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The estrogen metabolite tests detect the urinary products of estrogen metabolism.
The metabolites have their own specific biological actions; some have the stimulatory properties of estradiol, whilst others are weak and protective estrogen molecules.
An imbalance in estrogen metabolism has been associated with osteoporosis, high blood pressure, lupus and cancer (breast, endometrial, prostate, thyroid, head and neck).
As the estrogen metabolites are modifiable by lifestyle and nutritional changes, this test is useful for not only establishing risk but monitoring therapies which can reduce the probability of these disorders.
Estrogen has positive effects on the cardiovascular system, bones, brain, skin as well as reproductive organs. The issues experienced at menopause such as memory loss, osteoporosis and vaginal dryness validates the importance of maintaining optimal estrogen levels.
The view that all estrogens are ‘bad’ and cause cancer is a simplistic one. Estradiol (E2) and estrone (E1) are metabolised into at least 14 different species.
These breakdown products and have their own specific biological actions; some have the stimulatory properties of estradiol whilst others are weak and antagonistic to other estrogen molecules.
An imbalance of the stimulatory versus weak estrogen metabolites have been observed to be associated with many different health disorders. Whilst high levels of the 16α-hydroxyestrone stimulatory estrogen raise cancer risk, lower levels are associated with osteoporosis.
In contrast, if the weak estrogens are high they protect against cancer but inhibit bone growth. Therefore the estrogen metabolites are not inactive excretion products but powerful molecules in their own right and should be monitored.
- Hot flushes
- Irregular menstruation
- Bone loss
- Dry skin
- Elevated estrogens
- Gynaecological cancer history or family history
URINE 2OH-E1 METABOLITE
These estrogens have been named "good estrogen" and by some authors are thought to be cancer protective estrogens.
Their role and impact in males has not been adequately researched or published. Most of the research has been done relative to women's breast cancer.
URINE 16a(OH)-E1 METABOLITES:
High/Elevated levels of 16aOH-E1 have been associated with an increase risk in breast cancer. 16aOH-E1 is the immediate precursor to the weak estrogen, estriol (E3).
Lowering levels of 16aOH-E1 have been achieved via indole-3-carbinol or one of its metabolites, di-indol methane (DIM). Soy and flax meal have also been shown to lower 16aOH-E1 levels.
Postmenopausal women with high levels of 16aOH-E1 may want to forego estradiol and estrone therapy in favour of E3 and progesterone.
2(OH):16a(OH)-E1 METABOLITE RATIO
Ratio > 2.0 Beneficial
Ratio < 2.0 Increased risk of Breast Cancer
Patients with a ratio less than 2.0 may benefit from a modification in diet and lifestyle.
The supplementation of the diet with phytoestrogens may further improve the ratio.
A high protein, low fat diet rich in dietary sources of indole-3-carbinol may also improve the 2/16 ratio. Diindolylmethane (DIM) has also been shown to improve the 2/16 ratio.
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FostisT, Adlercruetz H. (1987).The multi-component analysis of estrogens in urine by ion-exchange chromatography and GC-MS- – 1 Quantitation of estrogens after initial hydrolysis of conjugates. J Steroid Biochem 28:203-213.