Patient Test Information

DHEAS

Also known as:

DHEA-SO4; DHEA Sulfate

Formal name:

Dehydroepiandrosterone Sulfate

Related tests:

Testosterone; ACTH; FSH; LH; Prolactin; Estrogens; SHBG; 17-Hydroxyprogesterone; Androstenedione

Why Get Tested?

To help evaluate adrenal gland function; to detect adrenal tumors or cancers; to help determine the cause of masculine physical characteristics (virilization) in girls and women or early puberty in boys

When to Get Tested?

When a girl or woman has excess facial and body hair (hirsutism), acne, absence of menstrual periods (amenorrhea), or a woman has infertility; when a boy shows signs of very early (precocious) puberty such as deeper voice, pubic hair, or muscle development

Sample Required?

A blood sample drawn from a vein in your arm

Test Preparation Needed?

None, although women should talk to their health practitioner about the timing of the test; your healthcare provider may want to have the sample collected a week before or after your menstrual period.

How is it used?

The test for dehydroepiandrosterone sulfate (DHEAS) is ordered along with tests for testosterone and several other male hormones (androgens) to:

  • Evaluate adrenal gland function
  • Distinguish DHEAS-secreting conditions that are caused by the adrenal glands from those that originate in the testicles or rarely in the ovaries (ovarian tumors)
  • Help diagnose tumors in the outer layer (cortex) of the adrenal gland (adrenocortical tumors) and adrenal cancers
  • Help diagnose congenital adrenal hyperplasia and adult-onset adrenal hyperplasia

In women, concentrations of DHEAS are often measured, along with other hormones such as FSH, LHprolactin, estrogen, and testosterone, to help diagnose polycystic ovarian syndrome (PCOS) and to help rule out other causes of infertility, lack of menstrual period (amenorrhea), and presence of excess facial and body hair (hirsutism).

DHEAS levels may be ordered with other hormones to investigate and diagnose the cause of the development of masculine physical characteristics (virilization) in young girls and early (precocious) puberty in young boys.

When is it ordered?

DHEAS levels are not routinely measured. A DHEAS test may be ordered, along with other hormone tests, whenever excess (or, more rarely, deficient) androgen production is suspected and/or when a health practitioner wants to evaluate a person's adrenal gland function.

It may be measured when a woman presents with signs and symptoms such as amenorrhea, infertility, and/or those related to virilization. These changes vary in severity and may include:

  • A deeper voice
  • Excess facial or body hair (hirsutism)
  • Male pattern baldness
  • Muscularity
  • Acne
  • Enlargement of the Adam's apple
  • Decreased breast size

It may also be ordered when a young girl shows signs of virilization or when a female infant has external genitalia that are not distinctly male or female in appearance (ambiguous genitalia).

DHEAS may also be measured when young boys show signs of precocious puberty, the development of a deeper voice, pubic hair, muscularity, and an enlarged penis well before the age of normal puberty.

What does the test result mean?

A normal DHEAS level, in addition to other normal male hormone (androgen) levels, likely indicates that the adrenal gland is functioning normally. Rarely, DHEAS may be normal when an adrenal tumor or cancer is present but is not secreting hormones.

A high DHEAS blood level may indicate that excess DHEAS production is causing or contributing to the person's symptoms. However, an increased level of DHEAS is not diagnostic of a specific condition; it usually indicates the need for further testing to pinpoint the cause of the hormone imbalance. An elevated DHEAS may indicate an adrenocortical tumor, Cushing disease, adrenal cancer, or adrenal hyperplasia, or rarely a DHEAS-producing ovarian tumor.

DHEAS may be elevated with polycystic ovarian syndrome (PCOS) but may also be normal as this disorder is usually related to ovarian androgen production (primarily testosterone).

A low level of DHEAS may be due to adrenal insufficiency, adrenal dysfunction, Addison disease, or hypopituitarism, a condition that causes low levels of the pituitary hormones that regulate the production and secretion of adrenal hormones.

Is there anything else I should know?

DHEAS levels are normally high in both male and female newborns. They drop sharply shortly after birth, then rise again during puberty. DHEAS concentrations peak after puberty, and then, like other male and female hormones, the levels tend to decline with age.

People taking DHEA supplements will have elevated blood levels of DHEAS. Certain antidiabetic drugs (such as metformin and troglitazone), prolactin, danazol, calcium channel blockers, and nicotine may also increase DHEAS levels. Drugs/hormones that may show decreased levels include insulin, oral contraceptives, corticosteroids, dopamine, hepatic enzyme inducers (carbamazepine, imipramine, phenytoin), fish oil, and vitamin E. It is important to inform your healthcare provider when taking any of these products.

What is being tested?

Thumbnail diagram of the adrenal gland

Dehydroepiandrosterone sulfate (DHEAS) is a male sex hormone (androgen) that is present in both men and women. This test measures the level of DHEAS in the blood.

DHEAS:

  • Plays a role in developing male secondary sexual characteristics at puberty
  • Can be converted by the body into more potent androgens, such as testosterone and androstenedione
  • Can be converted into the female hormone estrogen

DHEAS is produced almost exclusively by the adrenal glands, with smaller amounts being produced by a woman's ovaries and a man's testicles.

It is useful as a marker for adrenal gland function. Adrenal tumors (cancerous and non-cancerous) and adrenal hyperplasia can lead to the overproduction of DHEAS. Rarely, an ovarian tumor may produce DHEAS.

Excess DHEAS:

  • May not be noticed in adult men
  • Can cause early (precocious) puberty in young boys
  • Can lead to absence of menstrual periods (amenorrhea) and the development of masculine physical characteristics (virilization) in girls and women, such as excess body and facial hair (hirsutism)
  • Can cause a female baby to be born with genitals that are not distinctly male or female in appearance (ambiguous external genitalia)

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed. Women should talk to their health practitioner about the timing of the test. The healthcare provider may want to have the sample collected a week before or after a woman's menstrual period.

  1. Does my sample for a DHEAS level have to be drawn at a certain time of day like other hormone tests?

    Some hormones are increased in the morning while others rise and fall throughout the day. Some are released intermittently or with increased activity or in response to stress. Some hormones are higher at particular times of the month, and others are relatively stable. Blood sample collection for some hormone tests are timed so that the hormones can be evaluated at their highest or lowest levels. The DHEAS concentration, however, is stable, so your sample may be collected any time of day and it will not affect the result of the test.

  2. Does everyone with elevated DHEAS have symptoms?

    Not necessarily.  It may be difficult to determine when adult men have an elevated level of DHEAS (since they already have masculine secondary sexual characteristics) and women of some ethnic groups (for example, Asian women) may have elevated levels of testosterone and DHEAS without exhibiting symptoms such as excess hair growth or acne.  Also, it should be noted that the symptoms present and their severity will vary from person to person.

  3. Can the DHEAS test be performed in my doctor's office?

    No, the testing requires specialized equipment and is not performed in every laboratory. Your blood may need to be sent to a reference laboratory for testing.

  4. Should everyone have a DHEAS test?

    Testing is typically only performed when a person has symptoms that suggest excess or inadequate production of DHEAS. Most people will not need to have this test performed.