From the Guidelines
A DHEA-S level of 45 μg/dL is considered low and may require supplementation, particularly in women with primary adrenal insufficiency (PAI) who are experiencing symptoms such as fatigue, decreased libido, or low energy levels. Normal DHEA-S ranges vary by age and sex, with levels naturally declining as we age 1. For most adults, normal ranges are approximately 80-560 μg/dL for men and 35-430 μg/dL for women. Low DHEA-S levels may be associated with adrenal insufficiency, chronic stress, certain medications (especially corticosteroids), or simply the natural aging process.
Key Considerations
- If symptoms persist, a healthcare provider may recommend DHEA supplementation, typically starting at 25-50 mg daily, taken in the morning 1.
- DHEA supplements should only be taken under medical supervision as they can affect hormone balance and may interact with certain medications.
- Lifestyle factors like adequate sleep, stress management, regular exercise, and proper nutrition can naturally support adrenal function and potentially help improve DHEA-S levels.
Important Factors to Consider
- The long-term effects of DHEA replacement therapy in patients with PAI are not well established, and such a regimen should be used with caution 1.
- A pragmatic approach is to offer female patients with a persistent lack of libido and/or low energy levels despite optimized glucocorticoid and mineralocorticoid replacement a 6-month trial of DHEA replacement, which can be continued if clinically effective 1.
From the Research
DHEA-S Level of 45
- A DHEA-S level of 45 is considered low, as normal levels typically range from 55.4 µg/dL to 437 µg/dL for men and 27.4 µg/dL to 328 µg/dL for women 2.
- Low DHEA-S levels have been associated with various health issues, including adrenal insufficiency, cardiovascular disease, and mortality 3, 4, 2.
- In the context of adrenal insufficiency, a low DHEA-S level can be an indicator of the condition, but it is not sufficient for diagnosis on its own 4.
- DHEA-S levels can also be influenced by age, gender, and other factors, making it essential to consider these variables when interpreting test results 5, 6.
- Research suggests that DHEA-S may have a role in maintaining cardiovascular health, with low levels potentially increasing the risk of heart failure and mortality 2.
- Additionally, DHEA-S has been shown to have immunomodulatory effects, improving physical and psychological well-being, muscle strength, and bone density, while reducing body fat and age-related skin atrophy 3.