Davis's Lab & Diagnostic Tests

Dehydroepiandrosterone Sulfate

General

Synonym/Acronym:
DHEAS.

Common Use:
To assist in identifying the cause of infertility, amenorrhea, or hirsutism.

Specimen:
Serum collected in a red- or red/gray-top tube. Plasma collected in a lavender-top (EDTA) tube is also acceptable. Place separated serum into a standard transport tube within 2 hr of collection.

Normal Findings:
(Method: Immunochemiluminometric assay [ICMA])

AgeMale Conventional Units mcg/dLMale SI Units micromol/L (Conventional Units × 0.027)Female Conventional Units mcg/dLFemale SI Units micromol/L (Conventional Units × 0.027)
Newborn108–6072.9–16.4108–6072.9–16.4
7–30 d32–4310.9–11.632–4310.9–11.6
1–5 mo3–1240.1–3.33–1240.1–3.3
6–35 mo0–300–0.80–300–0.8
3–6 yr0–500–1.40–500–1.4
7–9 yr5–1150.1–3.15–940.1–2.5
10–14 yr22–3320.6–922–2550.6–6.9
15–19 yr88–4832.4–1363–3731.7–10
20–29 yr280–6407.6–17.365–3801.8–10.3
30–39 yr120–5203.2–1445–2701.2–7.3
40–49 yr95–5302.6–14.332–2400.9–6.5
50–59 yr70–3101.9–8.426–2000.7–5.4
60–69 yr42–2901.1–7.813–1300.4–3.5
70 yr and older28–1750.8–4.710–900.3–2.4

Description

Dehydroepiandrosterone sulfate (DHEAS) is the major precursor of 17-ketosteroids. DHEAS is a metabolite of dehydroepiandrosterone, the principal adrenal androgen. DHEAS is primarily synthesized in the adrenal gland, with a small amount secreted by the testes. DHEAS is a weak androgen and can be converted into more potent androgens (e.g., testosterone) as well as estrogens (e.g., estradiol). It is secreted in concert with cortisol, under the control of adrenocorticotropic hormone (ACTH) and prolactin. Excessive production causes masculinization in women and children. DHEAS has replaced measurement of urinary 17-ketosteroids in the estimation of adrenal androgen production.

This procedure is contraindicated for

N/A

Indications

  • Assist in the evaluation of androgen excess, including congenital adrenal hyperplasia, adrenal tumor, and Stein-Leventhal syndrome.
  • Evaluate women with infertility, amenorrhea, or hirsutism.

Potential Diagnosis

Increased In:

DHEAS is produced by the adrenal cortex and testis; therefore, any condition stimulating these organs or associated feedback mechanisms will result in increased levels.

  • Anovulation
  • Cushing’s syndrome
  • Ectopic ACTH-producing tumors
  • Hirsutism
  • Hyperprolactinemia
  • Polycystic ovary (Stein-Leventhal syndrome)
  • Virilizing adrenal tumors

Decreased In:

DHEAS is produced by the adrenal cortex and testis; therefore, any condition suppressing the normal function of these organs or associated feedback mechanisms will result in decreased levels.

  • Addison’s disease
  • Adrenal insufficiency (primary or secondary)
  • Aging adults (related to natural decline in production with age)
  • Hyperlipidemia
  • Pregnancy (related to DHEAS produced by fetal adrenals and converted to estrogens in the placenta)
  • Psoriasis (some potent topical medications used for long periods of time can result in chronic adrenal insufficiency)
  • Psychosis (related to acute adrenal insufficiency)

Critical Findings

N/A

Interfering Factors

  • Drugs and other substances that may increase DHEAS levels include aloin, benfluorex, clomiphene, corticotropin, danazol, exemestane, gemfibrozil, metformin, mifepristone, and nitrendipine
  • Drugs and other substances that may decrease DHEAS levels include aspirin, carbamazepine, dexamethasone, exemestane, finasteride, ketoconazole, leuprolide, oral contraceptives, phenobarbital, phenytoin, and tamoxifen

Nursing Implications Procedure

Related Studies

Pretest

  • Positively identify the patient using at least two person-specific identifiers before services, treatments, or procedures are performed.
  • Patient Teaching: Inform the patient this test can assist in diagnosing the cause of hormonal fluctuations.
  • Obtain a list of the patient’s current medications, including over-the-counter medications and dietary supplements (see Effects of Dietary Supplements online at DavisPlus).
  • Review the procedure with the patient. Inform the patient that specimen collection takes approximately 5 to 10 min. Address concerns about pain and explain that there may be some discomfort during the venipuncture.
  • Sensitivity to social and cultural issues, as well as concern for modesty, is important in providing psychological support before, during, and after the procedure.
  • Note that there are no food, fluid, or medication restrictions unless by medical direction.

Intratest

Potential Complications:
N/A

  • Avoid the use of equipment containing latex if the patient has a history of allergic reaction to latex.
  • Instruct the patient to cooperate fully and to follow directions. Direct the patient to breathe normally and to avoid unnecessary movement.
  • Observe standard precautions, and follow the general guidelines in Patient Preparation and Specimen Collection online at DavisPlus. Positively identify the patient, and label the appropriate specimen container with the corresponding patient demographics, initials of the person collecting the specimen, date, and time of collection. Perform a venipuncture.
  • Remove the needle and apply direct pressure with dry gauze to stop bleeding. Observe/assess venipuncture site for bleeding or hematoma formation and secure gauze with adhesive bandage.
  • Promptly transport the specimen to the laboratory for processing and analysis.

Post Test

  • Inform the patient that a report of the results will be made available to the requesting health-care provider (HCP), who will discuss the results with the patient.
  • Reinforce information given by the patient’s HCP regarding further testing, treatment, or referral to another HCP. Answer any questions or address any concerns voiced by the patient or family.
  • Depending on the results of this procedure, additional testing may be performed to evaluate or monitor progression of the disease process and determine the need for a change in therapy. Evaluate test results in relation to the patient’s symptoms and other tests performed.
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