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5-Alpha-Tetrahydrocortisol [Mass Rate] in 24-Hour Urine

Published: August 9, 2026Updated: August 16, 2026

Measures the amount of a cortisol-related steroid metabolite released in urine over 24 hours to help evaluate adrenal hormone production.

Quick summary

["This test helps assess adrenal steroid production, particularly when a disorder affecting cortisol synthesis or an adrenal enzyme is suspected."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
21044-3
Short code
5-A THF 24h Ur-mRate
Synonyms
5-A THF 24h Ur-mRate
Category
liver
Sample
urine
Container
Sterile urine container
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Specimen volume
10 mL
Stability
Room temperature: 2h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
0
Lipemia max
0
Icterus max
0
TAT
4–24 hours
Order
routine

What is this test?

This test measures 5-alpha-tetrahydrocortisol, a metabolite formed during cortisol metabolism. It reports the amount excreted per unit of time rather than a concentration in a single urine sample.

Why might I need this test?

The test may be used with other steroid tests to investigate unusual adrenal hormone production. It can help evaluate conditions involving congenital adrenal hyperplasia or reduced activity of enzymes involved in cortisol synthesis.

How is the test performed?

All urine produced over 24 hours is collected in a labeled container, and the amount of 5-alpha-tetrahydrocortisol is measured using laboratory testing. The result is adjusted to reflect the total amount released over the collection period.

How do I prepare for the test?

Collect urine for the full 24-hour period, usually starting after emptying your bladder and ending at the same time the following day. Follow the laboratory's storage instructions, keep the container closed, and record any urine samples that are missed.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

An elevated amount may indicate increased production of cortisol-related adrenal steroids and can support evaluation for an adrenal enzyme disorder or congenital adrenal hyperplasia. A reduced amount may be seen when adrenal steroid production is low, including in some cases of adrenal insufficiency. Results should be interpreted with symptoms, medication use, and related hormone tests.

Short name

24-Hour Urine 5-Alpha-Tetrahydrocortisol

Frequently asked questions

What does this test measure?
It measures the amount of 5-alpha-tetrahydrocortisol, a cortisol metabolite, released in urine over 24 hours.
Why is a 24-hour urine collection used?
Steroid hormone production varies throughout the day. Collecting all urine for 24 hours provides a more representative measure than testing a single sample.
Can this test diagnose an adrenal disorder by itself?
No. An abnormal result is usually interpreted with other steroid levels, physical findings, and the results of the 24-hour urine free cortisol test.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy