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DHEA is an adrenal androgen that increases in response to stress (especially chronic stress). DHEA-S is a sulfated version of DHEA, with levels that are 100x higher than DHEA. DHEA is converted to various sex hormones in the body and plays a role in regulating aging and immune function.

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Name: DHEA-S
Category: Stress/Sexual Arousal 
Type of Test: Blood + Saliva 

DHEA (dehydroepiandrosterone) and its sulfate-bound form, DHEA-S, are mildly androgenic steroid hormones. Like all steroid hormones, DHEA and DHEA-S are derived from cholesterol. The production of DHEA primarily occurs in the zona reticularis of the adrenal glands. However, the reproductive organs (gonads: testes and ovaries) also produce small amounts of DHEA and DHEA-S. DHEA is a precursor to androgenic and estrogenic hormones (e.g., testosterone and estradiol).

The secretion of DHEA is regulated via a negative feedback loop under the control of the hypothalamic-pituitary-adrenal (HPA) axis. Like cortisol, DHEA concentrations exhibit circadian rhythmicity, peaking in the early morning, and gradually diminishing throughout the day. Levels of DHEA also increase in the context of stress, particularly when exposure to stressors is prolonged. Most DHEA is secreted in the sulfate-bound form, DHEA-S. DHEA-S is converted to DHEA by an enzyme specialized in removing sulfate groups.

DHEA secretion is age-dependent; it is present at low levels during early childhood (i.e., prior to puberty) and old age. Accordingly, many researchers have hypothesized that DHEA plays a role in regulating both pubertal development and aging. Additionally, DHEA also influences a number of other bodily functions, such as immune function. The levels of DHEA and DHEA-S present in the body may serve as indicators of adrenal health and other health-related concerns. For example, abnormal DHEA levels are associated with infertility, autoimmune diseases, and anxiety. DHEA can be measured via salivary samples and serum / plasma samples; there is a high positive correlation between levels measured in each of these sample types. 

Mulligan, E. M., Hajcak, G., Crisler, S., & Meyer, A. (2020). Increased dehydroepiandrosterone (DHEA) is associated with anxiety in adolescent girls. Psychoneuroendocrinology, 119, 104751. https://doi.org/10.1016/j.psyneuen.2020.104751

Lam, J. C., Shields, G. S., Trainor, B. C., Slavich, G. M., & Yonelinas, A. P. (2019). Greater lifetime stress exposure predicts blunted cortisol but heightened DHEA responses to acute stress. Stress and Health35, 15-26. https://pubmed.ncbi.nlm.nih.gov/30110520/

Schwartz, K. E. (2002). Autoimmunity, dehydroepiandrosterone (DHEA), and stress. Journal of Adolescent Health, 30, 37–43. https://doi.org/10.1016/s1054-139x(01)00385-8

Nakamura, Y., Gang, H. X., Suzuki, T., Sasano, H., & Rainey, W. E. (2009). Adrenal changes associated with adrenarche. Reviews in endocrine & metabolic disorders10, 19–26. https://doi.org/10.1007/s11154-008-9092-2

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