What are the normal levels of Dehydroepiandrosterone (DHEA) in adults?

Normal DHEA Levels in Adults

Normal DHEA sulfate (DHEAS) levels in adults vary by age and sex, with levels typically peaking around age 20-30 and declining progressively thereafter to approximately 10-20% of young adult levels by age 70-80. 1

Normal Reference Ranges for DHEAS

By Age and Sex:

• Young Adults (20-29 years):

  • Men: Higher levels than women (30-50% higher) 2
  • Women: Lower than men but in the micromolar range 2

• Age 30-39 years:

  • Women: DHEAS levels >2700 ng/ml considered normal 3

• Age 40-65 years:

  • Progressive decline begins, with levels decreasing at approximately 1.6% per year 1, 2

• Age 70-80 years:

  • Levels decline to approximately 10-20% of young adult values 1, 2

Clinical Significance of DHEAS Levels

Low DHEAS Levels:

• Men: DHEAS below 55.4 μg/dL (15th percentile) associated with increased heart failure hospitalization 4
• Women: DHEAS below 27.4 μg/dL (15th percentile) associated with increased heart failure hospitalization 4
• Mortality risk: DHEAS below 70.0 μg/dL in men and 37.1 μg/dL in women (25th percentile) associated with increased mortality 4

DHEAS in Specific Conditions:

• Adrenal insufficiency: Low DHEAS levels are characteristic 5
• Polycystic ovary syndrome (PCOS): DHEAS may be elevated 3
  • Diagnostic accuracy studies show DHEAS has moderate sensitivity (67-82%) and specificity (57-81%) for PCOS 3

Physiological Role and Significance

• DHEAS is primarily produced by the adrenal cortex 1
• DHEA is produced by both ovaries and adrenal glands 5
• DHEAS secretion begins around age 10, peaks at age 20, and then gradually declines 5
• The decline in DHEAS with age is termed "adrenopause" 1

Measurement Considerations

• Morning samples are preferred for accurate assessment 3
• Multiple measurements may be needed for accurate assessment due to pulsatile secretion 3
• Different assay methods may yield different results:
  • LC-MS/MS methods generally provide more accurate measurements than direct immunoassays 3

Clinical Implications

• Low DHEAS levels have been associated with:

  • Increased risk of heart failure hospitalization in both men and women 4
  • Higher mortality rates, particularly in men 2, 4
  • Potential impacts on sexual function, particularly in women 5
  • Possible associations with functional limitations and depressive symptoms in elderly women 2

• Significant decline in DHEAS levels over time (particularly in men) may indicate increased risk for heart failure 4

Common Pitfalls in DHEAS Assessment

• Failure to account for age-related decline when interpreting results 1, 2
• Not considering sex differences in normal ranges 2
• Using inappropriate assay methods that may lack sensitivity at lower concentrations 3
• Not accounting for diurnal variation in levels 3