17-hydroxycorticosteroids

Definition

17-hydroxycorticosteroid (17-OHCS) is an inactive product formed when the liver and other body tissues break down the steroid hormone, cortisol. This article discusses the laboratory test to measure the amount of 17-OHCS in urine.

How the test is performed

A 24-hour urine sample is needed.

• On day 1, urinate into the toilet when you get up in the morning.
• Collect all urine in a special container for the next 24 hours.
• On day 2, urinate into the container when you get up in the morning.
• Cap the container. Keep it in the refrigerator or a cool place during the collection period.
• Label the container with your name, the date, and the time of completion, and return it as instructed.

For an infant, thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on the infant. For males, place the entire penis in the bag and attach the adhesive to the skin. For females, place the bag over the labia. Diaper as usual over the secured bag.

This procedure may take a couple of attempts -- lively infants can move the bag, causing the urine to be absorbed by the diaper. Check the infant often and change the bag after the infant has urinated into it. Drain the urine from the bag into the container given to you by your health care provider.

Deliver the container to the laboratory or your health care provider as soon as possible.

How to prepare for the test

The health care provider will instruct you, if necessary, to stop taking drugs that may interfere with the test.

• Ampicillin and glucocorticoids can increase 17-OHCS measurements.
• Estrogens (birth control pills) and dexamethasone can decrease 17-OHCS measurements.

If you are collecting urine from an infant, you may need a couple of extra collection bags.

How the test will feel

The test involves only normal urination, and there is no discomfort.

Why the test is performed

This test can help determine if the body is producing too much of the hormone cortisol.

Normal Values

• Male: 4 - 14 milligrams per 24 hours
• Female: 2 - 12 milligrams per 24 hours

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

Greater-than-normal levels of 17-OHCS may indicate:

• Cushing syndrome caused by adrenal or pituitary tumor
• Ectopic ACTH-producing tumor
• Severe physical or emotional stress

Greater-than-normal levels may also occur with:

• Depression
• Hydrocortisone therapy
• Malnutrition
• Obesity
• Pregnancy
• Severe high blood pressure

Lower-than-normal levels of 17-OHCS may indicate:

• Adrenal hemorrhage
• Adrenal insufficiency
• Adrenal infarction
• Hereditary enzyme deficiency
• Hypopituitarism
• Surgical removal of the adrenal gland

What the risks are

There are no risks.

References

Stewart PM. The adrenal cortex. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, PA: Saunders Elsevier; 2008: chap 14.