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
DHEAS
DHEAS
Also Known As
DHEA-SO4
DHEA Sulfate
Formal Name
Dehydroepiandrosterone Sulfate
This article was last reviewed
on
This article waslast modified
on
May 23, 2018.
At a Glance
Why Get Tested?
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.
Accordion Title
Common Questions
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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, LH, prolactin, estrogen, and testosterone, to help diagnose polycystic ovary 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.
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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.
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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 ovary 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.
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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.
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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.
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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.
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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.
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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.
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Location of the adrenal gland. Image credit: Alan Hoofring, National Cancer Institute