What to Avoid Before Taking DHEAS Levels
Before taking DHEAS (dehydroepiandrosterone sulfate) levels, patients should avoid oral contraceptives, glucocorticoids, and acute stress, as these can significantly alter test results. 1
Optimal Timing and Patient Preparation
- DHEAS blood tests should be collected in the morning, ideally after the patient has been out of bed for 2 hours and has been seated for 5-15 minutes 1
- The patient should not eat for at least 3 hours before the test 2
- Unlike many other hormones, DHEAS has minimal diurnal variation due to its long half-life, making the timing less critical than for other adrenal hormones 3
Medications to Avoid
- Oral contraceptives: These can significantly decrease DHEAS levels by reducing DHEA, DHEAS, and androstenedione through inhibition of delta5-pregnenolone synthesis from cholesterol 4, 1
- Glucocorticoids/steroids: Dexamethasone and other glucocorticoids can suppress adrenal function and reduce DHEAS levels 5, 1
- Never abruptly discontinue steroids before testing; proper tapering is essential to prevent rebound adrenal insufficiency 1
Other Factors That May Interfere with Results
- Acute stress: Stress related to testing can impact androgen responses, particularly in healthy individuals 5, 1
- Recent exercise: Vigorous physical activity can temporarily alter hormone levels 2
- Significant electrolyte imbalances: These should be corrected before testing 2
Special Considerations
- DHEAS levels naturally peak around age 25 and decline steadily with age, so interpretation should consider age-specific reference ranges 1, 3
- Serum albumin levels can affect DHEAS measurements, as DHEAS is strongly bound to albumin 6
- In women with polycystic ovary syndrome (PCOS), DHEAS levels may acutely decline during glucose-induced hyperinsulinemia 5
Common Pitfalls to Avoid
- Failing to account for age-related decline when interpreting results
- Not considering the effects of binding proteins (particularly albumin) on measured DHEAS levels
- Overlooking medication effects, especially from oral contraceptives and steroids
- Testing during periods of acute illness or stress, which can alter results
By following these guidelines for DHEAS testing, clinicians can obtain more accurate and reliable results for diagnosing and managing adrenal disorders.