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5-Alpha-Tetrahydrocortisol, 24-Hour Urine — Z-Score

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

Measures 5-alpha-tetrahydrocortisol in a 24-hour urine collection and reports a Z-score for standardized comparison with reference data.

Quick summary

["This test helps assess steroid metabolism by measuring a cortisol metabolite in urine collected over 24 hours."]

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

Key facts at a glance

LOINC
95582-3
Short code
5-A THF 24h Z-score Ur
Synonyms
5-A THF 24h Z-score Ur
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. The result from a 24-hour urine collection is expressed as a Z-score, which shows how far the measurement differs from the average in an appropriate reference group.

Why might I need this test?

It may be used as part of an evaluation of adrenal steroid production or metabolism, particularly when symptoms or other laboratory results suggest an imbalance in cortisol handling. It is generally interpreted alongside the rest of a steroid profile rather than as a stand-alone diagnosis.

How is the test performed?

You collect all urine for 24 hours, usually beginning in the morning and ending at the same time the following morning. The laboratory measures the 5-alpha-tetrahydrocortisol amount and converts it to a standardized Z-score.

How do I prepare for the test?

Follow the collection instructions provided by your clinician or laboratory, including the exact start and stop times. Inform your care team about medicines or supplements that may affect steroid metabolism, and ask whether any medication changes are needed.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

24-Hour Urine 5-Alpha-Tetrahydrocortisol

Frequently asked questions

What does the Z-score mean?
A Z-score compares your result with the average of an appropriate reference group. It does not by itself establish a diagnosis; the clinician must consider the clinical context and other results.
How is a 24-hour urine collection done?
Collect all urine during the specified 24-hour period, including nighttime samples, and record the collection times. Follow the laboratory's instructions carefully to avoid missing urine or collecting outside the required period.
Can medications affect this test?
Yes. Medicines that influence cortisol production or steroid metabolism can change the result. Tell your clinician about all prescription medicines, supplements, and steroid products before the collection.
  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