Optimal Result:
0.03 - 0.17 Ratio.
4-OH-E1 : 2-OH-E1 is a ratio that compares how much estrone (E1) your body routes down the 4-hydroxylation pathway (to 4-hydroxyestrone) versus the 2-hydroxylation pathway (to 2-hydroxyestrone). It’s a distribution metric, not a raw estrogen level. On this urine panel, values are typically normalized to creatinine so hydration has less effect.
Why it matters
Both 4-OH-E1 and 2-OH-E1 are catechol estrogens made by Phase I enzymes. The 2-OH route generally produces less estrogenic metabolites, while the 4-OH route forms reactive catechols that your body normally neutralizes via COMT-mediated methylation into methoxy estrogens. The ratio helps show your routing preference between these two pathways. It does not diagnose disease or predict cancer risk by itself; it’s one piece of your estrogen-metabolism picture and should be interpreted with 4-methoxy/2-methoxy partners, overall estrogen output, cycle timing, symptoms, and clinical history.
How to interpret (use your lab’s reference range)
Lower ratio (relatively more 2-OH than 4-OH): Often a comfortable pattern when 2-methoxy levels indicate good methylation. Still interpret with total estrogen production and symptoms.
Balanced ratio: Suggests a typical split between the 4-OH and 2-OH routes. Confirm that methoxy metabolites are adequate (showing COMT is working) and review the rest of the panel (4-OH %, 2-OH %, 16-OH %, total estrogen output).
Elevated ratio (relatively more 4-OH versus 2-OH): Indicates a shift toward 4-hydroxylation. On its own this does not equal high risk, but it’s a cue to check 4-methoxy-E1, 2-methoxy-E1, overall methylation support, oxidative stress, and modifiable factors (see below).
What can influence this ratio
Diet & lifestyle: Lower intake of cruciferous vegetables, high alcohol use, tobacco smoke, and habitual intake of charred foods can shift Phase I patterns; inadequate fiber, poor sleep, and high stress may impair downstream clearance.
Methylation capacity (COMT) & Phase II pathways: Adequate folate, B12, B6, magnesium, choline/betaine, phytonutrient diversity, and hydration support conversion to methoxy estrogens and excretion.
Medications/supplements: Enzyme inducers/inhibitors (some anticonvulsants, PPIs, botanicals like St. John’s wort) and hormonal contraception/HRT change metabolism.
Cycle timing & collection: Aim for consistent timing (many labs prefer early follicular) and first-morning urine; creatinine correction helps but extreme dilution/concentration can still nudge near-cutoff results.
What to do next (actionable plan)
Confirm properly if results are unexpected: repeat with first-morning urine, consistent cycle timing, and limited alcohol for 24–48 hours before the test.
Review partners: Look at 4-OH %, 2-OH %, 16-OH %, and especially 4-methoxy-E1 and 2-methoxy-E1 to ensure catechols are being methylated.
Food-first balance: Emphasize cruciferous vegetables (broccoli, kale, cabbage), broad plant diversity, and 25–35 g/day fiber; maintain hydration; prioritize sleep and stress management.
Consider clinician-guided supplements only if indicated: Compounds like I3C/DIM can alter Phase I routing, and methylation nutrients may support Phase II—but these should be personalized and re-tested, not self-prescribed.
Medication & exposure review: Discuss drugs/botanicals that affect liver enzymes; minimize smoking and excessive alcohol.
Key takeaways
The 4-OH-E1 : 2-OH-E1 ratio shows routing between two estrogen pathways; it isn’t a diagnosis or risk score.
Elevated ratios signal a relative shift toward 4-hydroxylation and call for a check of methoxy partners and modifiable factors.
Aim for balanced pathways and healthy downstream methylation, guided by your clinician and your symptoms.
A high 4-OH-E1 : 2-OH-E1 ratio means your estrogen metabolism is relatively more routed to 4-hydroxylation than to 2-hydroxylation. This does not diagnose disease or equal high risk, but it’s a cue to confirm that your body is methylating these catechols efficiently (making 4-methoxy-E1 and 2-methoxy-E1) and to address modifiable factors.
Why it can be elevated
Phase I enzyme balance favoring the 4-OH route.
Lower methylation support (COMT) or low methoxy metabolites.
Alcohol, smoking, low cruciferous vegetable intake, low fiber, poor sleep, and high stress.
Medications/botanicals that induce or inhibit liver enzymes; hormonal contraception/HRT can reshape patterns.
Collection/cycle timing differences or very dilute urine (even with creatinine correction).
What to do next (practical plan)
Confirm correctly: Repeat with first-morning urine, consistent cycle timing, and minimal alcohol for 24–48 hours before testing.
Assess partners: Check 4-methoxy-E1 and 2-methoxy-E1 to ensure catechols are being neutralized; review 4-OH %, 2-OH %, 16-OH % for the whole pattern.
Food-first strategies: Increase cruciferous vegetables and overall plant diversity; target 25–35 g/day fiber; hydrate; prioritize sleep and stress care; moderate alcohol.
Targeted support (clinician-guided): Consider whether I3C/DIM or methylation nutrients (folate, B12, B6, magnesium; choline/betaine from foods) are appropriate; re-test rather than guessing.
Review meds & exposures: Discuss drugs/botanicals that alter CYP/COMT activity; reduce smoke exposure.
Key takeaways
A high ratio = relative shift toward 4-OH; it’s a routing clue, not a diagnosis.
Focus on methylation adequacy (methoxy metabolites) and modifiable habits to rebalance pathways.
Work with your clinician and re-test to confirm improvement over time.
Import lab results from multiple providers, track changes over time, customize your reference ranges, and get clear explanations for each result. Everything is stored securely, exportable in one organized file, and shareable with your doctor—or anyone you choose.
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Our database covers over 10,000 biomarkers with clear, simple explanations—so you can finally understand your results and what to do next.
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Enter Your Lab Reports — Always Free
If you'd like to handle inputting your health data into your account, you can do so with our easy-to-use data entry forms. Our user-friendly form is designed to guide you through the quick and easy submission process, making it simple to keep track of your health metrics. This is available to both Complete plan and Unlimited plan members.
Our user-friendly form guides you through a quick, simple submission process, making it easy to enter your health metrics.
Add your results anytime with our easy entry form. It's quick, guided, and helps you stay organized — free for all members.
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View your lab data through easy-to-read graphs and tables. Quickly spot patterns, track changes, and compare results across different dates — all without digging through multiple reports. You can also select and compare graphs of specific biomarkers side-by-side to better understand how they relate and change over time.
See your lab reports in clear graphs and tables. Spot patterns, track changes, and compare results over time — all in one place.
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Export Your Complete Lab History
After collecting lab results from different providers, you can download your entire history combined into a single file. Choose from PDF, Excel, or CSV formats to easily review, share, or get a second opinion—no more juggling multiple reports.
After collecting lab results from different providers, you can download your entire history combined into a single file.
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Data Entry Service for Your Reports
Our inclusive service handles the data entry for your lab reports. Just submit your information and we'll take care of the rest. Complete plan members receive one report entered for free, then $15 per report after that. Unlimited plan members receive ten report entries for free, then $15 per report after that.
Our inclusive service handles the data entry for your lab reports. Just submit your information and we'll take care of the rest.
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Whether you're working with a doctor, nutritionist, caregiver, or wellness coach, you can securely share your complete lab history by sending an invite link to anyone you trust. You have full control over who sees your information and for how long, ensuring your privacy and peace of mind at every step.
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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!
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Healthmatters is a personal health dashboard that helps you organize and understand your lab results. It collects and displays your medical test data from any lab in one secure, easy-to-use platform.
With a Healthmatters account, you can:
Professionals can also analyze client data more efficiently and save time managing lab reports.
Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:
You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.
If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we work with many popular labs, we welcome reports from lots of other places too.
It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
If you're on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.
The Complete Plan ($15/month) is perfect for individuals who want ongoing access to their health data. It includes unlimited lab imports, visual tracking, custom ranges, result explanations, full account exports, and secure sharing — all with a simple monthly subscription. You can cancel anytime and restart your plan whenever you're ready — your data will still be there waiting for you. You can also upgrade to the Unlimited Plan at any time, with the cost prorated based on what you've already paid.
The Unlimited Plan ($250 one-time) is also designed for individuals but offers lifetime access with no ongoing subscription. You'll get all the same features as the Complete Plan, plus a larger initial data entry allowance (10 reports), making it a great choice if you prefer a one-time payment and long-term use without monthly fees.
In short:
There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."
Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.
For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.
We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.
Our Data Entry Service is for when you don't want to manually type in your lab results yourself. You simply upload your report (PDF, image, or screenshot), and our trained team enters the information into your Healthmatters account for you — accurately and neatly organized, ready to view in graphs, tables, and timelines.
The $15 per report covers the time and care it takes for a real person to review your file, make sure each result is entered correctly, and double-check for accuracy. This ensures your health data is precise and easy to work with — without you having to spend the time doing it yourself.
Prefer to do it yourself? You can always use our free self-entry tool to add results manually — it just takes a bit more time and attention.
For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.
Unlimited account holders enjoy the entry of ten reports without charge. Subsequent reports are subject to a $15 fee per report.
Additionally, users on the Complete plan can upgrade to a yearly subscription from the account settings. The annual subscription includes a data entry service for five reports.
All professional accounts allow you to import and onboard an unlimited number of clients and their lab results. The distinction between professional plans lies solely in the data entry service.
The Pro Monthly Plus plan is priced at $75 per month and includes a data entry service for five reports each month. Additional reports can be self-entered at no extra cost or, if preferred, you can use our data entry service for an additional fee of $15 per report.
The Pro Monthly plan is priced at $45 per month and does not include a data entry service. Self-entry is free for an unlimited number of reports, and you can opt for the data entry service at a fee of $15 per report.
You also have the option to upgrade to higher monthly or to annual plans, which come with substantial discounts. All upgrades can be done directly from your account.
Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.
Our goal has been to make your Healthmatters account as intuitive as possible.
We've crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.
1. Graph View:Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.
2. All Tests ViewExplore neatly organized reports on a timeline, highlighting crucial details like dates, critical results, and lab/panel names. Each report opens up to reveal in-depth descriptions and additional recommendations for each biomarker. The history of previous results is just a click away, and you can download a comprehensive report for deeper insights. Color-coded and user-friendly, it's designed for easy reading, understanding, and navigation.
3. Table View:For a holistic view of all biomarkers side by side, our table view is your go-to. Results are neatly displayed in a categorized and dated table, ideal for those with an extensive test history. Utilize sorting, filters, and color-coding to enhance your analysis and gain extra insights.
Yes, you can download your information anytime. We offer two easy ways to export your lab data:
This makes it simple to save, back up, or share your health data whenever you need.
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Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the "Profile and Security" section of your account, where you will find instructions for activating 2FA.
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.
A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.
The professional account is designed for health professionals who wish to track and organize their clients' laboratory results.
To learn more about Healthmatters Pro, please refer to the professional page.
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