity and may be linked to various hormonal or adrenal conditions. While DHEA is a natural steroid hormone involved in the production of testosterone and estrogen, excessively high levels—especially in women—can result in symptoms of androgen excess and signal an underlying endocrine disorder.
Possible Causes of Elevated DHEA or DHEA-S
1. Polycystic Ovary Syndrome (PCOS):
One of the most common causes in women. PCOS is characterized by irregular menstrual cycles, infertility, hirsutism (excess hair growth), acne, and weight gain due to insulin resistance and elevated androgen levels.
2. Congenital Adrenal Hyperplasia (CAH):
A group of inherited genetic disorders that affect the adrenal glands' ability to produce hormones. In some forms, the body produces excess androgens like DHEA, leading to symptoms similar to PCOS, even in childhood.
3. Adrenal Tumors (Benign or Malignant):
Tumors in the adrenal glands can lead to overproduction of DHEA or other hormones. While many are benign (adrenal adenomas), some may be cancerous or hormonally active.
4. Adrenal Hyperplasia (Non-CAH):
Overgrowth of adrenal gland tissue can result in higher-than-normal hormone production without a genetic cause.
5. Early-Onset Puberty (Premature Adrenarche):
In children, elevated DHEA may cause early signs of puberty, such as body odor, acne, and the development of pubic or underarm hair at an unusually young age.
6. Stress (Acute or Chronic):
DHEA is part of the body’s stress response. Acute stress may temporarily raise levels, while chronic stress might disrupt the balance of DHEA and cortisol.
7. DHEA Supplementation or Medications:
Exogenous DHEA supplements and certain drugs (such as hormonal therapies or corticosteroids) can elevate DHEA or DHEA-S in the bloodstream.
Symptoms of Elevated DHEA/DHEA-S
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Irregular or missed menstrual periods (amenorrhea)
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Excess facial or body hair (hirsutism)
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Oily skin and persistent acne
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Hair thinning or scalp hair loss (male-pattern baldness)
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Deepening of the voice (in severe cases)
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Enlargement of external genitals in girls (virilization)
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Mood changes, including anxiety, irritability, or depression
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Fatigue or low energy
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Weight gain and signs of insulin resistance
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Early puberty in children
Clinical Significance
Persistently high levels of DHEA or DHEA-S are markers of androgen excess and can guide the evaluation of adrenal or ovarian function. Blood tests for DHEA-S are commonly ordered as part of a hormonal panel when symptoms suggest hormonal imbalance, PCOS, adrenal disorders, or premature puberty.
Treatment Options for Elevated DHEA/DHEA-S
The treatment plan depends on the underlying cause of elevated DHEA levels:
1. Polycystic Ovary Syndrome (PCOS):
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Oral contraceptives: Help regulate menstrual cycles and reduce androgen-related symptoms.
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Anti-androgen medications: Such as spironolactone, which can reduce hair growth and acne.
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Metformin: Improves insulin sensitivity and may help lower androgen levels.
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Lifestyle interventions: Weight loss, a low-glycemic diet, and regular exercise are often first-line recommendations.
2. Congenital Adrenal Hyperplasia (CAH):
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Glucocorticoid therapy: Medications like hydrocortisone can help suppress excess androgen production.
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Specialist care: Ongoing monitoring by an endocrinologist is essential for hormone regulation and fertility planning.
3. Adrenal Tumors or Hyperplasia:
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Surgical removal: Tumors that produce excess DHEA, especially if malignant or causing severe symptoms, may require surgery.
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Monitoring: Benign adrenal nodules may be observed with periodic imaging and hormone testing.
4. Early-Onset Puberty:
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Pediatric endocrinology evaluation: Hormonal therapy may be needed to delay puberty progression and normalize growth patterns.
5. Stress-related elevations:
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Stress management: Techniques such as cognitive behavioral therapy (CBT), mindfulness, sleep hygiene, and exercise can help rebalance adrenal hormones.
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Nutritional support: Adaptogenic herbs and targeted nutrients (with medical guidance) may support adrenal health.
6. Supplement or medication-induced elevations:
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Discontinuation or dose adjustment: Review and adjust any supplements or prescriptions that may be contributing to elevated levels, under medical supervision.
When to See a Doctor
If your bloodwork shows elevated DHEA or DHEA-S—especially alongside symptoms of hormonal imbalance—it's important to consult a healthcare provider. Further testing may be necessary to evaluate adrenal and ovarian function and rule out more serious conditions.
Summary
High DHEA or DHEA-S levels often point to excess androgen production, commonly seen in conditions like PCOS, adrenal tumors, and congenital adrenal hyperplasia. These imbalances can lead to significant symptoms affecting appearance, mood, metabolism, and fertility. Fortunately, with accurate diagnosis and individualized treatment—ranging from medications to lifestyle changes—hormone levels can often be managed effectively.
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What does it mean if your Dehydroepiandrosterone Sulfate (DHEA-S) result is too low?
Please check the age and gender specific reference ranges in the "Research" section.
Although DHEA levels decline naturally with age, they may also be lowered by conditions such as:
- Autoimmune disease such as Addision's disease, lupus, and rheumatoid arthritis.
- Chronic stress
Unfortunately, some of the medications used to treat symptoms of these illnesses can also deplete DHEA in the body. Do not attempt to adjust the dosage of your medication on your own. If your DHEA is low, your doctor will sugget the best way to remedy the problem.
If chronic stress is behind decreased DHEA, do your best to eliminate the source of stress from your life. Getting at least eight hours of sleep every night can also help reduce strew, as can exercising aerobically for approximately thirty minutes a day, three to four times a week. As low DHEA levels may be associated with inflammation, it is wise to cut back on foods that can have an inflammatory reaction in your body.
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