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Test Code ESTRN Estrone, Serum

Reporting Name

Estrone, S

Useful For

As part of the diagnosis and workup of precocious and delayed puberty in females and, to a lesser degree, males


As part of the diagnosis and workup of suspected disorders of sex steroid metabolism (eg, aromatase deficiency and 17 alpha-hydroxylase deficiency)


As an adjunct to clinical assessment, imaging studies and bone mineral density measurement in the fracture risk assessment of postmenopausal women, and, to a lesser degree, older men


Monitoring low-dose female hormone replacement therapy in postmenopausal women


Monitoring antiestrogen therapy (eg, aromatase inhibitor therapy)

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum Red

Specimen Required

Collection Container/Tube: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1.2 mL

Collection Instructions:

1. Centrifuge and remove serum from red blood cells within 2 hours of draw.

2. Aliquot serum to submission container.

Additional Information: See Steroid Pathways in Special Instructions.

Specimen Minimum Volume

0.8 mL

Testing Algorithm

See Steroid Pathways in Special Instructions.

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Special Instructions

Reference Values


1-14 days: Estrone levels in newborns are very elevated at birth but will fall to prepubertal levels within a few days.


Tanner Stages#

Mean Age

Reference Range

Stage I (>14 days and prepubertal)

7.1 years

Undetectable-16 pg/mL

Stage II

11.5 years

Undetectable-22 pg/mL

Stage III

13.6 years

10-25 pg/mL

Stage IV

15.1 years

10-46 pg/mL

Stage V

18 years

10-60 pg/mL

#Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for boys at a median age of 11.5 (± 2) years. For boys there is no proven relationship between puberty onset and body weight or ethnic origin. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.



Tanner Stages#

Mean Age

Reference Range

Stage I (>14 days and prepubertal)

7.1 years

Undetectable-29 pg/mL

Stage II

10.5 years

10-33 pg/mL

Stage III

11.6 years

15-43 pg/mL

Stage IV

12.3 years

16-77 pg/mL

Stage V

14.5 years

17-200 pg/mL

#Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for girls at a median age of 10.5 (± 2) years. There is evidence that it may occur up to 1 year earlier in obese girls and in African American girls. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.


*The reference ranges for children are based on the published literature(1,2), cross-correlation of our assay with assays used to generate the literature data and on our data for young adults.



Males: 10-60 pg/mL


Premenopausal: 17-200 pg/mL

Postmenopausal: 7-40 pg/mL

Conversion factor

E1: pg/mL x 3.704=pmol/L (molecular weight=270)


For SI unit Reference Values, see

Day(s) and Time(s) Performed

Monday through Friday

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
E1 Estrone, S 2258-2


Result ID Test Result Name Result LOINC Value
81418 Estrone, S 2258-2

Clinical Reference

1. Bidlingmaier F, Wagner-Barnack M, Butenandt O, Knorr D: Plasma estrogens in childhood and puberty under physiologic and pathologic conditions. Pediatr Res 1973;7(11):901-907

2. Elmlinger MW, Kuhnel W, Ranke MB: Reference ranges for serum concentrations of lutropin (LH), follitropin (FSH), estradiol (E2), prolactin, progesterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), cortisol and ferritin in neonates, children and young adults. Clin Chem Lab Med 2002;40(11):1151-1160

3. Cummings SR, Browner WS, Bauer D, et al: Endogenous hormones and the risk of hip and vertebral fractures among older women. N Engl J Med 1998;339:733-738

4. Iughetti L, Predieri B, Ferrari M, et al: Diagnosis of central precocious puberty: endocrine assessment. J Pediatr Endocrinol Metab 2000;13 Suppl 1:709-715

5. Ismail AA, Barth JH: Endocrinology of gynaecomastia. Ann Clin Biochem 2001;38:596-607

6. Kligman I, Rosenwaks Z: Differentiating clinical profiles: predicting good responders, poor responders, and hyperresponders. Fertil Steril 2001;76:1185-1190

7. Traggiai C, Stanhope R: Delayed puberty. Best Pract Res Clin Endocrinol Metab 2002;16:139-151

Method Description

Estrone is extracted from 0.5 mL of serum with the organic solvent methylene chloride. Deuterated 17 beta-estradiol-d5 and estrone-d4 are added to each specimen before the liquid extraction and serve as internal standards. After derivatization with dansyl chloride, HPLC is used prior to introduction of the derivatized sample extract into the tandem mass spectrometer.(1) The calibration utilizes an 8 point standard curve over a concentration range of 0 to 600 pg/mL.(Anari MR, Bakhtiar R, Zhu B, et al: Derivatization of ethynylestradiol with dansyl chloride to enhance electrospray ionization: application in trace analysis of ethynylestradiol in Rhesus monkey plasma. Anal Chem 2002;74:4136-4144)

Analytic Time

2 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK
Other Serum gel or SST tube

Method Name

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)