In short:
- DHEA is a prohormone produced by the adrenal glands. Its level peaks at around age 25–30 and then falls by about 2% a year.
- Too little DHEA causes fatigue, a drop in libido, mood disorders and muscle weakness.
- Too much DHEA can cause acne, hair loss and, in women, menstrual disorders.
- A blood test (DHEA-S) is used to assess DHEA levels, and treatment requires medical supervision.
DHEA (dehydroepiandrosterone) is one of the most abundant steroid hormones in the body, secreted by the adrenal glands. DHEA symptoms – whether levels are too low or too high – can affect your energy, libido, muscle health and mental wellbeing. In this evidence-based overview, we explain which symptoms point to a DHEA imbalance and what causes them.
What are the symptoms of low DHEA?
Low DHEA occurs with aging, adrenal insufficiency and chronic stress. DHEA acts as a precursor hormone for androgens and estrogens – as its level falls, many hormone-dependent functions decline (Traish et al., 2011).
The most common symptoms:
- Chronic fatigue and low energy – when DHEA is lacking, the body’s capacity for energy production is noticeably lower and recovery is slower.
- Reduced libido – DHEA-S levels are directly linked to sexual function in both men and women (Arlt et al., 1999).
- Mood disorders and depression – low DHEA is associated with a higher risk of depression (Wolkowitz et al., 1999).
- Muscle weakness and loss – a drop in DHEA accelerates sarcopenia. Muscle cramps can also be a sign of a hormonal imbalance, especially in older age.
- Cognitive problems – worsening memory and concentration.
- Skin and hair changes – dry skin and thinning hair.
DHEA levels peak at around age 25–30 and then fall by an average of 2% a year (Orentreich et al., 1984). In 70-year-olds, DHEA-S is often only 10–20% of the value in young adults – an important factor behind age-related health decline.
What causes a DHEA imbalance – both low and high levels?
The main causes of low DHEA:
- Natural aging (a physiological decline from the 3rd decade of life)
- Primary adrenal insufficiency (Addison’s disease)
- Hypopituitarism (an underactive pituitary gland)
- Long-term use of corticosteroids
- Chronic stress and persistent cortisol overload
- Severe malnutrition and eating disorders
Causes of too much DHEA:
Too much DHEA is less common, but it is also clinically significant. Possible causes include congenital adrenal hyperplasia (CAH), adrenal tumors, polycystic ovary syndrome (PCOS) in women, and overdosing on DHEA supplements.
Symptoms of high DHEA:
- Acne and oily skin
- Hair loss (androgenetic alopecia)
- In women: menstrual disorders, hirsutism (excessive hair growth), a deepening voice
- Elevated blood pressure
- In men, with long-term overdosing: testicular dysfunction
How does the decline in DHEA affect aging and quality of life?
The decline in DHEA that comes with aging is one of the hallmarks of aging, affecting many body systems at once. Studies show that low DHEA-S is associated with a higher cardiovascular risk, osteoporosis and loss of muscle mass (Baulieu et al., 2000).
In clinical studies, DHEA replacement therapy has shown a positive effect in women with adrenal insufficiency – quality of life, energy and sexual function improved (Arlt et al., 1999). In healthy adults, however, the effect of DHEA supplements remains controversial, and no uniform clinical recommendations have yet been established.
Athletes need to be aware that DHEA is on the World Anti-Doping Agency (WADA) list of prohibited substances. Competitive athletes must consult a doctor and an anti-doping specialist before using DHEA in any form.
When choosing between different supplements – for example among the products sold in Sportland stores – it is worth paying attention to ingredients that may affect hormone levels.
When and how should you have your DHEA level checked?
DHEA is measured with a blood test that assesses the concentration of DHEA-S (the sulfated form) – a more stable marker than free DHEA itself. According to the NIH, DHEA-S testing is indicated for suspected adrenal insufficiency, for assessing PCOS and for diagnosing precocious puberty.
It is worth seeing a doctor if:
- You have unexplained chronic fatigue lasting more than 4 weeks
- You have unexplained weight gain or loss
- Women have menstrual disorders or abnormal hair growth
- Men have a drop in libido along with other symptoms
- Young people show early puberty
All of the symptoms described above can also point to other hormonal disorders, which is why a comprehensive hormonal assessment under a doctor’s guidance is important.
References
- Orentreich N et al. (1984). Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood. J Clin Endocrinol Metab. PMID: 6429738
- Arlt W et al. (1999). Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med. PMID: 10441497
- Baulieu EE et al. (2000). Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging. Proc Natl Acad Sci USA. PMID: 10811874
- Traish AM et al. (2011). Dehydroepiandrosterone (DHEA)—a precursor steroid or an active hormone in human physiology. J Sex Med. PMID: 21521477
- Wolkowitz OM et al. (1999). Antidepressant effects of dehydroepiandrosterone. Arch Gen Psychiatry. PMID: 10197567
Frequently asked questions
What is a normal DHEA level in the blood?
A normal DHEA-S level depends on sex and age. In young adults (20–30 years old), the normal range is roughly 280–640 µg/dl for men and 65–380 µg/dl for women, but the exact reference ranges are given in the results from the specific laboratory that ran your test.
Can you buy DHEA supplements in Estonia without a prescription?
In Estonia and the EU, DHEA supplements are regulated more strictly than in, for example, the US. It is worth consulting a doctor before using them, especially since the long-term effects have not been studied sufficiently and doses vary considerably from one manufacturer to another.
How can you support DHEA levels naturally?
To support DHEA naturally, regular physical activity (especially strength training), enough sleep (7–9 hours a day), stress management and balanced nutrition are recommended. If your DHEA is chronically low, see a doctor.
Is DHEA banned for athletes?
Yes, DHEA is on the prohibited list of WADA (the World Anti-Doping Agency) in the category of anabolic steroids. Competitive athletes may not use DHEA either in or out of competition.
When do DHEA levels start to decline, and is that normal?
DHEA levels peak at around age 25–30 and then decline naturally by roughly 2% per year. This is a normal part of aging, but if the decline is faster or the symptoms are pronounced, it is worth investigating adrenal function.
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