Complete Testing & Optimization Guide
Optimal ranges, provider comparison, and strategies to improve your DHEA-S levels
Included in 8 of 10 major testing providers
Sex Hormones (Male)
stress
Abnormal DHEA-S levels can indicate underlying health issues that may go undetected without proper testing. Regular monitoring helps catch problems early when they're most treatable.
Understanding your DHEA-S levels enables targeted interventions, tracks treatment effectiveness, and helps optimize your overall health and performance.
DHEA-S (dehydroepiandrosterone sulfate) is the sulfated, stable form of DHEA, a precursor hormone produced primarily by the adrenal glands (95% adrenal, 5% gonads in men, some ovarian production in women). DHEA and DHEA-S are the most abundant steroid hormones in your body and serve as building blocks for other hormones, including testosterone, estrogen, and other androgens. DHEA-S has a much longer half-life than DHEA (7-10 hours vs 15-30 minutes), making it a more reliable marker of adrenal androgen production.
Here's the key insight:DHEA-S declines dramatically with age—it peaks in your mid-20s and drops by about 80% by age 70-80. This decline is so predictable that DHEA-S is sometimes called a "biomarker of aging."Low DHEA-S is associated with accelerated aging, increased mortality, frailty, cognitive decline, and reduced quality of life. However, the evidence for DHEA supplementation is mixed:some studies show benefits for mood, bone density, and body composition in older adults, while others show minimal effect.
DHEA-S is also a marker of adrenal function. Very low levels may indicate adrenal insufficiency (Addison's disease or hypopituitarism), while very high levels in women often point to PCOS, adrenal hyperplasia, or adrenal tumors. Unlike cortisol (which fluctuates throughout the day), DHEA-S is stable and doesn't require specific timing for testing.
Bottom line: TSH and Free T4 alone miss people with conversion problems. Free T3 is the only way to know if you have enough active thyroid hormone at the tissue level.
| Range Type | Level | Clinical Significance |
|---|---|---|
| Optimal (Men 20-30) | 280-640 mcg/dL | Peak DHEA-S levels in young adults. Levels decline ~2% per year after age 30. |
| Optimal (Men 40-50) | 120-520 mcg/dL | Age-appropriate range for middle-aged men. Supplementation may be considered if <150 mcg/dL with symptoms. |
| Optimal (Men 60+) | 80-350 mcg/dL | Expected range for older men. Low-normal or below may benefit from DHEA supplementation (25-50 mg/day). |
| Optimal (Women 20-30) | 145-395 mcg/dL | Peak levels in young women. Note:Women have lower DHEA-S than men at all ages. |
Standard lab range:stress
60-340 mcg/dL
Optimal (Women 60+)
Expected range for older women. Very low levels (<50 mcg/dL) may indicate adrenal insufficiency.
DHEA supplements:25-50 mg/day is typical replacement dose for adults with low DHEA-S. Start low (10-25 mg) and titrate based on symptoms and retesting. Take in the morning to mimic natural circadian rhythm.
Caution in women:DHEA converts to testosterone and can cause acne, facial hair, oily skin if dose is too high. Monitor symptoms and retest in 3 months.
Caution in men:DHEA can convert to estrogen via aromatization. Monitor estradiol if on DHEA + TRT.
7-keto DHEA:Metabolite of DHEA that doesn't convert to sex hormones. May support metabolism and weight loss without androgenic/estrogenic effects. Weaker evidence than DHEA.
Very low DHEA-S (<40 mcg/dL in adults) may indicate primary adrenal insufficiency (Addison's disease) or secondary adrenal insufficiency (pituitary failure).
Check cortisol, ACTH, electrolytes. If confirmed adrenal insufficiency, requires hydrocortisone replacement ± fludrocortisone.
DHEA supplementation (25-50 mg/day) may improve quality of life, mood, and libido in patients with adrenal insufficiency on glucocorticoid replacement.
Note: High DHEA-S in women (>400-500 mcg/dL) suggests:| PCOS:Insulin resistance drives ovarian and adrenal androgen production. Treat with metformin, inositol, low-carb diet, weight loss. | Non-classic congenital adrenal hyperplasia (NCAH):21-hydroxylase deficiency causes androgen excess. Check 17-hydroxyprogesterone. May need low-dose glucocorticoid. | Adrenal tumor:Rare but consider if DHEA-S >700-800 mcg/dL. Requires adrenal CT/MRI imaging.
Note: Manage stress:Chronic stress depletes adrenal reserves over time. Prioritize sleep (7-9 hours), meditation, stress reduction techniques. | Adaptogenic herbs:Ashwagandha, rhodiola, holy basil may support adrenal function and stress resilience. Modest evidence. | Vitamin C (1-2 g/day):High concentrations in adrenal glands;supports cortisol synthesis. | B vitamins:Pantothenic acid (B5), B6 support adrenal hormone production. | Magnesium (400 mg/day):Critical for HPA axis regulation and stress response.
Acne, oily skin (especially in women on DHEA supplementation)|Increased facial or body hair (hirsutism in women)|Male-pattern baldness in women|Irregular menstrual periods, anovulation (women)|Deepening voice (women, if very high)|Mood changes, irritability|Insulin resistance (in PCOS with high DHEA-S)
Source:High DHEA-S in women often indicates PCOS or adrenal hyperplasia. In men, high DHEA-S is less clinically significant unless extremely elevated (>800 mcg/dL, suggesting adrenal tumor).
PCOS (polycystic ovary syndrome):Insulin resistance drives ovarian and adrenal androgen production. Most common cause of high DHEA-S in women.|Non-classic congenital adrenal hyperplasia (NCAH):21-hydroxylase enzyme deficiency causes androgen excess. Usually milder than classic CAH.|Adrenal tumors:Adrenocortical carcinoma or adenoma can overproduce DHEA-S. Consider if DHEA-S >800 mcg/dL.|Cushing's syndrome:Excess cortisol production may be accompanied by elevated adrenal androgens.|Ovarian tumors (rare):Some ovarian tumors secrete androgens.
Source:If considering DHEA supplementation:Baseline DHEA-S, then retest 3 months after starting supplementation to ensure appropriate dosing and monitor for excess.|If very low (<40 mcg/dL):Check cortisol and ACTH to rule out adrenal insufficiency before attributing to aging.|If high in women:Check testosterone, 17-hydroxyprogesterone, and consider pelvic ultrasound to evaluate for PCOS or adrenal pathology.|Age-based monitoring:DHEA-S declines predictably with age. Can retest every 2-3 years in adults >40 to track trajectory and consider supplementation if symptomatic with low levels.|No specific timing needed:Unlike cortisol, DHEA-S is stable throughout the day. Can be tested any time.
DHEA-S peaks at age 20-30 (300-600 mcg/dL in men, 200-400 mcg/dL in women) and declines ~2%/year. By age 70-80, levels are 10-20% of peak. This decline is so consistent that DHEA-S is sometimes called a "biomarker of aging."Lower DHEA-S in older adults correlates with frailty, cognitive decline, and mortality.
Source:Orentreich N, et al. Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations. J Clin Endocrinol Metab. 1984;59(3):551-555.
Observational studies show higher DHEA-S levels in older adults are associated with 20-30% lower all-cause mortality. However, randomized controlled trials of DHEA supplementation show mixed results:some show improvements in bone density, body composition, and well-being, while others show no benefit. Benefits may be greatest in those with very low baseline levels.
Source:Samaras N, et al. A review of age-related dehydroepiandrosterone decline and its association with well-known geriatric syndromes. Rejuvenation Res. 2013;16(4):285-294.
DHEA supports bone formation via conversion to estrogen and testosterone. Meta-analyses show DHEA supplementation (50 mg/day) modestly increases bone mineral density in older adults, particularly in women >60. Effects are smaller than standard HRT but may be useful in those who cannot or will not take estrogen.
Source:Weiss EP, et al. Dehydroepiandrosterone replacement therapy in older adults. J Clin Endocrinol Metab. 2009;94(10):4103-4110.
| Provider | Includes Test | Annual Cost | Total Biomarkers |
|---|---|---|---|
 Superpower | ✓ | $199 | 100+ |
 WHOOP Advanced Labs | — | $349 | 65 |
 Labcorp OnDemand | — | $398 | 30+ |
| ✓ | $486 | 40+ | |
| ✓ | $468 | 83 | |
| ✓ | $798 | 100+ | |
 InsideTracker | ✓ | $680 | 48 |
 Function Health | ✓ | $499 | 100+ |
| ✓ | $900 | 70+ | |
| ✓ | $1150 | 110 | |
| — | $Varies | 75+ |
Choose from 8 providers that include this biomarker in their panels
DHEA-S is a sex hormones (male) biomarker that Precursor hormone for testosterone and estrogen The normal reference range is stress. Regular testing helps track changes and identify potential health issues early.
8 out of 10 major blood testing providers include DHEA-S in their standard panels. These include Superpower, Blueprint, Mito Health and others.
For most people, testing DHEA-S 2-4 times per year is recommended to establish baseline levels and track trends. If you have abnormal results or are actively working to optimize this biomarker, more frequent testing (quarterly) may be beneficial. Always consult with your healthcare provider for personalized testing frequency recommendations.
The standard laboratory reference range for DHEA-S is stress. However, many functional medicine practitioners recommend tighter "optimal" ranges for peak health and performance. Your ideal range may vary based on your age, sex, health goals, and other individual factors. Work with a healthcare provider familiar with optimal ranges to determine your target levels.
Most direct-to-consumer blood testing services that include DHEA-S provide the physician order as part of their service. However, some states have restrictions on direct-to-consumer testing. Check with your chosen provider about availability in your state and whether they provide the necessary physician authorization.
Adrenal hormone that declines with age. Low levels associated with aging
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs and before making decisions about blood testing.
