DHEA-S Test: Purpose, High/Low Levels, Symptoms, Normal Range & Complete Guide
Overview
The DHEA-S (Dehydroepiandrosterone Sulfate) Test is a blood test used to measure the level of DHEA-S in the body. DHEA-S is the sulfated, more stable form of DHEA — a hormone produced mainly by the adrenal glands. Because DHEA-S stays in the bloodstream longer and exists in higher concentrations than DHEA, it is considered the most reliable marker for adrenal androgen production.
Doctors usually recommend this test to evaluate adrenal gland function, diagnose abnormal hair growth, investigate irregular periods, assess infertility, monitor early or delayed puberty, and detect conditions such as adrenal tumors or congenital adrenal hyperplasia (CAH). Since DHEA-S influences many hormonal processes, its measurement provides an important picture of overall endocrine health.
What Is the DHEA-S Test?
The DHEA-S test measures the amount of:
- DHEA-S, a stable hormone that reflects how active the adrenal glands are
DHEA-S functions as a precursor hormone. This means the body converts it into:
- Testosterone (androgen hormone)
- Estrogens (female hormones)
Because almost all DHEA-S is made in the adrenal glands, an abnormal test result gives a strong clue about adrenal hormone production. It also helps identify whether symptoms like hair growth, acne, infertility, or early puberty are related to hormone imbalance.
Where Is DHEA-S Produced in the Body?
1. Adrenal Cortex (Primary Source)
The adrenal cortex, which is the outer layer of the adrenal glands located above the kidneys, produces most of the DHEA and DHEA-S in the body.
Here:
- DHEA is synthesized
- DHEA is converted (sulfated) into DHEA-S, making it more stable and longer-lasting
2. Gonads (Small Amounts)
A very small portion of DHEA-S is produced in the:
- Ovaries (women)
- Testes (men)
However, these organs contribute only a minor fraction compared to the adrenal glands.
Main Functions and Importance of DHEA-S
DHEA-S is involved in several important hormonal functions:
1. Precursor for Androgens and Estrogens
DHEA-S is used by the body to produce testosterone and estrogen. Any abnormal level affects reproductive health, mood, and energy.
2. Marker of Adrenal Androgen Production
DHEA-S levels directly reflect adrenal gland activity, making this test extremely useful for diagnosing adrenal disorders.
3. Helps Diagnose Hormonal Disorders
Doctors use this test to identify:
- Polycystic Ovary Syndrome (PCOS)
- Congenital adrenal hyperplasia (CAH)
- Adrenal tumors (benign or cancerous)
4. Important for Sexual Development
In children and adolescents, DHEA-S plays a key role in starting puberty, body hair growth, and hormonal maturation.
5. Influences Fertility, Bone Strength & Mood
Abnormal DHEA-S levels can affect:
- Libido
- Energy levels
- Bone density
- Menstrual cycle regularity
- Muscle strength
- Emotional stability
Causes of Low DHEA-S Levels
Low DHEA-S usually indicates reduced adrenal function. Common causes include:
1. Adrenal Insufficiency (Addison’s Disease)
The adrenal glands fail to produce enough hormones, leading to very low DHEA-S.
2. Hypopituitarism
The pituitary gland does not release enough ACTH to stimulate the adrenal glands.
3. Natural Aging
DHEA-S levels peak in early adulthood and decline steadily after age 30.
4. Long-Term Corticosteroid Use
Steroid medications suppress normal adrenal function and reduce DHEA-S production.
5. Chronic Illnesses
Long-term health conditions such as autoimmune diseases or severe infections may lower hormone levels.
Symptoms of Low DHEA-S Levels
Symptoms may develop slowly and can be easily confused with other health issues. They include:
- Persistent fatigue
- Low energy or weakness
- Reduced libido
- Mood swings or depression
- Bone weakness or early osteopenia
- Muscle weakness
- Irregular or absent periods (women)
Because these symptoms are nonspecific, testing is important for accurate diagnosis.
Causes of High DHEA-S Levels
High DHEA-S typically indicates that the adrenal glands are producing excess androgens. Possible causes include:
1. Adrenal Tumors
Both non-cancerous and cancerous tumors can increase DHEA-S levels.
2. Congenital Adrenal Hyperplasia (CAH)
A genetic disorder that increases adrenal hormone production.
3. Polycystic Ovary Syndrome (PCOS)
A common cause of elevated DHEA-S in women due to excess androgen production.
4. Early Puberty
Children may produce high DHEA-S when puberty starts earlier than normal.
5. Rare Androgen-Secreting Tumors
Some ovarian or testicular tumors may increase DHEA-S.
Symptoms of High DHEA-S Levels
Symptoms depend on age and gender.
In Women
- Excess facial or body hair (hirsutism)
- Acne and oily skin
- Hair thinning or male-pattern baldness
- Irregular menstrual cycles
- Infertility
- Deepened voice in more severe cases
In Children
- Early pubic or underarm hair
- Rapid growth spurt
- Early puberty signs
In Men
Men usually show fewer symptoms, but may experience:
- Increased acne
- Mood changes
- Aggressive behavior
Reference Ranges
Typical DHEA-S values (may vary by laboratory):
Men (20–50 years)
- 125 – 619 µg/dL
Women (20–50 years)
- 45 – 270 µg/dL
DHEA-S levels are highest in early adulthood and decline naturally with age.
Sample Type
- Blood sample (serum)
- Collected from a vein
- No fasting required
- Morning collection may provide more accurate results due to hormone fluctuations
Test Preparation
- No fasting needed
- Avoid vigorous exercise before the test
- Inform doctors about steroid medications
- Women should note the timing of their menstrual cycle
- Stay well hydrated for easier blood collection
When to Consult a Doctor
Seek medical guidance if you have symptoms of low or high DHEA-S.
Low DHEA-S Symptoms
- Chronic tiredness
- Low sex drive
- Weak bones
- Muscle weakness
- Depression or mood disturbances
- Missed or irregular periods
High DHEA-S Symptoms
- Excess body or facial hair
- Severe acne
- Deepening of the voice
- Early puberty signs in children
- Rapid hair loss
- Fertility problems
Emergency Symptoms
Seek urgent medical attention if you experience:
- Sudden severe abdominal pain
- Signs of adrenal tumor
- Extremely high blood pressure
- Suspicion of very early puberty in a child
Important Word Explanations
ACTH: Pituitary hormone that stimulates adrenal glands.
DHEA-S: A stable sulfated hormone made from DHEA.
Precursor Hormone: A hormone that converts into other hormones.
Adrenal Glands: Endocrine glands on top of the kidneys.
CAH: Genetic disorder causing excessive adrenal hormone levels.
Hirsutism: Excessive facial or body hair in women.
~END~