Most consider 2-OH-E1 favorable - In women not on hormonereplacement therapy, 2-OH-E1 is considered a “good” estrogen because it is associated with reduced cancer growth.
Estrogen is metabolized (primarily by the liver) down three phase I pathways. The 2-OH pathway is considered the safest because of the anti-cancer properties of 2-OH metabolites. Conversely, the 4-OH pathway is considered the most genotoxic as its metabolites can create reactive products that damage DNA. The third pathway, 16-OH creates the most estrogenic of the metabolites (although still considerably less estrogenic than estradiol). 16-OH-E1 has been shown to encourage tumor development.
2-Hydroxyestrone is an endogenous biomarker and major urinary metabolite of estrone and estradiol. Along with 16α-Hydroxyestrone, 2-Hydroxyestrone is used as an indicator for increased risk of breast cancer.
This metabolite of Estrone is considered protective. A comparison with 2-Methoxyestrone, its Phase II liver metabolite, may help with assessing adequacy of methylation processes.
There are numerous modifiers of this value, most of which induce changes in the level of 2-OH-E1. These include intake of indole-3-carbinols from cruciferous vegetables, flaxseed, soy, omega-3 fatty acids, and vigorous exercise. All are shown to improve the levels of 2-OH-E1 in most individuals. It is to be emphasized that some individuals in clinical studies have exhibited a paradoxical response to treatments that would typically raise the 2-OH-E1 levels. Therefore, follow-up testing after treatment is strongly suggested. There may be an increased likelihood of osteoporosis with excessive 2-OH-E1 production. It is important to note that the ideal upper limit of 2-OH-E1 is not apparent from the existing literature.
Attention to bone loss processes in the urine is perhaps warranted in individuals with a very high 2:16alpha-hydroxyestrone ratio.
If low your health professional can work with you to address this in a few different ways, such as:
- Cruciferous vegetables like broccoli contain I3C
- I3C (=Indole-3-carbinol) gets metabolized to DIM
- DIM (=diindolylmethane) increases the conversion of estrogen to 2-OH-Estrogens
- Some health care professionals promote DIM, some I3C, and some providers promote a combination to help estrogens move down the 2-OH pathway.
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- High levels of the “good estrogen” are typically considered beneficial; however, when coupled with a low 2-Methoxy-E1, it may indicate poor methylation activity.
- If both 2-OH-E1 and 16-OH-E1 are high, then total estrogen load may be high. Consider methods to better clear the estrogens from the body or HRT dosing may need revision if only 2-OH-E1 is very high.
- In post-menopausal women on hormone-replacement therapy, a very high 2-OH-E1 can result from high doses of estradiol. Thus, elevated levels of 2-OH-E1 are associated with increased cancer risk. The prescribing doctor should be consulted about dosing when such very high 2-OH-E1 are found.
The 2 pathway is the most favourable and we want to see it used more. It excretes estradiol and estrone. Estrone is converted into 2-Hydroxyestrone (2-OH-E1) as part of Phase 1 detox which is known as hydroxylation. 2-OH-E1 is a ‘good’ estrogen because it doesn’t stimulate cell growth. When it is methylated into the 2-Methoxy-E1 in Phase 2 it becomes cancer protective. Enough exercise, cruciferous veggies like broccoli, and specific supplements can raise 2-OH-E1 levels.
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16a-OH Estrone, 2-MeO E1/2-OH E1, 2-MeO Estradiol, 2-MeO Estrone, 2-OH (E1 + E2)/16-a- OH E1, 2-OH Estradiol, 2-OH Estrone, 20a- Dihydroprogesterone, 3a- Dihydroprogesterone, 3a-Dihydroprogesterone (Postmenopausal), 4-MeO E1/4-OH E1, 4-MeO E2/4-OH E2, 4-MeO Estradiol, 4-MeO Estrone, 4-OH Estradiol, 4-OH Estrone, 5a,3a-Androstanediol, 5a,3a-Androstanediol (Postmenopausal), 5a-DHT, 5a-DHT (Postmenopausal), Allopregnanediol, Allopregnanediol (Postmenopausal), Allopregnanolone, Allopregnanolone (Postmenopausal), Androstenedione, Androsterone, Androsterone (Postmenopausal), Bisphenol A, Bisphenol A (Postmenopausal), Corticosterone, Cortisol/Cortisone, Creatinine (1st morning), Creatinine (2nd morning), Creatinine (Evening), Creatinine (Night), Creatinine (pooled), Deoxycorticosterone, DHEA, E3/(E1+E2), Epi-Testosterone, Estradiol, Estriol, Estrone, Etiocholanolone, Free Cortisol (1st Morning), Free Cortisol (2nd Morning), Free Cortisol (Evening), Free Cortisol (Night), Free Cortisone (1st Morning), Free Cortisone (2nd Morning), Free Cortisone (Evening), Free Cortisone (Night), Melatonin (1st Morning), Melatonin (2nd Morning), Melatonin (Evening), Melatonin (Night), Pgdiol/E2, Pregnanediol, T/Epi-T, Testosterone, Tetrahydrocortisol, Tetrahydrocortisone, Total Cortisol, Total Cortisone