DHEAS


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DHEAS

Abbreviation for the sulfate salt of dehydroepiandrosterone.

Dehydroepiandrosterone Sulfate

Synonym/acronym: DHEAS.

Common use

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

Specimen

Serum (1 mL) collected in a red- or red/gray-top tube. Plasma (1 mL) 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
Tanner StageMale 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)
I7–2090.2–5.67–1260.2–3.4
II28–2600.8–713–2410.4–6.5
III39–3901.1–10.532–4460.9–12
IV & V81–4882.2–13.265–3711.8–10

Description

Dehydroepiandrosterone sulfate (DHEAS) is the major precursor of 17-ketosteroids. DHEAS is a metabolite of DHEA, 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 that may increase DHEAS levels include aloin, benfluorex, clomiphene, corticotropin, danazol, exemestane, gemfibrozil, metformin, mifepristone, and nitrendipine.
  • Drugs that may decrease DHEAS levels include aspirin, carbamazepine, dexamethasone, exemestane, finasteride, ketoconazole, leuprolide, oral contraceptives, phenobarbital, phenytoin, and tamoxifen.

Nursing Implications and Procedure

Pretest

  • Positively identify the patient using at least two unique identifiers before providing care, treatment, or services.
  • Patient Teaching:   Inform the patient this test can assist in diagnosing the cause of hormonal fluctuations.
  • Obtain a history of the patient’s complaints, including a list of known allergens, especially allergies or sensitivities to latex.
  • Obtain a history of the patient’s endocrine system, symptoms, phase of menstrual cycle, and results of previously performed laboratory tests and diagnostic and surgical procedures.
  • Obtain a list of the patient’s current medications, including herbs, nutritional supplements, and nutraceuticals (see Effects of Natural Products on Laboratory Values).
  • 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. 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.

Related Monographs

  • Related tests include ACTH, cortisol, prolactin, and testosterone.
  • Refer to the Endocrine System table at the end of the book for related tests by body system.
References in periodicals archive ?
Thus, the role of androgens in acne pathogenesis can be observed by the difference in their serum levels, especially in the case of Testosterone and DHEAS.25
This ionization source offers improved data quality and reliable DHEA measurement, leading to optimal diagnosis and treatment of the disease.
The concentrations of DHEA, androstenedione, and free testosterone increased with age starting from the age of 6 years [Table 2], [Figure 1].{Table 2}{Figure 1}
Human studies show that supplementation with DHEA has dramatic impacts on mood disorders--especially depression--and can improve memory and cognition in older adults.
Further, administration of DHEA was beneficial in patients with depression and anxiety and in schizophrenic patients with negative symptoms.
We reasoned that there might exist subpopulations of tumors in which this kill-switch had not been completely triggered, but which still might be triggered by administration of DHEA sufficient to inhibit tumor G6PD.
Serum DHEAS and DHEA levels were determined using commercially available radioimmunoassay kits (Beckman Coulter; Indianapolis, Indiana) according to manufacturer directions.
In conclusion, before uterus evacuation, in women with a diagnosis of complete HM, hCG, free T, and DHEAS concentrations were significantly higher when compared with controls finding a strong and significant positive correlation between hCG and free T/DHEA-S concentrations.
Because ergosterol-5,8-endoperoxide (6) has a similar steroid backbone as DHEAS (Fig.
Researchers have also established links between declining DHEAS levels and diseases such as type 2 diabetes and lymphoma, as well as a decreased lifespan.