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Dehydroepiandrosterone
(DHEA)

Clinical Significance
Dehydroepiandrosterone is a 17-Ketosteroid produced primarily by the adrenal gland by side chain cleavage of 17-HydroxyPregnenolone.  It is reversibly converted to Dehydroepiandrosterone-Sulfate and Androstenediol.  It is also converted to Androstenedione.  It is excreted in the urine as Sulfate and Glucuronide conjugates and unconjugated (Free) forms.  DHEA is a weak androgen strongly bound to Sex Steroid Binding Globulin and weakly bound to Corticosteroid Binding Globulin and Albumin.  DHEA is one of the first androgens to increase significantly at the onset on adrenarche.  Levels increase throughout puberty until adulthood.  In females, levels drop off sharply after menopause.  DHEA may distinguish adrenal causes of overandrogenization from gonadal causes.

Reference Ranges
Male:                                                             20 - 380 ng/dl
Female:  Premenopausal:                               150 - 650 ng/dl
               Postmenopausal:                            120 - 360 ng/dl

Procedure
Dehydroepiandrosterone is measured by radioimmunoassay.

Patient Preparation
Patient should not be on any Steroid, ACTH, Estrogen, or Gonadotropin medications, if possible, for at least 48 hours prior to collection of specimen.

Specimen Collection
3 ml serum or EDTA plasma should be collected and separated.  Minimum specimen size is 1 ml.

Special Specimens
For tumor/tissue and various fluids (i.e. saliva, ­CSF, peritoneal, synovial, etc.), contact the Institute for requirements and special handling.

Shipping Instructions
Ship specimens at room temperature or frozen in dry ice.

References
1. Swinkels LMJW, Ross HA, Smals AGH, and Benraad ThJ. Concentrations of Total and Free Dehydroepiandrosterone in Plasma and Dehydroepiandrosterone in Saliva of Normal and Hirsute Women under Basal Conditions and during Administration of Dexamethasone/Synthetic Cortictropin.  Clin Chem 36: 2042-2046, 1990.

2. Carmina E, Levin JH, Malizia G, and Lobo RA. Ovine Corticotropin-Releasing Factor and Dexamethasone Responses in Hyperandrogenic Women.  Fertil  Steril 54: 245-250, 1990.

CPT Code: 
DHEA 82626

 

Dehydroepiandrosterone
(DHEA), Saliva*

* Test available on a research basis only. Contact ISI for details.

 

Dehydroepiandrosterone
(DHEA), urine

Clinical Significance:
Dehydroepiandrosterone is a 17-Ketosteroid produced primarily by the adrenal gland by side chain cleavage of 17-HydroxyPregnenolone.  It is reversibly converted to Dehydroepiandrosterone-Sulfate and to Androstenediol.  It is also converted to Androstenedione.  It is excreted in the urine as Sulfate and Glucuronide conjugates and unconjugated (Free) forms.  This assay measures the total of the unconjugated and conjugated forms of DHEA present in the urine.  DHEA is one of the first androgens to increase significantly at the onset of adrenarche.  Levels increase throughout puberty until adulthood.  In females, levels drop off sharply after menopause.  DHEA may distinguish adrenal causes of overandrogenization from gonadal causes.  Elevated levels of urine DHEA are found in third trimester pregnancies as DHEA becomes a direct precursor to Estrogen formation.

Reference Ranges:
Male:                                                                  0.5 - 7.2 mg/24 hours
Female:                                                               0.1 - 4.7 mg/24 hours

Procedure:
Urine Dehydroepiandrosterone is measured by radioimmunoassay or GC/MS following hydrolysis, derivatizations and chromatographic purification of specimens.

Patient Preparation:
Patient should not be on any steroid, ACTH, estrogen, or gonadotropin medications, if possible, for at least 48 hours prior to collection of specimen.

Specimen Collection:
10 ml of a 24 hour urine collection should be submitted for analysis. No special preservatives are required. Store specimen refrigerated during collection. Specimens should be frozen prior to shipping. Minimum specimen size is 5 ml.

Shipping Instructions:
Ship specimens frozen in dry ice. Provide the total volume per 24 hours.

References:
1. LH Parker and W O'Dell.  Decline of Adrenal Androgen Production as Measured by Radioimmunoassay of Urinary Unconjugated Dehydroepiandrosterone.  Journal of Clinical Endocrinology and Metabolism 47:  600, 1978.

2. E Carmina, JH Levin, G Malizia, and RA Lobo.  Ovine Corticotropin-Releasing Factor and Dexamethasone Responses in Hyperandrogenic Women.  Fertility and Sterility 54: 245-250, 1990.

 

Dehydroepiandrosterone Sulfate (DHEA-S)

Clinical Significance
Dehydroepiandrosterone (DHEA) is a 17-Ketosteroid produced primarily by the adrenal gland by side chain cleavage of 17-HydroxyPregnenolone. It is reversibly converted to DHEA-Sulfate (DHEA-S) and Androstenediol. It is also converted to Androstenedione. DHEA-S is strongly bound to Albumin which decreases its metabolic clearance rate and provides a high concentration storage system for production of the sex steroids. It is excreted in the urine directly as DHEA-S. DHEA-S is one of the first androgens to increase significantly at the onset of adrenarche. Levels increase throughout puberty until adulthood. In females, levels drop off sharply after menopause. Although DHEA-S has only weak androgenic properties, it is one of the most abundant steroids present and may be readily converted to the more potent sex steroids. DHEA-S may distinguish between adrenal causes of overandrogenization from gonadal causes. In pregnancy, DHEA-S is an immediate precursor to Estriol production.

Reference Ranges
Male:                                                             200 - 350 ug/dl
Female:  Premenopausal:                               40 - 300 ug/dl
               Postmenopausal:                            10 - 60 ug/dl

Procedure
DHEA-S is measured by direct radioimmunoassay on unextracted specimens.

Patient Requirements
Patient should not be on any steroid, ACTH, Estrogen or Gonadotropin medications, if possible, for at least 48 hours prior to collection.

Specimen Collection
3 ml serum or EDTA plasma should be collected and separated. Minimum specimen size is 0.5 ml.

Special Specimens
For tumor/tissue and various fluids (i.e. CSF, peritoneal, synovial, etc.) contact the Institute for requirements and special handling.

Shipping Instructions
Ship specimens room temperature, refrigerated, or frozen in dry ice.

References
1. Braithwaite SS, Collins S, Prinz RA et al. Decreased dehydroepiandrosterone sulfate in pigmented nodular adrenal dysplasia. Clin Chem.1989.Nov:35(11):2216-9.

2. . Cunningham SK, McKenna TJ. Dissociation of adrenal androgen and Cortisol secretion in cushing's syndrome. Clin Endocrinol (Oxf). 1994 Dec;41(6):795-800.

 

Dehydroepiandrosterone-Sulfate (DHEA-S), urine*

* Test available on a research basis only. Contact ISI for details.

11-Deoxycorticosterone*
(11-DOC)

* Test available on a research basis only. Contact ISI for details.

 

11-Deoxycorticosterone*
(11-DOC), urine

* Test available on a research basis only. Contact ISI for details.

 

11-Deoxycortisol *
(Compound S)

* Test available on a research basis only. Contact ISI for details.

 

11-Deoxycortisol, urine (As Metabolite of 11-Deoxycortisol) *
(Compound S)

* Test available on a research basis only. Contact ISI for details.

 

Dexamethasone

* Test available on a research basis only. Contact ISI for details.

 

Dihydrotestosterone
(DHT)

* Test available on a research basis only. Contact ISI for details.

 

Dihydrotestosterone, urine
(DHT)

* Test available on a research basis only. Contact ISI for details.

 

 
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