A 17-ketosteroids urine test measures specific hormone by-products in your urine to help your doctor evaluate adrenal and gonadal function. These by-products come from androgens — the hormones responsible for male characteristics in both men and women — and understanding this test can help you feel more prepared when your healthcare provider in Canada recommends it.
Why Is the 17-Ketosteroids Urine Test Ordered in Canada?
This androgen hormone test is commonly ordered when doctors suspect adrenal gland disorders, hormonal imbalances, or certain tumours. In this article, we explain what the test involves, who needs it, how to collect the 24-hour urine sample, and what your 17-ketosteroid levels can reveal about your health.
Step-by-Step Collection Instructions
Medications That Can Affect Your Results
How the Test Is Analyzed Understanding Your Results
When to See a Doctor Frequently Asked Questions
Can medications affect my 17-ketosteroids urine test results?
Is the 17-ketosteroids urine test covered by provincial health plans in Canada?
What Are 17-Ketosteroids?
Interpreting 17-Ketosteroids Urine Test Results: Normal Ranges and Clinical Significance
Result Category Reference Range (µmol/24h) Possible Clinical Indication Recommended Follow-Up
Normal (Adult Male) 28–76 µmol/24h Healthy adrenal and gonadal androgen production Routine monitoring; no immediate action required
Normal (Adult Female) 14–52 µmol/24h Normal adrenal androgen secretion Routine monitoring; no immediate action required
Elevated Levels Above upper reference limit Possible adrenal hyperplasia, Cushing’s syndrome, adrenal carcinoma, or polycystic ovary syndrome (PCOS) Referral to endocrinologist; additional imaging and hormonal testing recommended
Reduced Levels Below lower reference limit Possible Addison’s disease, hypopituitarism, or gonadal insufficiency Further adrenal function testing; endocrinology consultation advised
Borderline/Indeterminate Near upper or lower limits May reflect stress, illness, medications, or early hormonal imbalance Repeat testing under standardized conditions; review current medications with physician
17-ketosteroids are waste products your body makes when it breaks down androgen hormones. Androgens are often called “male hormones,” but women produce them too — just in smaller amounts. When your body uses up these hormones, it converts them into metabolites. These metabolites leave your body through your urine.
The main 17-ketosteroids measured in this test include:
Androstenedione — a hormone produced by the adrenal glands and sex organs
Androsterone — a mild androgen derived from testosterone
Dehydroepiandrosterone (DHEA) — one of the most abundant hormones in the human body
Epiandrosterone — a weaker form of androsterone
Etiocholanolone — a metabolite linked to fever and inflammation responses
Together, these compounds give doctors a broad picture of how well your adrenal glands and sex organs are functioning. Therefore, measuring them in urine provides useful diagnostic information that a simple blood test might miss.
Why Is the 17-Ketosteroids Urine Test Ordered?
Your family doctor or specialist may order this test for several reasons. Most commonly, it helps investigate conditions related to abnormal androgen levels. In Canada, this test is typically requested by an endocrinologist or a specialist in hormonal disorders.
The two most common reasons for ordering this test are:
Hirsutism — excessive or unwanted hair growth in women, often on the face, chest, or back
Virilization — the development of male physical characteristics in women or children, such as a deepened voice or increased muscle mass
However, doctors may also use the 17-ketosteroids urine test to investigate other conditions. These can include suspected adrenal gland tumours, congenital adrenal hyperplasia (a genetic hormone disorder), polycystic ovary syndrome (PCOS), or delayed puberty in children. In addition, the test can help monitor the effectiveness of treatment for known hormone disorders.
According to Mayo Clinic’s hormone testing resources, measuring urinary hormone metabolites over a full day gives a more complete and accurate picture than a single blood draw.
How to Prepare for the Test
Preparation is straightforward, but it requires attention to detail. The 17-ketosteroids urine test uses a 24-hour urine collection. This means you collect all the urine you produce over a full day and night.
Step-by-Step Collection Instructions
Your doctor or lab will provide a special collection container. Follow these steps carefully to ensure accurate results:
Day 1, morning: When you wake up, urinate as usual and discard this first sample. Note the time.
Day 1, all remaining urine: Collect every urine sample for the next 24 hours into the special container.
Day 2, morning: Collect your first morning urine. This completes the 24-hour period.
Storage: Keep the container in the refrigerator throughout the collection period.
Final step: Mix the collected urine well, then measure the total volume. Pour off 100 mL into the plastic container provided by the lab and return it promptly.
It is very important not to miss any urine during the collection period. Even one missed sample can affect the accuracy of your results. Furthermore, make sure you refrigerate the container at all times, as urine left at room temperature can break down and give false readings.
Dietary and Lifestyle Considerations
Ask your doctor whether you need to avoid any foods or activities before the test. Some labs recommend avoiding excessive physical exercise in the 24 hours before collection, as intense activity can temporarily raise androgen levels. Stay well hydrated, but do not drink unusually large amounts of water, as this can dilute the sample.
Always tell your doctor about any vitamins, supplements, or herbal remedies you take. These can sometimes interfere with hormone testing, just like prescription medications can.
Medications That Can Affect Your Results
This is one of the most important things to discuss with your doctor before the test. Several common medications can change your 17-ketosteroid levels. As a result, your doctor may ask you to temporarily stop certain drugs before testing — but never stop any medication without medical advice first.
Medications That May Raise 17-Ketosteroid Levels
The following drugs can cause your results to appear higher than they actually are:
Antibiotics — particularly certain broad-spectrum types
Chlorpromazine — an antipsychotic medication
Ethinamate — a sedative (rarely used today)
Meprobamate — an anti-anxiety medication
Nalidixic acid — an older antibiotic
Spironolactone — a diuretic often used for blood pressure or hormonal acne
Medications That May Lower 17-Ketosteroid Levels
The following drugs can cause your results to appear lower than they actually are:
Progestins — synthetic forms of progesterone found in birth control pills
Carbamazepine — an anti-seizure medication
Glucose (intravenous) — given in hospital settings
Cephalothin — an antibiotic
Propoxyphene — a pain reliever
Reserpine — a blood pressure medication
Chlordiazepoxide — a benzodiazepine used for anxiety
In addition to medications, stress, illness, and age can all naturally affect your 17-ketosteroid levels. Therefore, your doctor will always interpret your results alongside your full medical history, not in isolation.
How the Test Is Analyzed
Once your urine sample reaches the laboratory, technicians use a method called spectrophotometry to measure the 17-ketosteroids. This technique uses light to detect and measure the concentration of specific substances in your sample. It is a well-established, reliable method used in certified Canadian medical laboratories.
Results are typically expressed as milligrams per 24 hours (mg/24h). Normal ranges vary depending on age and sex. Your lab report will usually include the reference range used by that specific laboratory. However, always have your doctor explain what your personal results mean in context.
For more background on how hormone tests work, Healthline’s guide to hormonal imbalance testing offers a helpful overview of how doctors use urine and blood tests together.
Understanding Your Results
Abnormal 17-ketosteroid levels — either too high or too low — can point to several different conditions. However, one abnormal result does not automatically mean something is seriously wrong. Your doctor will consider many factors before making a diagnosis.
Higher-Than-Normal Levels May Suggest
Congenital adrenal hyperplasia (CAH)
Adrenal gland tumours (benign or malignant)
Polycystic ovary syndrome (PCOS)
Cushing’s syndrome (excess cortisol production)
Ovarian tumours that produce androgens
Testicular tumours in males
Lower-Than-Normal Levels May Suggest
Addison’s disease (underactive adrenal glands)
Hypothyroidism (underactive thyroid)
Hypopituitarism (underactive pituitary gland)
Chronic illness or severe nutritional deficiency
Ageing — levels naturally decline with age
It is worth noting that 17-ketosteroid levels naturally decline as we get older. Furthermore, women generally have lower levels than men throughout their lives. Therefore, age- and sex-specific reference ranges are essential for accurate interpretation.
The Health Canada information on diagnostic testing provides guidance on how laboratory tests are regulated and standardized across Canada to ensure accurate results for all patients.
When to See a Doctor
You should speak with your family doctor if you notice symptoms that might suggest a hormone imbalance. These symptoms include unexplained hair growth on the face or body, changes in your menstrual cycle, sudden weight gain (especially around the abdomen), acne that does not respond to usual treatment, or unusual fatigue.
If you do not have a family doctor, a walk-in clinic can be a good first step. A walk-in doctor can assess your symptoms, order initial bloodwork, and refer you to an endocrinologist if needed. Most provincial health plans in Canada cover medically necessary hormone testing, including urine tests like the 17-ketosteroids urine test. Check with your provincial health plan to understand what is covered in your province.
Do not try to interpret your own lab results without medical guidance. Hormone levels are complex, and what looks abnormal on paper may be perfectly normal for your age, sex, and health history. Always rely on your healthcare provider for a proper diagnosis.
Frequently Asked Questions
What does a 17-ketosteroids urine test measure?
A 17-ketosteroids urine test measures the breakdown products of androgen hormones in your urine over a 24-hour period. These by-products include compounds like DHEA, androsterone, and androstenedione. The test helps doctors assess how well your adrenal glands and sex organs are producing hormones.
Why would my doctor order a 17-ketosteroids urine test?
Your doctor may order a 17-ketosteroids urine test if you have symptoms of abnormal androgen activity, such as excessive hair growth (hirsutism) or virilization in women. It is also used to investigate adrenal gland disorders, PCOS, or to monitor hormone treatment. In Canada, this test is often requested by an endocrinologist after an initial assessment by a family doctor.
How do I collect a 24-hour urine sample for this test?
To collect a 24-hour urine sample, discard your first morning urine, then collect all urine for the next 24 hours — including the first urine of the following morning. Keep the collection container refrigerated throughout the process. Your lab will provide a special container and detailed instructions for the 17-ketosteroids urine test.
Can medications affect my 17-ketosteroids urine test results?
Yes, several medications can raise or lower your 17-ketosteroids urine test results. Drugs like spironolactone, certain antibiotics, and chlorpromazine may increase levels, while progestins, carbamazepine, and reserpine may decrease them. Always tell your doctor about every medication and supplement you take before collecting your sample.
What do high 17-ketosteroid levels mean?
High levels on a 17-ketosteroids urine test may point to conditions such as congenital adrenal hyperplasia, adrenal tumours, PCOS, or Cushing’s syndrome. However, a single elevated result is not a diagnosis on its own. Your doctor will order additional tests and review your full medical history before drawing any conclusions.
Is the 17-ketosteroids urine test covered by provincial health plans in Canada?
According to Mayo Clinic’s guide to urine tests and analysis, this information is supported by current medical research.
For more information, read our guide on kidney stones symptoms and urine test considerations in Canada.
In most Canadian provinces, medically necessary diagnostic tests — including the 17-ketosteroids urine test — are covered under provincial health plans when ordered by a physician. Coverage details vary by province, so it is a good idea to confirm with your provincial health authority or your family doctor’s office before the test.
Key Takeaways
The 17-ketosteroids urine test measures androgen hormone by-products in a 24-hour urine sample. It is most often ordered to investigate hirsutism, virilization, adrenal disorders, and PCOS. Careful collection is essential — refrigerate the sample and do not miss any urine during the 24-hour period. Several common medications can raise or lower your results, so always disclose all medications to your doctor. Abnormal results can point to many different conditions; your doctor will interpret results in the context of your full health picture. If you have symptoms of a hormone imbalance, speak with your family doctor or visit a walk-in clinic. Most medically necessary hormone tests are covered by Canadian provincial health plans. Never stop a prescribed medication or self-diagnose based on lab results — always consult a
Frequently Asked Questions
What is a 17-ketosteroids urine test?
A 17-ketosteroids urine test measures androgens (male hormones) excreted in urine over 24 hours. It helps diagnose adrenal gland disorders, such as adrenal tumours or congenital adrenal hyperplasia. In Canada, doctors order this test when hormone imbalances are suspected based on symptoms like unusual hair growth or fatigue.
What are the symptoms that indicate you need a 17-ketosteroids urine test?
Common symptoms prompting a 17-ketosteroids urine test include excessive facial or body hair (hirsutism), unexplained weight gain, severe acne, irregular menstrual periods, decreased libido, muscle weakness, and signs of early puberty in children. These symptoms may indicate adrenal or gonadal hormone overproduction requiring further investigation.
What do abnormal 17-ketosteroid levels mean for your health?
Elevated levels may indicate adrenal tumours, Cushing’s syndrome, or polycystic ovary syndrome (PCOS). Low levels can suggest Addison’s disease, pituitary gland dysfunction, or hypogonadism. Abnormal results alone are not diagnostic — your Canadian healthcare provider will order additional tests to confirm the underlying condition before recommending treatment.
How is an adrenal hormone imbalance treated after an abnormal urine test result?
Treatment depends on the underlying cause. Options include hormone replacement therapy for deficiencies, corticosteroid medications for adrenal hyperplasia, or surgical removal of adrenal tumours. In Canada, an endocrinologist typically manages these conditions. Lifestyle changes like stress reduction and a balanced diet may also support adrenal health alongside medical treatment.
When should you see a doctor about a 17-ketosteroids urine test in Canada?
See a doctor promptly if you experience persistent unexplained fatigue, abnormal hair growth, sudden weight changes, irregular periods, or signs of early puberty in children. Canadian family physicians can order initial hormone screening tests and refer you to an endocrinologist if results suggest a serious adrenal or reproductive hormone disorder requiring specialized care.