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Family Medicine (Expert Forum)
Elevated DHEA
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Elevated DHEA
by psimpkins1, Nov 10, 2006 12:00AM
I am 43 and overweight (5'4" and 194 pounds). I was a normal weight all my life until having children at 29 and 34, but lost most of the pregnancy weight after both children were born. In the last few years I have gained back up to my above weight and my stomach seems to protrude way out of proportion to the rest of my body. (My measurements are about 45-44-48). I know this can happen with aging and being fat, but my stomach seems unusually large, especially above my belly button. I also have a fat pad at the base of the back of my neck, and fat pads above my clavicles in the front.
In my late 30's I started getting a few stray coarse black hairs on my right jaw line and around my right nipple. My gyno said that was normal, but I am very un-hairy and don't seem to be anywhere near menopause. My Mom didn't enter menopause until 51 and didn't get any excess hair growth until after menopause. My sister is 6 years older than me and doesn't have any problem with excess hair.
I had read about Cushings syndrome and felt that I had a lot of the symptoms (except that my periods are normal and I have no purple stretch marks, only white ones). I have a protruding belly, more slender arms and legs, a chronically red, round face and chest, oily hair and skin with breakouts, and fat pads on my neck and above my clavicles.
I did a home plasma cortisol and DHEA test because I feel the Dr will just laugh and tell me I'm getting older and am fat. The results were surprising to me, my cortisol was on the low end of normal (AM: .35 mcg/dL PM: .07 mcg/dL), and my DHEA was above normal (324 pg/mL, normal 14-277 pg/mL). I purchased the test from the Great Smokies Diagnostic Laboratories.
What could elevated DHEA mean? (I don't take any supplements, by the way.) Should I bring this up to my Doc to be retested by him, and will he laugh at me for doing a home saliva test?
Thanks,
Patty
In my late 30's I started getting a few stray coarse black hairs on my right jaw line and around my right nipple. My gyno said that was normal, but I am very un-hairy and don't seem to be anywhere near menopause. My Mom didn't enter menopause until 51 and didn't get any excess hair growth until after menopause. My sister is 6 years older than me and doesn't have any problem with excess hair.
I had read about Cushings syndrome and felt that I had a lot of the symptoms (except that my periods are normal and I have no purple stretch marks, only white ones). I have a protruding belly, more slender arms and legs, a chronically red, round face and chest, oily hair and skin with breakouts, and fat pads on my neck and above my clavicles.
I did a home plasma cortisol and DHEA test because I feel the Dr will just laugh and tell me I'm getting older and am fat. The results were surprising to me, my cortisol was on the low end of normal (AM: .35 mcg/dL PM: .07 mcg/dL), and my DHEA was above normal (324 pg/mL, normal 14-277 pg/mL). I purchased the test from the Great Smokies Diagnostic Laboratories.
What could elevated DHEA mean? (I don't take any supplements, by the way.) Should I bring this up to my Doc to be retested by him, and will he laugh at me for doing a home saliva test?
Thanks,
Patty
Doctor's Answer
by Kevin Pho, MD, Nov 11, 2006 12:00AM
, Nov 11, 2006 12:00AM
A home cortisol level is generally not the best way to test for Cushings disease. That's because this level can fluctuate throughout the day. The better initial test would be a 24-hr urine test looking for cortisol.
An elevated DHEA can be indicative of an adrenocortical tumor, adrenal cancer, or adrenal hyperplasia. However, by itself, it is not diagnostic, and usually is ordered in conjunction with 17-ketosteroids and 17-OH progesterone. If there is suspicion of the adrenal gland, it can be imaged with an MRI.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
An elevated DHEA can be indicative of an adrenocortical tumor, adrenal cancer, or adrenal hyperplasia. However, by itself, it is not diagnostic, and usually is ordered in conjunction with 17-ketosteroids and 17-OH progesterone. If there is suspicion of the adrenal gland, it can be imaged with an MRI.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
P.