4-OH-E1 (male)

Optimal Result: 0 - 0.8 ng/mg.

4-OH-E1 is referred to as the “bad” estrogen, along with 16-OH-E1.

  • It is a minor pathway of estrogen metabolism.
  • It may also enhance cancer development.
  • It may directly damage DNA by causing breaks in the molecular strands of DNA. 

4-Hydroxyestrones have the ability to convert to metabolites that react with DNA and cause mutations that can be carcinogenic. It is also present in greater quantities in patients deficient in methionine and folic acid. 


  • Spink BC, Fasco MJ, Gierthy JF, Spink DC. 12-O-tetradecanoylphorbol-13-acetate upregulates the Ah receptor and differentially alters CYP1B1 and CYP1A1 expression in MCF-7 breast cancer cells. J Cell Biochem. Sep 1 1998;70(3):289- 296.
  • Hayes CL, Spink DC, Spink BC, Cao JQ, Walker NJ, Sutter TR. 17 beta-estradiol hydroxylation catalyzed by human cytochrome P450 1B1. Proc Natl Acad Sci USA. Sep 3 1996;93(18):9776-9781.
  • Yang L, Gaikwad NW, Meza J, et al. Novel biomarkers for risk of prostate cancer: results from a case-control study. Prostate. Jan 1 2009;69(1):41-48.
  • Castagnetta LA, Granata OM, Traina A, et al. Tissue content of hydroxyestrogens in relation to survival of breast cancer patients. Clin Cancer Res. Oct 2002;8(10):3146-3155.
  • https://www.sciencedaily.com/releases/2010/04/100419150813.htm

What does it mean if your 4-OH-E1 (male) result is too low?

Generally no treatment recommended

What does it mean if your 4-OH-E1 (male) result is too high?

This particular estrogen metabolite appears to be more abundant among men diagnosed with prostate cancer [1]

Possible treatment (please discuss with your doctor before starting any type of treatment)

  • Improve methylation by adding cofactors (B12, folate) or methyl donors (betaine, dimethyl glycine)
  • Consider genetic testing for COMT and CYP1B1 activity, particularly if positive family history
  • Reduce stress: COMT is involved in the metabolism of epinephrine, reducing availability for estrogen metabolism
  • Increase inhibitors of CYP1B1
    • Grapefruit
    • Ginseng
  • Avoidance of CYP1B1 inducers
    • Polycyclic aromatic hydrocarbons
  • Evaluate methylation activity:
    • Serum Homocysteine
    • Serum B12 or methylation
    • Urinary FIGLU
    • Urinary xanthurenate
  • Other potential protective factors:
    • Glutathione (reduction of estrogen quinones)
    • Resveratrol (prevents estrogen quinone formation)
    • Selenium, zinc, magnesium
10 000+ happy clients
100% satisfaction
★★★★★ customer support

Understand blood, stool, and urine medical results from your labs.

Get 10% off your plan.

Use promocode

Advanced Plan personal plan

  • Yearly subscription
  • Instant interpretation
  • We upload five reports for you
  • Use the free self-upload form
  • 2500+ biomarkers explained
  • Nutrition Recommendations
  • Online support
  • Cancel anytime

Own It For Life premium personal plan

  • No subscription
  • Unlimited access
  • Unlimited storage
  • Instant interpretations
  • We upload ten reports for you
  • Use the free self-upload form
  • 2500+ biomarkers explained
  • Nutrition Recommendations
  • Dedicated support

Pro Plan for health professionals

  • Track multiple clients results
  • No setup fees
  • No hidden costs
  • Cancel anytime
  • Instant interpretations
  • Use the free template forms
  • 2500+ biomarkers explained
  • Additional team member $25
  • Personal training and support

Healthmatters.io software for professional use.

Welcome to Healthmatters Pro.

Save time on interpreting lab results with the largest database of biomarkers online. In-depth research on any test at your fingertips, all stored and tracked in one place.

Learn More

We implement proven measures to keep your data safe.

At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.

General Data Protection Regulation (GDPR). HIPAA compliance for healthcare professionals

Understand Your Lab Result Now

  • Instant interpretation
  • 2500+ biomarkers explained
  • Science-based recommendations
  • Online support
  • Secure and private portal

Get 10% off with promocode: