Dehydroepiandrosterone Sulphate (DHEA-S)
DHEA-S is a hormone produced by the adrenal glands that serves as a precursor to sex hormones. Abnormal levels may indicate adrenal tumours, PCOS, or adrenal insufficiency.
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What the Dehydroepiandrosterone Sulphate (DHEA-S) test tells you
DHEA-S is a steroid hormone made almost entirely by the adrenal glands, the small glands that sit above each kidney. It is a precursor rather than an active hormone in its own right: tissues throughout the body take it up and convert it into androgens and oestrogens according to what they need. Because the adrenal glands are effectively its only significant source, measuring it is a clean way of asking how much androgen precursor those glands are currently producing.
This is what makes it useful when a woman has signs of androgen excess, such as unwanted facial or body hair, persistent adult acne, thinning scalp hair or irregular periods. Androgens in women come from two places, the ovaries and the adrenal glands, and the treatments differ depending on which is responsible. Testosterone is produced by both, so a raised testosterone does not localise the problem. DHEA-S largely does. A modest elevation is common in polycystic ovary syndrome and in the milder forms of congenital adrenal hyperplasia that only declare themselves in adulthood. A marked elevation that has developed quickly, particularly alongside rapidly progressive changes, prompts imaging of the adrenal glands.
Two further points shape how the result is read. First, the level falls steadily with age from early adulthood onward in everyone. This decline is entirely normal, and a result that sits low in an older person is a reflection of age rather than a sign of disease, so results are always compared against what is expected for your age and sex. Second, the sulphated form circulates at a fairly steady level through the day, unlike cortisol and many other hormones, which is why the sample does not need to be taken at a particular hour. Your doctor will read it alongside testosterone, your symptoms and, where appropriate, further hormonal or imaging studies.
Ordered to evaluate adrenal function, investigate signs of androgen excess in women (hirsutism, acne, irregular periods), or assess adrenal tumours.
- Locating the androgen source
Because the adrenal glands are its main source, it helps separate an adrenal cause of androgen excess from an ovarian one.
- Investigating hirsutism and acne
It is part of the standard hormonal assessment when a woman has unwanted hair growth, persistent acne or scalp hair thinning.
- Assessing adrenal activity
It gives a stable measure of adrenal androgen output that does not swing through the day the way cortisol does.
- Evaluating rapid virilisation
Signs of androgen excess that appear and progress quickly warrant urgent assessment, and a marked elevation directs attention to the adrenal glands.
Reasons your doctor may request the Dehydroepiandrosterone Sulphate (DHEA-S) test
Your doctor may order this test for any of the reasons below. Some are routine checks, others follow specific symptoms or an earlier result.
Signs of androgen excess
- You have unwanted facial or body hair, persistent adult acne, or thinning scalp hair.
- Your periods are irregular or absent alongside signs of androgen excess.
Rapid changes & early puberty
- Signs of virilisation have appeared and progressed quickly and need urgent assessment.
- A child or adolescent is showing signs of puberty earlier than expected.
Adrenal disorders
- Congenital adrenal hyperplasia or another adrenal disorder is being considered.
A result in the Normal band, 35 to 430 µg/dL, sits within a typical adult range, though what is expected falls steadily with age in everyone, so your result is read against your age and sex rather than the band alone. A result in the Low band, 0 to 34 µg/dL, is often simply age, and can also follow long-term corticosteroid treatment, adrenal insufficiency or pituitary disease; it is not used by itself to diagnose adrenal failure, which needs dedicated stimulation testing. A result in the High band, 431 to 1000 µg/dL, points to the adrenal glands as the source of androgen. A modest elevation is common in polycystic ovary syndrome and in milder congenital adrenal hyperplasia; a marked, quickly progressive rise prompts adrenal imaging. Over-the-counter DHEA supplements raise the level directly, so mention them. Your doctor reads it with testosterone, your symptoms and history.
Medically reviewed by Dr Nirupama Sabhapathy
Ranges are a guide: your physician interprets your result alongside your symptoms and history.
What a higher result can point to
- Polycystic ovary syndrome, in which a modest elevation is common.
- Congenital adrenal hyperplasia, including the milder forms that only become apparent in adulthood.
- Adrenal tumours, which typically produce a marked and rapidly progressive rise.
- Cushing's syndrome driven by excess ACTH from the pituitary gland.
- DHEA supplements bought over the counter, which raise the measured level directly.
What a lower result can point to
- Adrenal insufficiency, whether from disease of the adrenal glands themselves or from pituitary failure.
- Long-term corticosteroid treatment, which suppresses adrenal output.
- Normal ageing, since production declines steadily from early adulthood onward in everyone.
- Hypopituitarism following surgery, radiotherapy or head injury.
These are possibilities, not diagnoses. A single value outside the reference range is interpreted alongside your symptoms, history and other tests: your doctor decides what it means for you.
What this test cannot tell you
- A raised level indicates that the adrenal glands are the likely source of androgen but does not identify the underlying condition.
- The level declines steadily with age, so results must be read against what is expected for your age and sex rather than as an absolute.
- Over-the-counter DHEA supplements produce a high result in people with no adrenal disease at all.
- A low result has limited meaning on its own and is not used to diagnose adrenal insufficiency, which requires dedicated stimulation testing.
Risks of the blood draw
- Mild bruising or brief soreness where the needle went in.
- Occasional lightheadedness, which settles after a few minutes of rest.
- Bleeding or infection at the site, which is rare with sterile single-use equipment.
- 1DHEA-S is made almost entirely by the adrenal glands, which makes it a useful pointer to their activity.
- 2It is a precursor hormone, converted within tissues into androgens and oestrogens.
- 3Its sulphated form circulates at a steady level through the day, unlike many other hormones.
- 4It helps distinguish an adrenal source of androgen excess from an ovarian one.
- 5Levels fall with age in everyone, and an age-related decline is normal rather than a sign of disease.
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Frequently Asked Questions
Everything you need to know about the Dehydroepiandrosterone Sulphate (DHEA-S) test. Can't find what you're looking for?
Talk to our team→Our laboratory reports 35 to 430 µg/dL as a typical adult range. Below 35 µg/dL is reported as low and above 430 µg/dL as high. Because DHEA-S falls steadily with age in everyone, your doctor reads the result against what is expected for your age and sex, not against the band alone.
A modest rise in DHEA-S is common in polycystic ovary syndrome. Because DHEA-S comes almost entirely from the adrenal glands, it helps your doctor tell an adrenal source of excess androgen from an ovarian one when there is acne, excess hair growth or irregular periods. It is read with testosterone and your symptoms.
A low DHEA-S is often simply age. It can also follow long-term corticosteroid treatment, adrenal insufficiency or pituitary disease, including after pituitary surgery, radiotherapy or head injury. A low result is not used by itself to diagnose adrenal failure, which needs dedicated stimulation testing.
DHEA-S is a precursor hormone made almost entirely by the adrenal glands, which tissues convert into androgens and oestrogens. Testosterone is an active androgen that also comes from the ovaries or testes. Measuring both shows not only whether androgens are raised but also whether the adrenal glands are the likely source.
Yes. Corticosteroids suppress adrenal output, and this applies to inhaled, topical and injected preparations as well as tablets, so they can lower DHEA-S. Mention any you use, even occasionally, so a low result is not mistaken for adrenal disease. Your doctor will advise on any change to treatment.
The sulphated form circulates in far greater quantity and at a much steadier level through the day, while DHEA itself fluctuates considerably. That stability makes DHEA-S the more reliable measure of overall adrenal androgen production from a single sample.
No. Modest elevations are far more often explained by polycystic ovary syndrome, by a milder form of congenital adrenal hyperplasia, or by supplements. A marked rise that has developed quickly is taken more seriously and usually leads to imaging, but the result alone never makes the diagnosis.
Yes. Production peaks in early adulthood and then declines steadily throughout life in everyone. A result that sits low in an older person usually reflects that normal decline rather than disease, which is why your result is compared against what is expected for your age.
Very much so. DHEA is sold over the counter in some countries, and taking it raises the measured level directly, producing a high result in someone whose adrenal glands are working perfectly normally. Always tell your doctor about any supplement you take.
No. Fasting is not required, the sample does not need to be taken early in the morning, and it does not need to be timed to your menstrual cycle. Stop any over-the-counter DHEA or adrenal support supplement well before the test and tell your doctor if you have been taking one.
The DHEA-S test is AED 75, including a physician-reviewed report, with results usually within 24 hours. Home collection anywhere in Dubai is free when your order reaches AED 300 or includes a package; below that, a AED 100 home collection fee applies (AED 50 for a lab walk-in).