Compares cortisol with DHEA-S to give a quick view of adrenal balance.
The cortisol/DHEA-sulfate ratio is a calculated value, not a separate blood test. It is cortisol divided by DHEA-sulfate (DHEA-S), both adrenal hormones. It is studied as a marker of the balance between the body's main stress hormone and a hormone that tends to counter some of its effects.
A higher ratio means relatively more cortisol compared with DHEA-S, a pattern reported in chronic stress, ageing, and some illnesses. Because both hormones vary widely, the ratio is mostly used in research and wellness contexts rather than as a standalone diagnostic test. It is read together with the absolute hormone values.
Aniva reads your result against research-backed ranges, not just the lab's wide normal. The reference shown below is specific to this biomarker.
There is no firmly established clinical cut-off for this ratio. It is interpretive and depends heavily on the time of day and the units used, so it should be read with the individual hormone values.
| Pattern | Interpretation |
|---|---|
| Higher ratio | Relatively more cortisol; reported with chronic stress and ageing |
| Lower ratio | Relatively more DHEA-S |
Thresholds are not standardised. Source: Cortisol to DHEA-S ratio research review.
Cortisol swings through the day and rises with stress, illness, and some medicines, while DHEA-S falls with age. Time of collection strongly affects cortisol. Steroid medicines and the contraceptive pill can shift both hormones.
Best read with its components, cortisol and DHEA-sulfate, ideally with a morning cortisol and the relevant time of day noted.
What does a high or low ratio mean? High suggests more stress signal relative to rebuilding; low suggests the opposite. It’s context only, not a diagnosis.
Do I need to fast for this test? No. A morning sample is preferred because cortisol peaks then.
What can affect my result? Time of day, poor sleep, illness, exercise, pregnancy, and age can shift results. Steroid medicines, oral estrogen, and DHEA supplements also matter.
How often should I test this? If adjusting medicines or symptoms change, your clinician may repeat in 6 to 12 weeks. Otherwise, use sparingly and alongside direct hormones.
How long do results take? Results are usually ready in about 7 days.
What should I discuss with my clinician? Share symptoms, timing of the draw, and all medicines and supplements. Ask whether to confirm with cortisol, DHEA-S, and ACTH.
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