Cholesterol The Steroidogenic Pathways Congenital adrenal hyperplasia (CAH), Hyperglycemia, azole antifungals, aging, smoking, E2, progesterone, azole smoking, dioxin toxicity, HIV, licorice, Phytoestrogens, flaxseed, licorice, Alcohol, IL-6, abdominal obesity, DHEA, antifungals, spironolactone etomidate, liarozole progestins, tamoxifen forskolin (-) (-) (-) (+) Pregnenolone CYPc17 17-OH-Pregnenolone 17,20 Lyase DHEAA17βHSD ndrostenediol (+) Hyperglycemia, hyperinsulinemia, PCOS (ovary), stress, alcohol, antiepileptics (+) CAH, chronic ETOH ingestion, PCB toxicity, progestins, D D D (-) (-) D PCB toxicity, DHEA, antiepileptics isoflavonoids, metformin, troglitazone, trilostane HS Pregnanediol Pregnanetriol β HS HS 3 HS β β β 3 3 3 (+) Hyperadrenalism, hyperthyroidism, hyperinsulinemia, PCOS, IL-4 (+) and IL-13, IGF-1, forskolin Smoking, dioxin, isoflavones, flaxseed, procyanidins, flavonoids, EGCG, epilobium, vitamin C, anastrazole, etc; CYPc17 17,20 Lyase 17βHSD Progesterone 17-OH-Progesterone Androstenedione Testosterone chrysin, stinging nettles, (-) and other flavonoids; β 5 ketoconazole, metformin α (+) (+) 1 5 1 Sodium depletion, high prolactin More cortisol: Less cortisol: Etiocholanolone Obesity (esp. visceral), A Good insulin sensitivity, ro CAH, late-onset adrenal hyperplasia, primary adrenal CYP2 metabolic A CYP2 hyperthyroidism, ro 5 m Excess adipose, alcohol, zinc (-) insufficiency, ankylosing spondylitis, increased salt (-) syndrome, hypothyroid, m α DHT at reduced inflammation, atas a (+) deficiency, stress, cravings, resveratrol, soy isoflavonoids, DHEA, omeprazole inflammation, essential se Na restriction, hGH hyperinsulinemia, HT,c ortisol resistance, e (C (C inflammation, licorice, vitamin (via IGF-1), E2, D cholestasis, hypoxia, Y Corticosterone 11-Deoxycortisol coffee, rosiglitazone, Y P1 D3 (in osteoblasts), forskolin, licorice, vitamin D, P19) HS 1 9 isoproterenol ketoconazole α ) (-) grapefruit, forskolin 3 CAH, DHEA, azole antifungals, β etomidate, metyrapone 11 -OH-Androstenedione THS Androsterone 17βHSD Androstanediol CYP11b α 5 Mineralocorticoids 5β Cortisol 11βHSD Cortisone 11-OH-Androsterone (active) (inactive) Estrone (E1) 17βHSD Estradiol (E2) Insulin resistance, obesity, PCOS, androgenic Licorice 11-OH-Etiocholanolone alopecia, essential HT, high-carb diet, (+) (-) Insulin resistance, (-) β sodium restriction, DHEA 5 5 α β 1 5 obesity, A (+) (+) 1 (+) Crucifers, berries, I3C, DIM, soy, flaxseed, caffeine, rosemary, exercise, thyroxine fatty liver, nonalcoholic Adrenosterone Celiac disease, 5α-reductase inhibitors (e.g., (-) (-) Excess sugar or n6 fats, cimetidine, OCPs steatohepatitis (+) 3A finasteride, saw palmetto, pygeum, stinging Polycyclic aromatic 5β nettle), flaxseed, soy isoflavones, EGCG, α hydrocarbons, PCBs 4 a-THF THF THE 5 COMT quercetin, progesterone, some progestins 1 2-OH (E1+E2) 2-MeO (E1+E2) 1B Hypothyroidism, pesticide exposure, smoking, caffeine, various medications 11-Keto-Androsterone111KetoAndrosterone 11-Keto-Etiocholanoloneetotoc oa oo e (+) AVAILABLE ACROSS (-) Grapefruit, peppermint oil, rosemary, wild yam, anti-fungals & other medications THESE PROFILES: 17-Hydroxysteroids 17-Ketosteroids Hops, bioflavonoids, 16a-OH(E1) Estriol (E3) grapefruit (-) Hormones measurable COMT support: Adequate methionine, Mg, B vitamins, GSH; reduce stress, rule out Hg toxicity & oxidative stress ENZYMATIC STEPS: by Genova Diagnostics: 44-OH-OH (E1+E2) COMT 44-MeO-MeO ((E1+E2E1+E2) 3βHSD = 3beta-Hydroxysteroid dehydrogenase 5α = 5alpha-Reductase Measurable in Urine Estrogen Metabolites 5β = 5beta-Reductase CYP11β1 = 11beta-Hydroxylase 11βHSD = 11beta-Hydroxysteroid dehydrogenase Measurable in Blood ESTROGEN METABOLISM: 17βHSD = 17beta-Hydroxysteroid dehydrogenase 1A1 = Cytochrome p450 1A1 (CYP1A1) 17,20 Lyase = 17,20 Desmolase 3A4 = Cytochrome p450 3A4 (CYP3A4) CYPc17 = 17alpha-Hydroxylase Measurable in Saliva 1B1 = Cytochrome p450 1B1 (CYP1B1) CYP19 = Aromatase COMT = Catechol-O-Methyl-transferase CYP21 = 21-Hydroxylase Discover more at www.gdx.net © 2017 Genova Diagnostics.