Estradiol (E2)

Label Mnemonic:	EDIOL
Epic code:	LAB523
Order form:	Laboratory Requisition
Supply order:	Supply Order Form
Billing:	Billing Policies
CPT code:	82670

Specimen(s):

Plasma

Collection Medium:

Plasma Separator Tube 4.5 mL

Alternate Collection Media:

Call laboratory for additional acceptable specimen collection containers.

Minimum:

3 mL whole blood from light green top tube or TWO Microtainer^® devices

Testing Schedule:

24 hrs/day, 7 days a week, including holidays.

Turn Around Time:

1 hour (upon receipt in laboratory)

Reference Range:

Males (18+ years)     11 - 43 pg/mL

Females, non-pregnant
  Follicular Phase    12 - 233 pg/mL
  Ovulation Phase     41 - 398 pg/mL
  Luteal Phase        22 - 341 pg/mL
  Postmenopause       <5 - 138 pg/mL

Pregnancy
  1st Trimester      154 - 3,243 pg/mL
  2nd Trimester    1,561 - 21,280 pg/mL
  3rd Trimester    8,525 - >30,000 pg/mL

Children (1-10 years)
  Boys                <5 - 20 pg/mL
  Girls                6 - 27 pg/mL

Comments:

This assay may be significantly impacted by high-dose biotin (>5 mg dose) taken within previous 12 hours. High concentrations of biotin may lead to falsely increased results. These concentrations may be found in patients taking over-the-counter supplements with biotin content much higher than nutritional requirements for biotin. Specimens should not be collected until at least 12 hours after the last dose.

Assay methodology changed to Roche Diagnostics Estradiol III assay on April 20, 2015. Adult reference ranges updated as part of change in methodology. Adult male reference range further updated on March 7, 2017.

Test Limitations:

The assay is unaffected by icterus (bilirubin is less than 66 mg/dL), hemolysis (Hb is less than 1000 mg/dL), lipemia (Intralipid is less than 1000 mg/dL) and biotin is less than 36 ng/mL. (criterion: recovery within plus or minus 10% of initial value). No interference was observed from rheumatoid factors up to a concentration of 1200 U/mL.

The estradiol assay shows significant cross-reactivity with fulvestrant, a medication used to treat breast cancer. Contact commercial mailouts (319-356-8593) if estradiol measurement is needed in a patient currently receiving fulvestrant. In rare cases interference due to extremely high titers of antibodies to streptavidin and ruthenium can occur. Estradiol III contains additives which minimize these effects. For diagnostic purposes, the Estradiol III findings should always be assessed in conjunction with the patient's medical history, clinical examination and other findings.

Methodology:

Electrochemiluminescence Immunoassay

Sample Processing:

Centrifuge at a speed and time necessary to get barrier separation of plasma/serum and cells within 1 hour of collection. Send specimen in original tube. Do Not transfer to another tube.
Each sample must be labeled with at least TWO full patient identifiers (First/Last Name & DOB are sufficient for non-UIHC affiliated clients) to avoid sample rejection/delays.

Sample Storage:

Refrigerate.
All sample storage requirements are intended for delivery to UIHC within 24 hours of collection for testing. If samples won't arrive in this time period, please call the UIHC Core Lab for alternative storage/shipping instructions (319-356-3527).

Transport Instructions:

Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.

CPT Code:

82670

See Additional Information:
Biotin Interference with Immunoassays