Tetrahydrocortisone, Urine Creatinine Ratio Unit Converter

Tetrahydrocortisone (THE) is one of the major urinary metabolites of cortisone, which itself is the inactive form of cortisol. When cortisone is broken down in the liver, enzymes called 5β-reductase and 3α-hydroxysteroid dehydrogenase convert it into THE, which is then conjugated and excreted in the urine.

Measuring THE relative to urine creatinine corrects for differences in hydration and urine concentration, giving a more reliable picture of cortisol metabolism. THE itself has very little biological activity. Its value lies in what it reveals about adrenal output and the enzymes that process cortisol and cortisone.

THE is commonly interpreted alongside tetrahydrocortisol (THF) and allo-tetrahydrocortisol (allo-THF). The ratio of (THF + allo-THF) to THE reflects the balance between cortisol and cortisone pathways and is used to evaluate the activity of the enzyme 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2).

THE is produced primarily in the liver, where cortisone (the inactive form of cortisol) is broken down by 5β-reductase and 3α-hydroxysteroid dehydrogenase. The cortisol that feeds this pathway originates from the adrenal glands.