Dehydroepiandrosterone (DHEA) Sulfate 

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

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)

  Male Female
Tanner stage    
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
Age    
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
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Interpretation

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) [1]
  • Ectopic ACTH secreting tumor
  • Premature adrenarche [2]

Serum DHEA-S maybe decrease in

  • Cortisol secreting adrenal adenoma
  • Adrenal insufficiency

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
  • 21-hydroxylase deficiency
  • Normal when due to: aldosterone synthase deficiency
  • Low when due to: cholesterol side-chain cleavage enzyme deficiency
  • 17-hydroxylase
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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.

Panels: None

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Background

Description

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.

Indications/Applications

DHEA-S level is usually ordered with other hormones as part of the work up for the following:

Considerations

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.

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