Our doctor also likes 24-hour urine collections.  Below are excerpts from the article he wrote for the CARES newsletter re. the hormones that are measured in urine and how to interpret numbers.  We’ve also been doing the urine collections for a while so if anything is unclear, pls feel free to ask.

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http://www.caresfoundation.org/monitoringCAH.html

Urine Testing:
A single blood test measures androgen levels at one time of day. In comparison, a 24-hour urine collection reflects androgen secretion over the 24-hour day and is therefore recognized as the "gold standard" in assessing hormone production.
To assess adrenal hormone production one measures 17 ketosteroids (17KS) and pregnanetriol in the urine. The 17 KS are breakdown products (metabolic products) of androstenedione and testosterone. Pregnanetriol is the breakdown product of 17-hydroxyprogesterone (17 OHP).
Creatinine is also measured in urine samples. Creatinine is a breakdown product of muscle and is continuously released into the urine. It is produced at a rate of about 10-15 mg/kg (4-6 mg/lb) per day. Measuring the amount of creatinine in the sample indicates if the 24-hour collection is complete or incomplete.
Urine collections are saved in containers provided by hospital or commercial laboratories. They can be conveniently collected on a weekend day and avoid or reduce the need for blood-sticks. Collections are performed by having the child urinate into the toilet on the morning that the collection starts. The urine is then collected over the entire day, and the urine from the first void the following morning is also collected. The container is kept in a cool place until it is brought to the laboratory.

The elimination of 17 KS and pregnanetriol in the urine increases with age. The values obtained in a 24-hour collection can be compared to normal rates of excretion. 17 KS levels provide the best marker of androgen production. Even in situations in which there is adequate treatment, pregnanetriol levels can be elevated. Thus, when 17 KS and pregnanetriol levels do not agree, more emphasis should be placed on the 17 KS value.

 Urine testing
17 Ketosteroids (mg/24 hr) 1.5 (0.2- 3) Males 5 (3-10) 15 (10-25)
Female 3.5 (2.5-8) 10 (6-14)
Pregnanetriol (mg/24 hr) 0.5 1.0 2.0

-In CAH, levels of androstenedione, testosterone and 17 ketosteroids that are normal or modestly (about 25%) above normal are acceptable. Because blood 17 OHP levels can vary widely in CAH, higher 17 OHP levels are acceptable, but are usually less than 1000 ng/dl with adequate treatment.
-To convert ng/dl units to pmol/L, multiply androstenedione levels by 34, 17 OHP by 30, testosterone by 34.Urine testing
17 Ketosteroids (mg/24 hr) 1.5 (0.2- 3) Males 5 (3-10) 15 (10-25)
Female 3.5 (2.5-8) 10 (6-14)
Pregnanetriol (mg/24 hr) 0.5 1.0 2.0