Dehydroepiandrosterone, or DHEA, is a steroid hormone produced predominantly by the adrenal glands, small organs situated above the kidneys. The body utilizes DHEA as a “prohormone,” meaning it serves as a precursor that can be converted into other hormones, including androgens like testosterone and estrogens. While its precise functions are still being understood, DHEA contributes to various bodily processes.
The Lifecycle of DHEA Production
DHEA levels naturally fluctuate across a person’s lifespan, influenced by age and sex. Levels are low at birth, increasing significantly during adrenarche (ages 6-8), a phase before puberty. This surge contributes to the development of pubic and underarm hair. DHEA levels reach their peak in the mid-20s to early 30s.
After this peak, DHEA levels gradually decline with advancing age in both males and females. Reference ranges for DHEA-sulfate (DHEA-S), the stable form measured, vary by laboratory but show this decline. In males aged 18-29 years, ranges are 110-510 micrograms per deciliter (mcg/dL), decreasing to 25-240 mcg/dL for those aged 50-59, and further to less than 204 mcg/dL for individuals over 59 years. Females have lower DHEA-S levels than males of the same age. For females, ranges are 45-320 mcg/dL in their late teens and 20s, dropping to 15-170 mcg/dL for those aged 50-59, and less than 145 mcg/dL after age 59.
Symptoms of Imbalanced DHEA Levels
Imbalanced DHEA levels can lead to physical changes, reflecting either excess or deficiency. The specific symptoms depend on the individual’s sex and the degree of the imbalance. These symptoms can prompt further investigation.
Symptoms of High DHEA
Elevated DHEA levels, particularly in women, can lead to increased androgen activity. Common symptoms include oily skin, acne (especially cystic acne on the face, chest, and back). Excessive body and facial hair (hirsutism) can occur, along with male-pattern baldness or hair thinning. Women can also experience irregular menstrual cycles or missed periods, reduced breast size, and a deepening of the voice.
Symptoms of Low DHEA
Conversely, low DHEA levels can present with noticeable symptoms. Individuals can experience persistent fatigue, reduced energy, and decreased libido or sexual function. Other indicators include reduced muscle mass and bone density, aching joints, or unexplained weight gain. Mood changes can include irritability or feelings of depression, and difficulties with concentration or memory.
Medical Conditions and Lifestyle Factors Affecting DHEA
Beyond natural age-related decline, medical conditions and lifestyle elements can influence DHEA levels. These factors can increase or decrease the hormone, leading to imbalances. Identifying these underlying causes helps manage DHEA levels.
Conditions causing elevated DHEA levels include Polycystic Ovary Syndrome (PCOS), a common hormonal disorder in women involving excess androgen production. Congenital adrenal hyperplasia (CAH), a genetic disorder affecting adrenal hormone synthesis, results in high DHEA. Additionally, benign and cancerous tumors of the adrenal glands or ovarian tumors can lead to excessive DHEA production.
In contrast, low DHEA levels can be associated with conditions like Addison’s disease, where the adrenal glands do not produce enough hormones. Hypopituitarism, an underactive pituitary gland condition, can reduce DHEA production as the pituitary gland stimulates adrenal function. Chronic stress impacts DHEA levels; prolonged periods of high cortisol, the body’s primary stress hormone, can suppress DHEA production and accelerate its decline.
How DHEA Levels Are Tested
Measuring DHEA levels involves a blood test. Healthcare providers test for dehydroepiandrosterone sulfate (DHEA-S) because its levels remain stable throughout the day, providing a more reliable measurement than unconjugated DHEA. A blood sample is drawn, and the DHEA-S concentration is then analyzed in a laboratory.
DHEA-S test results should not be interpreted in isolation. Normal ranges vary between laboratories, and results must be considered within the context of overall symptoms, medical history, and a thorough physical examination. A healthcare professional is best equipped to evaluate these results and determine their significance.