Elevated Estriadol in a Man

[osiag]

I am a healthly 41 year old male.  My primary care doctor believes in checking hormone levels as a matter of routine.  That is, she checked my hormone levels merely as a part of my annual pyshical.  All serum levels in my basic chemistry panel, CBC plus differential, thyroid panel, and urine analysis were normal except my estradiol.  It was 84 with a lab range with an upper limit of 54.  My testosterone was normal at 630 and my DHEA was normal at 265.  I am thin and I have no masses on the testicles that can be felt.  But, i am nervous about the elevated estradiol.  My doctor seems not alarmed and will be repeating the test.  

What would be the most common cause of this elevated estriadol given my age, normal weight, no testicular mass, and aforementioned lab values?  How likely is an adrenal tumor?  Malignancy?

[osiag]

Thank you for the quick reply.  I am not a drinker but do eat of lot of soy

[Elaine Brown, MD]

Hi!
As far as I am aware, there is no indication for checking a "routine" hormone panel in a healthy asymptomatic individual.  It is usually a bad idea to order tests "just because" because this is exactly what happens!  You get a result that you have no idea what to do with or what it means, and it scares the patient to death.  If I were you, I would consider switching doctors so this doesn't happen again!  Estradiol and testosterone levels are expensive too!  Did you have to pay for it?
Sorry about the slight soap box!  
If you have no symptoms or complaints and are otherwise healthy, I would not be very concerned.  Are you a beer drinker? Something as simple as that could cause a slightly elevated level.  Adrenal tumors are very uncommon, as would be a testicular cancer in your age group.  I can tell that you are aware that adipose tissue produces estrogen too.
Hormones fluctuate broadly from day to day, and even within a single day, so repeating the test (more $) is probably a good next step.  Individuals vary a lot in hormone levels too, so it is most likely just your own personal normal value and nothing to get concerned about.
Truth of the matter is I have never checked an estradiol level in an asymptomatic male (what is the point?) so am just doing my best to give you a logical answer.
Good luck!
Dr B