DHEA VS DHEA-S
DHEA and DHEA-S have become key markers in hormone testing. Their role in producing sex hormones makes them essential for a comprehensive examination of your patient’s hormonal health. Beyond indicating adrenal function, the levels of these hormones can help identify hormonal imbalances, tumors, and other medical conditions. Although both DHEA and DHEA-S modulate the synthesis of neurotransmitters, they do so in dramatically different ways. It can be challenging to determine which marker to include in your testing. Let’s take a look at the differences between DHEA and DHEA-S and how those differences could shape your diagnostic process.
DHEA
Produced largely in the adrenal cortex and in trace amounts in the ovaries and testes, dehydroepiandrosterone (DHEA) is an adrenal steroid hormone derived from cholesterol. In peripheral target tissues, it signals the production of metabolites such as sex steroids, including testosterone, estrogen, and progesterone. As a result, though DHEA is a weak androgen, it is correlated with high levels of potent androgens. DHEA only occurs in the body in short bursts as needed before it is metabolized, so its half-life is 15-20 minutes.
One of the features that distinguish DHEA from DHEA-S is its strong diurnal variation. Like cortisol, DHEA follows a daily rhythm. Regular DHEA levels are highest in the morning and progressively decline, reaching their lowest point during sleep. Likewise, DHEA levels vary with age, peaking in young adulthood and gradually falling. An adult 70-80 years old will only have 10-20% of the DHEA concentration found in young adults. Due to DHEA’s correlation with sex hormones and its lack with the psychophysical changes of age, it is sometimes referred to as “the fountain of youth.” In fact, many DHEA supplements have been developed to combat aging. The daily changes from, lifelong variations of, and hormonal production caused by DHEA levels are some of the reasons it has become a common feature of hormone testing.
DHEA and Health
Because DHEA levels provide insight into the source of androgen synthesis, the amount of DHEA in your patient’s bloodstream helps treat several different health issues.
High Levels of DHEA
When DHEA is overproduced, an overabundance of sex steroids is sure to follow. An unusually high level of androgens, or hyperandrogenism, as seen in patients with polycystic ovary syndrome (PCOS), is often related to the production of DHEA. DHEA levels are also associated with adrenal insufficiencies like congenital adrenal hyperplasia (CAH). Patients with CAH show up to 5X or 10X typical DHEA levels. High levels of DHEA may also be a sign of androgen-producing tumors.
Low Levels of DHEA
Likewise, an underproduction of DHEA is associated with a litany of potential health issues. Decreased sex drive, vaginal atrophy, and erectile dysfunction all symptomize low DHEA levels. In extreme cases, a low DHEA concentration is associated with Addison’s disease and hypopituitarism.
When to Test DHEA
DHEA levels are well-suited for uncovering the source of androgen-related health issues. Among other health concerns, suspected adrenal tumors, hyperandrogenic activity, adrenal insufficiencies, and PCOS can all be informed by DHEA levels.
DHEA-S
Dehydroepiandrosterone sulfate (DHEA-S) is derived from DHEA. In the liver, adrenal gland, and intestines, DHEA is converted into DHEA-S by sulfotransferase hormones. This process is bidirectional; through the sulfatase enzyme, DHEA-S can be converted back to DHEA.
The most significant difference in the composition of the two hormones is the added sulfate molecule attached to DHEA-S. DHEA-S also has a much stronger bond to albumin, its carrier protein. The adrenocorticotropic hormone (ACTH), along with other pituitary hormones, controls the secretion of DHEA-S. Like its unconjugated form, DHEA-S can be metabolized into sex steroids, including dihydrotestosterone and androstenedione.
Although DHEA-S is a derivative of DHEA, it exists in much higher concentrations. Endogenous DHEA-sulfate is the most abundant circulating hormone. Due to its strong bond to its carrier protein, DHEA-S lives in the system much longer than DHEA, with a half-life of about ten hours.
How DHEA-S Shapes Health
As a product of DHEA, DHEA-S levels are related to many of the same health concerns. High levels of DHEA-S are associated with adrenal insufficiencies and overproduction of androgens. Overproduction of DHEA-S is related to fluctuating weight, infertility, and male-patterned hair growth in women, or hirsutism, among other symptoms. Partially due to the longevity of DHEA-S, it works to develop long-lasting mechanisms that affect hormone production over time.
When to Test DHEA-S
DHEA-S levels are ideal for analyzing hormone patterns, so DHEA-S testing is best suited for regular wellness check-ups. Consider incorporating DHEA-S into your regular testing regimen to track your patients’ hormonal health.
DHEA and DHEA-S Testing
Both DHEA and DHEA-S levels are central to whole-body health. At Access Medical Labs, DHEA or DHEA-S are included on all of our advanced hormone testing panels. Backed by a specialized team and premier facility, our tests provide you with the data you need to maintain high-quality patient care.
