What are the symptoms of low DHEA-S?
Low DHEA-S can cause fatigue, decreased libido, mood changes, muscle weakness, and cognitive issues. Testing your levels through blood work can help identify deficiencies and guide treatment to restore hormonal balance.
Understanding DHEA-S and Its Role in Your Body
Dehydroepiandrosterone sulfate (DHEA-S) is one of the most abundant hormones circulating in your bloodstream. Produced primarily by your adrenal glands, with smaller amounts made by the ovaries and testes, DHEA-S serves as a precursor to other important hormones, including testosterone and estrogen. Think of it as a master building block that your body converts into other hormones as needed.
DHEA-S levels naturally peak in your twenties and gradually decline with age, dropping by about 2-3% per year after age 30. By age 70, most people have only 10-20% of the DHEA-S levels they had in their youth. While this decline is normal, abnormally low levels at any age can lead to various symptoms that affect your quality of life.
Understanding whether your DHEA-S levels are optimal for your age and sex is crucial for maintaining hormonal balance and overall health. Regular monitoring can help identify deficiencies early and guide appropriate interventions.
DHEA-S Reference Ranges by Age and Sex
| Age Group | Males (μg/dL) | Females (μg/dL) | Clinical Significance | |
|---|---|---|---|---|
| 18-29 years | 18-29 years | 280-640 | 65-380 | Peak levels |
| 30-39 years | 30-39 years | 120-520 | 45-270 | Beginning decline |
| 40-49 years | 40-49 years | 95-530 | 32-240 | Noticeable decline |
| 50-59 years | 50-59 years | 70-310 | 26-200 | Significant decline |
| 60-69 years | 60-69 years | 42-290 | 13-130 | Low levels common |
| 70+ years | 70+ years | 20-200 | 17-90 | Minimal production |
Reference ranges may vary between laboratories. Optimal levels for symptom relief may differ from standard ranges.
Common Symptoms of Low DHEA-S
Physical Symptoms
Low DHEA-S levels can manifest through various physical symptoms that may develop gradually over time:
- Persistent fatigue and low energy levels, even with adequate sleep
- Decreased muscle mass and strength
- Increased body fat, particularly around the midsection
- Dry skin, eyes, and hair
- Joint pain and stiffness
- Slower wound healing
- Reduced bone density
- Weakened immune function with frequent infections
Sexual and Reproductive Symptoms
Since DHEA-S is a precursor to sex hormones, deficiency often affects sexual health:
- Decreased libido in both men and women
- Erectile dysfunction in men
- Vaginal dryness and painful intercourse in women
- Irregular menstrual cycles
- Reduced fertility
- Loss of pubic and underarm hair
Mental and Emotional Symptoms
The impact of low DHEA-S extends beyond physical health, significantly affecting mental well-being:
- Depression and mood swings
- Anxiety and increased stress sensitivity
- Poor concentration and memory issues
- Brain fog and mental fatigue
- Decreased motivation and drive
- Sleep disturbances
Who Is at Risk for Low DHEA-S?
While aging is the most common cause of declining DHEA-S levels, several factors can accelerate this decline or cause deficiency at younger ages:
- Chronic stress and adrenal fatigue
- Autoimmune conditions affecting the adrenal glands
- Pituitary gland disorders
- Long-term use of corticosteroid medications
- Chronic inflammatory conditions
- Poor nutrition and extreme dieting
- Excessive exercise without adequate recovery
- Certain medications including opioids and antipsychotics
Women may also experience accelerated DHEA-S decline during perimenopause and menopause, while men typically see a more gradual decrease over time. Understanding your individual risk factors can help you take proactive steps to maintain healthy hormone levels.
DHEA-S Levels by Age and Sex
DHEA-S levels vary significantly based on age and biological sex. Understanding these reference ranges helps contextualize your test results.
It's important to note that these are general reference ranges, and optimal levels may vary between individuals. Some people may experience symptoms even when their levels fall within the 'normal' range, particularly if they're at the lower end for their age group.
Testing and Diagnosis
Diagnosing low DHEA-S requires a simple blood test. Unlike cortisol, which fluctuates throughout the day, DHEA-S levels remain relatively stable, making it easier to test accurately at any time. However, for the most consistent results, morning testing is often recommended.
When evaluating DHEA-S levels, healthcare providers consider several factors:
- Your age and sex
- Current symptoms and their severity
- Other hormone levels, including cortisol, testosterone, and estrogen
- Medical history and current medications
- Lifestyle factors such as stress, diet, and exercise habits
A comprehensive hormone panel provides the most complete picture of your endocrine health, as hormone imbalances rarely occur in isolation. Testing multiple related hormones helps identify the root cause of symptoms and guides more effective treatment strategies.
Treatment Options for Low DHEA-S
DHEA Supplementation
DHEA supplements are available over-the-counter in many countries, though they require a prescription in others. Typical doses range from 25-50 mg daily, but the appropriate dose varies based on individual needs and should be determined by a healthcare provider. Starting with a lower dose and gradually increasing allows for better tolerance and monitoring of effects.
It's crucial to work with a healthcare provider when supplementing with DHEA, as improper use can lead to side effects including acne, hair loss, mood changes, and hormone imbalances. Regular monitoring through blood tests ensures levels stay within the optimal range.
Lifestyle Modifications
Several lifestyle changes can naturally support healthy DHEA-S levels:
- Stress management through meditation, yoga, or other relaxation techniques
- Regular moderate exercise, avoiding overtraining
- Adequate sleep of 7-9 hours nightly
- Balanced nutrition with sufficient healthy fats and protein
- Maintaining a healthy weight
- Limiting alcohol consumption
- Addressing underlying health conditions
Addressing Underlying Causes
Sometimes low DHEA-S is a symptom of an underlying condition that needs treatment. Addressing adrenal insufficiency, pituitary disorders, or chronic inflammation can help restore normal DHEA-S production. Working with an endocrinologist or functional medicine practitioner can help identify and treat these root causes.
The Connection Between DHEA-S and Other Hormones
DHEA-S doesn't work in isolation. It's part of a complex hormonal symphony that includes cortisol, testosterone, estrogen, and thyroid hormones. Understanding these relationships is crucial for effective treatment:
- Cortisol: Chronic stress and high cortisol can suppress DHEA-S production
- Testosterone: Low DHEA-S often correlates with low testosterone, especially in men
- Estrogen: DHEA-S serves as a precursor to estrogen, particularly important post-menopause
- Thyroid hormones: Thyroid dysfunction can affect DHEA-S metabolism
This interconnection explains why addressing DHEA-S deficiency often requires a comprehensive approach to hormone balance rather than focusing on a single hormone in isolation.
Long-term Health Implications
Chronically low DHEA-S levels have been associated with several long-term health risks. Research suggests that maintaining optimal DHEA-S levels may help protect against:
- Cardiovascular disease
- Osteoporosis and fracture risk
- Cognitive decline and dementia
- Metabolic syndrome and diabetes
- Depression and anxiety disorders
- Autoimmune conditions
- Premature aging
While DHEA-S supplementation shows promise in addressing these risks, more research is needed to fully understand its long-term effects. The key is maintaining levels appropriate for your age through a combination of lifestyle optimization and, when necessary, medical intervention.
Taking Action: Your Next Steps
If you're experiencing symptoms of low DHEA-S, taking action starts with proper testing and evaluation. Here's a practical roadmap:
- Document your symptoms, including when they started and their severity
- Get comprehensive hormone testing, including DHEA-S and related hormones
- Review results with a healthcare provider experienced in hormone optimization
- Implement lifestyle changes to support healthy hormone production
- Consider supplementation if recommended by your provider
- Monitor your levels regularly to track progress and adjust treatment
Remember that hormone optimization is a journey, not a destination. What works for one person may not work for another, and finding your optimal balance may take time and adjustment. The key is to start with accurate testing and work with knowledgeable healthcare providers who can guide you toward better hormonal health.
References
- Labrie F, Bélanger A, Cusan L, Gomez JL, Candas B. Marked decline in serum concentrations of adrenal C19 sex steroid precursors and conjugated androgen metabolites during aging. J Clin Endocrinol Metab. 1997;82(8):2396-402.[PubMed][DOI]
- Rutkowski K, Sowa P, Rutkowska-Talipska J, Kuryliszyn-Moskal A, Rutkowski R. Dehydroepiandrosterone (DHEA): hypes and hopes. Drugs. 2014;74(11):1195-207.[PubMed][DOI]
- Samaras N, Samaras D, Frangos E, Forster A, Philippe J. A review of age-related dehydroepiandrosterone decline and its association with well-known geriatric syndromes: is treatment beneficial? Rejuvenation Res. 2013;16(4):285-94.[PubMed][DOI]
- Maggio M, De Vita F, Fisichella A, et al. DHEA and cognitive function in the elderly. J Steroid Biochem Mol Biol. 2015;145:281-92.[PubMed][DOI]
- Peixoto C, Carrilho CG, Barros JA, et al. The effects of dehydroepiandrosterone on sexual function: a systematic review. Climacteric. 2017;20(2):129-137.[PubMed][DOI]
- Genazzani AR, Pluchino N. DHEA therapy in postmenopausal women: the need to move forward beyond the lack of evidence. Climacteric. 2010;13(4):314-6.[PubMed][DOI]
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Frequently Asked Questions
How can I test my DHEA-S at home?
You can test your DHEA-S at home with SiPhox Health's Hormone Focus Program, which includes DHEA-S testing along with other key hormone biomarkers. The program provides CLIA-certified lab results from a simple finger-prick blood sample collected at home.
What is the normal range for DHEA-S?
Normal DHEA-S ranges vary significantly by age and sex. For adults in their 20s-30s, typical ranges are 280-640 μg/dL for men and 65-380 μg/dL for women. These levels naturally decline with age, dropping to about 20-200 μg/dL for both sexes by age 70.
Can low DHEA-S cause weight gain?
Yes, low DHEA-S can contribute to weight gain, particularly increased abdominal fat. DHEA-S helps maintain muscle mass and metabolic rate, so deficiency can lead to decreased muscle mass, slower metabolism, and increased fat storage, especially around the midsection.
How long does it take to see improvements after starting DHEA supplementation?
Most people begin noticing improvements in energy and mood within 4-6 weeks of starting DHEA supplementation. However, full benefits for symptoms like muscle mass, bone density, and sexual function may take 3-6 months. Regular monitoring ensures optimal dosing and tracks progress.
Is DHEA-S testing covered by insurance?
DHEA-S testing may be covered by insurance if ordered by a physician for specific medical conditions. However, routine screening for optimization purposes is often not covered. At-home testing options provide an affordable alternative for regular monitoring without insurance hassles.
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