11-Deoxycortisol Corticosterone Pregnanediol Pregnanetriol THS a-THF THF THE 2-MeO (E1+E2) 2-OH (E1+E2) 16a-OH(E1) 4-OH (E1+E2) 4-MeO (E1+E2) Etiocholanolone Androsterone Androstanediol 11β -OH-Androstenedione Adrenosterone 11-OH-Androsterone 11-OH-Etiocholanolone 11-Keto-Androsterone 11-Keto-Etiocholanolone Cholesterol Pregnenolone Progesterone 17-OH-Progesterone 17-OH-Pregnenolone Androstenedione DHEA Androstenediol Estrone (E1) Estriol (E3) Estradiol (E2) DHT Testosterone Cortisol (active) Cortisone (inactive) 1A1 = Cytochrome p450 1A1 (CYP1A1) 3A4 = Cytochrome p450 3A4 (CYP3A4) 1B1 = Cytochrome p450 1B1 (CYP1B1) COMT = Catechol-O-Methyl-transferase ESTROGEN METABOLISM: 3βHSD = 3beta-Hydroxysteroid dehydrogenase 5α = 5alpha-Reductase 5β = 5beta-Reductase CYP11β1 = 11beta-Hydroxylase 11βHSD = 11beta-Hydroxysteroid dehydrogenase 17βHSD = 17beta-Hydroxysteroid dehydrogenase 17,20 Lyase = 17,20 Desmolase CYPc17 = 17alpha-Hydroxylase CYP19 = Aromatase CYP21 = 21-Hydroxylase ENZYMATIC STEPS: Mineralocorticoids 11 17-Hydroxysteroids 1 Keto Androsterone 11 17-Ketosteroids 4-OH (E1+E2) 4-MeO (E1+E2) Estrogen Metabolites Measurable in Urine Measurable in Blood Measurable in Saliva Hormones measurable by Genova Diagnostics: 3βHSD 17,20 Lyase 17,20 Lyase 3βHSD CYP21 CYPc17 CYPc17 CYP21 CYP11b1 5α 5β 5β 11βHSD 3βHSD 5α 5β 5 α 5β COMT Aromatase (CYP19) 3βHSD COMT 17βHSD 3A4 1A1 5α 3αHSD 17βHSD 1B1 17βHSD 5β 5α Aromatase (CYP19) 17βHSD AVAILABLE ACROSS THESE PROFILES: Excess adipose, alcohol, zinc deficiency, stress, hyperinsulinemia, inflammation, licorice, vitamin D3 (in osteoblasts), forskolin, isoproterenol Polycyclic aromatic hydrocarbons, PCBs Hops, bioflavonoids, grapefruit (-) (+) (+) (+) (+) (-) (-) (+) (-) (-) (+) (+) (-) (-) (+) Congenital adrenal hyperplasia (CAH), smoking, E2, progesterone, azole antifungals, spironolactone Insulin resistance, obesity, PCOS, androgenic alopecia, essential HT, high-carb diet, sodium restriction, DHEA Celiac disease, 5α-reductase inhibitors (e.g., finasteride, saw palmetto, pygeum, stinging nettle), flaxseed, soy isoflavones, EGCG, quercetin, progesterone, some progestins Hyperglycemia, azole antifungals, aging, smoking, dioxin toxicity, HIV, licorice, etomidate, liarozole Phytoestrogens, flaxseed, licorice, progestins, tamoxifen Alcohol, IL-6, abdominal obesity, DHEA, forskolin CAH, chronic ETOH ingestion, PCB toxicity, progestins, isoflavonoids, metformin, troglitazone, trilostane Hyperadrenalism, hyperthyroidism, hyperinsulinemia, PCOS, IL-4 and IL-13, IGF-1, forskolin Smoking, dioxin, isoflavones, flaxseed, procyanidins, flavonoids, EGCG, epilobium, vitamin C, anastrazole, etc; chrysin, stinging nettles, and other flavonoids; ketoconazole, metformin Crucifers, berries, I3C, DIM, soy, flaxseed, caffeine, rosemary, exercise, thyroxine Excess sugar or n6 fats, cimetidine, OCPs (+) (-) Grapefruit, peppermint oil, rosemary, wild yam, anti-fungals & other medications (-) (-) (-) Hypothyroidism, pesticide exposure, smoking, caffeine, various medications (+) (+) (+) COMT support: Adequate methionine, Mg, B vitamins, GSH; reduce stress, rule out Hg toxicity & oxidative stress Insulin resistance, obesity, fatty liver, nonalcoholic steatohepatitis Licorice Hyperglycemia, hyperinsulinemia, PCOS (ovary), stress, alcohol, antiepileptics (+) (+) (-) (-) More cortisol: Obesity (esp. visceral), metabolic syndrome, hypothyroid, inflammation, essential HT,c ortisol resistance, cholestasis, hypoxia, licorice, vitamin D, grapefruit, forskolin Less cortisol: Good insulin sensitivity, hyperthyroidism, reduced inflammation, Na restriction, hGH (via IGF-1), E2, coffee, rosiglitazone, ketoconazole Sodium depletion, high prolactin CAH, DHEA, azole antifungals, etomidate, metyrapone CAH, late-onset adrenal hyperplasia, primary adrenal insufficiency, ankylosing spondylitis, increased salt cravings, resveratrol, soy isoflavonoids, DHEA, omeprazole PCB toxicity, DHEA, antiepileptics (-) (-) The Steroidogenic Pathways © 2017 Genova Diagnostics Discover more at www.gdx.net