DHEA-S: what it is and what your result means

What is DHEA-S

DHEA-S (dehydroepiandrosterone sulphate) is a steroid hormone produced in the adrenal cortex. It is the sulphated form of DHEA, which the body can convert into more active androgens (testosterone) and oestrogens, which is why DHEA-S is often called a hormone precursor or prohormone.

An important property of DHEA-S is that its blood level is relatively stable throughout the day, because DHEA-S has a long half-life (approximately 10–20 hours). This makes it more convenient to measure than DHEA, which fluctuates during the day. DHEA-S reflects the overall level of adrenal androgen production and declines naturally with age — it peaks in the third decade of life and then decreases by approximately 10–20 % per decade.

Reference ranges

DHEA-S is measured in µg/dL. Reference ranges differ by sex:

• Men: 102–416 µg/dL
• Women: 45–320 µg/dL

It is very important to remember that these ranges are established for adults. In older individuals (over 60), normal values are usually in the lower part of the range, and this is not pathological. Some laboratory catalogues provide separate intervals by age group.

Why DHEA-S may be elevated

Elevated DHEA-S most commonly indicates excessive adrenal androgen production. Possible causes:

• Adrenal hyperplasia or tumour: excessive activity of adrenal tissue is one of the main causes.
• Polycystic ovary syndrome (PCOS): in women with PCOS, DHEA-S is often elevated.
• Cushing syndrome: overactivity of cortisol-producing glands may also increase DHEA-S.
• Androgen-producing tumours: a rare but serious condition, especially when the level is very high.
• Chronic stress: although cortisol responds to stress more rapidly, long-term stress can affect adrenal function.

Why DHEA-S may be low

Low DHEA-S most commonly reflects decreased adrenal production or the natural ageing process:

• Age: this is the most common cause. A low DHEA-S in older age is physiologically normal.
• Adrenal insufficiency (Addison's disease): when the adrenal glands do not produce enough hormones.
• Hypopituitarism: the pituitary gland controls the adrenal glands, so its dysfunction reduces DHEA-S.
• Long-term corticosteroid use: steroid medication suppresses adrenal function.
• Chronic stress and burnout: paradoxically, a chronic state of stress can eventually exhaust the adrenal glands.

What to do next

If DHEA-S is outside the reference range, the next steps depend on the direction of the deviation and the clinical symptoms.

When DHEA-S is elevated, the doctor will most likely want to investigate adrenal function more broadly — cortisol, 17-OH progesterone, and in women, other androgens. When DHEA-S is low, it is worth assessing overall adrenal axis function and checking pituitary markers.

From a lifestyle perspective, quality sleep, stress management and a balanced diet support adrenal health. High-intensity exercise without adequate rest can place additional strain on the adrenal glands.

Monitoring over time

DHEA-S is unique in that its age trajectory is one of the most consistent hormonal markers. This means it can be informative as a long-term marker of adrenal health.

If you have been diagnosed with PCOS or adrenal dysfunction, regular DHEA-S monitoring (every 6–12 months) allows you to objectively track how the condition is changing. It is also worth monitoring this marker alongside testosterone and SHBG to obtain a more complete picture of the hormonal profile.

Questions for your doctor

1. Does my DHEA-S level correspond to my age group, or is the deviation significant? 2. Should cortisol or other adrenal markers be checked additionally? 3. If DHEA-S is low due to age, are there lifestyle interventions that could slow further decline? 4. How often should I repeat this test? 5. Should my other hormone markers (testosterone, SHBG) be evaluated together with DHEA-S?

*This is not medical advice. Consult your doctor regarding any health decisions.*