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5β-Tetrahydrocortisol is an endogenous metabolite of hydrocortisone .1,2 It is also an intermediate in the biosynthesis of β-cortol .2 It is formed from cortisol by steroid 5β-reductase and is dehydrogenated by 20β-hydroxysteroid dehydrogenase (20β-HSD) to produce β-cortol in the liver.3,1,2 Urinary levels of 5β-tetrahydrocortisol have been used as a marker for cortisol production and are associated with metabolic syndrome in obese individuals.4

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