Other names: 17-OH Progesterone LCMS
Optimal Result:
35 - 290 ng/dL.
17-OHP is a hormone made mostly by the adrenal glands (two small glands that sit atop your kidneys). It’s a key “building block” in the pathway that makes cortisol.
Cortisol helps your body handle physical and emotional stress, regulate metabolism, and support the immune system. Your body releases small amounts throughout the day and more during stress.
Making cortisol requires several enzymes. If one is missing or doesn’t work well, cortisol production drops and 17-OHP builds up. Some of that excess 17-OHP can be redirected to make androgens (male-type hormones). Depending on which enzyme is affected, aldosterone (a hormone that controls salt and water balance) can also be low.
These inherited enzyme problems are grouped under congenital adrenal hyperplasia (CAH)—most often due to 21-hydroxylase deficiency.
Classic/early-onset CAH (infancy/childhood): may cause ambiguous genitalia, dehydration or shock from salt-wasting, early pubic hair, or severe acne.
Non-classic/late-onset CAH (later childhood or adulthood): can present more subtly with increased body hair, acne, irregular periods, a deeper voice, or more defined/“muscular” appearance.
Because severe dehydration can occur in infants, 17-OHP is commonly included in newborn screening.
A clinician may order 17-OHP (often by LC/MS-MS for best specificity) to:
Evaluate infants with signs of CAH or abnormal newborn screening
Assess children, teens, or adults with symptoms suggesting androgen excess
Monitor treatment in known CAH
Support results from an ACTH stimulation test when needed
Results depend on age, biological sex, time of day, menstrual cycle phase, and testing method (immunoassay vs. LC/MS-MS). Newborns normally have higher levels that fall after the first 24–48 hours.
High 17-OHP: suggests impaired cortisol synthesis (commonly 21-hydroxylase deficiency) and possible androgen excess. Borderline elevations may need confirmatory testing (e.g., ACTH stimulation, genotyping).
Normal/low 17-OHP: less consistent with CAH; can also reflect adequate treatment in known CAH.
Always interpret in clinical context and with related labs.
Ranges vary by lab, age, and method—especially with LC/MS-MS. Use the reference interval on your specific report.
Newborns (first day): ~1,000–3,000 ng/dL
Infants >24 hours old: <100 ng/dL
Adults: <200 ng/dL
Cortisol, ACTH
Androstenedione, testosterone, DHEA-S
Renin and aldosterone (salt-wasting assessment)
Electrolytes (sodium, potassium)
Liquid chromatography–tandem mass spectrometry (LC/MS-MS) provides high analytical specificity and reduces false positives compared with some immunoassays—especially important in newborns and in borderline cases.
Talk with your clinician about what your result means for you or your child and whether additional testing is needed.
Fritz MA, Speroff L. Clinical Gynecologic Endocrinology and Infertility. 8th ed. 2011.
Lambert SM, Vilain EJ, Kolon TF. A practical approach to ambiguous genitalia in the newborn period. Urol Clin North Am. 2010;37(2):195–205.
Mark T. Endocrinology. In: Engorn B, Flerlage J, eds. Johns Hopkins: The Harriet Lane Handbook. 20th ed. 2015.
White PC. Congenital adrenal hyperplasia and related disorders. In: Kliegman RM, et al., eds. Nelson Textbook of Pediatrics. 20th ed. 2016.
What do high levels mean?
High levels of 17-OH progesterone in the blood may indicate CAH. Infants with CAH tend to have 17-OH progesterone levels ranging from 2,000 to 4,000 ng/dL, while adults with CAH usually have 17-OH progesterone levels above 200 ng/dL.
High 17-OH progesterone levels could also indicate the presence of an adrenal tumor, which can also affect hormone levels. Further testing may be required to determine the specific cause of increased CAH levels.
Disclaimer: 17-OHP values vary with menstrual cycle phase (typically lower in the follicular phase and higher in the luteal phase), as well as assay method (immunoassay vs LC/MS-MS), time of day, and clinical context (e.g., pregnancy, hormonal contraception, menopause, HRT). When interpreting results, use the reference interval printed on your report for the appropriate population and phase. If the cycle phase is unknown, avoid phase-specific conclusions and rely on the lab’s general interval or clinician guidance. Documenting cycle day/phase at the time of collection improves accuracy.
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Understanding 17-OH Progesterone:
- What is 17-OH Progesterone? 17-OH Progesterone, or 17-Hydroxyprogesterone, is a steroid hormone produced by the adrenal glands and the ovaries. It's a precursor in the synthesis of cortisol and androgenic hormones. Its levels can provide valuable information about the functioning of these glands and the body's hormone balance.
- Why is it Important? The measurement of 17-OH Progesterone is crucial for diagnosing and managing conditions related to adrenal and ovarian function. One of the most common reasons for testing 17-OH Progesterone levels is to diagnose congenital adrenal hyperplasia (CAH), a group of genetic disorders affecting the adrenal glands. These disorders can lead to abnormalities in cortisol and androgen levels, affecting growth, development, and metabolism.
Reference intervals for adult females:
Follicular: 15 - 70 ng/dl
Luteal: 35 - 290 ng/dl
17-OH Progesterone and female cycles:
The levels of 17-OH Progesterone in females can vary significantly depending on the phase of the menstrual cycle, reflecting the complex interplay of hormones that regulate menstrual and reproductive functions. During the follicular phase, which occurs from the start of menstruation until ovulation (roughly days 1-14 of a typical 28-day cycle), levels of 17-OH Progesterone are generally lower. This is because this phase is characterized by the maturation of follicles in the ovaries, leading up to the release of an egg. In contrast, during the luteal phase, which follows ovulation and lasts until the onset of menstruation (approximately days 15-28 of the cycle), levels of 17-OH Progesterone increase significantly. This rise is due to the formation of the corpus luteum, a temporary endocrine structure that secretes progesterone to prepare the uterine lining for a potential pregnancy. If fertilization does not occur, the corpus luteum degenerates, leading to a decrease in progesterone and 17-OH Progesterone levels, eventually resulting in menstruation. Understanding these fluctuations is crucial for interpreting the results of hormone tests accurately and can provide valuable insights into a woman's ovulatory status and overall reproductive health.
What do low levels mean?
Decreased levels of 17-OH Progesterone can provide important clues about a person's health status, though it's crucial to interpret these levels within the broader context of other test results and clinical symptoms. Let's explore what decreased levels might indicate and why they're significant:
→ Adrenal Insufficiency
One of the primary concerns when 17-OH Progesterone levels are low is adrenal insufficiency, a condition where the adrenal glands do not produce adequate amounts of steroid hormones, including cortisol and aldosterone. This condition can lead to symptoms such as fatigue, muscle weakness, weight loss, low blood pressure, and sometimes darkening of the skin.
→ Ovarian Factors
For women, low levels of 17-OH Progesterone might also reflect issues related to ovarian function. Since the ovaries produce this hormone as part of the menstrual cycle, significantly low levels could indicate potential problems with ovulation or ovarian reserve. However, it's essential to correlate these levels with other hormone tests and clinical findings for a comprehensive understanding.
→ Impact on Fertility
In the context of fertility, decreased 17-OH Progesterone levels might suggest insufficient corpus luteum function. The corpus luteum is responsible for producing progesterone in the second half of the menstrual cycle, essential for preparing the uterine lining for a potential pregnancy. Low levels could therefore impact fertility and pregnancy outcomes.
Other Considerations:
→ Non-Classical Adrenal Hyperplasia: While much attention is given to elevated levels of 17-OH Progesterone in diagnosing conditions like congenital adrenal hyperplasia (CAH), significantly low levels, particularly when symptoms of adrenal dysfunction are present, warrant further investigation to rule out other forms of adrenal pathology.
→ Age and Phase of Menstrual Cycle: It's important to note that normal ranges for 17-OH Progesterone can vary based on age and, in females, the phase of the menstrual cycle. Therefore, what might be considered low in one context could be normal in another.
Decreased 17-OH Progesterone levels should always be interpreted within the broader context of a patient's overall health, symptoms, and other laboratory findings. A comprehensive evaluation, often involving additional tests and clinical assessment, is necessary to understand the implications fully.
While decreased levels of 17-OH Progesterone can hint at various health issues, including adrenal insufficiency and potential reproductive concerns, diagnosing and understanding the implications of these levels require a holistic approach to patient care. If low levels are detected, further evaluation by a healthcare provider is crucial to determine the underlying cause and appropriate management strategy.
Disclaimer: 17-OHP values vary with menstrual cycle phase (typically lower in the follicular phase and higher in the luteal phase), as well as assay method (immunoassay vs LC/MS-MS), time of day, and clinical context (e.g., pregnancy, hormonal contraception, menopause, HRT). When interpreting results, use the reference interval printed on your report for the appropriate population and phase. If the cycle phase is unknown, avoid phase-specific conclusions and rely on the lab’s general interval or clinician guidance. Documenting cycle day/phase at the time of collection improves accuracy.
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Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.
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