DHEA sulfate (DHEA-S)
DHEA sulfate is an adrenal hormone that falls with age, so reference ranges are set by sex and age band. Low levels go with more deaths in older adults, and one cohort found a J-shaped pattern. Trials that raised it with DHEA supplements found no meaningful change in body composition, physical performance or quality of life.
Checked 2026-11-13
- Status
- A blood test ordered by a clinician and also sold direct to consumers by some US laboratories. FDA classifies dehydroepiandrosterone (free and sulfate) test systems as class I devices [1].
- Measures
- The amount of DHEA sulfate in blood, the sulfated form of a hormone made by the adrenal glands that the body can convert to other hormones with weak androgen effects [2].
- Also called
- DHEA-S, DHEAS, DHEA sulfate, DHEA-sulfate, DHEA-SO4, dehydroepiandrosterone sulfate, dehydroepiandrosterone sulphate, serum DHEA-sulfate, DHEA-sulfate test, DHEA-S serum
- Tested for
- adrenal function, excess hair growth in women, acne, irregular periods, polycystic ovary syndrome, early puberty, aging, low sex drive, fatigue
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Linked in research1
Reported risks0
No risks sourced yet.
Reference ranges
Each range is the one its source published, in µg/dL. Also reported in µmol/L. Where sources differ, each is shown.
US National Library of Medicine, MedlinePlus, women aged 18 to 29
Females aged 18 to 29 · [2]
| Range | What the source calls it |
|---|---|
| below 45 µg/dL | No name given |
| 45 to 320 µg/dL | "normal" |
| above 320 µg/dL | No name given |
Printed as 45 to 320 µg/dL or 1.2 to 8.7 µmol/L. MedlinePlus calls these typical normal ranges, states that ranges may vary slightly among laboratories, and names no assay. It also states that DHEA levels normally decline with age in both men and women [2].
US National Library of Medicine, MedlinePlus, women aged 30 to 39
Females aged 30 to 39 · [2]
| Range | What the source calls it |
|---|---|
| below 40 µg/dL | No name given |
| 40 to 325 µg/dL | "normal" |
| above 325 µg/dL | No name given |
Printed as 40 to 325 µg/dL or 1.1 to 8.8 µmol/L. It names no assay [2].
US National Library of Medicine, MedlinePlus, women aged 40 to 49
Females aged 40 to 49 · [2]
| Range | What the source calls it |
|---|---|
| below 25 µg/dL | No name given |
| 25 to 220 µg/dL | "normal" |
| above 220 µg/dL | No name given |
Printed as 25 to 220 µg/dL or 0.7 to 6.0 µmol/L. It names no assay [2].
US National Library of Medicine, MedlinePlus, women aged 50 to 59
Females aged 50 to 59 · [2]
| Range | What the source calls it |
|---|---|
| below 15 µg/dL | No name given |
| 15 to 170 µg/dL | "normal" |
| above 170 µg/dL | No name given |
Printed as 15 to 170 µg/dL or 0.4 to 4.6 µmol/L. It names no assay [2].
US National Library of Medicine, MedlinePlus, women older than 59
Females older than 59 · [2]
| Range | What the source calls it |
|---|---|
| below 145 µg/dL | "normal" |
| 145 or above µg/dL | No name given |
Printed as less than 145 µg/dL or less than 3.9 µmol/L, so the range has no lower band. It names no assay [2].
US National Library of Medicine, MedlinePlus, men aged 18 to 29
Males aged 18 to 29 · [2]
| Range | What the source calls it |
|---|---|
| below 110 µg/dL | No name given |
| 110 to 510 µg/dL | "normal" |
| above 510 µg/dL | No name given |
Printed as 110 to 510 µg/dL or 3.0 to 14.0 µmol/L. MedlinePlus calls these typical normal ranges, states that ranges may vary slightly among laboratories, and names no assay. It also states that DHEA levels normally decline with age in both men and women [2].
US National Library of Medicine, MedlinePlus, men aged 30 to 39
Males aged 30 to 39 · [2]
| Range | What the source calls it |
|---|---|
| below 110 µg/dL | No name given |
| 110 to 370 µg/dL | "normal" |
| above 370 µg/dL | No name given |
Printed as 110 to 370 µg/dL or 3.0 to 10.0 µmol/L. It names no assay [2].
US National Library of Medicine, MedlinePlus, men aged 40 to 49
Males aged 40 to 49 · [2]
| Range | What the source calls it |
|---|---|
| below 45 µg/dL | No name given |
| 45 to 345 µg/dL | "normal" |
| above 345 µg/dL | No name given |
Printed as 45 to 345 µg/dL or 1.2 to 9.4 µmol/L. It names no assay [2].
What has been shown to move it
Shown to raise it1
Testosterone
Shown to raise testosterone in men, by about 57 ng/dL in one review, with no change in women. Rises stayed within physiological ranges.
In 57 overweight men aged 40 to 70 with mild fatigue, 8 weeks of an ashwagandha extract was associated with a 14.7% greater rise in salivary testosterone and an 18% greater rise in DHEA-S than placebo.
The numbers and sources
- Effect
- Across 20 trials of cognitive and physical outcomes, testosterone rose (SMD 0.33, 95% CI 0.13 to 0.54, I² 20.8%) [8]. A hormone meta-analysis found testosterone rose by 57.43 ng/dL in men but not in women (5.09 ng/dL), and estradiol did not change [6]. In 57 overweight men aged 40 to 70 with mild fatigue, 8 weeks of an ashwagandha extract was associated with a 14.7% greater rise in salivary testosterone and an 18% greater rise in DHEA-S than placebo. Fatigue, vigor and sexual well-being did not differ between groups [9].
- Population
- 1,249 participants in 20 RCTs [8]. 1,706 adults in 23 RCTs [6]. 57 men, crossover, 43 completed all 16 weeks [9].
- Sources
- [8], [6], [9]
- Caveats
- The 57-man trial tested one branded extract and was funded by its maker, Arjuna Natural Ltd [9]. In healthy adults, testosterone rises stayed within physiological ranges [7].
How it compares with the reference method
Mixed results2
Immunoassays against mass spectrometry
One comparison found three of seven DHEA-S immunoassays agreed well with mass spectrometry, and four had slopes of 0.84 to 1.28 against it.
The numbers and sources
- Compared with
- Isotope dilution liquid chromatography tandem mass spectrometry
- Effect
- Seven commercial assays each measured the same 75 serum samples. Three agreed well with mass spectrometry, with correlations of 0.93 to 0.99 and slopes of 0.92 to 1.07. Four showed standardization problems, with slopes of 0.84, 1.14, 1.20 and 1.28. One assay had a within-run coefficient of variation of 18%. The findings agreed with Dutch, German and British external quality schemes [13].
- Population
- 75 serum samples spanning 0.06 to 20.6 µmol/L by mass spectrometry [13].
- Sources
- [13]
- Caveats
- One comparison from 2013, so the assays may since have changed.
Variation from one test to the next
Small studies found DHEA-S varied about 9% within a man over 10 weeks and about 20% within a woman over a year.
The numbers and sources
- Compared with
- The same person's earlier results
- Effect
- In 38 men sampled weekly for 10 weeks, the within-person variation of DHEA-S was 9% [14]. In 21 women sampled monthly for a year, it was 20% within a woman and 49% between women, with a seasonal cycle [15]. In men sampled up to six times over 6 months, the within-person variation of eleven hormone measures, DHEA-S among them, implied that two measurements would differ by more than 18% to 28% about half the time [16].
- Population
- 38 men in the European Biological Variation Study [14]. 21 women [15]. 132 men aged 30 to 79 in Boston [16].
- Sources
- [14], [15], [16]
- Caveats
- Small studies. The last figure covers all eleven hormone measures, and the abstract does not give DHEA-S alone [16].
What studies tie it to
Linked in research1
Death from any cause
Linked to more deaths at low levels in older adults, 46% more in pooled cohorts, with a J-shaped pattern in one cohort where the highest levels also carried more.
The numbers and sources
- Effect
- In a meta-analysis of six prospective studies of older adults, the lowest DHEA-S category against higher levels had a pooled risk ratio of 1.46 for death from any cause (95% CI 1.25 to 1.70) and 1.49 for cardiovascular death (1.11 to 1.99). The association was found in men (1.41, 1.18 to 1.69) and did not reach significance in women (1.72, 0.99 to 2.99) [3]. In a German cohort followed for a median 17.7 years, both the lowest and the highest fifths for sex and age had more deaths from any cause than the middle fifth (hazard ratios 1.51, 1.25 to 1.82, and 1.31, 1.08 to 1.58) [4]. In the Atherosclerosis Risk in Communities cohort, DHEA-S below the 25th percentile for sex (70.0 µg/dL in men, 37.1 µg/dL in women) had hazard ratios for death of 1.12 in men (1.01 to 1.25) and 1.19 in women (1.03 to 1.37) [5]. In Swedish men aged 69 to 81, the lowest quarter against the rest had a hazard ratio of 1.54 (1.21 to 1.96) [6]. Among people who already had cardiovascular disease, lower DHEA-S had a pooled risk ratio for death of 1.47 (1.38 to 1.56) [7].
- Population
- 6,744 people in six prospective studies [3]. 7,370 men and women with mean ages of 55.0 and 52.4 [4]. 8,143 adults with a mean age of 63 and no cardiovascular disease at the start, followed for 18 years [5]. 2,644 men, mean follow-up 4.5 years [6]. 18 studies of patients with cardiovascular disease [7].
- Sources
- [3], [4], [5], [6], [7]
- Caveats
- Observational. DHEA-S falls with age and may mark illness already present. The trials that raised DHEA-S measured other outcomes (see the trial block below).
Mixed results1
Heart failure and coronary heart disease
One cohort found low DHEA-S went with 30% to 42% more heart failure hospitalizations and was not tied to coronary heart disease.
The numbers and sources
- Effect
- DHEA-S below the 15th percentile for sex (55.4 µg/dL in men, 27.4 µg/dL in women) had hazard ratios for heart failure hospitalization of 1.30 in men (95% CI 1.07 to 1.58) and 1.42 in women (1.13 to 1.79). In men a greater percentage fall in DHEA-S over 15 years also went with more heart failure hospitalization (1.94, 1.11 to 3.39). Neither a low level nor the change was associated with new coronary heart disease [5].
- Population
- 8,143 adults in the Atherosclerosis Risk in Communities study, mean age 63, without cardiovascular disease at the start. 3,706 had DHEA-S measured twice, 15 years apart [5].
- Sources
- [5]
- Caveats
- One observational cohort. The cut points are percentiles of that study's own participants [5].
Checked, no link found1
Body composition, physical performance and quality of life in trials that raised DHEA-S
Not shown to change body composition, physical performance, sexual function or quality of life in a meaningful way when DHEA-S was raised with DHEA in older adults.
The numbers and sources
- Effect
- In a 2-year trial in older adults with low DHEA-S, DHEA raised the level by a median of 3.4 µg/mL in men and 3.8 µg/mL in women, which is 340 and 380 µg/dL. It had no significant effect on body composition, and did not change peak oxygen consumption, muscle strength, insulin sensitivity or quality of life. Bone density rose at the femoral neck in men and at the ultradistal radius in women [8]. Across 25 trials in older men, DHEA reduced fat mass slightly (standardized mean difference -0.35, 95% CI -0.65 to -0.05), an effect that disappeared after adjusting for the rise in testosterone and estradiol, with no effect on blood lipids, blood sugar, bone, sexual function or quality of life [9]. A review of 8 trials called the effect on muscle strength and physical function inconclusive [10]. In postmenopausal women, 23 trials found no significant improvement in libido or sexual function (0.35, -0.02 to 0.73) and no significant effect on lipids, glucose, weight or bone density [11]. A Cochrane review found no improvement in quality of life (0.16, -0.03 to 0.34) and more androgenic side effects, mainly acne (odds ratio 3.77, 1.36 to 10.4) [12].
- Population
- 87 older men and 57 older women with low DHEA-S, treated for 2 years [8]. 1,353 older men in 25 trials, mean follow-up 36 weeks [9]. 661 adults aged 50 or older in 8 trials [10]. 1,188 postmenopausal women in 23 trials [11]. 1,273 women in 28 trials [12].
- Sources
- [8], [9], [10], [11], [12]
- Caveats
- A marker that tracks an outcome is not always one whose correction changes it. Low DHEA-S went with more deaths in cohorts. The trials measured body composition, function and quality of life, not deaths. The reviewers of the trials in women rated confidence in the evidence as low [11].
Sources
- US Food and Drug Administration. 21 CFR 862.1245, Dehydroepiandrosterone (free and sulfate) test system. Electronic Code of Federal Regulations. https://www.ecfr.gov/current/title-21/section-862.1245
- US National Library of Medicine. DHEA-sulfate test. MedlinePlus Medical Encyclopedia. Reviewed January 25, 2026. https://medlineplus.gov/ency/article/003717.htm
- Li R, E L, Zha N. Circulating dehydroepiandrosterone sulfate level and cardiovascular or all-cause mortality in the elderly population: a meta-analysis. Annals of Palliative Medicine. 2020. https://doi.org/10.21037/apm-20-441
- Mukama T, Johnson T, Katzke V, Kaaks R. Dehydroepiandrosterone Sulfate and Mortality in Middle-Aged and Older Men and Women: A J-shaped Relationship. The Journal of Clinical Endocrinology and Metabolism. 2023. https://doi.org/10.1210/clinem/dgac716
- Jia X, Sun C, Tang O, et al. Plasma Dehydroepiandrosterone Sulfate and Cardiovascular Disease Risk in Older Men and Women. The Journal of Clinical Endocrinology and Metabolism. 2020. https://doi.org/10.1210/clinem/dgaa518
- Ohlsson C, Labrie F, Barrett-Connor E, et al. Low Serum Levels of Dehydroepiandrosterone Sulfate Predict All-Cause and Cardiovascular Mortality in Elderly Swedish Men. The Journal of Clinical Endocrinology and Metabolism. 2010. https://doi.org/10.1210/jc.2010-0760
- Wu TT, Chen Y, Zhou Y, et al. Prognostic Value of Dehydroepiandrosterone Sulfate for Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis. Journal of the American Heart Association. 2017. https://doi.org/10.1161/jaha.116.004896
- Nair KS, Rizza RA, O'Brien P, et al. DHEA in Elderly Women and DHEA or Testosterone in Elderly Men. New England Journal of Medicine. 2006. https://doi.org/10.1056/NEJMoa054629
- Corona G, Rastrelli G, Giagulli VA, et al. Dehydroepiandrosterone Supplementation in Elderly Men: A Meta-Analysis Study of Placebo-Controlled Trials. The Journal of Clinical Endocrinology and Metabolism. 2013. https://doi.org/10.1210/jc.2013-1358
- Baker WL, Karan S, Kenny AM. Effect of Dehydroepiandrosterone on Muscle Strength and Physical Function in Older Adults: A Systematic Review. Journal of the American Geriatrics Society. 2011. https://doi.org/10.1111/j.1532-5415.2011.03410.x
- Elraiyah T, Sonbol MB, Wang Z, et al. The Benefits and Harms of Systemic Dehydroepiandrosterone (DHEA) in Postmenopausal Women With Normal Adrenal Function: A Systematic Review and Meta-analysis. The Journal of Clinical Endocrinology and Metabolism. 2014. https://doi.org/10.1210/jc.2014-2261
- Scheffers CS, Armstrong S, Cantineau AE, Farquhar C, Jordan V. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database of Systematic Reviews. 2015. https://doi.org/10.1002/14651858.CD011066.pub2
- Büttler RM, Kruit A, Blankenstein MA, Heijboer AC. Measurement of dehydroepiandrosterone sulphate (DHEAS): A comparison of Isotope-Dilution Liquid Chromatography Tandem Mass Spectrometry (ID-LC-MS/MS) and seven currently available immunoassays. Clinica Chimica Acta. 2013. https://doi.org/10.1016/j.cca.2013.04.028
- Itkonen O, Jonker N, Aarsand AK, et al. The European biological variation study (EuBIVAS): Biological variation data for testosterone, follicle stimulating hormone, prolactin, luteinizing hormone and dehydroepiandrosterone sulfate in men. Clinica Chimica Acta. 2024. https://doi.org/10.1016/j.cca.2024.117806
- Garde AH, Hansen AM, Skovgaard LT, Christensen JM. Seasonal and Biological Variation of Blood Concentrations of Total Cholesterol, Dehydroepiandrosterone Sulfate, Hemoglobin A1c, IgA, Prolactin, and Free Testosterone in Healthy Women. Clinical Chemistry. 2000. https://doi.org/10.1093/clinchem/46.4.551
- Brambilla DJ, O'Donnell AB, Matsumoto AM, McKinlay JB. Intraindividual variation in levels of serum testosterone and other reproductive and adrenal hormones in men. Clinical Endocrinology. 2007. https://doi.org/10.1111/j.1365-2265.2007.02976.x