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5-Alpha-Tetrahydrocortisol (5α-THF), Urine

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

A urine test that measures 5α-tetrahydrocortisol, a metabolite used to evaluate cortisol metabolism and adrenal steroid production.

Quick summary

["This test helps assess how your body is breaking down cortisol and may be used in evaluating adrenal or steroid-metabolism disorders."]

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

Key facts at a glance

LOINC
82894-7
Short code
Pregnanediol/THE+THF+5a-THF Ur-sRto
Synonyms
Pregnanediol/THE+THF+5a-THF 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 5α-tetrahydrocortisol, also called 5α-THF, in urine. It is a steroid metabolite related to cortisol, a hormone that helps regulate stress response, blood pressure, and other body functions.

Why might I need this test?

A clinician may order this test when there is concern about excess cortisol production, abnormal adrenal steroid activity, or an enzyme that changes cortisol into inactive forms. It may also be used as part of a broader evaluation of unusual hormone symptoms.

How is the test performed?

A urine specimen is collected and analyzed in the laboratory. Depending on the order, this may be a single urine sample or urine collected over a specified period, such as 24 hours. Follow the collection instructions provided by the laboratory.

How do I prepare for the test?

No fasting is usually required. If a timed or 24-hour urine collection is requested, collect all urine during the stated period, keep it refrigerated when instructed, and bring the complete specimen to the laboratory.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

An elevated result may occur when cortisol production is excessive or when cortisol is being metabolized differently than expected. Lower results or an unusual balance between urinary cortisol metabolites can reflect changes in adrenal function or steroid-processing enzymes. Results should be interpreted with symptoms, other hormone tests, and the collection method because this test alone does not establish a diagnosis.

Short name

5α-THF, urine

Frequently asked questions

What does 5α-THF measure?
It measures 5α-tetrahydrocortisol, a urinary metabolite formed as the body processes cortisol.
Do I need to collect urine for 24 hours?
It depends on your laboratory order. Some orders use a single urine sample, while others require a timed collection; follow the instructions supplied with the test.
Does an abnormal result mean I have Cushing syndrome?
Not by itself. An abnormal result may suggest excess cortisol or altered cortisol metabolism, but a clinician must interpret it alongside other findings and tests.
  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