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5-Alpha-Tetrahydrocortisol, 24-Hour Urine — Substance Concentration

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

Measures the amount of 5-alpha-tetrahydrocortisol excreted in urine over 24 hours to help assess adrenal steroid and cortisol metabolism.

Quick summary

["This test evaluates a cortisol metabolite in a 24-hour urine collection and is interpreted alongside other adrenal hormone tests."]

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

Key facts at a glance

LOINC
73864-1
Short code
5-A THF 24h Ur-sCnc
Synonyms
5-A THF 24h Ur-sCnc
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?

5-alpha-tetrahydrocortisol is a metabolite formed as the body breaks down cortisol. This test measures how much of this metabolite is released in urine during a 24-hour period, providing information about adrenal steroid production and metabolism.

Why might I need this test?

A clinician may order this test when evaluating adrenal function, excess cortisol production, or abnormal androgen levels. It is often interpreted with related steroid metabolites rather than as a stand-alone result.

How is the test performed?

You collect all urine for exactly 24 hours, usually beginning in the morning and ending the following morning. The laboratory then measures the concentration of 5-alpha-tetrahydrocortisol and accounts for the total volume and collection time.

How do I prepare for the test?

Follow the collection instructions provided by your healthcare professional, and record when the collection starts and ends. Fasting is usually not required, but medication use and any missed collections should be reported to the clinician.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

24-Hour Urine 5-Alpha-Tetrahydrocortisol

Frequently asked questions

Do I need to be fasting for this test?
Fasting is generally not required. Follow any specific instructions from your clinician, particularly if you are taking corticosteroid or other hormone medications.
What happens if I miss part of the 24-hour urine collection?
A missed collection can make the result inaccurate, especially when urine volume is used to calculate the amount excreted. Ask your clinician or laboratory whether the collection needs to be repeated.
Does an abnormal result mean I definitely have an adrenal disorder?
No. This test is one part of an adrenal evaluation, and abnormal levels may also result from medication effects or other factors. Your clinician will interpret it with your medical history and related laboratory results.
  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