High DHEA-S is a finding that needs a medical explanation, not a detox. The safest first steps are to stop non-prescribed DHEA or androgen products and arrange an evaluation for the cause. A 2023 international PCOS guideline recommends accurate androgen testing. In a woman with symptoms of androgen excess, a DHEA-S level above approximately 700 micrograms per deciliter can suggest an adrenal tumor, although that result is not a diagnosis. Age, sex, symptoms and the laboratory's reference range still matter.

There is no reliable over-the-counter treatment for unexplained high DHEA-S. If you are taking a product such as one of the DHEA supplements sold online, stopping it is the first thing a clinician will ask about. Treatment depends on the cause, which may include polycystic ovary syndrome, congenital adrenal hyperplasia, Cushing's syndrome, medication effects or, rarely, an adrenal or ovarian tumor.

First, Confirm What Is Actually Elevated

Most blood tests measure DHEA-S, or dehydroepiandrosterone sulfate, rather than free DHEA. The adrenal glands produce most DHEA-S. The body can convert it into testosterone and estrogen.

A result needs to be interpreted alongside your age, sex, symptoms and the lab's reference range.

Situation What to do
You take a DHEA supplement Contact the prescribing clinician. If it was not prescribed, ask how to stop it and arrange follow-up testing.
DHEA-S is mildly high Ask whether the test should be repeated and whether other androgen tests are needed.
DHEA-S is markedly high Arrange prompt medical evaluation, usually with an endocrinologist.
You have rapid facial hair growth, voice deepening or clitoral enlargement Seek prompt assessment for androgen excess.
You take steroid, testosterone or "hormone-balancing" products Give your clinician the exact product, dose and timing.

Do not stop prescribed corticosteroids suddenly. Abruptly stopping medicines such as prednisone or hydrocortisone can be dangerous.

Step 1: Stop Unnecessary DHEA and Androgen Supplements

Tell your healthcare professional if you take over-the-counter DHEA, 7-keto-DHEA, testosterone boosters, prohormones or bodybuilding products. DHEA can be converted into testosterone and estrogen. Longer-term use may contribute to acne, facial hair growth and other hormone-related effects. Some supplements may also contain undeclared hormone-like ingredients.

If a clinician prescribed DHEA for adrenal insufficiency, menopause symptoms, sexual function or another condition, do not change the dose without speaking with the prescriber. The next step may be a supervised dose reduction followed by repeat testing.

Step 2: Look for the Reason DHEA-S Is High

Possible causes include:

  • DHEA or androgen supplementation
  • Polycystic ovary syndrome, especially when irregular periods, acne or excess facial and body hair are present
  • Nonclassic congenital adrenal hyperplasia
  • Cushing's syndrome
  • An adrenal gland growth or tumor
  • Other disorders affecting adrenal or reproductive hormones

A high DHEA-S result by itself does not diagnose PCOS or an adrenal tumor. The pattern of symptoms, the degree of elevation and the results of other hormone tests all affect the interpretation.

Step 3: Ask About Follow-Up Tests

A clinician may repeat the DHEA-S test and order some of the following:

  • Total and free testosterone
  • Sex hormone-binding globulin
  • Androstenedione
  • Early-morning 17-hydroxyprogesterone to screen for nonclassic congenital adrenal hyperplasia
  • Cortisol testing when Cushing's syndrome is suspected
  • Pregnancy testing when relevant
  • Thyroid, prolactin, glucose or lipid testing based on your symptoms
  • Adrenal or pelvic imaging when hormone levels are markedly high or symptoms are progressing quickly

The 2023 international PCOS guideline recommends accurate laboratory methods, including liquid chromatography-tandem mass spectrometry when available. Androgen results can vary between testing methods and laboratories.

For a woman with symptoms of androgen excess, a DHEA-S level above approximately 700 micrograms per deciliter is considered suggestive of an adrenal tumor and warrants further evaluation. It is not proof of a tumor. The laboratory's reference range and the rest of the test results still need to be considered.

How High DHEA-S Is Treated

If Polycystic Ovary Syndrome Is the Cause

Treatment focuses on symptoms and metabolic health rather than forcing DHEA-S to a particular number.

Possible treatments include:

  • Healthy eating, regular physical activity and weight management when overweight or obese
  • Combined hormonal contraception for irregular cycles, acne or unwanted hair when medically appropriate
  • Metformin when insulin resistance, prediabetes or another metabolic indication is present
  • Spironolactone or another antiandrogen for unwanted hair, usually with reliable contraception because of pregnancy risks
  • Laser hair removal, electrolysis or another cosmetic treatment for existing hair

Lifestyle changes can improve androgen-related symptoms in women with obesity and PCOS, but they do not reliably correct every elevated DHEA-S result.

If Congenital Adrenal Hyperplasia Is the Cause

An endocrinologist may prescribe carefully adjusted glucocorticoid treatment to reduce excess adrenal androgen production. Do not take steroids on your own. Excess steroid exposure can cause serious complications.

If Cushing's Syndrome Is the Cause

Treatment targets the source of excess cortisol. The source may be a medication, pituitary condition, adrenal tumor or another hormone-producing tumor. Treatment can include supervised medication changes, surgery or other specialist care.

If an Adrenal or Ovarian Tumor Is Found

Treatment depends on the tumor's location, hormone production and whether it is benign or malignant. Surgery is commonly used for a hormone-producing adrenal or ovarian tumor.

Can Diet or Stress Reduction Lower DHEA?

A balanced diet, adequate sleep, regular exercise and stress management support general metabolic and hormone health. They should not be used as the main treatment for a markedly elevated DHEA-S level or rapidly progressing androgen symptoms.

For people with PCOS and overweight or obesity, gradual weight management may improve androgen-related symptoms. Restrictive diets and "adrenal support" supplements are not a substitute for medical evaluation when DHEA-S is substantially elevated.

When to Seek Prompt Medical Care

Arrange prompt medical assessment if high DHEA-S is accompanied by:

  • Rapidly increasing facial or body hair
  • Deepening of the voice
  • New clitoral enlargement
  • Rapid muscle gain or marked changes in body shape
  • Severe acne or sudden scalp hair loss
  • Very irregular or absent periods
  • A DHEA-S result far above the laboratory range, especially above about 700 micrograms per deciliter in women

Seek urgent care for severe abdominal or flank pain, fainting, severe weakness, repeated vomiting or symptoms of very high blood pressure.

The safest approach is to stop non-prescribed hormone products, avoid self-treating with steroids or antiandrogens, and have a clinician investigate the cause of the elevated result.