1. Low DHEA/ low cortisol,like high dhea / high cortiol, both I have found to be of limited clinical signficance . I have too many cases where with people with early, moderate and advance fatigue all present with the above. There is too much individual variance to make a call based on lab alone without any previous comparison.

2. The important ratio, high cortisol / low DHEA , points towards adrenal fatigue, especially if the the ratio is high. In adrenal fatique , a phenomena called "pregnenolone steal " commonly occurs where the body sacrifices the production of pregnenolone ( ad thus DHEA which is one step down the chain) and quickly shunt any production of both pregnenolone and DHEA toward production of and in favor of cortisol. This is the way the body wants as it tries to survive. You would think that a high cortisol would necessary mean high DHEA which is a precursor, but the body is smarter than all of us. Thus cortisol increase as DHEA goes down. The use of this ratio as an adjunct can be meaningful. The ratio in and of itself is not definitively in terms of diagnosis in my view.