17-OH Ketosteroids

Presence of 17‑ketosteroids (17‑KS) in urine reflects breakdown products of androgens from the adrenal glands and gonads. Normal amounts vary by age and sex; elevated levels suggest excess androgen production from adrenal or testicular sources (e.g., tumors, congenital adrenal hyperplasia, Cushing’s), while low levels may indicate hypogonadism or adrenal insufficiency. Abnormal results warrant further endocrine testing and imaging.

Androsterone is an example of a 17‑ketosteroid. It’s a metabolite of testosterone and androstenedione that contains a keto group at carbon‑17. Produced by the adrenal glands and gonads, androsterone (and its isomer etiocholanolone) is commonly measured in urine to assess androgen production. Elevated or low levels can indicate adrenal or gonadal disorders.

Normal 17‑ketosteroid (urine, 24‑hour) values vary by lab, age and sex. Typical adult references are roughly 6–20 mg/24 h for men and about 2–10 mg/24 h for women. Values outside the lab-specific reference range warrant clinical correlation and further endocrine assessment. Always interpret results against the laboratory’s stated normal range and the patient’s symptoms.

17-hydroxy corticosteroids are steroid hormones (or their metabolites) containing a hydroxyl group at the 17 position, primarily cortisol and related compounds produced by the adrenal cortex. Measurement—often of urinary 17-OH steroids—helps assess adrenal function: levels rise in Cushing’s syndrome and some congenital adrenal hyperplasias, and fall in adrenal insufficiency. They reflect corticosteroid synthesis and breakdown.

A high 17‑hydroxyprogesterone (17‑OHP) level generally indicates impaired steroidogenesis—most commonly 21‑hydroxylase deficiency causing congenital adrenal hyperplasia (classic or nonclassic). It can also reflect adrenal or ovarian tumors, adrenal hyperplasia, or PCOS and may be affected by stress or medications. Elevated 17‑OHP requires confirmatory testing (ACTH stimulation) and endocrine evaluation to determine cause and guide treatment.

The urine test for Cushing’s disease is the 24‑hour urinary free cortisol (UFC) measurement. It measures cortisol excreted over a full day to detect excessive cortisol production. Elevated UFC on two or more collections suggests Cushing’s and prompts further tests (dexamethasone suppression, late‑night salivary cortisol, imaging). Stress, medications, and collection errors can affect results.