DHEAS (dehydroepiandrosterone sulfate) is a hormone your adrenal glands produce that serves as a building block for other hormones, including testosterone and estrogen. It’s the most abundant steroid hormone circulating in your bloodstream, and its levels change dramatically over your lifetime, peaking in your 20s and dropping to as low as 10% to 20% of that peak by the time you reach your 70s or 80s.
Where DHEAS Comes From
Your body makes DHEAS in the innermost layer of the adrenal glands, small organs that sit on top of each kidney. This inner layer, called the zona reticularis, is essentially dedicated to producing DHEAS and its unsulfated form, DHEA. The middle and outer layers of the adrenal gland handle other jobs, like producing cortisol (your main stress hormone) and aldosterone (which regulates blood pressure). The zona reticularis produces almost no cortisol, and the cortisol-producing zone produces almost no DHEAS. They’re functionally separate factories.
DHEA vs. DHEAS
You’ll often see “DHEA” and “DHEAS” used almost interchangeably, but they’re slightly different forms of the same hormone. DHEA is the base molecule. DHEAS is DHEA with a sulfate group attached, which makes it far more stable in the bloodstream. DHEA has a half-life of only 1 to 3 hours, meaning it breaks down quickly. DHEAS lasts 10 to 20 hours, giving it much more staying power. That stability is why DHEAS circulates at concentrations 250 to 500 times higher than DHEA. It’s also why doctors test DHEAS rather than DHEA: the levels stay consistent throughout the day and give a more reliable snapshot.
What DHEAS Does in Your Body
DHEAS doesn’t do much on its own. Its real value is as a raw material. Your body converts it into active sex hormones in tissues throughout the body. In the adrenal glands and other tissues, enzymes transform DHEAS into androgens like testosterone. In the ovaries, a different enzyme (aromatase) converts it into estrogens like estradiol. This means DHEAS feeds into both male and female sex hormone pathways, which is why it matters for everyone regardless of sex.
DHEAS also plays a protective role during stress. When your body mounts a stress response and cortisol levels rise, DHEAS levels rise alongside them to counterbalance some of cortisol’s harmful effects, including suppression of the immune system and potential damage to brain cells. When this system works well, the two hormones stay in proportion. Chronic or repeated stress can blunt the DHEAS response, though, leaving cortisol relatively unopposed. A high cortisol-to-DHEAS ratio has been linked to depression, anxiety, cognitive decline, weakened immunity, and metabolic problems.
How Levels Change With Age
DHEAS follows one of the most dramatic age-related declines of any hormone. Levels peak during your 20s and then drop steadily, roughly 2% to 3% per year. By 70 to 80 years old, many people have only 10% to 20% of the DHEAS they had at their peak. This gradual decline is sometimes called “adrenopause.” Unlike menopause or the drop in testosterone that some men experience, adrenopause doesn’t cause sudden, obvious symptoms. But the slow erosion of DHEAS means less raw material for sex hormones and less buffering against cortisol’s effects, which some researchers believe contributes to age-related changes in body composition, bone density, mood, and cognitive function.
Normal Reference Ranges
DHEAS levels are reported in micrograms per deciliter (µg/dL) or nanograms per deciliter (ng/dL) and vary significantly by age and sex. Here are typical adult ranges, reported in µg/dL:
- Ages 21 to 30: 38 to 523 for men, 22 to 372 for women
- Ages 31 to 40: 33 to 416 for men, 17 to 286 for women
- Ages 41 to 50: 16 to 390 for men, up to 229 for women
- Ages 51 to 60: up to 298 for men, up to 215 for women
- Ages 61 to 70: up to 251 for men, up to 128 for women
- Ages 71 to 80: up to 208 for men, up to 111 for women
Children and teens have much lower levels that gradually rise during puberty. Premature infants actually have surprisingly high levels (a remnant of fetal adrenal activity), which drop rapidly in the first few months of life before climbing again as puberty approaches.
What High DHEAS Levels Mean
Elevated DHEAS is most commonly flagged in women and girls because the excess gets converted into androgens, producing noticeable symptoms. These can include excess facial and body hair, acne, thinning hair on the top of the head, a deepening voice, increased muscle bulk, and irregular periods.
The most common conditions behind high DHEAS include polycystic ovary syndrome (PCOS), which is a hormone disorder affecting women of reproductive age, congenital adrenal hyperplasia (an inherited condition where the adrenal glands overproduce androgens), and adrenal tumors, which can be noncancerous or cancerous. In rare cases, an ovarian tumor can also raise DHEAS levels.
What Low DHEAS Levels Mean
Low DHEAS can indicate that the adrenal glands aren’t functioning properly. This happens in conditions like Addison’s disease (where the adrenal glands are damaged) or secondary adrenal insufficiency (where the pituitary gland isn’t sending the right signals to the adrenals). Low levels are also entirely expected in older adults simply due to the natural age-related decline. In younger people, unusually low DHEAS may point to a problem worth investigating, particularly if accompanied by fatigue, low libido, or other signs of hormone deficiency.
The DHEAS Blood Test
One of the practical advantages of testing DHEAS over other hormones is its stability. Unlike cortisol, which spikes in the morning and drops at night, DHEAS levels stay relatively flat throughout the day. You don’t need to fast, and the time of your blood draw generally doesn’t affect results.
A few things can skew your numbers, though. Certain medications for diabetes and high blood pressure can raise DHEAS levels. Fish oil and vitamin E supplements can lower them. Nicotine also pushes levels up, so you should avoid smoking before the test. If you take any medications or supplements regularly, mention them to your provider before the test so the results can be interpreted accurately.
The Cortisol-to-DHEAS Ratio
Some clinicians look beyond the DHEAS number alone and consider it relative to cortisol. During a healthy stress response, both hormones rise together. DHEAS acts as a kind of brake on cortisol, protecting the immune system and brain from cortisol’s more damaging effects. When chronic stress wears down the DHEAS response while cortisol stays elevated, the ratio shifts. A high cortisol-to-DHEAS ratio has been associated with immune suppression, high blood pressure, metabolic disorders, and faster cognitive decline, particularly in older adults whose DHEAS levels are already low from aging. This ratio is increasingly used as a marker of how well the body is coping with long-term stress, rather than just measuring either hormone in isolation.