Androsterone/Etiocholanolone and Tetrahydrocortisol/5-alpha-Tetrahydrocortisol Ratios, 24-Hour Urine
Calculated urine steroid ratios assess 5-alpha- and 5-beta-reductase enzyme activity, which helps evaluate androgen and cortisol metabolism.
["This 24-hour urine test calculates steroid metabolite ratios that can help evaluate certain inherited enzyme disorders."]
Key facts at a glance
- LOINC
- 82850-9
- Short code
- An+Et/THE+THF+5a-THF 24h Ur-sRto
- Synonyms
- An+Et/THE+THF+5a-THF 24h Ur-sRto
- 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 steroid metabolites in urine collected for 24 hours and calculates ratios involving androsterone, etiocholanolone, tetrahydrocortisol, and 5-alpha-tetrahydrocortisol. The ratios reflect activity of the 5-alpha- and 5-beta-reductase enzyme pathways.
Why might I need this test?
This test may be used when a clinician is evaluating unusual genital development, virilization, or other signs of altered steroid hormone production. It can help identify changes in the enzymes that convert cortisol and androgen precursors into their active or inactive forms.
How is the test performed?
You collect all urine for a full 24-hour period in the container provided by the laboratory. The laboratory measures the steroid metabolites and calculates the reported ratios from the results.
How do I prepare for the test?
Follow the laboratory's 24-hour urine collection instructions, including when to start and finish the collection and how to record or discard a missed sample. Tell your clinician about medicines, supplements, and recent illness because they may affect steroid measurements.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
Abnormal ratios may indicate altered activity of the enzymes that metabolize cortisol and androgens. In a child with ambiguous genitalia or virilization, the pattern may support an inherited 5-alpha-reductase or 5-beta-reductase disorder. Results should be interpreted with symptoms, examination findings, and other hormone tests because illness and medications can also affect them.
Short name
24-Hour Urine Steroid Metabolite Ratios
Frequently asked questions
What do these urine ratios measure?
Why is urine collected for 24 hours?
Does an abnormal result confirm a genetic disorder?
Sources
- 1
- 2Lab Tests OnlineSource
- 3
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.
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