What does high DHEA-S mean?
High DHEA-S levels can indicate adrenal gland overactivity, PCOS, stress, or certain tumors, causing symptoms like acne, hair growth, and irregular periods. Testing and lifestyle changes can help identify causes and 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 hormone that your body converts into other important hormones, including testosterone and estrogen.
Think of DHEA-S as a hormonal building block. Your body uses it as raw material to create sex hormones based on what you need. This makes DHEA-S a crucial player in maintaining hormonal balance, supporting energy levels, immune function, bone density, and even mood regulation.
DHEA-S levels naturally fluctuate throughout life. They peak in your twenties and gradually decline with age, decreasing by about 2-3% per year after age 30. However, when DHEA-S levels rise above the normal range for your age and sex, it can signal underlying health issues that need attention.
Normal DHEA-S Ranges by Age and Sex
| Age Group | Women (μg/dL) | Men (μg/dL) | |
|---|---|---|---|
| 20-29 years | 20-29 years | 65-380 | 280-640 |
| 30-39 years | 30-39 years | 45-270 | 120-520 |
| 40-49 years | 40-49 years | 32-240 | 95-530 |
| 50-59 years | 50-59 years | 26-200 | 70-310 |
| 60+ years | 60+ years | 35-200 | 42-290 |
Reference ranges may vary slightly between laboratories. Always interpret results with your healthcare provider.
Normal vs. High DHEA-S Levels
DHEA-S levels vary significantly based on age and biological sex. Understanding where your levels fall within these ranges helps determine whether you have elevated DHEA-S.
Laboratory reference ranges can vary slightly between testing facilities, but generally, levels above these ranges are considered elevated. It's important to note that DHEA-S levels should always be interpreted in the context of your symptoms, other hormone levels, and overall health picture.
Why DHEA-S Testing Matters
Unlike cortisol, which fluctuates throughout the day, DHEA-S remains relatively stable, making it an excellent marker for assessing adrenal function. This stability means you can test DHEA-S at any time of day without worrying about timing affecting your results.
Common Causes of High DHEA-S
Several conditions and factors can lead to elevated DHEA-S levels. Understanding these causes helps guide appropriate testing and treatment strategies.
Polycystic Ovary Syndrome (PCOS)
PCOS is one of the most common causes of elevated DHEA-S in women of reproductive age. This hormonal disorder affects 6-12% of women and often involves excess androgen production from both the ovaries and adrenal glands. Women with PCOS typically have DHEA-S levels 20-30% higher than normal, contributing to symptoms like irregular periods, acne, and excess hair growth.
Congenital Adrenal Hyperplasia (CAH)
CAH is a group of inherited disorders affecting the adrenal glands' ability to produce certain hormones. The most common form, 21-hydroxylase deficiency, can cause elevated DHEA-S levels as the adrenal glands overproduce androgens while struggling to make cortisol. Late-onset CAH may not appear until adolescence or adulthood, making DHEA-S testing valuable for diagnosis.
Adrenal Tumors
Though rare, adrenal tumors can cause significant DHEA-S elevation. Adrenal adenomas and carcinomas may produce excess DHEA-S, often leading to levels several times higher than normal. Sudden, dramatic increases in DHEA-S, especially in adults over 40, warrant immediate medical evaluation to rule out adrenal tumors.
Other potential causes of elevated DHEA-S include:
- Chronic stress and adrenal overdrive
- Cushing's disease (in some cases)
- Certain medications, including DHEA supplements
- Hyperprolactinemia
- Insulin resistance and metabolic syndrome
Symptoms of High DHEA-S
Elevated DHEA-S often manifests through various symptoms related to excess androgen activity. The severity and combination of symptoms depend on how high your levels are and your individual sensitivity to androgens.
Physical Symptoms
- Acne, particularly cystic acne on the face, chest, and back
- Hirsutism (excess hair growth in male-pattern areas)
- Male-pattern baldness or hair thinning
- Oily skin and scalp
- Deepening of the voice (in severe cases)
- Increased muscle mass
- Changes in body fat distribution
Reproductive Symptoms
- Irregular or absent menstrual periods
- Fertility challenges
- Decreased breast size
- Enlarged clitoris (in severe cases)
Metabolic and Mood Symptoms
- Insulin resistance
- Weight gain, especially around the midsection
- Mood swings or irritability
- Increased aggression or competitiveness
- Changes in libido
Not everyone with high DHEA-S will experience all these symptoms. Some people may have significantly elevated levels with minimal symptoms, while others may be highly sensitive to even slight elevations. Regular monitoring through comprehensive hormone testing helps track your levels and symptom correlation.
Health Implications of Elevated DHEA-S
While DHEA-S itself isn't harmful, chronically elevated levels can contribute to various health concerns through its conversion to other hormones and its effects on multiple body systems.
Cardiovascular Health
Research shows mixed findings on DHEA-S and heart health. While some studies suggest moderate DHEA-S levels may be cardioprotective, very high levels, particularly when associated with PCOS or metabolic syndrome, can increase cardiovascular risk factors including:
- Elevated LDL cholesterol
- Decreased HDL cholesterol
- Increased triglycerides
- Higher blood pressure
- Increased inflammation markers
Metabolic Effects
High DHEA-S often correlates with insulin resistance, creating a cycle where metabolic dysfunction and hormonal imbalance reinforce each other. This can lead to:
- Difficulty losing weight
- Increased abdominal fat storage
- Higher risk of developing type 2 diabetes
- Fatty liver disease
- Metabolic syndrome
Long-term Risks
Persistently elevated DHEA-S may increase the risk of certain conditions over time, including endometrial hyperplasia in women (due to unopposed estrogen from irregular cycles), mood disorders and anxiety, osteoporosis (paradoxically, despite DHEA-S's usual bone-protective effects), and certain hormone-sensitive cancers, though research is ongoing.
Testing and Diagnosis
Accurate testing is crucial for identifying high DHEA-S and understanding its underlying cause. A comprehensive approach typically includes multiple tests to get a complete hormonal picture.
When to Test DHEA-S
Consider DHEA-S testing if you experience:
- Signs of excess androgens (acne, hirsutism, hair loss)
- Irregular menstrual cycles
- Difficulty conceiving
- Unexplained weight gain or difficulty losing weight
- Symptoms of PCOS or adrenal dysfunction
- Family history of CAH or adrenal disorders
Comprehensive Testing Approach
DHEA-S should rarely be tested in isolation. A complete hormonal evaluation typically includes:
- Total and free testosterone
- Sex hormone-binding globulin (SHBG)
- LH and FSH
- Estradiol and progesterone
- Cortisol (preferably multiple samples throughout the day)
- Thyroid hormones (TSH, Free T3, Free T4)
- Fasting glucose and insulin
- Lipid panel
- 17-hydroxyprogesterone (to rule out CAH)
For comprehensive hormone testing that includes DHEA-S along with other crucial markers, at-home testing provides convenient, accurate results without the hassle of multiple doctor visits.
Natural Ways to Lower High DHEA-S
While medical treatment may be necessary for significantly elevated DHEA-S, lifestyle modifications can help normalize levels and improve symptoms.
Dietary Strategies
Your diet significantly impacts hormone production and metabolism. To help lower DHEA-S naturally:
- Reduce refined carbohydrates and sugar to improve insulin sensitivity
- Increase omega-3 fatty acids from fish, flaxseeds, and walnuts
- Eat plenty of cruciferous vegetables (broccoli, cauliflower, Brussels sprouts) to support hormone metabolism
- Include spearmint tea, which studies show may help reduce androgens
- Limit caffeine and alcohol, which can stress the adrenal glands
- Focus on anti-inflammatory foods like berries, leafy greens, and turmeric
Stress Management
Since chronic stress can drive adrenal hormone production, effective stress management is crucial:
- Practice regular meditation or mindfulness
- Try yoga, particularly restorative or yin styles
- Ensure 7-9 hours of quality sleep nightly
- Consider adaptogenic herbs like ashwagandha or rhodiola
- Maintain consistent sleep-wake cycles
- Limit exposure to blue light in the evening
Exercise Considerations
While exercise is beneficial, the type and intensity matter when DHEA-S is elevated:
- Favor moderate-intensity exercise over high-intensity training
- Include strength training 2-3 times per week
- Add regular walking or swimming
- Avoid overtraining, which can stress the adrenals
- Consider gentle movement like tai chi or qigong
- Allow adequate recovery between workouts
Medical Treatment Options
When lifestyle changes aren't sufficient or when DHEA-S elevation stems from specific medical conditions, various treatments may help.
Treatment selection depends on the underlying cause, symptom severity, and individual health goals. Work closely with your healthcare provider to determine the most appropriate approach for your situation.
Monitoring Your Progress
Successfully managing high DHEA-S requires regular monitoring to track your response to treatment and adjust strategies as needed. Most experts recommend retesting DHEA-S levels every 3-6 months initially, then annually once levels stabilize.
Beyond laboratory values, pay attention to symptom improvements:
- Reduction in acne and oily skin
- Decreased unwanted hair growth
- More regular menstrual cycles
- Improved energy and mood
- Better weight management
- Enhanced insulin sensitivity
Keep a symptom journal to track changes over time and share this information with your healthcare provider to optimize your treatment plan.
Taking Control of Your Hormonal Health
High DHEA-S levels signal that your body's hormonal balance needs attention. While elevated levels can cause frustrating symptoms and health concerns, understanding the root cause empowers you to take targeted action. Whether through lifestyle modifications, medical treatment, or a combination approach, you can work toward restoring hormonal harmony.
Remember that hormones don't exist in isolation. DHEA-S interacts with numerous other hormones and body systems, making comprehensive testing and a holistic treatment approach essential. By addressing underlying causes rather than just symptoms, you can achieve lasting improvements in your hormonal health and overall well-being.
The journey to balanced hormones takes time and patience. Work with knowledgeable healthcare providers, stay consistent with your chosen interventions, and regularly monitor your progress through testing. With the right approach, you can successfully manage high DHEA-S and reclaim your vitality.
References
- Labrie, F., Bélanger, A., Cusan, L., Gomez, J. L., & Candas, B. (1997). Marked decline in serum concentrations of adrenal C19 sex steroid precursors and conjugated androgen metabolites during aging. Journal of Clinical Endocrinology & Metabolism, 82(8), 2396-2402.[PubMed][DOI]
- Azziz, R., Carmina, E., Chen, Z., Dunaif, A., Laven, J. S., Legro, R. S., ... & Yildiz, B. O. (2016). Polycystic ovary syndrome. Nature Reviews Disease Primers, 2(1), 1-18.[PubMed][DOI]
- Speiser, P. W., Arlt, W., Auchus, R. J., Baskin, L. S., Conway, G. S., Merke, D. P., ... & White, P. C. (2018). Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 103(11), 4043-4088.[PubMed][DOI]
- Grant, P., & Ramasamy, S. (2012). An update on plant derived anti-androgens. International Journal of Endocrinology and Metabolism, 10(2), 497-502.[PubMed][DOI]
- Fassnacht, M., Arlt, W., Bancos, I., Dralle, H., Newell-Price, J., Sahdev, A., ... & Dekkers, O. M. (2016). Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. European Journal of Endocrinology, 175(2), G1-G34.[PubMed][DOI]
- Maninger, N., Wolkowitz, O. M., Reus, V. I., Epel, E. S., & Mellon, S. H. (2009). Neurobiological and neuropsychiatric effects of dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS). Frontiers in Neuroendocrinology, 30(1), 65-91.[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 or the Women's Essential Hormone Panel. Both CLIA-certified programs include DHEA-S testing along with other key hormones, providing lab-quality results from the comfort of your home.
What is the normal range for DHEA-S?
Normal DHEA-S ranges vary by age and sex. For women aged 20-29, the range is typically 65-380 μg/dL, while men of the same age range from 280-640 μg/dL. Levels naturally decline with age, so someone over 60 might have normal levels of 35-200 μg/dL for women and 42-290 μg/dL for men.
Can high DHEA-S cause weight gain?
Yes, elevated DHEA-S can contribute to weight gain, particularly around the midsection. High DHEA-S often correlates with insulin resistance, which makes it harder to lose weight and easier to store fat. Additionally, the hormonal imbalances associated with high DHEA-S can affect metabolism and appetite regulation.
How long does it take to lower DHEA-S naturally?
With consistent lifestyle changes, you may start seeing improvements in DHEA-S levels within 3-6 months. However, the timeline varies based on the underlying cause and individual factors. Some people notice symptom improvements before laboratory values change. Regular testing every 3-6 months helps track your progress.
Is high DHEA-S dangerous?
While high DHEA-S itself isn't immediately dangerous, it can indicate underlying conditions that need attention, such as PCOS, adrenal disorders, or rarely, tumors. Long-term elevation may increase risks for metabolic syndrome, cardiovascular issues, and certain hormone-related conditions. It's important to identify and address the root cause.
Can stress cause high DHEA-S?
Yes, chronic stress can elevate DHEA-S levels. When you're under prolonged stress, your adrenal glands may overproduce hormones, including DHEA-S. This is why stress management techniques like meditation, adequate sleep, and regular moderate exercise are important components of naturally lowering DHEA-S levels.
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