Dehydroepiandrosterone (DHEA) 

Updated: Dec 05, 2014
  • Author: Georges Elhomsy, MD, ECNU, FACE; Chief Editor: Eric B Staros, MD  more...
  • Print

Reference Range

Dehydroepiandrosterone (DHEA) can be measured with radioimmunoassay, liquid chromatography–mass spectrometry (LC-MS), or chemiluminescent techniques, and the reference range varies by the technique used.

The reference ranges for DHEA concentrations measured with LC-MS are listed in Table 1.

Table 1. Reference Ranges of DHEA Concentrations by Tanner Stage, Age, and Sex as Measured With LC-MS (Open Table in a new window)

Tanner Stage Male Female
     
Stage I 110-2370 ng/L 140-2760 ng/L
Stage II 370-3660 ng/L 830-4870 ng/L
Stage III 750-5240 ng/L 1080-7560 ng/L
Stage IV and V 1216-67030 ng/L 1240-7880 ng/L
     
Age Male Female
6-24 months < 2500 ng/L < 1990 ng/L
2-3 years < 630 ng/L < 850 ng/L
4-5 years < 950 ng/L < 1030 ng/L
6-7 years 60-1930 ng/L < 1790 ng/L
7-9 years 100-2080 ng/L 140-2350 ng/L
10-11 years 320-3080 ng/L 430-3780 ng/L
12-13 years 570-4100 ng/L 890-6210 ng/L
14-15 years 930-6040 ng/L 1220-7010 ng/L
16-17 years 1170-6520 ng/L 1420-9000 ng/L
18-40 years 1330-7780 ng/L 1330-7780 ng/L
40-67 years 630-4700 ng/L 630-4700 ng/L

The image below depicts the molecular structure of DHEA.

Ball-and-stick model of the dehydroepiandrosterone Ball-and-stick model of the dehydroepiandrosterone molecule. Image courtesy of Wikimedia Commons.
Next:

Interpretation

Serum dehydroepiandrosterone (DHEA) concentrations peak around the third decade of life and then drop with age.

The serum DHEA level has a circadian variation and may vary during the menstrual cycle; therefore, dehydroepiandrosterone sulfate (DHEA-S) seems a better marker in clinical practice because it has a longer half-life with no circadian variation.

Serum DHEA levels may be increased in the following conditions:

Serum DHEA levels may be decreased in the following conditions:

Congenital adrenal hyperplasia

In congenital adrenal hyperplasia (CAH), the DHEA level varies with the type of the enzymatic deficiency.

Causes of increased DHEA levels in persons with CAH include the following:

  • 11-hydroxylase deficiency
  • 3-beta-hydroxysteroid dehydrogenase deficiency
  • 21-hydroxylase deficiency

DHEA levels are normal when CAH is caused by aldosterone synthase deficiency.

Causes of decreased DHEA levels in persons with CAH include the following:

  • Cholesterol side-chain cleavage enzyme deficiency
  • 17-alpha-hydroxylase deficiency
Previous
Next:

Collection and Panels

Patient instruction: No need for fasting

Collection tube: Red-top tube

Specimen type: Blood serum; hemolyzed specimens are not acceptable

Collection method: Venipuncture

Specimen volume: 1 mL

Specimen preparation: Separate serum from cells and transfer to transport tube

Storage/transport temperature: Refrigerated

Stability: Refrigerated, 14 days; frozen, 7 days

Panels: None

A new technique simultaneously analyzes serum and plasma testosterone, adrenostenedione, and DHEA levels using isotope-dilution liquid-chromatography tandem mass spectrometry. [2]

Previous
Next:

Background

Description

Dehydroepiandrosterone (DHEA) is a C-19 (19 carbon atoms) steroid hormone and one of three androgens (DHEA, DHEA-S, androstenedione) secreted by the adrenal gland. It is a biologically inert hormone produced from cholesterol in the zona reticularis with a rate of about 8 mg per day.

DHEA is transformed by DHEA sulfotransferase (SULT2A1) to DHEA-S, whereas steroid sulfatase can convert DHEA-S back to DHEA, possibly making DHEA-S function as a circulating storage pool. Later, DHEA is converted in the peripheral tissues to more active androgen (testosterone a dihydrotestosterone) or estrogen.

Serum DHEA concentrations decrease after birth and then begin to increase at around age 7-9 years (adrenarche) and continue increasing until the third decade of life. They then start to drop; by age 80 years, the concentration is about 20% of that at age 25 years.

Indications/Applications

The DHEA level is usually obtained with other hormones as part of the workup for the following conditions:

Hyperandrogenism

Hirsutism

Adrenal incidentaloma

Adrenal hyperplasia

Premature adrenarche

PCOS

Considerations

An abnormal DHEA level is not considered diagnostic of any disease, and it should be always measured in conjunction with other hormones.

The DHEA level can be decreased in anorexia nervosa and illness.

DHEA levels increase in association with smoking.

DHEA has been proposed to have anti-aging, anti-inflammatory, anti-atherosclerotic, and anti-depressant actions. It is available in the United States as an over-the-counter diet supplement, and it has been used in adrenal insufficiency, systemic lupus erythematosus, Sjögren syndrome, fibromyalgia, and depression, although there is not enough data to support these indications, and its safety is unknown. [3]

DHEA can be used illegally to improve athletic performance, but the NCAA, WADA, and other sports-governing agencies prohibit the use of DHEA.

Previous