Metabolite Ratios (Urine) - DUTCH
Urine
Performed by: Precision Analytical (DUTCH)
The Metabolite Ratios section of the DUTCH test evaluates how your body is processing and detoxifying estrogens.
These ratios compare different estrogen metabolites to help identify whether your estrogen metabolism is protective, balanced, or potentially risky.
The DUTCH test reports three key ratios:
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2-OH / 16-OH-E1 Balance
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2-OH / 4-OH-E1 Balance
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2-Methoxy / 2-OH Balance
1. 2-OH / 16-OH-E1 Balance
This ratio compares two major estrogen metabolites:
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2-OH-E1 → Often considered the safer pathway; weakly estrogenic and may help block cell overgrowth.
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16-OH-E1 → More estrogenic; can promote tissue growth and may contribute to estrogen-dominant symptoms.
Why it matters:
A higher ratio (more 2-OH compared to 16-OH) is generally considered more favorable for long-term hormone balance.
A lower ratio may suggest that estrogen is being metabolized in a way that could increase stimulation of estrogen-sensitive tissues.
2. 2-OH / 4-OH-E1 Balance
This ratio evaluates:
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2-OH-E1 → Protective, as above.
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4-OH-E1 → Can be more harmful, as it may damage DNA and has been linked to a higher risk of certain hormone-related cancers.
Why it matters:
A higher 2-OH to 4-OH ratio is generally better, indicating your body favors the less risky pathway.
A lower ratio means a greater share of estrogen is moving through the potentially DNA-damaging 4-OH pathway, which may require support for safe detoxification.
3. 2-Methoxy / 2-OH Balance
This ratio reflects phase 2 estrogen metabolism (methylation):
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2-OH-E1 → A phase 1 metabolite that needs to be neutralized.
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2-Methoxy-E1 → The methylated (neutralized) form of 2-OH-E1, created in phase 2 detoxification.
Why it matters:
A higher ratio suggests efficient methylation, meaning your body is converting potentially reactive estrogen metabolites into safer, excretable forms.
A low ratio may indicate sluggish methylation, which can allow reactive metabolites to remain active longer in the body.
Why These Ratios Are Important
By looking at these three ratios together, practitioners can see:
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Whether your estrogen metabolism favors protective or more risky pathways
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How efficiently your body neutralizes potentially harmful estrogen metabolites
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Whether additional nutritional or lifestyle support may help improve hormone detoxification
Balanced ratios are important for both women and men, as estrogen metabolism impacts reproductive health, breast and prostate health, and overall hormonal balance.
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Biomarkers included in this panel:
2-Methoxy / 2-OH Balance
The 2-Methoxy / 2-OH Balance is a measure used to assess the balance between two important forms of estrogen metabolites in the body. Estrogen, a hormone crucial for various bodily functions, undergoes a process called metabolism, where it is broken
Learn more2-OH / 16-OH-E1 Balance
The 2-OH / 16-OH-E1 Balance is a measure of the ratio between two types of estrogen metabolites in the body: 2-hydroxyestrone (2-OH) and 16-alpha-hydroxyestrone (16-OH-E1). Estrogen, a hormone primarily produced in the ovaries, plays a crucia
Learn moreThe 2-OH / 16-OH-E1 Balance is an important marker that helps assess how your body processes estrogen, which is a hormone present in both men and women. While estrogen is often associated with female health, men also produce and rely on it for variou
Learn more2-OH / 4-OH-E1 Balance
The 2-OH / 4-OH-E1 Balance refers to the balance between two different forms of estrogen metabolites in the body, specifically 2-hydroxyestrone (2-OH) and 4-hydroxyestrone (4-OH-E1). Estrogen is a hormone that plays a crucial role in various bodily f
Learn more