DHEA-S: the adrenal hormone and what it reflects

DHEA-S is one of the two adrenal hormones in the Complete panel, alongside cortisol. It is often marketed as a youth or vitality hormone. The reality is more modest. DHEA-S is a helpful marker of what your adrenal glands are doing, and it is most useful when something else in your health points in its direction.

What DHEA-S is

DHEA, short for dehydroepiandrosterone, is a weak male-type hormone, or androgen. The body converts some of it into stronger hormones, including testosterone and oestrogen. DHEA-S is the sulphated form of DHEA, and it is the version stored and carried in the blood.

Almost all DHEA-S comes from the adrenal glands, which makes it a good window on adrenal androgen output specifically. The ovaries and testes make only small amounts. Unlike cortisol, DHEA-S has a long life in the blood, so it barely changes through the day. Time of day matters much less for this marker.

It changes a lot with age

DHEA-S rises through childhood and puberty, peaks in the 20s, and then falls steadily with every decade. By later life it is a fraction of its peak. Men tend to have higher levels than women at the same age.

Because of this, a single adult range makes little sense. Labs print age and sex specific ranges, and LifePrint uses the lab's range for your age. A low DHEA-S in a 65 year old is usually just age.

When a raised DHEA-S matters

In women, DHEA-S is mainly used to look for the source of excess androgens. Signs that prompt this include acne in adulthood, extra facial or body hair, scalp hair thinning and irregular periods.

• Polycystic ovary syndrome, the most common cause of these signs, can come with a mildly raised DHEA-S.
• Some inherited conditions of the adrenal glands, such as non-classic congenital adrenal hyperplasia, can raise androgens. A doctor would use other specific tests to check.
• Rarely, a clearly high DHEA-S points to a tumour of the adrenal gland. This is uncommon, but a very high result, especially with fast-developing symptoms such as a deepening voice or rapid hair growth, needs prompt medical review.
• DHEA supplements raise DHEA-S directly and can make the result impossible to interpret.

When a low DHEA-S matters

A low result is usually due to age. Less often it reflects reduced adrenal or pituitary function, long-term use of steroid medicines, or serious illness. On its own, a low DHEA-S is rarely a reason for alarm. It becomes more meaningful when morning cortisol is also low, or when there are symptoms of adrenal insufficiency such as weight loss, dizziness and salt craving.

What about DHEA supplements?

DHEA is sold as a supplement in some countries and online, with claims about energy, libido, mood and ageing. The evidence for these benefits in healthy people is weak, and the Endocrine Society advises against its routine use in women. Because DHEA converts into testosterone and oestrogen, it can cause acne, unwanted hair growth and other hormonal side effects. Speak to a doctor before taking it, and always mention it before a blood test.

Getting a reliable result

DHEA-S is less fussy than most hormones, but a few things still help. Tell whoever reads your results about any DHEA, testosterone or steroid medicines you use, including creams and gels. Avoid testing during an acute illness. If you are being checked for signs of excess androgen and use hormonal contraception, mention it, because it can lower androgen levels and change how the results are read.

What to do with your result

Your LifePrint report shows your DHEA-S against the lab's age-specific range and reads it alongside cortisol and your sex hormones. If it is flagged, discuss it with a registered healthcare practitioner, who can decide whether further testing is needed.