While the traditional 2/16 ratio clinical utility may not be as robust as previously thought, a majority of findings indicate that metabolism of parent estrogens through 2-hydroxylation (independent of any relationship to 16α-OHE1) may be considered as a benign or even protective pathway.
Note: Moderation should be used, however, in up-regulating the "lesser estrogenic" 2- hydroxylation pathway, particularly in women with a positive family history of osteoporosis, since excessive 2-hydroxylation has been associated with decreased bone mineral density
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