The Cortisol to DHEA Ratio: The Number That Tracks How Fast You Age

Old people wake up at 4 AM. Have you ever asked why?

My view: their cortisol is too high and their youthful hormones are too low. DHEA, progesterone, DHT. Glycogen runs out early in the night, so cortisol has to step in to keep blood sugar up. And cortisol wakes you up.

That part is my interpretation. But there is hard data on the two hormones at the center of it.

Two adrenal hormones, opposite jobs

• Cortisol is the stress hormone. It breaks tissue down to make glucose.
• DHEA comes from the same glands. Researchers describe DHEA-S as a glucocorticoid antagonist: it works against cortisol.

With age, DHEA falls. Cortisol does not. So the ratio between them climbs.

The aging study

Researchers used data from 969 adults in the Midlife in the United States study. They measured cortisol, DHEA-S and the ratio between them, then compared each one with epigenetic clocks, the DNA-based measures of biological age.

• Cortisol alone: a weak predictor
• DHEA-S alone: no significant link to epigenetic age
• The cortisol to DHEA-S ratio: the best predictor. A higher ratio went with an older biological age on three of the six clocks.

Neither hormone told the story alone. The balance did.

The mood study

In 3,005 men with symptoms of low testosterone, a lower DHEA-S to cortisol ratio went with worse depression scores and worse aging-male symptom scores.

Their testosterone level did not correlate with the ratio at all.

The honest part

These are correlations. They do not prove that changing the ratio slows aging, and the correlations in the mood study were small. But they point in the same direction, and the ratio is cheap to measure.

What I do to move the ratio

To lower the cortisol side:

• Eat enough carbs, including some before bed, so cortisol is not needed to hold blood sugar at night
• Sleep
• Sunlight
• Salt

On the DHEA side, a small dose of DHEA is an option. Read what the DHEA trials found first.

Ask your lab for morning cortisol and DHEA-S on the same blood draw.

Quick answers

What is the cortisol to DHEA ratio?

It is your cortisol level divided by your DHEA-S level. Cortisol is the main stress hormone and DHEA-S works against it, so the ratio shows the balance between the two.

Is a high cortisol to DHEA ratio bad?

In a study of 969 adults, a higher cortisol to DHEA-S ratio was linked to faster epigenetic aging and predicted it better than either hormone alone. This is a correlation, not proof of cause.