Cholesterol

Congenital adrenal hyperplasia (CAH), Hyperglycemia, azole antifungals, aging,

The Steroidogenic Pathways
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 DHEA 17βHSD Androstenediol

(+)
Hyperglycemia, hyperinsulinemia, PCOS (ovary), stress, alcohol, antiepileptics (+)

3βHSD
CAH, chronic ETOH ingestion, PCB toxicity, progestins,
(-) (-)

3βHSD

3βHSD
Pregnanediol Pregnanetriol

3βHSD
PCB toxicity, DHEA, antiepileptics isoflavonoids, metformin, troglitazone, trilostane

(+) Hyperadrenalism, hyperthyroidism, hyperinsulinemia, PCOS, IL-4 (+)

and IL-13, IGF-1, forskolin Smoking, dioxin, isoflavones,
flaxseed, procyanidins,
flavonoids, EGCG, epilobium,
Progesterone CYPc17 17-OH-Progesterone 17,20 Lyase Androstenedione 17βHSD Testosterone vitamin C, anastrazole, etc;
chrysin, stinging nettles,
(-) and other flavonoids;
5β ketoconazole, metformin
(+) (+)

5α
Etiocholanolone

CYP21
Sodium depletion, high prolactin
CYP21

More cortisol:
Less cortisol:
Obesity (esp. visceral),
Good insulin sensitivity,

Ar
CAH, late-onset adrenal hyperplasia, primary adrenal metabolic
hyperthyroidism, Excess adipose, alcohol, zinc

Ar

om
(-) insufficiency, ankylosing spondylitis, increased salt (-) syndrome, hypothyroid, DHT

5α
om
reduced inflammation, (+) deficiency, stress,

at
cravings, resveratrol, soy isoflavonoids, DHEA, omeprazole inflammation, essential

a
at
Na restriction, hGH hyperinsulinemia,

se
as
HT,c ortisol resistance, inflammation, licorice, vitamin
(via IGF-1), E2,
11-Deoxycortisol

(C
3αHSD
Corticosterone cholestasis, hypoxia,

(C
coffee, rosiglitazone, D3 (in osteoblasts), forskolin,

YP
licorice, vitamin D,

YP
isoproterenol

CYP11b1
ketoconazole

19
(-) grapefruit, forskolin

19
CAH, DHEA, azole antifungals,

)
11β -OH-Androstenedione

)
etomidate, metyrapone
THS Androsterone 17βHSD Androstanediol

5α
Mineralocorticoids

5β
Cortisol 11βHSD Cortisone 11-OH-Androsterone
(active) (inactive) Estrone (E1) 17βHSD Estradiol (E2)
Insulin resistance, obesity, PCOS, androgenic
alopecia, essential HT, high-carb diet,
Licorice 11-OH-Etiocholanolone
(+) (-) Insulin resistance, (-)

5β
sodium restriction, DHEA
5α

5β

obesity,
(+) Crucifers, berries, I3C, DIM, soy, flaxseed, caffeine, rosemary, exercise, thyroxine

1A
(+) (+)
fatty liver, nonalcoholic Adrenosterone

1
Celiac disease, 5α-reductase inhibitors (e.g., (-) (-) Excess sugar or n6 fats, cimetidine, OCPs
steatohepatitis (+)
finasteride, saw palmetto, pygeum, stinging Polycyclic aromatic

3A4
nettle), flaxseed, soy isoflavones, EGCG, a-THF THF THE hydrocarbons, PCBs

5α

5β
quercetin, progesterone, some progestins 2-OH (E1+E2) COMT 2-MeO (E1+E2)

1B1
Hypothyroidism, pesticide exposure, smoking, caffeine, various medications
(+)
AVAILABLE ACROSS 11
1 Keto Androsterone
11-Keto-Androsterone eto t oc o a o o e
11-Keto-Etiocholanolone (-) Grapefruit, peppermint oil, rosemary, wild yam, anti-fungals & other medications

THESE PROFILES: 17-Hydroxysteroids 16a-OH(E1)

17-Ketosteroids Hops, bioflavonoids,
grapefruit
Estriol (E3)
(-)

COMT support: Adequate methionine, Mg, B vitamins, GSH; reduce stress, rule out Hg toxicity & oxidative stress
Hormones measurable
ENZYMATIC STEPS: by Genova Diagnostics: 4-OH (E1+E2) COMT 4-MeO (E1+E2)
3βHSD = 3beta-Hydroxysteroid dehydrogenase
5α = 5alpha-Reductase
5β = 5beta-Reductase
Measurable in Urine Estrogen Metabolites
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

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