Description of urine analysis:

While a total 17-KS test provides a single sum of androgen metabolites, the Fractionated 17-KS analysis breaks this number down into its specific components (such as Androsterone, Etiocholanolone, Dehydroepiandrosterone (DHEA), and others). This detailed separation is vital for clinicians to determine the exact origin of hormone production. By looking at the ratios between these fractions, doctors can pinpoint whether an excess of “male-type” hormones is coming from the adrenal glands or the gonads (ovaries or testes). This is a sophisticated diagnostic tool used when general tests cannot clarify the source of a complex hormonal imbalance.

What does the analysis represent?

• Goal: To qualitatively and quantitatively separate androgen metabolites to identify their glandular source.
• Primary Application: Differential diagnosis of adrenal vs. ovarian/testicular tumors, identifying specific types of Congenital Adrenal Hyperplasia (CAH), and investigating severe hirsutism (excessive hair growth).
• Method: Gas Chromatography-Mass Spectrometry (GC-MS) or liquid chromatography of a 24-hour urine sample.

Recommendations for the Test (General)

• Time: Requires a strict 24-hour urine collection.
• Hygiene: Thorough external cleansing is required before each void to prevent sample contamination.
• Collection: Use a large, clean laboratory container. The specimen must be kept refrigerated (+2°C to +8°C) throughout the 24-hour period to prevent the breakdown of specific hormone fractions.
• Specific Rules: Women should ideally avoid testing during menstruation. For 72 hours prior to the test, it is recommended to avoid foods containing vanillin, as well as citrus fruits and bananas.

What can affect the results?

• Factors altering levels: Use of hormonal contraceptives, glucocorticoids, or anabolic steroids; acute infections; extreme physical exhaustion; and improper storage (heat can rapidly degrade individual fractions).

When to take the test?

• Recommendations: If there are signs of rapid virilization (deepening of the voice or male-pattern hair growth in women), suspected hormone-active tumors, or ambiguous sexual development in adolescents.
• Preparation: Consult your doctor about tapering off any medications that influence the adrenal-gonadal axis at least one week before the test.

How to interpret the results?

Deciphering the “map” of 17-KS fractions is a highly specialized intellectual task performed by your endocrinologist. A simple “high” or “low” is not enough; the physician evaluates the ratios between fractions. For example, a high DHEA fraction often points to an adrenal source, while high etiocholanolone might suggest a different metabolic path. Your doctor integrates these ratios with your clinical symptoms and imaging results. This professional synthesis is the only way to distinguish between a benign functional shift and a potentially serious tumorous process.

Possible further investigations

• DHEA-S and Total Testosterone (Blood): To correlate urinary metabolites with circulating hormone levels.
• 17-OH Progesterone: To specifically check for enzyme blocks in the adrenal glands.
• Adrenal or Pelvic CT/MRI: To look for physical masses in the glands or ovaries.
• Genetic Testing: If a hereditary enzyme deficiency is suspected based on the fractional profile.
• Consultation with an Endocrinologist or Reproductive Specialist.

When does the next step make sense?

If the fractional analysis reveals a dominance of metabolites characteristic of a tumor, the next logical step is immediate diagnostic imaging (CT or MRI) of the suspected organ. A precise fractional profile allows your medical team to choose the most effective treatment—whether it be targeted medication or surgical intervention.

👉 If necessary, you can discuss the results of the analysis with a specialist, such as an endocrinologist (Doctors – TAMC).