17-hydroxycorticosteroids urine test

17-OH corticosteroids; 17-OHCS

Definition

The 17-hydroxycorticosteroids (17-OHCS) test measures the level of 17-OHCS in the urine.

How the Test is Performed

A 24-hour urine sample is needed. You will need to collect your urine over 24 hours. Your health care provider will tell you how to do this. Follow instructions exactly.

How to Prepare for the Test

Your provider will instruct you, if necessary, to stop medicines that may interfere with the test. These may include:

  • Birth control pills that contain estrogen
  • Certain antibiotics
  • Glucocorticoids

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

17-OHCS is a product formed when the liver and other body tissues break down the steroid hormone cortisol.

This test can help determine if the body is producing too much cortisol. The test may be used to diagnose Cushing syndrome. This is a disorder that occurs when the body has a constant high level of cortisol.

The urine volume and urine creatinine are often done with 17-OHCS test at the same time. This helps the provider interpret the test.

This test is not done often now. The free cortisol urine test is a better initial test for Cushing disease.
 

Normal Results

Normal values:

  • Male: 3 to 9 mg/24 hours (8.3 to 25 µmol/24 hours)
  • Female: 2 to 8 mg/24 hours (5.5 to 22 µmol/24 hours)

Normal value ranges may vary slightly among different labs. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

A higher than normal level of 17-OHCS may indicate:

A lower than normal level of 17-OHCS may indicate:

  • Adrenal glands are not producing enough of their hormones (Addison disease)
  • Pituitary gland is not producing enough of its hormones (hypopituitarism)
  • Hereditary enzyme deficiency
  • Previous surgery to remove the adrenal gland
  • An expected result if part of a standard three-day dexamethasone suppression test

Urinating more than 3 liters a day (polyuria) can make the result of the test high, even though cortisol production is normal.

Risks

There are no risks with this test.

References

Auchus RJ, Pandey CEF. The adrenal cortex. In: Melmed S, Auchus, RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 13.

Nieman LK. Adrenal cortex. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 208.

Review Date: 4/24/2025

Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.


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