17-hydroxycorticosteroid urine test
17-OH corticosteroids; 17-OHCS
The 17-hydroxycorticosteroids (17-OHCS) test measures the level of 17-OHCS in the urine. It may be used to diagnose Cushing syndrome. However, it is not done often now. The free cortisol urine test is a better initial test for Cushing syndrome.
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.
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 type of Cushing syndrome caused by a tumor in the adrenal gland that produces cortisol
- Depression
- Hydrocortisone therapy
- Malnutrition
- Obesity
- Pregnancy
- A hormonal cause of severe high blood pressure
- Severe physical or emotional stress
- Tumor in the pituitary gland or elsewhere in the body that releases a hormone called adrenocorticotropic hormone (ACTH)
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.
Version Info
Last reviewed on: 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.
