DHEA is by volume the most abundant steroid hormone in your blood, and yet it rarely appears on a standard hormone profile. Your adrenals make most of it, your ovaries a smaller share. Your body uses it as raw material to build testosterone and oestrogen.
What strikes me: almost every page on this explains what DHEA is, and almost none explains why your lab measures DHEA-S instead of DHEA. That difference decides whether your result is usable.
Below is what the value does, what high and low can mean, and where DHEA as a supplement stands in the Netherlands.
Where does DHEA come from?
About 90 percent of your DHEA comes from the adrenal cortex, the outer layer of the small glands above your kidneys. The rest comes from your ovaries. From around six to eight years of age production climbs, a phase called adrenarche.
DHEA itself does little. In your tissue it is converted into stronger androgens such as androstenedione and testosterone, and partly onward into oestrogen.
In women after menopause that route matters relatively more, because the ovaries contribute far less. A classic review of the origin and control of adrenal androgens sets out the system (PMID 9536209).
What is the difference between DHEA and DHEA-S?
DHEA-S is the same substance with a sulphate group attached, and that small difference makes it far better suited to measurement. DHEA-S stays fairly stable across the day and circulates at high concentration. DHEA itself pulses along with your cortisol, which makes it hard to read at a random moment.
If your GP requests DHEA, in practice DHEA-S nearly always comes back. That is not a lab error, that is the usable variant.
If you do measure DHEA, the time of day weighs heavily. Early morning values run higher than late afternoon ones.
How does your DHEA-S change with age?
More steeply than almost any other hormone. The value peaks around your early twenties and then declines steadily, until in people over seventy it is often a fraction of that peak. A reference value without an age attached therefore says little.
| Age | DHEA-S order of magnitude | What it means for your result |
|---|---|---|
| 20 to 29 | The highest range of your life | A value just under the upper limit is ordinary here |
| 30 to 39 | Clearly lower than at 25 | The decline is normal, not an adrenal problem |
| 40 to 49 | Roughly half the peak | Often misread as a deficiency |
| 50 and older | Lowest range | Relatively more important as an androgen source |
Laboratories therefore use age-banded reference values, usually in micromoles per litre. Always compare your result against your own age band at your own lab, not against a number from the internet.
What can a raised DHEA-S mean?
A high DHEA-S points to the adrenal as the source of androgen, which is a different track from the ovary. The height of the value gives direction.
Take two women of 34 who both present with jawline acne and increasing hair growth. One has a DHEA-S of 6 micromoles per litre, comfortably within her age band, plus a long cycle: that fits an ovarian source such as PCOS. The other has 18 micromoles per litre, well above her band: that shifts attention to the adrenal.
In the second, 17-OH-progesterone is often drawn alongside, because a mild form of an inherited adrenal enzyme disorder can produce the same picture (PMID 30272171). Rapidly increasing symptoms, a deeper voice or marked muscle growth warrant a prompter assessment.
Mild elevations are common and not specific. They gain meaning only beside your testosterone, your SHBG and your symptoms, see hyperandrogenism.
What can a low DHEA-S mean?
Often nothing remarkable. A DHEA-S at the bottom of the reference band goes with getting older and is not a condition in itself.
A genuinely low DHEA-S can fit an underperforming adrenal, long-term corticosteroid use, or a pituitary that under-drives the adrenal. In those cases it rarely stands alone: cortisol, sodium and potassium belong beside it.
Fatigue alone is a weak pointer. Many women who present with tiredness and find a low DHEA-S have another explanation that needs ruling out first. The adrenal and stress route is in stress, adrenals and your hormones.
Can you buy DHEA as a supplement in the Netherlands?
Not freely. In the Netherlands DHEA falls under medicines legislation and is not an over-the-counter food supplement. That differs from the United States, where it sits on supplement shelves. Many Dutch readers land on American information and assume it is sold here too.
The Dutch Farmacotherapeutisch Kompas is where the national status of substances like this can be checked. Discuss any use with your GP or pharmacist, including anything bought abroad.
On the effect itself, the evidence is modest. A meta-analysis of randomised trials in older women found supplementation measurably raises testosterone but showed no convincing effect on BMI (PMID 33220453). In fertility care DHEA is sometimes used around IVF with reduced ovarian reserve; the underlying idea is described, but outcomes vary (PMID 24330163).
Worth knowing if you are having a value measured: if you take DHEA in any form, your DHEA-S can no longer be interpreted. So always mention it.
When is DHEA-S requested?
DHEA-S is rarely requested alone. It usually comes along when there are signs of androgen excess and the question is where they originate, or when adrenal function is in doubt.
Timing is forgiving. DHEA-S does not hang on your cycle day and you need not fast, which makes it easier than oestradiol or progesterone. Still prefer a morning draw if the rest of your profile asks for one.
The explanation of the value itself is on DHEA-S, and the follow-up value on 17-OH-progesterone. How to read it together with testosterone and SHBG is in SHBG in women.
The wider overview of which hormone test fits when is in hormone testing in women, and hormones for women fits alongside it. Discuss an abnormal result with your GP; Thuisarts describes the route that usually follows.
References
- McKenna TJ, Fearon U, Clarke D, Cunningham SK. A critical review of the origin and control of adrenal androgens. Baillieres Clin Obstet Gynaecol. 1997;11(2):229-248. PMID 9536209.
- Hu Y, Wan P, An X, Jiang G. Impact of dehydroepiandrosterone (DHEA) supplementation on testosterone concentrations and BMI in elderly women: a meta-analysis of randomized controlled trials. Complement Ther Med. 2021;56:102620. PMID 33220453.
- Speiser PW, Arlt W, Auchus RJ, et al. Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(11):4043-4088. PMID 30272171.
- Ford JH. Reduced quality and accelerated follicle loss with female reproductive aging: does decline in theca dehydroepiandrosterone (DHEA) underlie the problem? J Biomed Sci. 2013;20:93. PMID 24330163.
- Farmacotherapeutisch Kompas. Information on medicines and their status in the Netherlands. Available via farmacotherapeutischkompas.nl.
- Thuisarts. I have an abnormal blood test result. Available via thuisarts.nl.
Every blood test result at Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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