Cortisol:DHEA ratio

Cortisol:DHEA ratio is the ratio of cortisol to DHEA (or DHEA-S) in blood, hair, or nail tissue, used as a biomarker of chronic stress and metabolic rate.

Ratio over single measurement

A single serum cortisol reading fluctuates through the day and is often unreliable on its own. Measuring cortisol against an antagonistic steroid such as DHEA-S, testosterone, or progesterone gives a more stable picture of chronic stress load. The cortisol/DHEA-S ratio has been proposed as one of the most reliable predictors of all-cause mortality, alongside roles in depression, cardiovascular health, and immune function.

Alzheimer's disease

A pilot study of Serbian patients found Alzheimer's patients had significantly higher serum cortisol than controls (398.85 vs. 337.40 nmol/L, p = 0.026). The cortisol/DHEA-S ratio trended higher overall (p = 0.078) and was significantly higher among patients aged 65 to 75 (p = 0.031).

Schizophrenia

Elevated cortisol/DHEA and cortisol/testosterone ratios have also been linked to schizophrenia. Serotonin is the primary driver of cortisol production, and anti-serotonin treatments have lowered cortisol in Cushing's disease, giving a mechanistic link between high serotonin, high cortisol, and psychiatric illness.

Lowering the ratio

Aspirin, pregnenolone, progesterone, thyroid hormone, and DHEA supplementation have been proposed to lower the cortisol/DHEA-S ratio, either by suppressing cortisol production or raising DHEA.

See also

• Cortisol
• DHEA
• Pregnenolone
• Progesterone