Elevated DHEA

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	Elevated DHEA

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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | It can lead to... | Recommendations


	DHEA levels begin increasing at approximately age seven and decline in the 30's. The adrenals secrete DHEA (and cortisol) under the control of ACTH, with a smaller amount being generated by the testes through LH stimulation. In women and children, excess DHEA can indirectly lead to virilization and hirsutism, as it is metabolized into stronger androgens such as testosterone. DHEA measurements are important when investigating the source of excess androgens (hyperandrogenism) in cases of hirsutism, alopecia, infertility, and amenorrhea. It is also of value in the assessment of adrenarche and delayed puberty. High levels of DHEA are often encountered in polycystic ovary syndrome, adrenal hyperplasia and adrenal tumors. In men, high levels of DHEA are often encountered in adrenal hyperplasia and adrenal tumors.

Signs, symptoms & indicators of Elevated DHEA:

Lab Values - Hormones

Elevated DHEA level

Counter-indicators:

Reduced/low DHEA level

Conditions that suggest Elevated DHEA:

Circulation

Arrhythmias/Dysrhythmias

A Dr. Sahelian reports in a 1998 letter to the Annals of Internal Medicine, a case report of heart rhythm irregularities with the use of DHEA. It was the first time such association was made and published. The case report mentioned heart palpitations that occurred in Dr. Borken who was taking 25mg of DHEA daily. When he stopped the DHEA, the palpitations went away, when he resumed the DHEA, the palpitations recurred. [Ann Intern Med. 1998 Oct 1;129(7):588]

Risk factors for Elevated DHEA:

Early puberty onset

Girls with premature puberty have been found to have elevated levels of DHEA-S. The elevated levels are normally one of the first biochemical signs of awakening of the reproductive glands, in this case the adrenal gland after the long period of childhood inactivity."

Cushing's Syndrome / Hypercortisolism

DHEA levels are markedly elevated in patients with adrenal hyperplasia. The majority of patients with Cushing’s disease (pituitary etiology) have moderately elevated levels of DHEA.

Uro-Genital

Polycystic Ovary Syndrome (PCOS)

In PCOS, there are often increased circulatory levels of androgens produced by both the ovaries and the adrenal glands. If they are elevated, serum testosterone levels are usually between 70-120ng/dl, and androstenedione levels are usually between 3 and 5ng/ml. Also, about half the women with this syndrome have elevated DHEA-S.

Elevated DHEA can lead to:

Recommendations for Elevated DHEA:

Drug

Conventional Drugs / Information

Aldactone (spironolactone) decreases androgens like DHEA and testosterone and thus helps to decrease excess hair growth and acne.

KEY

		Weak or unproven link
		Strong or generally accepted link
		Proven definite or direct link
		Very strongly or absolutely counter-indicative
		Likely to help

GLOSSARY

Alopecia: Loss of hair.

DHEA: Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. DHEA may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEA-S. One form is converted into the other as needed.

Milligram: (mg): 1/1,000 of a gram by weight.

ng: Nanogram: 0.000000001 or a billionth of a gram.

Pituitary: The pituitary gland is small and bean-shaped, located below the brain in the skull base very near the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands.

Serum: The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Testosterone: The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.