From the Guidelines
If your DHEAS level is elevated at 730, it is crucial to consult with an endocrinologist for proper evaluation and management to rule out underlying conditions such as non-classical congenital adrenal hyperplasia, given that the normal range for DHEAS varies by age, with levels above 3800 ng/ml for those aged 20-29 and above 2700 ng/ml for those aged 30-39 being considered elevated 1.
Key Considerations
- The approach to managing elevated DHEAS levels depends on identifying the underlying cause, which could include polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia (CAH), adrenal tumors, or other conditions.
- Additional tests such as cortisol levels, ACTH stimulation tests, or imaging studies like CT or MRI of the adrenal glands may be ordered to determine the exact cause of the elevation 1.
- Treatment is directed at the underlying condition rather than the DHEAS level itself, and may include lifestyle modifications, medications, or in some cases, surgical intervention.
Potential Underlying Conditions and Management
- For PCOS, which is a common cause of irregular periods in women and can be associated with elevated androgen levels, lifestyle modifications including weight loss and medications like metformin or combined oral contraceptives may be recommended 1.
- For adrenal tumors, surgical removal might be necessary.
- For CAH, corticosteroid replacement therapy may be prescribed to manage symptoms and hormonal imbalances.
Importance of Monitoring and Follow-Up
- Monitoring symptoms such as hirsutism, acne, menstrual irregularities in women, or muscle mass changes in men is important during treatment to assess effectiveness and adjust therapy as needed.
- Regular follow-up appointments with an endocrinologist are essential to monitor treatment effectiveness and make any necessary adjustments to the treatment plan.
From the Research
Elevated DHEAS Levels
If the Dehydroepiandrosterone sulfate (DHEAS) level is elevated, at 730, it is essential to understand the implications and potential causes.
- DHEAS is primarily of cortico-adrenal origin in women, and a level over 600 mg/dl may indicate a diagnosis of androgen-secreting adrenal cortical adenoma 2.
- Elevated DHEAS levels can also be associated with polycystic ovary syndrome (PCOS), although the exact cause of this association remains unclear 3.
- In some cases, elevated testosterone is associated with a marked elevation of SHBG, possibly due to the use of medication having an estrogenic effect, hyperthyroidism, or liver disease 2.
Potential Courses of Action
Given the elevated DHEAS level, potential courses of action may include:
- Further testing to determine the underlying cause of the elevation, such as assessing total testosterone levels and other hormonal markers 2.
- Evaluation for PCOS or other conditions that may be contributing to the elevated DHEAS level 3, 4.
- Consideration of treatment options, such as spironolactone, which may help reduce androgen production and alleviate symptoms 5.
Importance of Age-Dependent Norms
When interpreting DHEAS levels, it is crucial to consider age-dependent norms, as DHEAS production correlates negatively with age 4.