# Low estriol



## august20 (Aug 27, 2008)

Hi everyone,

Without really thinking about it, I had the second trimester quad screen. (It wasn't offered to me with my first DD.) Well, it shows low estriol so it raised my chances of T21 and T18 to 1 in 5. In a moment of weakness, I consented to the amnio and it came back normal of course. There is one other rare genetic condition they are testing for and we are still waiting for the results.

I am wondering if anyone else has any experience with low estriol or knows anything about what else could cause low estriol. Also if anyone knows what the level is supposed to be. These past three weeks of waiting have just been so stressful-I should have skipped the quad screen.

Any info would be great.

Thanks


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## Pipi (Mar 22, 2010)

Hi August 20,

I also tested low for Estriol on the Triple Test. All my other values were good and showed no other increased risk factors. I am now waiting for the Amnio results. I am wondering if the cause for you low Estriol was ever detected, and what the outcome was.


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## soso-lynn (Dec 11, 2007)

The test you did was meant as a screening test, meaning that it has an inherent relatively high false-postive rate. It serves the only purpose of avoiding an amnio if someone's results show a low risk, not the other way around.

Estriol should be at a certain level because it is produced by the baby. Low levels could indicate that the baby is not developing normally or has a metabolic issue preventing production of estriol. However, many other factors can lower estriol. Being overweight, having diabetes, etc can have an impact. Also, the acceptable level is determined in accordance with your age, ethnicity, number of previous pregnancies and other factors. If you are older, the test is more likely to show a positive result with the exact same numbers.

I guess my point is that the quad screen and any other prenatal screening need to be interpreted according to the mathematical formula they are associated with and an individual result means nothing. Basically, you do not have low estriol levels, your estriol levels are simply below the cut-off for being considered statistically low-risk according to your other results and your situation.


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## Pipi (Mar 22, 2010)

Thanks soso-lynn for your response. I realize the sequential screening is not a diagnostic test. Nevertheless, my Estriol levels came back as extremely low (don't have numbers). They never gave me an estimated risk, due to rare occurrence. In the 3D ultrasound everything looked good and the Amnio went well, results outstanding. I am 35 this is my first pregnancy, I am not overweight (low end), no diabetes or other risk factors. Are there any known causes of low estriol which are benign?

Thanks!


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## tarasattva (Feb 6, 2009)

I too had low ue3 (estriol) values.

Had the amnio - came back all clear.

Had the SLOS test - came back all clear.

At this point they will monitor growth in the third tri (since low ue3 is associated with fetal growth restriction), but don't consider it enough of an issue to label me "high risk".

Was the worst month I've had in a long time waiting for those results, but it appears that everything is ok (and the little guy is actively kicking me right now to remind me that he's happily growing!).


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## soso-lynn (Dec 11, 2007)

It could potentially be an indicator of several things such as adrenal or pituary problems with the baby. It can also be linked to certain medications that you might be taking. It can also be indicative of things like anencephaly and such but I am assuming you had an ultrasound and that would have been detected. The important distinction is to know if your levels were simply low according to the parameters of your test or if they were pathologically low in and of themselves (as in almost undetectabal). If they are just low for the test, then they really are not low at all, they are just not within the range of the test. Either way, it is not something to worry about.


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## Pipi (Mar 22, 2010)

So sorry you had to go through this Tarasattva, I know what it feels like. Did they tell you about any risks associated with the growth restriction? Did they come up with an explanation for the low Estriol, or repeat the testing?

My ultrasound indicated everything to be good, I do not take any medications, and the amnio results are still outstanding. I will ask for the value of my Estriol level when I get a chance.


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## Pipi (Mar 22, 2010)

For anyone affected, low estriol levels can often be attributed to a steroid sulfatase deficiency (enzyme), which is seen to manifest itself as a scaly skin condition called x-linked ichthyosis.


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## LilyStar776 (Mar 1, 2011)

Hi there I'm going through the same thing. I have seen a couple blogs on the same situation and I'm just wondering what the results of the baby are. I don't see anyone following up and telling whether the baby is ok. It can help be get a better insight on what to expect. I'm a little younger i'm 26 and this is my 4th pregnancym with one surviving daughter the other two were etopic pregnancies that didn't make it past a month.


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## LilyStar776 (Mar 1, 2011)

Just wondering what the outcome was of your pregnancy, are you and baby ok? I have the same issue just trying to do some research, a response will help me out alot. Please get back to me as soon as possible.


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## Ryan22 (Sep 30, 2012)

My estriol levels were .025 (super low). I am having a girl so no chance of the skin disorder. Amnio and Level II Ultrsound came back fine. I am still uneasy and would like to know if anyone had babies with pituitary problems, as that was brought to our attention to check at birth.


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## Ryan22 (Sep 30, 2012)

I made a promise to myself that I would return to this forum and give an update as I hated the fact that so many moms left questions unanswered. My baby is a week old. They constantly monitored her weight through the pregnancy. She was born 8lbs 9oz so obviously NOT a problem. She has passed her newborn screen with no problems. I wish I never got the bloodwork done or even knew about her "mysteriously low" estriol levels. Those 6 months of waiting were awful and I could cry just thinking about the anxiety. I am probably a case study somewhere at the prenatal diagnosis center because all those geneticists were positive it was "something." Sometimes too much information is a bad thing. She is perfect. Have faith.


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## phathui5 (Jan 8, 2002)

Thank you for updating us!


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## A2JC4life (Feb 11, 2010)

I am not familiar with this test, but...does it specifically test the baby's levels, or does it test the overall levels in your body, including what the baby produces? If it's the latter, I would guess that if your own estriol levels were low to start with, the total would also show low.


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## KellyMaine (Oct 23, 2014)

I am 30-years and pregnant with my first child. My sequential screening test noted low estriol levels (EU3). My other markers were normal. Low EU3 levels increased my risk of Smith-Lemli-Opitz Syndrome (SLOS). SLOS is a rare genetic condition with serious implications (mental retardation). Both my husband and I would have to be carriers. I just had an amniocentesis. My US showed a normal forming active baby  I really appreciate other people's post and will update the group. It can be hard to find information from real people not statistics so I will update my post.


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## shecurry (Mar 18, 2015)

*Low Estriol Could mean ACTH Deficiency/Cortisol Disorder*

Hi All,
I just wanted to post to let anyone that is having a mysterious Low Estriol indication in their pregnancy know of the outcome of mine. I had low estriol and no other markers--had amnio and everything came back good. NO SLOS, no skin disorder, no down syndrome. They continued to monitor me for growth, but all was good throughout the rest of my pregnancy. About a month before I had my son I came across an article that sounded very familiar to my pregnancy and I alerted my high risk doctor in case this could be a potential outcome. Here is the article : http://pediatrics.aappublications.org/content/117/2/e322.abstract

My doctor said that it would be extremely unlikely as this is very very rare but that she would have my son's blood sugar tested at birth anyway--A very easy test, but not routine at birth. 
Fast forward to my son's birth: c-section, high apgar, everything looked good, but soon after they took him from me, his temp and blood pressure were a little off. When they brought him to me he breastfed no problem but as soon as they tested his blood sugar we knew something was wrong. He tested at a 9, and it should have been well above 60. He was taken to the NICU and the process began. Two days later, after lots and lots and lots of tests he was diagnosed with the same thing in this article: Isolated ACTH Deficiency. 
I am posting today because my son could have easily never been diagnosed and we would likely have lost him--if not the day of his birth, within the first month or so of his life. This is an easily managed disorder and my son is very healthy as he takes hydrocortisone daily, but it can so easily be missed and could lead to fetal death. I don't mean to scare anyone, but I want to raise awareness of this as my doctors (from a very reputable medical group--my son was born at Stanford Hospital) were not aware of this connection between low estriol and ACTH Disorder as it is so rare. Please feel free to contact me if you feel this could be a connection to you. Thanks and I wish you all healthy happy babies!


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## Rora (Dec 18, 2021)

Pipi said:


> Hi August 20,
> 
> I also tested low for Estriol on the Triple Test. All my other values were good and showed no other increased risk factors. I am now waiting for the Amnio results. I am wondering if the cause for you low Estriol was ever detected, and what the outcome was.


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