DHEAS
Note: this site is for informational purposes only. To view test results or book a test, use the NHS app in England or contact your GP.
DHEAS (dehydroepiandrosterone sulphate) tests measure the level of DHEAS in a blood sample to assess the production of this hormone by the adrenal glands. They are used to investigate hormone imbalances, including causes of excess androgen symptoms (such as virilisation), adrenal tumours, and certain adrenal gland disorders.
Why get tested?
DHEAS is measured to evaluate adrenal function and certain adrenal tumours, and to investigate the cause of virilisation (showing features of male hormones) or excess facial and body hair (hirsutism) in girls and women or early (precocious) puberty in boys.
When to get tested?
The measurement of DHEAS is used very infrequently in the UK as other tests can be more helpful. A doctor may measure DHEAS in those with signs or symptoms that may be due to the presence or too much male hormone.
It is sometimes used in the investigation of Cushing’s syndrome.
Sample required?
A blood sample taken from a vein in your arm.
Test preparation needed?
No test preparation is needed
What is being tested?
Dehydroepiandrosterone Sulphate (DHEAS) is the sulphated form of a weak androgen, DHEA, a male sex hormone that is present in the blood of both men and women. It has a role to play in developing male secondary sexual characteristics at puberty, and it can be changed by the body into stronger androgens (male hormones), such as testosterone and androstenedione, or can be changed into the female hormone oestrogen. DHEAS is produced by the adrenal cortex, the outer layer of the adrenal glands, with much smaller amounts being produced by the woman’s ovaries and man’s testes. DHEAS secretion is controlled by the pituitary hormone adrenocorticotropic hormone (ACTH) and by other pituitary factors.
Since DHEAS is primarily produced by the adrenal glands, it is useful as a marker for adrenal function. Adrenal cancers, and hyperplasia (excessive growth) can lead to the overproduction of DHEAS but is frequently inappropriately low when an adrenal tumour is present. While elevated concentrations may not be noticed in adult men, they can lead to amenorrhoea and visible symptoms of virilisation in women. These changes vary in severity and may include:
- a deeper voice
- hirsutism (increased facial and/or body hair)
- male pattern baldness
- increased muscularity
- acne
- enlargement of the Adam’s apple
DHEAS may be useful in the investigation of precocious puberty in some boys but in girls only in precocious puberty associated with signs of virilisation. DHEAS may also be used in the specialist investigation of disorders of sex development such as in babies with ambiguous genitalia (when difficult to determine whether a baby is boy or girl) or at any point thereafter.
A distinct period of puberty, which can occur before the other stages, is called adrenarche. This is activation of the adrenal gland before the ovaries or testicles where a surge of adrenal androgens, primarily DHEAS, can result in some body hair and the change to adult body odour (sweat starts to smell). Premature (early) adrenarche is mostly benign and is more common in girls and children of South Asian and Afro-Caribbean origin.
Common questions
DHEAS concentrations are not routinely measured. Unless you have symptoms that warrant its use, you will most likely never have a DHEAS test done. DHEAS can be measured to help diagnose adrenal conditions.
More commonly other hormones such as FSH, LH, prolactin, oestrogen and testosterone are measured to diagnose polycystic ovarian syndrome (PCOS) and to help rule out other causes of infertility, amenorrhea, virilisation and hirsutism. The measurement of DHEAS is not recommended in NICE guidance for either infertility or PCOS investigation.
DHEAS concentrations may be requested in the investigation of disorders of sex development such as ambiguous genitalia in babies and in boys showing early puberty.
A DHEAS test may be requested with other hormone tests when excess androgen (male hormone) production is suspected. This will be apparent by either precocious puberty in boys, or hirsutism or virilisation in women. DHEAS concentrations may be used in the investigation of disorders of sex development. If an enzyme deficiency is present that causes increased DHEAS in such cases then the hormone may be requested to monitor treatment.
Low concentrations of DHEAS may be due to adrenal dysfunction or hypopituitarism or a condition that causes decreased levels of the pituitary hormones that regulate the production and secretion of adrenal hormones. Normal DHEAS concentrations, along with normal concentrations of other androgens, may indicate that the adrenal gland is functioning normally or (more rarely) that an adrenal tumour or cancer present is not secreting hormones. Normal concentrations of DHEAS are frequently seen with PCOS, as this disorder is usually related to ovarian androgen production (primarily testosterone).
Elevated concentrations of DHEAS may indicate an adrenal cancer, or adrenal hyperplasia. Increased concentrations of DHEAS are not diagnostic of a specific condition; they usually indicate the need for further testing to pinpoint the cause of the hormone imbalance.
DHEAS concentrations are normally high in both male and female newborns. They drop sharply shortly after birth, then rise again during puberty. DHEAS concentrations peak between the ages of 18 to 30 years and then slowly decline with age.
People taking DHEA supplements will have elevated blood concentrations of DHEAS.
DHEAS concentrations are stable and not affected by time of day, meals or activity so your sample may be collected any time of day.
Not necessarily. It may be difficult to determine when adult men have elevated concentrations of DHEAS (since they already have masculine secondary sexual characteristics) for example. Also, it should be noted that the symptoms present, and their severity, will vary from person to person.