Serum dehydroepiandrosterone sulfate (DHEA-S) peaks around the third decade and then drop with age.
DHEA-S can be measured by radioimmunoassay, liquid chromatography-mass spectrometry, or chemiluminescent techniques, and the reference range varies with the technique used.
The reference range given below is for DHEA-S measured by chemiluminescent technique.
Table. Reference Range for DHEA-S, as Measured by Chemiluminescent Technique (Open Table in a new window)
|Stage I||< 15-120 mcg/dL||16-96 mcg/dL|
|Stage II||< 15-333 mcg/dL||22-184 mcg/dL|
|Stage III||< 15-312 mcg/dL||< 15-296 mcg/dL|
|Stage IV||29-412 mcg/dL||17-343 mcg/dL|
|Stage V||89-457 mcg/dL||44-332 mcg/dL|
|18-29 years||89-457 mcg/dL||44-332 mcg/dL|
|30-39 years||65-334 mcg/dL||31-228 mcg/dL|
|40-49 years||48-244 mcg/dL||18-244 mcg/dL|
|50-59 years||35-179 mcg/dL||< 15-200 mcg/dL|
|≥ 60 years||25-131 mcg/dL||< 15-157 mcg/dL|
In clinical practice measurement of serum DHEA-S is preferred over serum DHEA, since DHEA-S has no circadian variation and longer half life.
Serum DHEA-S maybe increased in:
Polycystic ovary syndrome (PCOS)
Androgen-secreting adrenal carcinoma
Cushing's disease (elevated ACTH) 
Ectopic ACTH secreting tumor
Premature adrenarche 
Serum DHEA-S maybe decrease in
Cortisol secreting adrenal adenoma
In Congenital adrenal hyperplasia (CAH), DHEA-S level varies with the type of the enzymatic deficiency:
High when due to 11-hydroxylase deficiency
3-beta-hydroxysteroid dehydrogenase deficiency
Normal when due to: aldosterone synthase deficiency
Low when due to: cholesterol side-chain cleavage enzyme deficiency
Collection and Panels
Patient instruction: No need for fasting
Collection tube: Red top tube
Unacceptable Conditions: Hemolyzed specimens
Specimen Preparation: Separate serum from cells and transfer to transport tube
Storage/Transport Temperature: Refrigerated
Stability: Refrigerated 7 days; frozen: 2 months.
DHEA-S is a C-19 (19 carbon atoms) steroid hormones and 1 of 3 androgens (DHEA, DHEAS, androstenedione) secreted by the adrenal gland. It is a biologically inert hormone, produced from cholesterol in the zona reticularis with a daily rate of about 20 mg per day. [3, 4]
In the adrenal gland and the liver the DHEA is converted by DHEA sulfotransferase (SULT2A1) to dehydroepiandrosterone-sulfate (DHEA-S). DHEA-S possibly functions as a circulating storage pool for DHEA.
DHEA-S, under the effect of steroid sulfatase, is converted back to DHEA in the peripheral tissues, which in turn is converted to either more active androgens or estrogen.
Serum DHEA-S concentrations fall after birth then begins to increase around the age of 7-9 (adrenarche). It keeps increasing until the third decade. After that, it starts to drop, and, by the age of 80 years, the concentration is about 20% of that at age 25.
DHEA-S level is usually ordered with other hormones as part of the work up for the following:
Abnormal DHEA-S is not considered diagnostic to any disease and should always be measured in conjunction with other hormones.
DHEA-S level can be decreased in anorexia nervosa and illness.
DHEA-S is increased with smoking.