Estrogens and Metabolites (Urine) - DUTCH
Urine
Performed by: Precision Analytical (DUTCH)
Estrogen is a key anabolic hormone, meaning it promotes growth and development in the body.
There are three primary forms of estrogen:
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Estrone (E1) – weaker, but still biologically active
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Estradiol (E2) – the most potent and biologically active form, responsible for most estrogen effects
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Estriol (E3) – weaker, plays a bigger role in vaginal and urinary tract health
Where Is Estrogen Made?
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In Women:
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In premenopausal women, most estrogen is produced in the ovaries.
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Smaller amounts are created by converting testosterone into estrogen through a process called aromatization.
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After menopause, estrogen production shifts almost entirely to aromatization.
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The enzyme responsible for aromatization is found in fat tissue, the brain, gonads, blood vessels, skin, and bone.
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In Men:
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Men produce estrogen mainly through aromatization of testosterone.
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Men’s estrogen levels are much lower than those of cycling women—but interestingly, men often have higher estrogen levels than postmenopausal women.
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What Does Estrogen Do?
Estrogen plays a role in multiple systems of the body:
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Reproductive health:
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Supports the growth of female secondary sex characteristics
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Thickens the uterine lining for implantation
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Increases vaginal acidity (protects against infection)
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Maintains vaginal lubrication (E3 is especially important here)
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Bone health: Maintains bone density and strength
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Brain function:
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Helps regulate body temperature
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Protects against memory decline
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Increases serotonin and serotonin receptors
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Skin and connective tissue:
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Supports collagen production
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Maintains skin thickness
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Improves blood flow to the skin
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Cardiovascular protection: Helps protect against atherosclerosis
What Is a Metabolite?
When your body makes estrogen, it eventually needs to break it down and eliminate it.
This happens in the liver through phase 1 and phase 2 detoxification, producing intermediate forms called metabolites.
Phase 1 Estrogen Metabolism
In phase 1, estrone (E1) and estradiol (E2) are converted into three main metabolites:
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2-OH-E1 – considered the “safer” metabolite; weakly stimulates cell growth and may even help inhibit it
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4-OH-E1 – can damage DNA; linked to higher cancer risk
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16-OH-E1 – more estrogenic; can contribute to symptoms of estrogen dominance
Typical healthy distribution of phase 1 metabolites:
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70% → 2-OH-E1
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10% → 4-OH-E1
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20% → 16-OH-E1
Unbalanced ratios—especially high 4-OH-E1—may increase health risks in both men and women.
Phase 2 Estrogen Metabolism (Methylation)
After phase 1, metabolites move into phase 2 detoxification, specifically methylation.
Methylation neutralizes the potentially harmful phase 1 metabolites, preparing them for safe elimination instead of allowing them to recirculate in the body.
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Only 2-OH and 4-OH metabolites can be methylated.
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16-OH-E1 is not methylated and is eliminated through other pathways.
Why This Matters in the DUTCH Test
By measuring estrogens and their metabolites, the DUTCH test can:
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Assess overall estrogen production
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Determine how your body is processing estrogen through phase 1 and phase 2 detoxification
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Identify unfavorable metabolism patterns that may contribute to symptoms or long-term health risks
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Guide targeted support for liver detoxification and hormone balance
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Biomarkers included in this panel:
16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estri
Learn more16α-Hydroxyestrone (16α-OH-E1), or hydroxyestrone, also known as estra-1,3,5(10)-trien-3,16α-diol-17-one, is an endogenous steroidal estrogen and a major metabolite of estrone, as well as an intermediate in the biosynthesis of estri
Learn moreThe 2-Methoxy Estrogens are considered to be protective. 2-Methoxy-E1 is produced from 2-OH-E1 through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH-E1 and particularly 2-Methoxy-E1. 2-Methoxy-E1 has shown antiproliferat
Learn moreThe 2-Methoxy Estrogens are considered to be protective. 2-Methoxy-E1 is produced from 2-OH-E1 through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH-E1 and particularly 2-Methoxy-E1. 2-Methoxy-E1 has shown antiproliferat
Learn moreThe 2-Methoxy Estrogens are considered to be protective. 2-Methoxy estrogens are produced from 2-OH estrogens through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH estrogens and particularly 2-Methoxy estroge
Learn moreThe 2-Methoxy Estrogens are considered to be protective. 2-Methoxy estrogens are produced from 2-OH estrogens through the COMT enzyme. Anti-cancerogenic effects have been ascribed to 2-OH estrogens and particularly 2-Methoxy estroge
Learn moreMost consider 2-OH-E1 favorable 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 cons
Learn moreMost consider 2-OH-E1 favorable 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 cons
Learn moreResearch and clinical studies show that the 2-hydroxylated estrogens (2-OH E2 and 2-OH E1) are a safer pathway of hydroxylation than the 4-hydroxyestrogens (4-OH E2 and 4-OH E1), which bind to and damage DNA, leading to mutations that are associated
Learn moreResearch and clinical studies show that the 2-hydroxylated estrogens (2-OH E2 and 2-OH E1) are a safer pathway of hydroxylation than the 4-hydroxyestrogens (4-OH E2 and 4-OH E1), which bind to and damage DNA, leading to mutations that are associated
Learn more- The 4-OH pathway is considered the most genotoxic as its metabolites can create reactive products that damage DNA. - Estrone is hydroxylated through Phase 1 detox to form 4-OH-E1. In Phase 2 it is methylation to form 4-MeE1. When 4-OH-E1 is prop
Learn more- The 4-OH pathway is considered the most genotoxic as its metabolites can create reactive products that damage DNA. - Estrone is hydroxylated through Phase 1 detox to form 4-OH-E1. In Phase 2 it is methylation to form 4-MeE1. When 4-OH-E1 is prop
Learn more4 hydroxy estrone (4-OH-E1) and estradiol (4-OH-E2) are metabolites of estrone and estradiol and are very reactive estrogens. They are highly prone to the formation of catechol estrogen-derived 3,4 semi-quinones, which are potent, electrophilic,
Learn more4 hydroxy estrone (4-OH-E1) and estradiol (4-OH-E2) are metabolites of estrone and estradiol and are very reactive estrogens. They are highly prone to the formation of catechol estrogen-derived 3,4 semi-quinones, which are potent, electrophilic,
Learn moreThe most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving abs
Learn moreThe most physiologically active estrogen. Binds to both to ER and Estrogen Receptor Beta (ERβ). Estradiol, made in the ovary, rapidly converts to estrone. Poor symptom control with estrogen replacement may suggest the need for improving abs
Learn moreHas weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.
Learn moreHas weak estrogen activity. Considered to be a protective estrogen. Most prevalent estrogen in pregnancy.
Learn moreProduced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, since it is the least powerful of
Learn moreProduced by the ovaries, the estrone hormone is one of three types of estrogen, and it is one of the major hormones found in the bodies of postmenopausal women. While research into estrone function is still ongoing, largely due to the fact that it is
Learn moreTotal Estrogen measures the combined levels of estradiol (E2), estrone (E1), and estriol (E3). These hormones support reproductive function, bone strength, brain health, and cardiovascular protection. Abnormal levels may indicate menopause, pregnancy
Learn moreTotal estrogen is a reliable test for estrogen status and is used to detect hormone imbalances. Estrogen is known as the “female” hormone. The four major naturally occurring estrogens in women are estrone (E1), estradiol
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