Dehydroepiandrosterone sulfate, or DHEAS, is a steroid hormone produced primarily by the adrenal glands, which are small glands located on top of each kidney. It is one of the most abundant circulating steroid hormones in the human body, and the body uses it as a raw material, converting it into other hormones like testosterone and estrogens. This hormone is present in both men and women and contributes to the development of secondary sexual characteristics that emerge during puberty. Its production is part of a complex feedback system involving the brain and the adrenal glands, making it a necessary component of the body’s endocrine system.
Understanding DHEAS Testing and Normal Ranges
The amount of DHEAS in the body is measured with a straightforward blood test. A healthcare provider may order this test to evaluate the function of the adrenal glands or to investigate symptoms related to hormonal imbalances. The blood sample is analyzed in a laboratory to determine the concentration of the hormone, usually measured in micrograms per deciliter (mcg/dL).
There is no single universal “normal” DHEAS level; reference ranges are highly dependent on a person’s age and sex. Hormone levels follow a distinct pattern over a person’s lifetime. They are high at birth, drop during infancy, and then begin to rise again around the ages of nine or ten.
DHEAS concentrations peak in a person’s twenties or early thirties and then begin a gradual, steady decline with age. For example, a woman in her twenties might have a level between 65 and 380 mcg/dL, while a woman over 60 could have a level below 130 mcg/dL. Similarly, a man in his twenties could have a level up to 640 mcg/dL, which might naturally decrease to below 290 mcg/dL after age 60.
Causes and Symptoms of High DHEAS Levels
Elevated levels of DHEAS can lead to a condition of androgen excess, which manifests differently in women and children. In women, symptoms can include:
- Male-pattern hair growth on the face, chest, and abdomen, a condition known as hirsutism
- Persistent acne
- Hair loss on the scalp resembling male-pattern baldness
- Irregular or absent menstrual periods
- A deepening of the voice or increased muscle mass
For children, unusually high DHEAS can trigger precocious puberty, which is the early onset of developmental changes. In boys, this might present as the premature development of a deep voice, pubic hair, or an enlarged penis. In girls, it can cause early development of pubic hair or ambiguous genitalia in newborns.
One of the most common causes of high DHEAS is Polycystic Ovary Syndrome (PCOS), a hormonal disorder affecting women of reproductive age that can involve androgen overproduction. Another cause is Congenital Adrenal Hyperplasia (CAH), a group of genetic disorders where a missing enzyme disrupts hormone production, leading the adrenal glands to produce too much DHEAS.
Tumors on the adrenal glands, which can be either noncancerous (benign) or cancerous, can also secrete large amounts of DHEAS. An extremely high DHEAS level, particularly with a sudden onset, often prompts further investigation to rule out an adrenal tumor.
Causes and Symptoms of Low DHEAS Levels
Symptoms associated with low DHEAS levels can be less specific than those of high levels. Adults may experience persistent fatigue, a reduced sex drive (libido), or a general decrease in their sense of well-being. In men, low levels have been associated with erectile dysfunction, while in women, they may be linked to thinning vaginal tissues.
A primary medical cause for significantly low DHEAS is Addison’s disease, a condition where the adrenal glands are damaged and cannot produce enough hormones, including DHEAS and cortisol. Symptoms specific to this adrenal insufficiency can include unexplained weight loss, dizziness, dehydration, and a craving for salt.
Another cause is hypopituitarism, which is a disorder of the pituitary gland located at the base of the brain. The pituitary gland produces hormones that signal other glands, including the adrenals, to do their jobs. If the pituitary is not sending the right signals, the adrenal glands will not produce enough DHEAS, even if the adrenal glands themselves are healthy.
Medical Approach to Abnormal DHEAS Levels
An abnormal DHEAS test result is not a final diagnosis but a signal that further investigation is needed to identify and address the underlying cause of the hormonal imbalance. The diagnostic process begins with a thorough review of a patient’s symptoms, medical history, and a physical examination.
To determine the root cause, a doctor will order additional tests, often including a broader panel of hormones like testosterone, cortisol, and pituitary hormones. This helps pinpoint whether the issue originates from the adrenal glands, ovaries, or pituitary gland. If an adrenal or pituitary tumor is suspected, imaging studies such as a CT or MRI scan are used to visualize the glands.
The management strategy is tailored to the underlying condition. For a woman with PCOS, treatment may involve lifestyle modifications or medications like oral contraceptives to regulate menstrual cycles. If an adrenal tumor is the cause, surgical removal is often the recommended course of action. For Addison’s disease, the standard treatment is hormone replacement therapy.