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24-Hour Urine Tetrahydrocortisol and 5-Alpha-Tetrahydrocortisol — Pregnancy Assessment

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

Measures cortisol metabolites in a 24-hour urine collection to assess adrenal steroid metabolism during pregnancy.

Quick summary

["This test evaluates the body's handling of cortisol using hormone metabolites collected over 24 hours."]

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

Key facts at a glance

LOINC
82898-8
Short code
Pregntrl/THE+THF+5a-THF 24h Ur-sRto
Synonyms
Pregntrl/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 forms of tetrahydrocortisol, including 5-alpha-tetrahydrocortisol, in urine collected for 24 hours. These substances are metabolites formed as the body breaks down cortisol.

Why might I need this test?

It may be used during pregnancy to evaluate cortisol metabolism and the activity of enzymes that regulate cortisol. Results are generally interpreted along with other hormone measurements and clinical findings.

How is the test performed?

You collect all urine for a full 24-hour period in a labeled container provided by the laboratory. The laboratory then measures the cortisol metabolites and may calculate metabolite patterns or ratios.

How do I prepare for the test?

Begin the collection at the time specified by the laboratory, usually after emptying your bladder, and collect every urine sample for the next 24 hours. Follow the laboratory's instructions for refrigeration, storage, and returning the sample, and note any missed collections.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Abnormal results can reflect altered cortisol metabolism, including differences in the activity of 11-beta-hydroxysteroid dehydrogenase type 2. In pregnancy, these measurements may help evaluate maternal or placental steroid metabolism, but they must be interpreted with gestational stage, symptoms, and other test results.

Short name

24-Hour Urine Cortisol Metabolites

Frequently asked questions

Do I need to fast for this test?
Fasting is generally not required for a 24-hour urine collection. Follow any medication and diet instructions provided by the laboratory or ordering clinician.
What happens if I miss part of the collection?
A missed collection can make the results inaccurate or unusable. Contact the laboratory for guidance if you are unable to collect all urine during the 24-hour period.
Are these the same as a routine urine cortisol test?
No. This test measures specific cortisol metabolites over 24 hours, and the results may include calculated ratios that are different from a single urine cortisol measurement.
  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