Skip to content Skip to sidebar Skip to footer
Lets'Talk

DHEA Sulfate

Close
Order Code

4225

Preferred Specimen

Collect 2 mL of serum using an SST tube. Allow the sample to clot in an upright position for a minimum of 30 minutes before centrifuging within 2 hours of collection. Store the specimen refrigerated.
Note: Samples should not be collected from patients receiving high-dose biotin therapy (>5 mg/day) until at least 8 hours have passed since the last biotin dose.

ContainerType

Serum separator tube

Alternate Specimen Requirements

Obtain 2 mL of serum in a plain red-top tube. Allow the blood to clot upright for at least 60 minutes, then centrifuge the sample and transfer the serum into a plastic transport tube within 2 hours of collection. Ensure the tube is clearly labeled as serum from a plain red-top tube. Refrigerate after processing.
Note: Avoid sample collection from patients on high-dose biotin therapy (>5 mg/day) until a minimum of 8 hours after the last biotin administration.

Minimum Volume

0.5 mL serum

Transport Temperature

Refrigerated

Expected Turnaround Time

2 days

Specimen Stability

5 days room temperature;14 days refrigerated; 12 months frozen;allow for one freeze/thaw cycle

Methodology

Roche COBAS Electrochemiluminescent Immunoassay (ECLIA)

Overview

Dehydroepiandrosterone (DHEA) and its sulfated metabolite, DHEA-S, are 19-carbon steroids produced and secreted by the adrenal cortex under the stimulation of adrenocorticotropin hormone (ACTH). Both DHEA and DHEA-S are weak androgens but serve as precursors for the biosynthesis of more potent androgens like testosterone and estrogens such as estradiol. These steroids can be converted into one another primarily within the adrenal gland. In healthy females, DHEA-S synthesis occurs exclusively in the adrenal cortex, while approximately 50% of DHEA is adrenal-derived, 20% originates from the ovaries, and 30% results from peripheral conversion of DHEA-S. In males, the adrenal cortex is the main source of both DHEA and DHEA-S, with the testes contributing roughly 10% to 25% of DHEA and about 5% of DHEA-S production.

During pregnancy, the fetal adrenal gland produces large quantities of DHEA and DHEA-S, which are found at high levels in newborns. Serum concentrations of both hormones decline shortly after birth, remain low during early childhood, and increase starting around 8 years of age (adrenarche). Peak levels are generally reached around 30 years old, followed by a gradual decline. By 70 to 80 years of age, DHEA and DHEA-S levels decrease to approximately 10% to 25% of their peak values (Kroboth, 1999). Measurement of DHEA-S is particularly useful for assessing adrenal androgen production and related disorders.

Clinical Significance

Biomarker to help determine the adrenal contribution to diseases of androgen excess (more commonly) in conjunction with other steroids and hormones; rarely diagnostic of any condition alone. Aid in the diagnosis of:

  • Congenital adrenal hyperplasias (CAH)
  • Hyperandrogenism and virilization
  • Virilizing adrenal tumor
  • Premature adrenarche
  • Evaluation of adrenal insufficiency
  • Evaluation of hypopituitarism

Additional Information

In adult females, DHEA-S is produced at an estimated rate of 3.5 to 20 mg per day, with serum concentrations ranging from 100 to 350 mcg/dL. Under normal conditions, the molar serum concentration of DHEA-S is roughly 300 to 500 times greater than that of DHEA. This disparity is partly due to the considerably slower metabolic clearance of DHEA-S, which has a half-life of 10 to 20 hours, compared to 1 to 3 hours for DHEA (Orth, 1998). DHEA exhibits diurnal variation, whereas DHEA-S levels show minimal fluctuations and remain relatively stable throughout the menstrual cycle.

In cases of congenital adrenal hyperplasia (CAH), levels of DHEA and DHEA-S may be normal, elevated, or decreased depending on the specific enzyme deficiency present. Typically, DHEA-S is elevated in 11β-hydroxylase deficiency, 21-hydroxylase deficiency, and 3β-hydroxysteroid dehydrogenase deficiency. Conversely, decreased DHEA-S levels are seen in 17-hydroxylase deficiency, lipoid CAH, cholesterol side-chain cleavage enzyme deficiency, and P450-oxidoreductase deficiency. Aldosterone synthase deficiency generally does not affect DHEA-S levels (Turcu, 2015).

Interpretative Information
  • Elevated DHEA-S levels can be seen with adrenal tumor, premature adrenarche, polycystic ovary syndrome (PCOS), Cushing disease, smoking, and an ectopic ACTH secreting tumor.
  • Decreased DHEA-S levels can be seen with adrenal insufficiency, cortisol secreting adrenal adenoma, hypopituitarism, corticosteroid therapy, and chronic illness

Values >600 to 700 mcg/dL may be indicative of an androgen-secreting adrenal tumor and requires further investigation.

References

Al-Aridi R, Abdelmannan D, Arafah BM. Biochemical diagnosis of adrenal insufficiency: the added value of dehydroepiandrosterone sulfate measurements. Endocr Pract. 2011;17(2):261-270.21134877

Burger HG. Androgen production in women. Fertil Steril. 2002;77 Suppl 4:S3-5.12007895

Elhomsy G. Dehydroepiandrosterone (DHEA) Sulfate. Medscape website. http://www.medscape.com/. Updated December 5, 2014. Accessed May 14, 2018.

Fritz MA, Speroff L. Hirsutism. In: Fritz MA, Speroff L, eds. Clinical Gynecologic Endocrinology and Infertility. 8th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2011:533-566.

Gronowski AM. Reproductive Disorders. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry. 6th ed. Philadelphia, PA: WB Saunders Co; 2008:780-801.

Korkidakis KA, Reid RL. Testosterone in Women: Measurement and Therapeutic Use. J Obstet Gynaecol Can. 2017;39(3):124-130.28343552

Kroboth PD, Salek FS, Pittenger AL, Fabian TJ, Frye RF. DHEA and DHEA-S: a review. J Clin Pharmacol. 1999;39(4):327-348.10197292

Lois K, Kassi E, Prokopiou M, et al. Adrenal Androgens and Aging. In: De Groot LJ, Chrousos G, Dungan K, et al, eds. Endotext [Internet]. South Dartmouth, MA: MDText.com, Inc.; 2000-2014. Published June 18, 2014.25905237

Orth DN, Kovacs WJ. The Adrenal Cortex. In: Wilson JD, Foster DW, Kronenberg HM, Larsen PR, eds. Williams Textbook of Endocrinology. 9th ed. Philadelphia, PA: WB Saunders Co; 1998:517-664.

Turcu AF, Auchus RJ. Adrenal steroidogenesis and congenital adrenal hyperplasia. Endocrinol Metab Clin North Am. 2015;44(2):275-296.26038201

Alias
  • Dehydroepiandrosterone-sulfate
  • DHEA-s
Test Setup Days

Monday through Friday PM shift

CPT

82627 LOINC: 2191-5

Reference Range

Age Female(UG/DL) Male(UG/DL)
0 Days-6 Days 108-607 108-607
7 Days-4 Weeks 32-431 32-431
5 Weeks-12 Months 3-124 3-124
13 Months-4 Years <19 <19
5 Years-9 Years <85 <85
10 Years-14 Years 34-280 24-247
15 Years-19 Years 65-368 70-492
20 Years-24 Years 148-407 211-492
25 Years-34 Years 99-340 160-449
35 Years-44 Years 61-337 89-427
45 Years-54 Years 35-256 44-331
55 Years-64 Years 19-205 52-295
65 Years-74 Years 9-246 34-249
>=75 Years 12-154 16-123

UNIT CODEUNIT CODE NAMEANALYTEGENDERAGEREFERENCE RANGEUnits of Measure
4225DHEA SULFATEDHEASNOT SPECIFIED0Y12-154UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED6D108-607UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED4W32-431UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED12M3-124UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED4Y<19UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED9Y<85UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED14Y24-280UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED19Y65-492UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED24Y148-492UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED34Y99-449UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED44Y61-427UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED54Y35-331UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED64Y19-295UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED74Y9-249UG/DL
4225DHEA SULFATEDHEASNOT SPECIFIED150Y12-154UG/DL
4225DHEA SULFATEDHEASMALE0Y16-123UG/DL
4225DHEA SULFATEDHEASMALE6D108-607UG/DL
4225DHEA SULFATEDHEASMALE4W32-431UG/DL
4225DHEA SULFATEDHEASMALE12M3-124UG/DL
4225DHEA SULFATEDHEASMALE4Y<19UG/DL
4225DHEA SULFATEDHEASMALE9Y<85UG/DL
4225DHEA SULFATEDHEASMALE14Y24-247UG/DL
4225DHEA SULFATEDHEASMALE19Y70-492UG/DL
4225DHEA SULFATEDHEASMALE24Y211-492UG/DL
4225DHEA SULFATEDHEASMALE34Y160-449UG/DL
4225DHEA SULFATEDHEASMALE44Y89-427UG/DL
4225DHEA SULFATEDHEASMALE54Y44-331UG/DL
4225DHEA SULFATEDHEASMALE64Y52-295UG/DL
4225DHEA SULFATEDHEASMALE74Y34-249UG/DL
4225DHEA SULFATEDHEASMALE150Y16-123UG/DL
4225DHEA SULFATEDHEASFEMALE0Y12-154UG/DL
4225DHEA SULFATEDHEASFEMALE6D108-607UG/DL
4225DHEA SULFATEDHEASFEMALE4W32-431UG/DL
4225DHEA SULFATEDHEASFEMALE12M3-124UG/DL
4225DHEA SULFATEDHEASFEMALE4Y<19UG/DL
4225DHEA SULFATEDHEASFEMALE9Y<85UG/DL
4225DHEA SULFATEDHEASFEMALE14Y34-280UG/DL
4225DHEA SULFATEDHEASFEMALE19Y65-368UG/DL
4225DHEA SULFATEDHEASFEMALE24Y148-407UG/DL
4225DHEA SULFATEDHEASFEMALE34Y99-340UG/DL
4225DHEA SULFATEDHEASFEMALE44Y61-337UG/DL
4225DHEA SULFATEDHEASFEMALE54Y35-256UG/DL
4225DHEA SULFATEDHEASFEMALE64Y19-205UG/DL
4225DHEA SULFATEDHEASFEMALE74Y9-246UG/DL
4225DHEA SULFATEDHEASFEMALE150Y12-154UG/DL

Leave a comment

Receive News

Subscribe for the Updates!