Quick answer: DHEA-S is a hormone made mainly by the adrenal glands and used by the body to make testosterone and estrogen. It naturally declines with age. High DHEA-S can be seen in PCOS or adrenal conditions; low levels can reflect aging, chronic stress or adrenal problems. DHEA supplements can affect hormones and should only be used with testing and guidance.
Key takeaways
Not sure what kind of doctor to see for hormones that feel out of balance? Read What kind of doctor should I see for fatigue, hormones, or gut issues?, or book a free 15-minute consult with Dr. Kneessi, a licensed naturopathic doctor in Maryland.
DHEA-S is an adrenal hormone that the body converts into testosterone and estrogen inside the tissues.
It falls steadily with age, so it is often used as a gauge of hormonal aging, while unusually high levels can point toward PCOS or adrenal issues.
Good sleep, stress care and strength training are the everyday foundations, and DHEA supplements are best used only after testing.
DHEA-S is easiest to interpret alongside cortisol and your other hormone results, and a short call is a good way to talk it through.
What is DHEA-S?
DHEA sulfate is a precursor hormone made by the adrenal glands. It circulates in large amounts and is converted into sex hormones in tissues.
Why DHEA-S matters
DHEA-S is raw material for testosterone and estrogen, and it matters for energy, libido and mood, stress resilience, and immune function.
Understanding your result
Reference ranges vary by lab, age and sex. Your provider interprets your result against the lab’s range and your overall picture, rather than chasing a single number. Functional labs are optional. They can be helpful in more complex cases.
What low DHEA-S can mean
Low DHEA-S can reflect normal aging, chronic stress, adrenal insufficiency or pituitary problems, or some medications, including steroids.
What high DHEA-S can mean
High DHEA-S can reflect PCOS, adrenal hyperplasia or, rarely, adrenal tumors, or DHEA supplements.
What affects DHEA-S
DHEA-S is affected by age and sex, stress, steroid medications, and supplements.
Ways to support healthy levels
Manage stress and sleep (see adrenal health), strength train, and stay active. Only use DHEA supplements with testing and provider guidance, and evaluate a high DHEA-S with your provider.
DHEA-S and healthy aging
DHEA-S declines steadily with age and is often used as a marker of hormonal aging. Low levels are linked with lower resilience to stress and changes in immune signaling.
Related tests and articles: cortisol, pregnenolone.
What does the research show about DHEA-S?
Studies link low DHEA-S with aging outcomes, but supplement trials have been less impressive. In the MrOS Sweden study published in 2010, Ohlsson and colleagues measured DHEA-S in 2,644 men aged 69 to 81 and followed them for an average of 4.5 years. Men in the lowest quarter of DHEA-S had a 54% higher risk of death from any cause and a 61% higher risk of cardiovascular death than the other men, after adjusting for traditional heart risk factors, and the link was stronger in men under about 75. The limitation is that this was an observational study in older Swedish men, so it shows an association, not that raising DHEA-S changes outcomes.
The DHEAge study, published in 2000, gave 280 healthy men and women aged 60 to 79 either DHEA 50 mg a day or placebo for one year. DHEA-S rose to levels typical of younger adults without harmful buildup, and testosterone and estradiol rose slightly, especially in women. Women over 70 showed better bone turnover markers and libido scores, and women showed skin changes such as better hydration, with smaller changes in men. The study was not designed to show effects on energy, illness, or lifespan.
A 2-year randomized trial in the New England Journal of Medicine by Nair and colleagues tested DHEA in 87 older men with low DHEA-S and low testosterone and in 57 older women with low DHEA-S. DHEA raised median DHEA-S by 3.4 µg/mL in men and 3.8 µg/mL in women, but it did not change body composition, muscle strength, fitness, insulin sensitivity, or quality of life. There were small bone density gains at single sites. Together these studies suggest that a low DHEA-S is worth understanding, but supplementing it is not a proven anti-aging strategy and is best guided by testing and a clinician.
When to see a naturopathic doctor
It may be time to see a naturopathic doctor if you have low energy, libido or mood, or signs of PCOS such as acne or excess hair. The same is true if you are dealing with chronic stress, or if you are considering DHEA supplements.
See a medical provider promptly for rapid hair growth, deepening voice or other signs of virilization, or severe fatigue with dizziness and weight loss.
DHEA-S at a glance
| Topic | What the article explains |
|---|---|
| Where it is made | Mainly in the adrenal glands |
| What it feeds into | Testosterone and estrogen |
| What can affect it | Age and sex, stress, steroid medications and supplements |
| Supportive habits | Stress care, sleep, strength training and staying active |
Questions to bring to your clinician
These questions can help you get the most out of your next visit.
Which of my other results would help put my DHEA-S result in context?
How should I read my DHEA-S alongside the rest of my labs and my symptoms?
How often would it make sense to recheck my DHEA-S in my situation?
Which daily habits or medications could be influencing my DHEA-S before we retest?
Frequently asked questions
What does low DHEA-S mean?
It can reflect aging, chronic stress or adrenal problems.
What does high DHEA-S mean?
It can be seen in PCOS or adrenal conditions and should be evaluated.
Should I take DHEA?
Only with testing and guidance. It can raise sex hormones and cause side effects.
Does DHEA decline with age?
Yes, steadily after early adulthood.
What is a normal DHEA-S level?
DHEA-S ranges depend heavily on age and sex, peaking in early adulthood and falling steadily after that. Always compare your result to the age-specific range on your lab report rather than a single number.
What are the symptoms of low DHEA or DHEA-S?
Research has linked low DHEA-S to fatigue, low libido, lower stress resilience, and changes in mood, though these symptoms overlap with many other conditions. Low DHEA-S is also seen with long-term stress, certain medications such as steroids, and normal aging.
Is DHEA the same as DHEA-S?
DHEA-S is the sulfate form of DHEA. Most DHEA in the blood circulates as DHEA-S, which stays steadier through the day, so it is the form usually measured on a blood test. If you are reading about low DHEA symptoms, the lab number you will usually see is DHEA-S.
How do I find out if my DHEA is low?
A DHEA-S blood test is the usual way to check. Because levels fall with age, the result is compared with the age- and sex-specific range on your report, and it is often read alongside cortisol and sex hormones for a fuller picture.
DHEA-S is easiest to interpret alongside cortisol and your other hormone results, and a short call is a good way to talk it through.
Work with a naturopathic doctor near you
Dr. Kneessi sees patients in person in Odenton and by telehealth anywhere in Maryland. Learn more about visits for Annapolis, Odenton, Crofton, and Severna Park, or read about hormone testing and functional medicine in the area.
You can book a free 15-minute consult, or start with the free 28-Day Reset for Energy and Focus, a short daily email series on sleep, light, movement, and food.
Have questions about whether this fits your situation? Dr. Kneessi offers a free 15-minute call to talk through your history and goals.
Please don’t include health details by text.
Sources
- Nakamura Y, et al. Adrenal changes associated with adrenarche. Rev Endocr Metab Disord 2009. PMID: 18821019. https://pmc.ncbi.nlm.nih.gov/articles/PMC3712864/
- Labrie F, et al. Marked decline in serum concentrations of adrenal C19 sex steroid precursors and conjugated androgen metabolites during aging. J Clin Endocrinol Metab 1997. PMID: 9253307. https://pubmed.ncbi.nlm.nih.gov/9253307/
- Goodarzi MO, Carmina E, Azziz R. DHEA, DHEAS and PCOS. J Steroid Biochem Mol Biol 2015. PMID: 25008465. https://pubmed.ncbi.nlm.nih.gov/25008465/
- MedlinePlus: DHEA Sulfate Test
- MedlinePlus: Adrenal Gland Disorders
- Ohlsson C, et al. Low serum levels of dehydroepiandrosterone sulfate predict all-cause and cardiovascular mortality in elderly Swedish men. J Clin Endocrinol Metab 2010. PMID: 20610590. https://pubmed.ncbi.nlm.nih.gov/20610590/
- Baulieu EE, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci U S A 2000. PMID: 10760294. https://pubmed.ncbi.nlm.nih.gov/10760294/
- Nair KS, et al. DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med 2006. PMID: 17050889. https://pubmed.ncbi.nlm.nih.gov/17050889/
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
