The Role of DHEA in Adrenal Fatigue & Loss of Libido

By James Wilson, DC, ND, PhD

DHEA is one of the androgen hormones secreted by the adrenal glands and is the precursor to several other sex hormones. During adrenal fatigue, DHEA levels often become depressed. A saliva test can determine whether a patient’s DHEA levels are below normal.

I usually recommend measuring DHEA-S levels with the saliva test as well because the adrenals are the primary source of DHEA-S (but not necessarily DHEA). Adrenal fatigue syndrome often involves decreased DHEA-S. The DHEA-S level is a direct indicator of the functioning of the area within the adrenal glands that produces sex hormones (the zona reticularis).

Saliva tests for testosterone, the estrogens, progesterone and other hormones can also be done, if needed, and may be of value in working with adrenal fatigue. Testosterone and DHEA-S levels are two of the most reliable indicators of biological age. Testosterone and DHEA-S levels below the reference range for the person’s age may be indicators of increased aging. If the cortisol levels are also decreased, the three tests together further indicate chronically decreased adrenal function.

Although the sex hormones are made primarily by the gonads (ovaries and testes), the adrenal zona reticularis manufactures an ancillary portion of sex hormones for each sex and also produces male hormones in women and female hormones in men to keep the effects of the dominant sex hormones in balance. DHEA and its relatively inactive precursor, DHEA-S, are two other major hormones that are manufactured and secreted by the zona reticularis. Nearly all of the DHEA-S in circulation is manufactured by the adrenals, which is why DHEA-S blood or saliva levels are excellent indicators of adrenal function.

The adrenal sex hormones and their immediate precursors such as DHEA, pregnenolone and androstenedione do more than add to or balance other sex hormones. They also help balance the effects of cortisol and act as cellular anti-oxidants. Thus, the sex hormones and DHEA both limit cortisol’s possible detrimental effects on cells and at the same time facilitate its actions by functioning as hormonal anti-oxidants. These precursors have their own actions as well as serving as raw material from which the sex hormones are made. For example, DHEA is exported to most cells and once inside the cells, it often becomes the resource material from which small amounts of local hormones can be created to carry out various specific tasks.

The Physiological Effects of Stress and Aging on Adrenal Sex Hormones

The more the adrenals are stimulated by stress and internal demands, the less responsive the zona reticularis becomes. Consequently, the adrenal output of sex hormones and their precursors decreases with chronic stress and adrenal fatigue. When less DHEA-S is manufactured in the zona reticularis, less DHEA-S and DHEA is available for export and use by other cells. This diminishes your ability to respond adequately to the demands placed on your body for increased DHEA-S and DHEA, thus, in turn, increasing the negative effects of chronic stress.

Loss of libido is commonly associated with adrenal fatigue, probably due in large part (in both men and women) to a drop in testosterone production by the adrenals. From your body’s point of view, when you are in the midst of having to fight tigers and run for your life (i.e. when you are under a lot of stress), it is not a good time to feel amorous because your energy must be used for survival.

Output of adrenal sex hormones and their precursors also decreases with age. A decline in DHEA and testosterone levels accounts for many of the degenerative processes of aging. In fact, the levels of these two hormones in males track the progression of biological aging more closely than do any other markers. As we lose the available DHEA and testosterone, we become less able to counter the intense effects of cortisol in the cells. With age, cortisol levels remain relatively steady, while DHEA and testosterone decline and the other hormones range somewhere in between. In general as the levels of sex hormones and their precursors such as DHEA and testosterone decrease because of age, stress and adrenal fatigue, their many and varied beneficial effects decrease as well.

Related: How & Why I Use Saliva Hormone Tests for Adrenal Fatigue


Original blog by Dr. James Wilson can be found here.

Dr James Wilson

James L. Wilson, DC, ND, PhD, received his Ph.D. in Human Nutrition from the University of Arizona, with minors in Immunology, Microbiology, Pharmacology and Toxicology, and research in Cellular Immunology. His doctorates in Chiropractic Medicine and Naturopathic Medicine are from the Canadian Memorial Chiropractic College and the Ontario College of Naturopathic Medicine (CCNM).

As one of the 14 founding members of CCNM, now the largest Naturopathic College in the world, Dr. Wilson has long been on the forefront of alternative medicine. For over twenty-five years, he was in private practice in Canada and the United States. In 1998, Dr. Wilson coined the term ‘adrenal fatigue’ to identify below optimal adrenal function resulting from stress and distinguish it from Addison’s disease.

With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad.