17-Hydroxyprogesterone (17-OHP)
Hormones marker
17-Hydroxyprogesterone
17-Hydroxyprogesterone (17-OHP)
An intermediate steroid in the adrenal and gonadal steroidogenesis pathway, produced from progesterone and pregnenolone and converted onward toward cortisol and androgens. Its main clinical use is screening for 21-hydroxylase deficiency (non-classic congenital adrenal hyperplasia, CAH).
PED Notes
Relevant to AAS users on two fronts. First, exogenous androgens and glucocorticoid-like compounds suppress the HPA and HPG axes, which can lower endogenous 17-OHP; a suppressed value on cycle is expected and not itself alarming. Second, an unexpectedly elevated 17-OHP in someone with hirsutism, acne, or fertility problems can flag non-classic CAH, which changes how androgen excess should be managed. Draw in the early morning (levels are highest around 8am) and, in cycling athletes, ideally at a hormonal baseline off suppressive compounds.
When high
When elevated (>200 ng/dL, or clearly above the lab cutoff):
- The classic concern is 21-hydroxylase deficiency (non-classic CAH). A morning 17-OHP above roughly 200 ng/dL warrants an ACTH (cosyntropin) stimulation test to confirm; stimulated values above ~1000 ng/dL are diagnostic
- Mild elevations can also come from ovarian or adrenal sources, recent stress, or a non-fasting/late-day draw. Repeat early morning before escalating
- In AAS users, rule out assay cross-reactivity: some injectable progesterone-derived compounds and recent steroid dosing can interfere. Interpret alongside the full androgen panel (testosterone, DHEA-S, androstenedione)
Management if non-classic CAH is confirmed (endocrinologist-led):
- Low-dose glucocorticoid (for example hydrocortisone 10-20mg/day in divided doses, or dexamethasone 0.25-0.5mg at night) suppresses ACTH-driven adrenal androgen overproduction; reserved for symptomatic patients (infertility, severe hirsutism) and requires physician oversight because of adrenal-suppression and metabolic risks
- Address the downstream androgen excess rather than the number itself; consult an endocrinologist before any pharmacological intervention
When low
When low or suppressed:
- A low 17-OHP on cycle usually reflects expected HPA/HPG suppression from exogenous androgens or glucocorticoids and needs no specific treatment
- Persistently low values with symptoms of adrenal insufficiency (fatigue, hypotension, salt craving) should prompt a full adrenal workup (morning cortisol, ACTH) rather than treating 17-OHP in isolation
History Chart
Reading History
Frequently Asked Questions
Reference Ranges
Standard Range