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5-Alpha-Hydroxycortisol/Creatinine Ratio, Serum

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

A specialized endocrine test that measures 5-alpha-hydroxycortisol relative to creatinine in a blood sample.

Quick summary

["This test evaluates a cortisol-related steroid and may help assess abnormal adrenal hormone production or metabolism."]

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

Key facts at a glance

LOINC
81804-7
Short code
5a-4HC/creat Ur-sRto
Synonyms
5a-4HC/creat 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 5-alpha-hydroxycortisol, a metabolite formed during cortisol processing, and compares its concentration with creatinine in serum. It is a specialized test used to evaluate adrenal steroid production and metabolism.

Why might I need this test?

A clinician may order this test when symptoms or laboratory findings suggest an adrenal, pituitary, or other hormonal disorder. It may also be used to evaluate the effects of certain medicines on steroid metabolism.

How is the test performed?

A blood sample is drawn and separated into serum. A laboratory then measures 5-alpha-hydroxycortisol and creatinine and calculates their ratio.

How do I prepare for the test?

No special preparation is usually required, but stress, illness, and steroid medicines can affect the result. Tell your clinician about all medicines and supplements, and do not stop prescribed treatment unless instructed to do so.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

An abnormal result may indicate altered adrenal steroid production or metabolism, including conditions involving the adrenal glands or pituitary gland. The result must be interpreted with symptoms, other hormone tests, kidney function, and medication history because stress and medicines can also affect it.

Short name

5-Alpha-Hydroxycortisol/Creatinine Ratio

Frequently asked questions

Is this the same as a routine cortisol test?
No. It measures a specific cortisol metabolite and compares it with creatinine rather than measuring cortisol alone.
Does an abnormal result diagnose an adrenal disorder by itself?
No. The result is interpreted with other laboratory findings, symptoms, medical history, and sometimes additional hormone tests.
Can medicines affect this test?
Yes. Steroid medicines, other hormone treatments, and some other medicines may change steroid production or metabolism and should be reported to the clinician.
  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