Sorted By Test Name - Mayo Medical Laboratories

diagnostic accuracy than DHEA-S measurements. Consequently, DHEA-S testing should not be used as
the primary tool for CAH diagnosis. Similarly, discovering a high DHEA-S level in an infant or child
with symptoms or signs of possible CAH should prompt additional testing, as should the discovery of
very high DHEA-S levels in an adult. In the latter case, adrenal tumors need to be excluded and additional
adrenal steroid profile testing may assist in diagnosing nonclassical CAH. Girls below the age of 7 to 8
and boys before age 8 to 9, who present with early development of pubic hair, or, in boys, penile
enlargement, may be suffering from either premature adrenarche or premature puberty, or both.
Measurement of DHEA-S (DHES/8493, Dehydroepiandrosterone Sulfate [DHEA-S], Serum),
dehydroepiandrosterone (DHEA/81405, Dehydroepiandrosterone [DHEA], Serum), and androstenedione
(ANST/9709 Androstenedione, Serum), alongside determination of sensitive estradiol (EEST/81816
Estradiol, Serum), testosterone and bioavailable (TTBS/80065 Testosterone, Total and Bioavailable,
Serum), or free testosterone (TGRP/8508 Testosterone, Total and Free, Serum), sex hormone-binding
globulin (SHBG/9285 Sex Hormone Binding Globulin [SHBG], Serum), and luteinizing hormone
(LH/8663 Luteinizing Hormone [LH], Serum)/follicle-stimulating hormone (FSH/8670
Follicle-Stimulating Hormone [FSH], Serum) levels will allow correct diagnosis in most cases. In
premature adrenarche, only the adrenal androgens, chiefly DHEA-S, will be above prepubertal levels,
whereas early puberty will also show a fall in SHBG levels and variable elevations of gonadotropins and
gonadal sex-steroids above the pre-puberty reference range. Levels of DHEA-S do not show significant
diurnal variation. Many drugs and hormones can result in changes in DHEA-S levels. Whether any of
these secondary changes in DHEA-S levels are of clinical significance and how they should be related to
the established normal reference ranges is unknown. In most cases, the drug-induced changes are not large
enough to cause diagnostic confusion, but when interpreting mild abnormalities in DHEA-S levels, drug
and hormone interactions should be taken into account. Examples of drugs and hormones that can reduce
DHEA-S levels include: insulin, oral contraceptive drugs, corticosteroids, central nervous system agents
that induce hepatic enzymes (eg, carbamazepine, clomipramine, imipramine, phenytoin), many
antilipemic drugs (eg, statins, cholestyramine), domapinergic drugs (eg, levodopa/dopamine,
bromocryptine), fish oil, and vitamin E. Drugs that may increase DHEA-S levels include: metfomin,
troglitazone, prolactin, (and by indirect implication many neuroleptic drugs), danazol, calcium channel
blockers (eg, diltiazem, amlodipine), and nicotine.
Reference Values:
Mean Age Reference Range (mcg/dL)
Stage I >14 days
Stage II 11.5 years
Stage III 13.6 years
Stage IV 15.1 years 29-412
Stage V 18.0 years 89-457 *Puberty onset (transition from
Tanner stage I to Tanner stage II) occurs
for boys at a median age of 11.5 (+/-) 2
years. For boys, there is no proven
relationship between puberty onset and
body weight or ethnic origin. Progression
through Tanner stages is variable. Tanner
stage V (adult) is usually reached by age
18. 18-29 years: 89-457 mcg/dL 30-39
years: 65-334 mcg/dL 40-49 years: 48-244
mcg/dL 50-59 years: 35-179 mcg/dL > or
=60 years: 25-131 mcg/dL FEMALES 1-14
days: DHEA-S levels in newborns are very
elevated at birth but fall to prepubertal
levels within a few days. Tanner Stages*
Mean Age Reference Range (mcg/dL)
Stage I >14 days 16-96
Stage II 10.5 years 22-184
Stage III 11.6 years
Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or MayoMedicalLaboratories.com Page 604