24-Hour Urine Steroid Metabolite Panel (Tetrahydrocortisone, Tetrahydrocortisol, and 5-Alpha-Tetrahydrocortisol)
Measures cortisol-related steroid metabolites in urine collected for 24 hours to help evaluate adrenal steroid production and metabolism.
["This test can help identify abnormal adrenal steroid production or changes in how cortisol is metabolized."]
Key facts at a glance
- LOINC
- 82855-8
- Short code
- PDONE+PT/THE+THF+5a-THF 24h Ur-sRto
- Synonyms
- PDONE+PT/THE+THF+5a-THF 24h Ur-sRto
- Category
- liver
- Sample
- urine
- Container
- Sterile urine container
- Units
- N/A
- Ref low
- 0.8
- Ref high
- 1.2
- Critical range
- — – 5 N/A
- Fasting
- false
- Population
- adult
- Sex
- all
- Age range
- 18–65 years
- CPT
- 85610
- SNOMED
- 396252006
- 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 tetrahydrocortisone, tetrahydrocortisol, and 5-alpha-tetrahydrocortisol, which are metabolites formed as the body processes cortisol. They are measured in urine collected over 24 hours.
Why might I need this test?
It may be used to evaluate adrenal steroid production when symptoms or other laboratory findings suggest an endocrine disorder. The relative amounts of these metabolites can also provide information about the way cortisol is metabolized.
How is the test performed?
You collect all urine into a designated container for a full 24-hour period. The laboratory then measures the steroid metabolites in the collected sample, and the results are interpreted along with your symptoms and other tests.
How do I prepare for the test?
Follow the laboratory's instructions for the collection container, start time, and storage. A timed 24-hour collection usually begins with an empty bladder, discards the first urine, and includes the final urine at the end of the collection period. Tell your clinician about corticosteroid or other hormone medications before the test.
Reference range
INR: 0.8-1.2 (warfarin: 2.0-3.0)N/A
Inform your healthcare provider if you are taking blood thinners. No special preparation required.
Clinical interpretation
How abnormal results are interpreted and what conditions they suggest.
Elevated urinary cortisol metabolites may indicate increased adrenal cortisol production. Changes in the relative levels of tetrahydrocortisol and 5-alpha-tetrahydrocortisol can reflect altered activity of enzymes involved in cortisol metabolism. Results are not diagnostic by themselves and should be interpreted with symptoms, medication use, and other endocrine tests.
Short name
24-Hour Urine Cortisol Metabolites
Frequently asked questions
Is fasting required for this test?
Why does the urine need to be collected for 24 hours?
What if part of the urine collection is missed?
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