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What Causes Elevated DHEA Levels?

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Posted on Mon, 18 Jul 2016
Question: I have one dr who says this dhea level is the result of stress and not pcos. He says pcos ppl have more extreme hormonal levels. Another dr who calls it slight case of pcos. Which one is it?
doctor
Answered by Dr. Shehzad Topiwala (23 minutes later)
Brief Answer:
DHEA

Detailed Answer:
Mild elevations are possible in stress and PCOS. But the main concern while ordering a test for DHEA is to rule out worrisome 'androgen' secreting tumors. These are tumors producing excessive amounts of male hormones.

Moreover, it is preferable to measure DHEAS where the S stands for sulfate, because it is more stable in the blood than DHEA. Therefore measurements of DHEAS are more reliable as indicators of the blood levels of DHEA.

So as long as DHEAS is not significantly elevated, it is ok to conclude that the likelihood of a male hormone secreting tumor is low
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (1 hour later)
Here r my levels
doctor
Answered by Dr. Shehzad Topiwala (31 hours later)
Brief Answer:
Follow up

Detailed Answer:
I have reviewed the attached report. Yes the DHEAS is elevated but it is not in the typical range where one would be worried about the male hormone producing tumors.
Moreover, the other male hormone levels appear to be normal which is good. However the calculated Free Testosterone using a preferred calculation is 0.936 ng/dl which is considered high. The normal range is 0.2 to 0.5

So although the free testosterone reported by the lab seems normal, the indirectly calculated Free Testosterone by the formula I have used indicates otherwise.

This might seem a bit complex to you. The easiest way to resolve this is to repeat the following tests around 9 am in the morning. Fasting is not necessary.

The test is called Free Testosterone by Equilibrium/Direct Dialysis method

Few laboratories in US do it by this technique. Check with the lab before you give the blood sample. It is quite likely the two national lab chains use this method.

This result will indicate the actual levels of free testosterone in the body.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (13 minutes later)
Can the dhea level be attributed to stress
doctor
Answered by Dr. Shehzad Topiwala (6 hours later)
Brief Answer:
Second follow up

Detailed Answer:
Although in theory , stressful situations can raise blood levels of a hormone called ACTH which in turn can increase DHEA and DHEAS levels but it is not of practical significance
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (6 hours later)
Is this pcos?
doctor
Answered by Dr. Shehzad Topiwala (8 hours later)
Brief Answer:
Third follow up

Detailed Answer:
Diagnosing PCOS requires a thorough physical examination and sometimes even an Ultrasound of the ovaries.

Polycystic ovary syndrome (PCOS) is the most common hormonal disorder among women of reproductive age. Infertility is one of the most common PCOS symptoms. Because the symptoms of PCOS are seemingly unrelated to one another, the condition is often overlooked and undiagnosed.

Overview
Polycystic ovary syndrome causes irregular menstrual cycles, excessive body or facial hair and polycystic ovaries as its main symptoms. Polycystic means "many cysts," and PCOS often causes clusters of small, pearl-sized cysts in the ovaries. The cysts are fluid-filled and contain immature eggs. Women with PCOS produce slightly higher amounts of male hormones known as androgens, which contribute to some of the symptoms of the condition.
The cause of PCOS is not known. Some women with PCOS are less sensitive to insulin than other women, a condition known as insulin resistance. Insulin resistance can causes the ovaries to produce too many male hormones. The resulting hormonal imbalance can cause the symptoms of PCOS. The condition appears to run in families, and sisters of those with it are twice as likely to have it. Currently, PCOS has no cure, but a variety of PCOS treatments can help alleviate the symptoms of this disease, including infertility.

PCOS Symptoms
PCOS is a syndrome disease defined by a collection of signs and symptoms. The symptoms of PCOS that one patient experiences can be very different from the symptoms of another patient. If you have two or more of the following symptoms, you need to have a thorough checkup to determine if you need PCOS treatment:
Irregular or missing menstrual periods
Infertility
Excess or unwanted body or facial hair growth
Thinning hair on the scalp
Weight problems, often including weight gain around the waist
Skin problems, including skin tags, darkening skin and acne

Complications of PCOS
The common PCOS symptoms are difficult enough for most women, but some will experience further complications, including:
Diabetes, elevated insulin levels or insulin resistance
Heart and blood vessel problems
Uterine cancer
Sleep apnea
Each of these problems can be life threatening, which is why treatment for PCOS is so important.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (1 hour later)
Ok I have been examined and ultrasound was clean, no cysts present. Uterus however was found to be a few cm larger than average. I have no physical signs of pcos but some weight gain
doctor
Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer:
Fourth follow up

Detailed Answer:
I see.

Well it is impossible to diagnose or rule out PCOS on an online forum like this. Physical examination in-person is necessary.

I strongly suggest you schedule an appointment with an endocrinologist near you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (39 minutes later)
But do the test results attached themselves lean toward pcos
doctor
Answered by Dr. Shehzad Topiwala (10 hours later)
Brief Answer:
Fifth follow up

Detailed Answer:
DHEAS is not the only test done when PCOS is suspected. Moreover PCOS is not diagnosed on the basis of one test alone. As explained above, a constellation of features point towards it or against. That is why you need a more comprehensive assessment
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Causes Elevated DHEA Levels?

Brief Answer: DHEA Detailed Answer: Mild elevations are possible in stress and PCOS. But the main concern while ordering a test for DHEA is to rule out worrisome 'androgen' secreting tumors. These are tumors producing excessive amounts of male hormones. Moreover, it is preferable to measure DHEAS where the S stands for sulfate, because it is more stable in the blood than DHEA. Therefore measurements of DHEAS are more reliable as indicators of the blood levels of DHEA. So as long as DHEAS is not significantly elevated, it is ok to conclude that the likelihood of a male hormone secreting tumor is low