2/16OH E1 test, 2/16-hydroxyestrone

Bodily hormones are a normal part of daily life for all of us. We all are at some point along the timeline of maturation (increasing hormones) into adulthood and then we move into elderhood (declining hormones). But, because of the industrialized world we live in, environmental chemicals that mimic hormones are also affecting us from conception to death.

How a woman or man metabolizes estrogens, whether they make it or it is taken in from the environment, is determined by genetics and environmental influences.

Up until now there was no way of monitoring our individualized reactions to our own hormones let alone the influence of drugs and or industrial hormone mimics. With the advent of the 2/16-OH-E1 (2/16-hydroxyestrone) urine or blood test we can now determine how your body processes any hormonal substance that it makes, ingests or absorbs.

2/16OHE1 Pathway:

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Interventions Proven Useful in Changing 2/16OHE1 Ratios

The following therapies have show to favorably change the 2/16OHE1 ratios thus representing possible protective therapies for estrogen dependent cancers.

Diets high in brassica vegetables like cabbage, Brussels sprouts, and broccoli can increase the removal of circulating estrogens. [1]

Phytochemicals contained in these foods that have been identified as increasing the removal of circulating estrogens are indole-3-carbinol (I-3-C) and diindolylmethane (DIM) [2].

	Population research shows that African-American women have better 2/16 ratios than Caucasian women
	African-American women respond better to treatment with indole-3-carbinol [3].

One to two servings of brassica vegetables a day can lower breast cancer risk by as much as 40% [4].

Indole derivatives contained in cruciferous or brassica vegetables induce apoptosis (programmed cell death) [5, 6].

Soy isoflavones (i.e., daidzein and genistein)

	Have many estrogen-like properties even though they operate through different receptor sites on target tissues [7-9].
	Have little or no effect on induction of tumors[7-9].
	Have favorably modulated the production rates of 2/16a-hydroxyestrone [10]
	Is associated with a reduction in the risk of breast cancer in premenopausal women [11].

Flaxseed supplementation at 10 g/d 12]

Omega-3 oils from fish, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)13].

Prevention of Estrogen Dependent Cancers.........is a life long process. Some of the proven lifestyle plans that seen to be helpful are[14]:

	Monitor estrogen metabolism and make changes as indicated if you have a positive family history of breast cancer
	Monitor estrogen metabolism and make changes as indicated if you are on any hormonal manipulation (HRT, OC's, phytohormones)
	Limit alcohol consumption (one drink increases circulating estrogens by 300%)
	Quit smoking (Decreases Folic Acid and B12 levels)
	Exercise regularly
	Lose weight if over weight or obese
	Extend lactation if you breast feed your children
	Daily take adequate antioxidant vitamins, fish oils, flaxseed, and brassica vegetables
	Reduce stress and be happy!

References

1. Fowke, J.H., C. Longcope, and J.R. Hebert, Brassica vegetable consumption shifts estrogen metabolism in healthy postmenopausal women. Cancer Epidemiol Biomarkers Prev, 2000. 9(8): p. 773-9.

2. Zeligs, M., Diet and estrogen status: The cruciferous connection. J Med Food, 1998. 1(2): p. 67-81.

3. Taioli, E., et al., Role of estradiol metabolism and CYP1A1 polymorphisms in breast cancer risk. Cancer Detect Prev, 1999. 23(3): p. 232-7.

4. Terry, P., et al., Brassica vegetables and breast cancer risk. Jama, 2001. 285(23): p. 2975-7.

5. Fares, F.A., et al., Dietary indole derivatives induce apoptosis in human breast cancer cells. Adv Exp Med Biol, 1998. 451: p. 153-7.

6. Telang, N.T., et al., Inhibition of proliferation and modulation of estradiol metabolism: novel mechanisms for breast cancer prevention by the phytochemical indole-3-carbinol. Experimental Biology & Medicine, 1997. 216(2): p. 246-52.

7. Xu, X., et al., Soy consumption alters endogenous estrogen metabolism in postmenopausal women. Cancer Epidemiol Biomarkers Prev, 2000. 9(8): p. 781-6.

8. Nagata, C., et al., Inverse association of soy product intake with serum androgen and estrogen concentrations in Japanese men. Nutr Cancer, 2000. 36(1): p. 14-8.

9. Greaves, K.A., et al., Consumption of soy protein reduces cholesterol absorption compared to casein protein alone or supplemented with an isoflavone extract or conjugated equine estrogen in ovariectomized cynomolgus monkeys. J Nutr, 2000. 130(4): p. 820-6.

10. Lu, L.J., et al., Increased urinary excretion of 2-hydroxyestrone but not 16alpha-hydroxyestrone in premenopausal women during a soya diet containing isoflavones. Cancer Res, 2000. 60(5): p. 1299-305.

11.Vincent, A. and L.A. Fitzpatrick, Soy isoflavones: are they useful in menopause? Mayo Clinic Proceedings, 2000. 75(11): p. 1174-84.

12. Haggans, C.J., et al., The effect of flaxseed and wheat bran consumption on urinary estrogen metabolites in premenopausal women. Cancer Epidemiol Biomarkers Prev, 2000. 9(7): p. 719-25.

13. Rose, D.P., Dietary fatty acids and prevention of hormone-responsive cancer. Proc Soc Exp Biol Med, 1997. 216(2): p. 224-33.

14. Hulka, B.S. and A.T. Stark, Breast cancer: cause and prevention. [see comments]. Lancet, 1995. 346(8979): p. 883-7.

15. Newfield, L., et al., Estrogen metabolism and the malignant potential of human papillomavirus immortalized keratinocytes. Proc Soc Exp Biol Med, 1998. 217(3): p. 322-6.

16. Auborn, K., et al., Estrogen metabolism and laryngeal papillomatosis: a pilot study on dietary prevention. Anticancer Res, 1998. 18(6B): p. 4569-73.