Synonym/Acronym
DHEAS.
Rationale
To assist in identifying the cause of infertility, amenorrhea, or hirsutism.
Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction.
Normal Findings
Method: Immunochemiluminometric assay (ICMA).
| Age | Male Conventional Units mcg/dL | Male SI Units micromol/L (Conventional Units × 0.027) | Female Conventional Units mcg/dL | Female SI Units micromol/L (Conventional Units × 0.027) |
|---|
| Newborn | 108–607 | 2.9–16.4 | 108–607 | 2.9–16.4 | | 7–30 d | 32–431 | 0.9–11.6 | 32–431 | 0.9–11.6 | | 1–5 mo | 3–124 | 0.1–3.3 | 3–124 | 0.1–3.3 | | 6–35 mo | 0–30 | 0–0.8 | 0–30 | 0–0.8 | | 3–6 yr | 0–50 | 0–1.4 | 0–50 | 0–1.4 | | 7–9 yr | 5–115 | 0.1–3.1 | 5–94 | 0.1–2.5 | | 10–14 yr | 22–332 | 0.6–9 | 22–255 | 0.6–6.9 | | 15–19 yr | 88–483 | 2.4–13 | 63–373 | 1.7–10 | | 20–29 yr | 280–640 | 7.6–17.3 | 65–380 | 1.8–10.3 | | 30–39 yr | 120–520 | 3.2–14 | 45–270 | 1.2–7.3 | | 40–49 yr | 95–530 | 2.6–14.3 | 32–240 | 0.9–6.5 | | 50–59 yr | 70–310 | 1.9–8.4 | 26–200 | 0.7–5.4 | | 60–69 yr | 42–290 | 1.1–7.8 | 13–130 | 0.4–3.5 | | 70 yr and older | 28–175 | 0.8–4.7 | 10–90 | 0.3–2.4 |
|
Study type: Blood collected in a red-, red/gray-, or lavender-[EDTA] top tube; related body system: Endocrine and Reproductive systems.
Dehydroepiandrosterone sulfate (DHEAS) is the major precursor of 17-ketosteroids. DHEAS is a metabolite of dehydroepiandrosterone, the principal adrenal androgen. DHEAS is primarily synthesized in the adrenal gland, with a small amount secreted by the testes. DHEAS is a weak androgen and can be converted into more potent androgens (e.g., testosterone) as well as estrogens (e.g., estradiol). It is secreted in concert with cortisol, under the control of adrenocorticotropic hormone (ACTH) and prolactin. Excessive production causes masculinization in women and children. DHEAS has replaced measurement of urinary 17-ketosteroids in the estimation of adrenal androgen production.
Factors That May Alter the Results of the Study
- Drugs and other substances that may increase DHEAS levels include clomiphene, corticotropin, danazol, exemestane, gemfibrozil, metformin, mifepristone, and nitrendipine.
- Drugs and other substances that may decrease DHEAS levels include acetylsalicylic acid, carbamazepine, dexamethasone, exemestane, finasteride, ketoconazole, leuprolide, oral contraceptives, phenobarbital, phenytoin, and tamoxifen.
Increased In
DHEAS is produced by the adrenal cortex and testis; therefore, any condition stimulating these organs or associated feedback mechanisms will result in increased levels.
Decreased In
DHEAS is produced by the adrenal cortex and testis; therefore, any condition suppressing the normal function of these organs or associated feedback mechanisms will result in decreased levels.
- Addison disease
- Adrenal insufficiency (primary or secondary)
- Aging adults (related to natural decline in production with age)
- Hyperlipidemia
- Pregnancy (related to DHEAS produced by fetal adrenals and converted to estrogens in the placenta)
- Psoriasis(some potent topical medications used for long periods of time can result in chronic adrenal insufficiency)
- Psychosis(related to acute adrenal insufficiency)
Before the Study: Planning and Implementation
Teaching the Patient What to Expect
- Discuss how this test can assist in diagnosing the cause of hormonal fluctuations.
- Explain that a blood sample is needed for the test.
- Discuss fertility implications with women diagnosed with hirsutism, including the effects of treatment.
- Address body image concerns associated with excess hair growth associated with an excess of androgen.
After the Study: Implementation & Evaluation Potential Nursing Actions
Treatment Considerations
- Symptoms of hirsutism in women include enlarged clitoris, deepened voice, increased hair (face, back, chest, lower abdomen, inner thigh), enlarged muscle mass, decreasing breast size, baldness.
- Treatment for hirsutism may not be necessary; however, some options are antiandrogens, oral contraceptives, and topical creams.
Clinical Judgement
- Consider how to mitigate the emotional impact of negative body image changes and failure to conceive.
Follow-Up and Desired Outcomes
- Acknowledges that depending on the results of this procedure, additional testing may be performed to evaluate or monitor the progression of the disease process and determine the need for a change in therapy.
- Agrees to seek genetic counseling for a diagnosis of congenital adrenal hyperplasia.