Precursor hormone for testosterone and estrogen
16 of 22 providers
Sex Hormones (Male)
stress
DHEA-S (dehydroepiandrosterone sulfate) is the sulfated, stable form of DHEA, a precursor hormone produced primarily by the adrenal glands (95% adrenal, 5% gonads in men, some ovarian production in women). DHEA and DHEA-S are the most abundant steroid hormones in your body and serve as building blocks for other hormones, including testosterone, estrogen, and other androgens. DHEA-S has a much longer half-life than DHEA (7-10 hours vs 15-30 minutes), making it a more reliable marker of adrenal androgen production.
Here's the key insight:DHEA-S declines dramatically with age—it peaks in your mid-20s and drops by about 80% by age 70-80. This decline is so predictable that DHEA-S is sometimes called a "biomarker of aging."Low DHEA-S is associated with accelerated aging, increased mortality, frailty, cognitive decline, and reduced quality of life. However, the evidence for DHEA supplementation is mixed:some studies show benefits for mood, bone density, and body composition in older adults, while others show minimal effect.
DHEA-S is also a marker of adrenal function. Very low levels may indicate adrenal insufficiency (Addison's disease or hypopituitarism), while very high levels in women often point to PCOS, adrenal hyperplasia, or adrenal tumors. Unlike cortisol (which fluctuates throughout the day), DHEA-S is stable and doesn't require specific timing for testing.
| Range Type | Level | Significance |
|---|---|---|
| Optimal (Men 20-30) | 280-640 mcg/dL | Peak DHEA-S levels in young adults. Levels decline ~2% per year after age 30. |
| Optimal (Men 40-50) | 120-520 mcg/dL | Age-appropriate range for middle-aged men. Supplementation may be considered if <150 mcg/dL with symptoms. |
| Optimal (Men 60+) | 80-350 mcg/dL | Expected range for older men. Low-normal or below may benefit from DHEA supplementation (25-50 mg/day). |
| Optimal (Women 20-30) | 145-395 mcg/dL | Peak levels in young women. Note:Women have lower DHEA-S than men at all ages. |
60-340 mcg/dL
Optimal (Women 60+)
Expected range for older women. Very low levels (<50 mcg/dL) may indicate adrenal insufficiency.
DHEA supplements:25-50 mg/day is typical replacement dose for adults with low DHEA-S. Start low (10-25 mg) and titrate based on symptoms and retesting. Take in the morning to mimic natural circadian rhythm.
Caution in women:DHEA converts to testosterone and can cause acne, facial hair, oily skin if dose is too high. Monitor symptoms and retest in 3 months.
Caution in men:DHEA can convert to estrogen via aromatization. Monitor estradiol if on DHEA + TRT.
7-keto DHEA:Metabolite of DHEA that doesn't convert to sex hormones. May support metabolism and weight loss without androgenic/estrogenic effects. Weaker evidence than DHEA.
Very low DHEA-S (<40 mcg/dL in adults) may indicate primary adrenal insufficiency (Addison's disease) or secondary adrenal insufficiency (pituitary failure).
Check cortisol, ACTH, electrolytes. If confirmed adrenal insufficiency, requires hydrocortisone replacement ± fludrocortisone.
DHEA supplementation (25-50 mg/day) may improve quality of life, mood, and libido in patients with adrenal insufficiency on glucocorticoid replacement.
Acne, oily skin (especially in women on DHEA supplementation)|Increased facial or body hair (hirsutism in women)|Male-pattern baldness in women|Irregular menstrual periods, anovulation (women)|Deepening voice (women, if very high)|Mood changes, irritability|Insulin resistance (in PCOS with high DHEA-S)
Source:High DHEA-S in women often indicates PCOS or adrenal hyperplasia. In men, high DHEA-S is less clinically significant unless extremely elevated (>800 mcg/dL, suggesting adrenal tumor).
PCOS (polycystic ovary syndrome):Insulin resistance drives ovarian and adrenal androgen production. Most common cause of high DHEA-S in women.|Non-classic congenital adrenal hyperplasia (NCAH):21-hydroxylase enzyme deficiency causes androgen excess. Usually milder than classic CAH.|Adrenal tumors:Adrenocortical carcinoma or adenoma can overproduce DHEA-S. Consider if DHEA-S >800 mcg/dL.|Cushing's syndrome:Excess cortisol production may be accompanied by elevated adrenal androgens.|Ovarian tumors (rare):Some ovarian tumors secrete androgens.
Source:If considering DHEA supplementation:Baseline DHEA-S, then retest 3 months after starting supplementation to ensure appropriate dosing and monitor for excess.|If very low (<40 mcg/dL):Check cortisol and ACTH to rule out adrenal insufficiency before attributing to aging.|If high in women:Check testosterone, 17-hydroxyprogesterone, and consider pelvic ultrasound to evaluate for PCOS or adrenal pathology.|Age-based monitoring:DHEA-S declines predictably with age. Can retest every 2-3 years in adults >40 to track trajectory and consider supplementation if symptomatic with low levels.|No specific timing needed:Unlike cortisol, DHEA-S is stable throughout the day. Can be tested any time.
DHEA-S peaks at age 20-30 (300-600 mcg/dL in men, 200-400 mcg/dL in women) and declines ~2%/year. By age 70-80, levels are 10-20% of peak. This decline is so consistent that DHEA-S is sometimes called a "biomarker of aging."Lower DHEA-S in older adults correlates with frailty, cognitive decline, and mortality.
Source:Orentreich N, et al. Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations. J Clin Endocrinol Metab. 1984;59(3):551-555.
Observational studies show higher DHEA-S levels in older adults are associated with 20-30% lower all-cause mortality. However, randomized controlled trials of DHEA supplementation show mixed results:some show improvements in bone density, body composition, and well-being, while others show no benefit. Benefits may be greatest in those with very low baseline levels.
Source:Samaras N, et al. A review of age-related dehydroepiandrosterone decline and its association with well-known geriatric syndromes. Rejuvenation Res. 2013;16(4):285-294.
DHEA supports bone formation via conversion to estrogen and testosterone. Meta-analyses show DHEA supplementation (50 mg/day) modestly increases bone mineral density in older adults, particularly in women >60. Effects are smaller than standard HRT but may be useful in those who cannot or will not take estrogen.
Source:Weiss EP, et al. Dehydroepiandrosterone replacement therapy in older adults. J Clin Endocrinol Metab. 2009;94(10):4103-4110.
| Provider | Includes | Annual Cost | Biomarkers |
|---|---|---|---|
 Superpower | ✓ | $199 | 100+ (150 with ratios) |
 WHOOP Advanced Labs | ✓ | $349 | 65 |
 Labcorp OnDemand | — | $398 | 30+ |
| ✓ | $486 | 40+ | |
| ✓ | $468 | 83 | |
| ✓ | $349 | 100+ | |
 InsideTracker | ✓ | $680 | 54 |
 Function Health | ✓ | $365 | 100+ |
| — | $250 | 65 | |
| ✓ | $495 | 70+ | |
| ✓ | $895 | 100+ | |
| ✓ | $1950 | 150+ | |
| — | $399 | 100+ | |
| — | $Varies | 75+ | |
| — | $190 | 100+ | |
| — | $99 | 50 | |
| ✓ | $125 | 60 | |
| — | $199 | 50 | |
| ✓ | $499 | 120+ | |
| ✓ | $4188 | 80+ | |
| ✓ | $375 | 85 | |
| ✓ | $700 | 129 |
16 providers include this biomarker in their panels
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.
