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Transcript of The Steroidogenic Pathways - Genova Diagnostics, Steroidogenic Pathway_Poster-COMPLEX-24x36.indd...

  • 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 Androstanediol 11β -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-Reductase 5β = 5beta-Reductase CYP11β1 = 11beta-Hydroxylase 11βHSD = 11beta-Hydroxysteroid dehydrogenase 17βHSD = 17beta-Hydroxysteroid dehydrogenase 17,20 Lyase = 17,20 Desmolase CYPc17 = 17alpha-Hydroxylase CYP19 = Aromatase CYP21 = 21-Hydroxylase

    ENZYMATIC STEPS:

    Mineralocorticoids

    11

    17-Hydroxysteroids 1 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:

    3β H

    SD

    17,20 Lyase

    17,20 Lyase

    3β H

    SD C

    YP 21

    CYPc17

    CYPc17

    C YP

    21 C

    YP 11

    b1

    5β 5 β

    11βHSD

    3β H

    SD

    5α 5β

    COMT

    Arom atase (CYP19)

    3β H

    SD

    COMT

    17βHSD

    3A 4

    1A1

    5α 3α

    H SD

    17βHSD

    1B 1

    17βHSD

    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, liarozole Phytoestrogens, flaxseed, licorice,

    progestins, tamoxifen Alcohol, 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),

    metabolic syndrome, 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

    Discover more at www.gdx.net