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)
|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|
|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.
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:
Androgen-secreting adrenal carcinoma
Cushing syndrome (elevated adrenocorticotropic hormone [ACTH] level)
Ectopic ACTH-secreting tumor
Serum DHEA levels may be decreased in the following conditions:
Congenital adrenal hyperplasia
Causes of increased DHEA levels in persons with CAH include the following:
3-beta-hydroxysteroid dehydrogenase 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
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
A new technique simultaneously analyzes serum and plasma testosterone, adrenostenedione, and DHEA levels using isotope-dilution liquid-chromatography tandem mass spectrometry. 
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.
The DHEA level is usually obtained with other hormones as part of the workup for the following conditions:
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. 
DHEA can be used illegally to improve athletic performance, but the NCAA, WADA, and other sports-governing agencies prohibit the use of DHEA.