DHEA is the major precursor of testosterone and the estrogens. It becomes active at puberty. In this profile, the more stable, sulfated form of DHEA, DHEA-S is measured, providing a more reliable measure of DHEA levels than measuring DHEA directly. DHEA is an important modulator of many physiological processes. It promotes the growth and repair of protein tissue (especially muscle), and acts as a counter-regulatory agent to cortisol, negating many of the harmful effects of continued excess cortisol. When increased demand for cortisol is prolonged, DHEA levels decline. DHEA then is no longer able to balance the negative effects of excess cortisol. Depressed DHEA levels serve as an early warning of potential adrenal exhaustion. In fact, adrenal exhaustion is evidenced by an elevated ratio of the sum of the four cortisol measurements to the DHEA-S average. (The ideal level of the aforementioned ratio is 5 or 6:1).

A chronic imbalance between adrenal stimulation and cortisol and/or DHEA output is associated with a multitude of both clinical and subclinical systemic disorders. Chronically depressed DHEA output results in an imbalance in sex hormones. Abnormal cortisol and/or DHEA values (either elevated or depressed) result in a decrease in the activity of the immunocytes that produce secretory IgA (sIgA). SIgA provides a mucosal first-line immune defense against virtually every pathogen, including parasites, protozoa, yeasts, fungi, bacteria, and viruses. SIgA also provides a normal immune response to regularly encountered food proteins. Dysfunctional mucosal immunity is associated with an increased risk of infections and of adverse food reactions.

Other significant physiological stressors can be subclinical and include intolerance to the gliadin fraction of gluten protein, lactose or sucrose intolerance, glycemic dysregulation, delayed food sensitivity, and infection with viruses, bacteria parasites and/or other pathogens. Additional testing may be necessary to rule out the possibility of these and other factors interfering with digestion and absorption and creating inflammation and stress on adrenal glands. These types of problems could impede absorption and assimilation of essential nutrients and the maintenance of normal blood sugar. Chronic dysfunction of any of these processes is a sufficient cause of adrenal exhaustion.

Conditions that may be assessed include adrenal exhaustion, often misdiagnosed as hypothyroid, but may include a hypothyroid condition as well; systemic hyper- or hypo-excitability, whether of suspected neural or hormonal origin, including suspected thyroid, pancreatic, and sex hormone disorders; states of immunodeficiency; and states of abnormal physiological response to any of a variety of stimuli including foods in the normal diet.
Since DHEA can convert to Estradiol and/or Testosterone, the use of DHEA may be contraindicated if Estradiol and/or Testosterone levels are elevated. Conversely, if Estradiol and/or Testosterone levels are depressed, DHEA and/or other therapeutic measures may be indicated.