2-OH-E1 % is the percentage of estrone (E1) that your body converts down the 2-hydroxylation pathway to 2-hydroxyestrone. It’s a distribution marker, not a raw hormone level: it shows how your estrogen metabolism is partitioned among pathways (2-OH, 4-OH, 16-OH). Results are reported from a spot urine sample, typically normalized to creatinine, so hydration has less impact.
Your body breaks down estrogens through several Phase I pathways:
2-hydroxylation (this marker): makes 2-hydroxyestrone, a less estrogenic “catechol” estrogen. It is usually considered a benign/neutral route when it is subsequently methylated by COMT to 2-methoxy metabolites.
4-hydroxylation: produces reactive catechols that can form quinones if not well methylated/neutralized.
16-hydroxylation: yields 16α-OH-E1, a more estrogenic metabolite that can act longer at receptors.
A healthy pattern is balanced, within your lab’s reference ranges. This marker does not diagnose cancer risk and shouldn’t be used alone to predict disease—it’s a metabolic snapshot that helps you and your clinician see where estrogen is being routed.
Lower 2-OH-E1 % (shift away from 2-pathway):
Suggests a relative preference for 16-OH and/or 4-OH pathways. In context with other metabolites, this may reflect lower CYP1A activity, certain medications, or lifestyle factors. Clinically, the goal is not “max 2-OH,” but an appropriate balance with good downstream neutralization (methylation, glucuronidation, sulfation).
Higher 2-OH-E1 % (shift toward 2-pathway):
Indicates more estrone is routed to 2-hydroxylation. On its own, that’s often fine—especially if 2-methoxy metabolites are also adequate (showing COMT is methylating well). If 2-OH-E1 % is high but 2-methoxy levels are low, discuss methylation support and overall antioxidant status with your clinician.
Pair this marker with its “downstream” partner. High 2-OH alongside low 2-methoxy suggests bottlenecks in methylation (COMT); low 2-OH with high 16-OH shows a different pattern and a different plan.
Dietary patterns: Cruciferous vegetables (broccoli, kale, cabbage), I3C/DIM supplements, and a diet rich in polyphenols can tilt metabolism toward 2-hydroxylation; always use supplements judiciously and with clinician guidance.
Alcohol, caffeine, tobacco smoke, and charred foods: Can modify CYP enzymes (Phase I) and shift pathway percentages.
Medications/supplements: Certain drugs (e.g., enzyme inducers/inhibitors), proton-pump inhibitors, St. John’s wort, and others may change Phase I/II balance. Hormonal contraception and HRT alter overall estrogen production and metabolite patterns.
Methylation capacity (COMT) & Phase II pathways: Adequate folate, B12, B6, magnesium, and choline/betaine support methylation; fiber and hydration aid glucuronidation/excretion.
Cycle timing & collection: Aim for consistent timing (many labs prefer early follicular) and a first-morning urine sample for comparisons.
If your 2-OH-E1 % is low (relative shift to 16-/4-OH):
Recheck under optimal collection conditions; 2) Review medications and alcohol/smoking; 3) Discuss with your clinician adding/lifestyle sources of crucifers and overall plant diversity; 4) Ensure adequate fiber (25–35 g/day), sleep, and exercise, which support Phase II clearance; 5) Consider whether I3C/DIM is appropriate (clinician-guided), especially if 16-OH is relatively high.
If your 2-OH-E1 % is high:
Confirm that 2-methoxy metabolites are also sufficient—good methylation helps neutralize catechols; 2) If methoxy is low, prioritize methylation nutrients (food-first; supplements only with guidance), manage alcohol, and consider stress/sleep optimization; 3) Keep perspective—a high percentage alone isn’t harmful, but balance across pathways matters.
If any result is far outside range or symptoms are significant (cycle irregularity, heavy bleeding, hot flashes/night sweats out of the expected life stage, new breast symptoms): follow up with your clinician for targeted serum testing (estradiol, estrone, SHBG), pelvic evaluation when appropriate, and a review of thyroid, iron, and metabolic markers.
Does a higher 2-OH-E1 % mean lower breast-cancer risk?
Not necessarily. Research on ratios/percentages and risk is mixed. Use this marker to understand metabolism, not to predict risk or guide treatment by itself.
Can I fix a “low” 2-OH-E1 % with supplements?
Sometimes dietary changes (crucifers, fiber, whole-foods pattern) help. Supplements like DIM/I3C can alter metabolism but aren’t for everyone—work with your clinician and re-test rather than self-treating.
Is more 2-OH always better?
No. The key is balance and downstream methylation (adequate 2-methoxy). An extreme shift without good Phase II support isn’t the goal.
2-OH-E1 % shows the share of estrone routed to 2-hydroxylation; it’s a distribution metric, not a disease diagnosis.
Low %: relative shift toward 16-/4-OH; consider diet, lifestyle, and medication factors.
High %: more 2-OH routing—fine if 2-methoxy is adequate; if not, consider methylation support.
Aim for balanced pathways within your lab’s ranges, guided by your symptoms and clinician input.
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I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
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What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
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As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
A decreased 2-OH-E1 % means a smaller share of your estrone is being metabolized through the 2-hydroxylation route and more is being shunted toward 4-OH and/or 16-OH pathways. It does not mean your overall estrogen is low—it reflects how your body is processing estrogen, not how much you make.
Enzyme balance: Relatively lower activity of Phase I enzymes that favor 2-hydroxylation (e.g., CYP1A family), or relatively higher activity of pathways that form 16-OH or 4-OH metabolites.
Lifestyle and diet: Low intake of cruciferous vegetables (broccoli, kale, cabbage), low overall plant diversity/fiber, high alcohol intake, or high exposure to environmental stressors can shift pathway percentages.
Medications/supplements: Enzyme inducers/inhibitors (various prescription meds and botanicals) may alter Phase I balance; hormonal contraception/HRT changes the whole estrogen milieu and its metabolites.
Collection/timing: Non–first-morning samples, very dilute urine, or different cycle days can nudge borderline percentages. Always compare to your lab’s reference range.
Mildly low: Common and often transient. Re-check with an optimized collection to confirm.
Persistently low: Look at the pattern with partner markers—16-OH-E1 %, 4-OH-E1 %, and 2-methoxy metabolites. A low 2-OH-E1 % with high 16-OH suggests a different plan than a low 2-OH with high 4-OH.
Remember: This marker does not diagnose disease or predict cancer risk on its own. It’s a metabolism snapshot to guide sensible, food-first adjustments and, when appropriate, targeted clinical follow-up.
Confirm correctly: Repeat using a first-morning urine sample, keep collection consistent (many labs prefer early follicular phase), and limit alcohol for 24–48 hours beforehand.
Review the pattern: Check 16-OH-E1 %, 4-OH-E1 %, and 2-methoxy metabolites to see where estrogen is being routed and whether methylation (COMT) looks supported.
Food-first support for balance:
Emphasize cruciferous vegetables and overall plant diversity.
Aim for 25–35 g/day of fiber, adequate protein, and hydration to support Phase II clearance.
Moderate alcohol; prioritize sleep and regular activity.
Consider supplements only with your clinician: Compounds like I3C/DIM can tilt metabolism toward 2-hydroxylation but aren’t for everyone; re-test rather than self-treat.
Medication and exposure check: Discuss prescription meds/botanicals that influence liver enzymes; address tobacco smoke and other exposures that skew Phase I/II balance.
Decreased 2-OH-E1 % reflects a relative shift away from the 2-hydroxylation route; it does not equal “low estrogen.”
Interpret in context with 16-OH, 4-OH, and 2-methoxy partners, your symptoms, and cycle timing.
Focus on balanced pathways via food-first strategies and clinician-guided changes; confirm improvements with a repeat test.
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Anthony
Unlimited Plan Member since 2021
I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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2-M-E2:2-OH-E2 (Post-menopausal), 2-M-E2:2-OH-E2 (Pre-menopausal), 2-Methoxyestradiol (male), 2-Methoxyestradiol (Post-menopausal), 2-Methoxyestradiol (Pre-menopausal), 2-Methoxyestrone (male), 2-Methoxyestrone (Post-menopausal), 2-Methoxyestrone (Pre-menopausal), 2-OH-E1 % (male), 2-OH-E1 % (Post-menopausal), 2-OH-E1 % (Pre-menopausal), 2-OH-E1:16-OH-E1 (male), 2-OH-E1:16-OH-E1 (Post-menopausal), 2-OH-E1:16-OH-E1 (Pre-menopausal), 21-Hydroxyprogesterone (male), 21-Hydroxyprogesterone (Post-menopausal), 21-Hydroxyprogesterone (Pre-menopausal), 4-Hydroxyestradiol (male), 4-Hydroxyestradiol (Post-menopausal), 4-Hydroxyestradiol (Pre-menopausal), 4-Hydroxyestrone (male), 4-Hydroxyestrone (Post-menopausal), 4-Hydroxyestrone (Pre-menopausal), 4-M-E1:4-OH-E1 (male), 4-M-E1:4-OH-E1 (Post-menopausal), 4-M-E1:4-OH-E1 (Pre-menopausal), 4-M-E2:4-OH-E2 (male), 4-M-E2:4-OH-E2 (Post-menopausal), 4-M-E2:4-OH-E2 (Pre-menopausal), 4-Methoxyestradiol (male), 4-Methoxyestradiol (Post-menopausal), 4-Methoxyestradiol (Pre-menopausal), 4-Methoxyestrone (male), 4-Methoxyestrone (Post-menopausal), 4-Methoxyestrone (Pre-menopausal), 4-OH-E1 % (male), 4-OH-E1 % (Post-menopausal), 4-OH-E1 % (Pre-menopausal), 4-OH-E1:2-OH-E1 (male), 4-OH-E1:2-OH-E1 (Post-menopausal), 4-OH-E1:2-OH-E1 (Pre-menopausal), 5-pregnenetriol (male), 5-pregnenetriol (Post-menopausal), 5-pregnenetriol (Pre-menopausal), 5a-Androstanediol (male), 5a-Androstanediol (Post-menopausal), 5a-Androstanediol (Pre-menopausal), 5a-Dihydrotestosterone (male), 5a-Dihydrotestosterone (Post-menopausal), 5a-Dihydrotestosterone (Pre-menopausal), 5A-PD:5B-PD (male), 5A-PD:5B-PD (Post-menopausal), 5A-PD:5B-PD (Pre-menopausal), 5a-Pregnanediol (male), 5a-Pregnanediol (Post-menopausal), 5a-Pregnanediol (Pre-menopausal), 5a-Tetrahydrocorticosterone, 5a-Tetrahydrocorticosterone (Pre-menopausal), 5a-Tetrahydrocortisol (male), 5a-Tetrahydrocortisol (Post-menopausal), 5a-Tetrahydrocortisol (Pre-menopausal), 5A-THF+5B-THF/THE (male), 5A-THF+5B-THF/THE (Post-menopausal), 5A-THF+5B-THF/THE (Pre-menopausal), 5A-THF/5B-THF ratio (male), 5A-THF/5B-THF ratio (Post-menopausal), 5A-THF/5B-THF ratio (Pre-menopausal), 5b-Androstanediol (male), 5b-Androstanediol (Post-menopausal), 5b-Androstanediol (Pre-menopausal), 5b-Pregnanediol (male), 5b-Pregnanediol (Post-menopausal), 5b-Pregnanediol (Pre-menopausal), 5b-Tetrahydrocorticosterone, 5b-Tetrahydrocorticosterone (Pre-menopausal), 5b-Tetrahydrocortisol (male), 5b-Tetrahydrocortisol (Post-menopausal), 5b-Tetrahydrocortisol (Pre-menopausal), 8-hydroxy-2-deoxyguanosine (Pre-menopausal), 8-hydroxy-2’-deoxyguanosine (male), 8-hydroxy-2’-deoxyguanosine (Post-menopausal), Allopregnanolone (male), Allopregnanolone (Post-menopausal), Allopregnanolone (Pre-menopausal), Androstenedione (Male), Androstenedione (Post-menopausal), Androstenedione (Pre-menopausal), Androsterone (5a) / Etiocholanolone (5b) (male), Androsterone (5a) / Etiocholanolone (5b) (Post-menopausal), Androsterone (5a) / Etiocholanolone (5b) (Pre-menopausal), Androsterone (male), Androsterone (Post-menopausal), Androsterone (Pre-menopausal), Corticosterone, Corticosterone (Pre-menopausal), Cortisol Bedtime, Cortisol Bedtime (Pre-menopausal), Cortisol Dinnertime, Cortisol Dinnertime (Pre-menopausal), Cortisol Waking, Cortisol Waking (Pre-menopausal), Cortisol Waking+2hrs, Cortisol Waking+2hrs (Pre-menopausal), Cortisol/Cortisone, Cortisol/Cortisone (Pre-menopausal), Cortisol/day, Cortisol/day (Pre-menopausal), Cortisone Bedtime, Cortisone Bedtime (Pre-menopausal), Cortisone Dinnertime, Cortisone Dinnertime (Pre-menopausal), Cortisone Waking, Cortisone Waking (Pre-menopausal), Cortisone Waking+2hrs, Cortisone Waking+2hrs (Pre-menopausal), Cortisone/day, Cortisone/day (Pre-menopausal), Creatinine Bedtime (male), Creatinine Bedtime (Post-menopausal), Creatinine Bedtime (Pre-menopausal), Creatinine Dinnertime (male), Creatinine Dinnertime (Post-menopausal), Creatinine Dinnertime (Pre-menopausal), 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Etiocholanolone (Pre-menopausal), Progesterone (male), Progesterone (Post-menopausal), Progesterone (Pre-menopausal), Testosterone (male), Testosterone (Post-menopausal), Testosterone (Pre-menopausal), Testosterone / EPI-Testosterone (male), Testosterone / EPI-Testosterone (Post-menopausal), Testosterone / EPI-Testosterone (Pre-menopausal), Tetrahydrocortisone (male), Tetrahydrocortisone (Post-menopausal), Tetrahydrocortisone (Pre-menopausal), Tetrahydrodehydrocorticosterone, Tetrahydrodehydrocorticosterone (Pre-menopausal), THE+5A-THF+5B-THF (male), THE+5A-THF+5B-THF (Post-menopausal), THE+5A-THF+5B-THF (Pre-menopausal)
