Tetrahydrocortison (THE) is a down-stream metabolite of cortisol and cortisone. It can often reflect a chronic adrenal picture if levels are out of normal limits.
Excess cortisol will result in high levels of urinary THE and are usually from exogenous sources (confirm with urinary cortisol). If there is excess cortisol to cortisone conversion or excess metabolization of cortisone, urinary levels of THE will be high.
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