Question: I’ve heard people talk about having testing for 17-OH and DHEA in their pursuit for a diagnosis.  I had my first round with Cushing’s five years ago and only remember cortisol tests.  What are these and how do they help diagnose Cushing’s? 

Answer: DHEA is a low-potency sex steroid produced by the adrenal gland. The best way to evaluate its production is by measurement of dehydroepiandrosterone-sulfate (DHEA-S). Measurement of dehydroepiandrosterone-sulfate (DHEA-S) may assist in diagnosis of Cushing’s syndrome in patients with lower than normal or low-normal ACTH levels. DHEA-S is usually lower than normal in patients with adrenal Cushing’s caused by a unilateral adrenal adenoma. DHEA-S can be elevated in patients with adrenal lesions that secrete both cortisol and androgens. Finally, most patients with pituitary Cushing’s (also called Cushing’s disease) have normal DHEA-S levels.

By Dr. Adriana Ioachimescu, Emory University Hospital, Atlanta, GA (Winter-Spring 2018 issue)