What does a Dehydroepiandrosterone (DHEA) blood level of 105 indicate?

Interpreting DHEA Blood Level of 105

A DHEA blood level of 105 is likely normal, but requires interpretation based on age, gender, and reference range of the specific laboratory, as DHEA levels naturally decline with age at approximately 2% per year. 1

Understanding DHEA and Its Normal Values

DHEA (Dehydroepiandrosterone) is an important prohormone secreted by the adrenal cortex that serves as a precursor to both androgens and estrogens. It follows a characteristic age-related pattern of secretion, with levels peaking in early adulthood and progressively declining thereafter 1, 2.

Normal DHEA reference ranges vary by:

• Age (highest in young adults, declining with age)
• Gender (typically higher in males)
• Laboratory-specific reference ranges
• Time of day (follows diurnal pattern similar to cortisol)

According to clinical guidelines, age-specific reference ranges for DHEAS (DHEA sulfate, the storage form) are:

• Age 20-29: Values >3800 ng/ml may be abnormal
• Age 30-39: Values >2700 ng/ml may be abnormal 3

Clinical Significance of DHEA Levels

Elevated DHEA Levels

• May indicate adrenal hyperplasia
• Possible polycystic ovary syndrome (PCOS) in women
• Potential adrenal or ovarian tumors (especially if significantly elevated)

Low DHEA Levels

• Common with advancing age (natural decline)
• May be associated with adrenal insufficiency
• Potentially linked to decreased vitality, muscle mass, and bone density in older adults 4, 5

Interpreting a Level of 105

Without knowing the specific units (ng/ml, μg/dl, nmol/L) and laboratory reference range, a definitive interpretation is challenging. However:

• If measured as DHEAS in ng/ml, a value of 105 would be considered low for most age groups
• If measured as DHEA in ng/dl, this could be within normal range depending on age and gender

Clinical Approach to DHEA Level Interpretation

1. Confirm units and laboratory reference range

   • Different laboratories use different methodologies and reference ranges

2. Consider age and gender context

   • DHEA levels naturally decline with age
   • Women typically have lower levels than men of the same age

3. Evaluate for associated symptoms

   • In women: menstrual irregularities, hirsutism, acne (if elevated)
   • In both sexes: fatigue, decreased muscle mass, reduced bone density (if low)

4. Consider additional testing if indicated

   • If suspecting PCOS: LH/FSH ratio, testosterone, pelvic ultrasound
   • If suspecting adrenal dysfunction: cortisol levels, ACTH stimulation test

Clinical Pearls and Pitfalls

• Isolated DHEA measurements have limited diagnostic value without clinical context
• DHEA levels fluctuate throughout the day, so timing of blood draw matters
• DHEA supplementation in older adults remains controversial despite some studies showing modest benefits for bone health, muscle strength, and well-being 5, 6
• DHEA is considered a dietary supplement in the US but a hormone in many European countries, leading to different regulatory approaches 4

Common Causes of Abnormal DHEA Levels

Elevated DHEA

• PCOS (common in women with temporal lobe epilepsy, affecting 10-25%) 3
• Congenital adrenal hyperplasia
• Adrenal or ovarian tumors
• Cushing's syndrome

Low DHEA

• Advanced age (natural decline)
• Adrenal insufficiency
• Hypopituitarism
• Long-term glucocorticoid therapy

Remember that DHEA levels should always be interpreted within the clinical context of the patient's symptoms, age, gender, and other laboratory findings.