Also Known As
DHEA Blood Test, Dehydroepiandrosterone Sulfate, DHEA-S Test, DHEA-SO4
What Is a DHEA-S Blood Test?
A DHEA-S blood test measures the level of dehydroepiandrosterone sulfate (DHEA-S) in your blood — a hormone produced almost exclusively by the adrenal glands. DHEA-S is the most abundant steroid hormone in the human body and serves as the primary building block for producing sex hormones including testosterone and estrogen.
Testing DHEA-S levels helps evaluate adrenal gland function, investigate the cause of hormonal imbalances, assess aging-related hormone decline, and screen for adrenal disorders. According to the National Institutes of Health, DHEA-S peaks in your mid-20s and declines steadily with age — dropping to just 20–30% of peak levels by your 70s and 80s.
What Does DHEA-S Do in the Body?
DHEA-S is a precursor hormone — meaning its primary role is to convert into other hormones your body needs. Once produced by the adrenal glands, DHEA-S converts into:
- Testosterone — supporting muscle mass, libido, energy, and bone density in both men and women
- Estrogen — supporting reproductive health, bone protection, and mood regulation
- Other androgens — influencing body composition, skin health, and immune function
Beyond its role as a hormone precursor, DHEA-S has been studied for its effects on immune function, cognitive health, mood, and energy levels — particularly as it relates to age-related decline.
DHEA-S Normal Reference Ranges
Reference ranges vary significantly by age and sex:
Women
| Age | Normal Range (µg/dL) |
|---|---|
| 18–29 | 44–332 |
| 30–39 | 31–228 |
| 40–49 | 18–244 |
| 50–59 | 21–170 |
| 60–69 | 11–171 |
| 70+ | 17–90 |
Men
| Age | Normal Range (µg/dL) |
|---|---|
| 18–29 | 160–449 |
| 30–39 | 112–397 |
| 40–49 | 79–377 |
| 50–59 | 70–310 |
| 60–69 | 42–290 |
| 70+ | 28–175 |
Reference ranges may vary slightly by laboratory. Always interpret results in the context of age, symptoms, and clinical history.
What Does High DHEA-S Mean?
Elevated DHEA-S above the age-adjusted normal range may indicate:
- Congenital adrenal hyperplasia (CAH) — a genetic disorder affecting adrenal hormone production
- Adrenal tumor or cancer — adrenal tumors can produce excess DHEA-S
- Cushing syndrome — excess cortisol production often accompanied by elevated DHEA-S
- Polycystic ovary syndrome (PCOS) — elevated DHEA-S is a common finding in women with PCOS
- Ectopic ACTH syndrome — ACTH produced outside the pituitary gland stimulates excess adrenal hormone output
Symptoms of high DHEA-S in women may include:
- Excess facial or body hair (hirsutism)
- Acne
- Irregular or absent periods
- Deepening of the voice
- Infertility
- Male-pattern hair thinning
Symptoms of high DHEA-S in men may include:
- Acne
- Aggressive behavior or mood changes
- Early puberty in adolescents
What Does Low DHEA-S Mean?
Low DHEA-S below the age-adjusted normal range may indicate:
- Addison’s disease — the adrenal glands don’t produce enough hormones
- Adrenal insufficiency — partial or complete failure of adrenal hormone production
- Hypopituitarism — the pituitary gland fails to adequately stimulate the adrenal glands
- Adrenal hypoplasia — underdevelopment of the adrenal glands
- Age-related decline — natural and expected reduction in DHEA-S production after age 30
Symptoms of low DHEA-S may include:
- Fatigue and low energy
- Decreased libido
- Depression or low mood
- Difficulty building or maintaining muscle
- Decreased bone density
- Brain fog or difficulty concentrating
- Reduced immune function
- Salt cravings, dizziness, or nausea (signs of adrenal insufficiency)
Who Should Get a DHEA-S Test?
- Women with unexplained excess facial or body hair, acne, or irregular periods
- Women with known or suspected PCOS
- Women or men experiencing unexplained fatigue, low libido, or mood changes
- Anyone with suspected adrenal gland dysfunction
- Anyone with symptoms of Cushing syndrome or Addison’s disease
- Men or women experiencing early signs of hormone-related aging
- People considering DHEA supplementation — baseline testing before starting is essential
- Anyone currently taking DHEA supplements to monitor levels
- Children or adolescents with signs of early or delayed puberty
Test Preparation
No fasting required for the DHEA-S blood test. You can eat and drink normally beforehand.
Biotin supplements: If you are taking high-dose biotin (vitamin B7), wait at least 8 hours after your last dose before giving your blood sample. High biotin levels can interfere with immunoassay test results.
DHEA supplements: If you currently take DHEA supplements, note this when reviewing your results. Supplementation will elevate DHEA-S levels and needs to be factored into interpretation.
Time of day: DHEA-S is relatively stable throughout the day compared to cortisol, so there is no specific time requirement for this test.
How Much Does a DHEA-S Test Cost?
| Where You Get Tested | Typical Cost | Notes |
|---|---|---|
| Personalabs | $49–$69 | Physician order included |
| Doctor’s office visit + lab | $200–$400+ | Office copay + lab fees |
| Endocrinologist visit | $300–$600+ | Specialist fees apply |
| Hospital outpatient lab | $300–$700+ | Facility fees apply |
HSA and FSA eligible. DHEA-S testing qualifies as a reimbursable medical expense.
How to Order Your DHEA-S Test
Step 1: Order online — your physician-approved lab order is ready within 2–4 hours. Step 2: Find a lab near you using our Lab Locator. Step 3: Walk in for your blood draw — no fasting needed. Step 4: Get results in your secure Personalabs account within 24–48 hours.
Frequently Asked Questions
What is the difference between DHEA and DHEA-S?
DHEA (dehydroepiandrosterone) and DHEA-S (dehydroepiandrosterone sulfate) are closely related hormones. DHEA-S is the sulfated, more stable form of DHEA and is present in much higher concentrations in the blood. Because DHEA-S has a longer half-life and more stable blood levels than DHEA, it is the preferred marker for laboratory testing of adrenal androgen production. When you order a DHEA blood test through Personalabs, the test measures DHEA-S.
Can low DHEA-S cause fatigue and depression?
Yes — low DHEA-S is frequently associated with fatigue, low energy, depression, and reduced motivation, particularly as people age. DHEA-S plays a role in the production of sex hormones and has direct effects on brain chemistry. Some research suggests DHEA supplementation may improve mood and energy in people with documented deficiency, though supplementation should always be guided by a healthcare provider based on lab results.
Should I test DHEA-S before taking DHEA supplements?
Absolutely. DHEA supplements are widely available over the counter, but taking them without knowing your baseline levels is not recommended. DHEA-S that is already within the normal range doesn’t need supplementation, and excess DHEA can convert to testosterone or estrogen in ways that may cause unintended hormonal effects. Testing first gives you a clear picture of whether supplementation is warranted and what dose may be appropriate.
Is DHEA-S tested as part of a routine blood panel?
No — DHEA-S is not included in standard panels like the CMP, CBC, or basic hormone panels. It requires a specific order. If you want a comprehensive adrenal and hormone evaluation, consider combining DHEA-S with a cortisol test and testosterone panel for a complete picture.
How does DHEA-S relate to testosterone in women?
In women, the adrenal glands are a primary source of androgens including DHEA-S, which converts to testosterone. Elevated DHEA-S is one of the most common causes of high androgen levels in women, leading to symptoms like excess hair growth, acne, and irregular cycles. Testing DHEA-S alongside testosterone helps determine whether elevated androgens are coming from the adrenal glands (elevated DHEA-S) or the ovaries (normal DHEA-S with high testosterone).
What conditions cause both high DHEA-S and high cortisol?
Cushing syndrome — caused by chronically elevated cortisol — can be associated with elevated DHEA-S, particularly when the cause is an adrenal tumor that produces multiple hormones. However, DHEA-S can also be normal or low in some forms of Cushing syndrome. If Cushing syndrome is suspected, your provider will typically order both a cortisol test and DHEA-S along with other confirmatory tests.
How often should I retest DHEA-S?
For monitoring age-related decline or tracking supplementation response, retesting every 6–12 months is reasonable. For investigating a specific condition like PCOS or adrenal dysfunction, your provider will determine the appropriate follow-up schedule based on your results and treatment plan.
Related: 10 Essential Blood Tests You Should Take Every Year
