A high proportion of urinary C 19 5β to 5α steroid metabolites has been found on administration of glucocorticoids in a number of instances. During long term treatment with prednisone or dexamethasone, 100 mg testosterone propionate was administered to 3 patients. The ratios of the resulting metabolites etiocholanolone (E, 5β) to androsterone (A, 5α) were 2.7, 3.3 and 2.1, compared to 1.3 and 0.9 after withdrawal of corticoids from the first 2 patients. In 3 normal men, ratios of endogenously derived E and A while receiving corticoids, compared to control ratios were 2.3 to 1.0, 2.2 to 0.6 and 1.2 to 0.9. Ratios in normal women rose from 1.1 to 2.2 and 2.4 to 4.3 on receiving dexamethasone. Not all subjects gave the expected response. In 3 of these the dosage of corticoid was either low or given for a short time. The ratio of C 19 O 3 metabolites of administered 11β-hydroxy-androst-4-ene-3,17-dione was also changed in favour of the 5β products during corticoid treatment. In a man with periodic fever the high E/A ratios observed were probably related to dexamethasone therapy rather than to the disease.
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Wilson et al. (1964) studied this question.