Assessing the 2/16 Ratio in Estrogen Metabolism
The Estrogen Metabolism Assessment™ is a convenient, at-home urinary collection profile. This targeted hormone assessment measures select hydroxyestrogens:
- 16α-hydroxyestrone (16α-OH E1)
- 2-hydroxyestrone and 2-hydroxyestradiol (2-OHE1 + 2-OHE2)
The ratio of 2/16 hydroxyestrogens is calculated based on these results.
Estrogen metabolism and the ratio of 2-hydroxyestrogens to 16α-hydroxyestrone has been used to identify patients at risk for cancer and other hormone-related diseases in both men and women.1-5 Relative increases in levels of the 2-hydroxylation pathway metabolites are associated with decreased risk.1,6
How can the results be clinically useful?
Knowing the 2/16 ratio is clinically important since estrogen metabolism may be modified by a variety of dietary and lifestyle changes, including, but not limited to:
- smoking cessation
- cruciferous vegetables
- essential fatty acids
- flaxseed 7-11
What other profiles can offer insight into Estrogen Metabolism?
The Estrogen Metabolism Assessment profile is a sub-panel of two other available urinary hormone profiles:
- Complete Hormones is our most comprehensive urinary profile. It assesses parent hormones, downstream metabolites, methylation and enzymatic activity, and other key metabolic pathways. An evaluation of stress-hormone metabolism is also provided as an assessment of anabolic and catabolic balance.
- Essential Estrogens is a targeted, focused evaluation of estrogen metabolism, including parent estrogens, key estrogen metabolites, and ratios.
Both are available as a first morning void sample or 24-hour collection for those on hormone therapy. Genetic single nucleotide polymorphisms (SNPs) are available as add-ons to these profiles for a combined genotypic and phenotypic assessment.
- Sampson JN, Falk RT, Schairer C, et al. Association of estrogen metabolism with breast cancer risk in different cohorts of postmenopausal women. Cancer Res. 2017;77(4):918-925.
- Muti P, Westerlind K, Wu T, et al. Urinary estrogen metabolites and prostate cancer: a case-control study in the United States. Cancer Causes Control. 2002;13(10):947-955.
- Leelawattana R, Ziambaras K, Roodman-Weiss J, et al. The oxidative metabolism of estradiol conditions postmenopausal bone density and bone loss. J Bone Mineral Res. 2000;15(12):2513-2520.
- Napoli N, Faccio R, Shrestha V, Bucchieri S, Rini GB, Armamento-Villareal R. Estrogen metabolism modulates bone density in men. Calcif Tissue Int. 2007;80(4):227-232.
- Sepkovic DW, Bradlow HL. Estrogen hydroxylation--the good and the bad. Ann N Y Acad Sci. 2009;1155:57-67.
- Samavat H, Kurzer MS. Estrogen metabolism and breast cancer. Cancer Lett. 2015;356(2 Pt A):231-243.
- Matthews CE, Fortner RT, Xu X, Hankinson SE, Eliassen AH, Ziegler RG. Association between physical activity and urinary estrogens and estrogen metabolites in premenopausal women. J Clin Endocrinol Metab. 2012;97(10):3724-3733.
- Gu F, Caporaso NE, Schairer C, et al. Urinary concentrations of estrogens and estrogen metabolites and smoking in caucasian women. Cancer Epidemiol Biomarkers Prev. 2013;22(1):58-68.
- Kall MA, Vang O, Clausen J. Effects of dietary broccoli on human in vivo drug metabolizing enzymes: evaluation of caffeine, oestrone and chlorzoxazone metabolism. Carcinogenesis. 1996.
- Fowke JH, Longcope C, Hebert JR. Brassica vegetable consumption shifts estrogen metabolism in healthy postmenopausal women. Cancer Epidemiol Biomarkers Prev. 2000;9(8):773-779.
- Lord RS, Bongiovanni B, Bralley JA. Estrogen metabolism and the diet-cancer connection: rationale for assessing the ratio of urinary hydroxylated estrogen metabolites. Altern Med Rev. 2002;7(2):112-129.
Test Type: Urine Test
Upon purchase of this exam, you are able to schedule a free 15-minute phone consultation with Dr. Bob to discuss your results.
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