11-DeoxycortisolCorticosterone

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 Androstanediol11β -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-Reductase5β = 5beta-ReductaseCYP11β1 = 11beta-Hydroxylase11βHSD = 11beta-Hydroxysteroid dehydrogenase17βHSD = 17beta-Hydroxysteroid dehydrogenase17,20 Lyase = 17,20 Desmolase CYPc17 = 17alpha-HydroxylaseCYP19 = AromataseCYP21 = 21-Hydroxylase

ENZYMATIC STEPS:

Mineralocorticoids

11

17-Hydroxysteroids1 Keto Androsterone eto t oc o a o o e11

17-Ketosteroids

4-OH (E1+E2) 4-MeO (E1+E2)

Estrogen MetabolitesMeasurable in Urine

Measurable in Blood

Measurable in Saliva

Hormones measurable by Genova Diagnostics:

3βH

SD

17,20 Lyase

17,20 Lyase

3βH

SDC

YP21

CYPc17

CYPc17

CYP

21C

YP11

b1

5α

5β 5β

11βHSD

3βH

SD

5α

5β

5α 5β

COMT

Aromatase (CYP19)

3βH

SD

COMT

17βHSD

3A4

1A1

5α3α

HSD

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, liarozolePhytoestrogens, flaxseed, licorice,

progestins, tamoxifenAlcohol, 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),

metabolicsyndrome, 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

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