Synonym

• DHEA
• 3beta-Hydroxy-5-androsten-17-one
• 3beta-Hydroxyandrost-5-en-17-one
• Dehydroisoandrosterone
• Hydroxyandrost-5-en-17-one
• Prasterone
• Trans-dehydroandrosterone
• Unconjugated DHEA

Tubes

• Red or tiger top tube
• Gold top tube (gel barrier) also acceptable
• 5-7 mL of venous blood

Additional information

• Avoid administration of radioisotopes 24 hours prior to sample collection
• Sample collected during morning hours is preferred
• Separate serum or plasma from cells ASAP and refrigerate if delay is expected
• Handle blood sample gently to prevent hemolysis and send to lab immediately

Info

• Dehydroepiandrosterone (DHEA) assay estimates the concentration of the steroid prohormone dehydroepiandrosterone in blood
• DHEA is an unconjugated prohormone, which serves as a precursor of androgen (testosterone) and estrogens (esterone and estradiol)
• DHEA is produced chiefly in the adrenal cortex and in smaller amounts by the testis and ovary
• Abnormal levels of DHEA have been associated with conditions such as adrenocortical tumors and hyperplasia and polycystic ovary syndrome

Clinical

• The clinical utility of DHEA testing includes:
• Evaluation and diagnosis of adrenocortical abnormalities such as adrenal neoplasms or congenital adrenal hyperplasia
• Evaluation of hirsutism
• Evaluation of Stein-Leventhal syndrome
• Evaluation of female infertility
• Evaluation of persistent anovulation
• Hirsutism/virilization in females may clinically present as:
• Terminal hairs typically over the face/chin, lower abdomen, arms, legs, and around the areola of the breast
• Clitoral enlargement
• Temporal hair loss
• Breast atrophy
• Deepening of voice
• Elevated DHEA with normal testosterone levels may be indicative of an adrenal cause of excessive androgen
• Synthetic form of DHEA or DHEA supplements:
• It is derived from diosgenin, a plant sterol extracted from Mexican wild yams
• Health claims, some of which may be reasonably supported by data, include:
• "Aging reversal"
• Builds muscles
• Decreases body fat
• Decreases cholesterol levels
• Deepening of nightly sleep
• Improved ability to function well under stress
• Improved athletic ability/strength
• Improved brain functioning in Alzheimer's disease
• Improved energy
• Improved libido
• Improves mood
• Increased sense of well-being
• "Stimulation" of the immune system
• High doses may increase the risk of developing gynecomastia in men, hirsutism in women, as well as stimulation of prostate and breast cancer
• Dehydroepiandrosterone sulfate (DHEA-S):
• This is the sulfated form of DHEA and its levels are about 300 times higher than free DHEA
• DHEA (taken orally) is converted to DHEA-S form when it is absorbed by the intestines and then metabolized by the liver
• Elevated DHEA-S is associated with hyperprolactinemia, women with infertility, amenorrhea, or hirsutism, Stein-Leventhal syndrome, and adrenocortical diseases

Additional information

• Normal day-to-day variation of DHEA levels is ~30%, with peak level in the morning and lowest level at night
• DHEA levels increase with age through childhood, with a peak at ~20 years and then gradually declines thereafter
• DHEA levels decline dramatically after menopause in women and levels are higher in women who have never been pregnant
• Factors interfering with test results include:
• Contaminated samples
• Frozen or clotted specimen
• Hemolyzed sample
• Related laboratory tests include:
• Alanine Aminotransferase
• Aspartate Aminotransferase
• Dehydroepiandrosterone sulfate (DHEA-S)
• Follicle stimulating hormone (FSH)
• Glucose
• Insulin
• Luteinizing hormone (LH)
• Prolactin
• Testosterone (serum, urine)
• Thyroid stimulating hormone (TSH)

Nl Result

Consult your laboratory for their normal ranges as these may vary somewhat from the ones listed below.

High Result

Conditions associated with elevated DHEA levels include:

• Adrenal tumors
• Congenital adrenal hyperplasia
• Polycystic ovary syndrome
• Stein-Leventhal syndrome
• Drugs
• ACTH
• Clomiphene

Low Result

Conditions associated with decreased DHEA levels include:

• Acquired immune deficiency syndrome (AIDS)
• Adrenal insufficiency
• Anorexia
• Critically ill persons
• Dieting
• Down's syndrome
• End-stage kidney disease
• Malnutrition
• Pregnancy
• Type II diabetes
• Drugs
• Ampicillin (decreases excretion in pregnancy)
• Androgens
• Corticosteroids
• Danazol
• Etomidate
• Insulin
• Ketoconazole
• Opiates

References

• ARUP Consult®. Polycystic Ovarian Syndrome. [Homepage on the Internet]©2008. Last updated in May 2008. Last accessed on October 22, 2008. Available at URL: http://www.arupconsult.com/Topics/EndocrineDz/PCOS.html
• ARUP's Laboratories®. Dehydroepiandrosterone, Serum. [Homepage on the Internet]©2008. Last accessed on October 22, 2008. Available at URL: http://www.aruplab.com/guides/ug/tests/0070199.jsp
• eMedicine from WebMD®. Adrenal Carcinoma. [Homepage on the Internet]©1996-2008. Last updated on May 22, 2006. Last accessed on October 22, 2008. Available at URL: http://www.emedicine.com/med/topic63.htm
• Labrie F et al. DHEA and its transformation into androgens and estrogens in peripheral target tissues: intracrinology. Front Neuroendocrinol. 2001 Jul;22(3):185-212.
• Laboratory Corporation of America. Dehydroepiandrosterone (DHEA). [Homepage on the internet]©2007. Last accessed on October 18, 2008. Available at URL: https://www.labcorp.com/datasets/labcorp/html/chapter/mono/sr001600.htm
• Nozaki S et al. Mental and physical fatigue-related biochemical alterations. Nutrition. 2008 Sep 30.
• Poretsky L et al. Metabolic and Hormonal Effects of Oral DHEA in Premenopausal Women with HIV Infection: A Randomized, Prospective, Placebo-controlled Pilot Study. Horm Metab Res. 2008 Sep 22.
• Sawalha AH et al. Dehydroepiandrosterone in systemic lupus erythematosus. Curr Rheumatol Rep. 2008 Aug;10(4):286-91.
• University of Maryland Medical Center (UMMC). Dehydroepiandrosterone (DHEA). [Homepage on the Internet]©2008. Last updated on April 2, 2004. Last accessed on October 22, 2008. Available at URL: http://www.umm.edu/altmed/articles/dehydroepiandrosterone-dhea-000299.htm