Estrogens are metabolised in two ways:

  1. Hydroxylation – Phase I liver detoxification

The 2-hydroxyestrone (2-OH E1) pathway is protective whilst the 16α-hydroxyestrone (16a-OH E1) and 4 hydroxyestrone (4-OH E1) are shown to potentially be harmful.

  1. Methylation – Phase II liver detoxification

The last step of estrogen metabolism is methylation. The Methylation Index shows how well the body is achieving this important step where 2 -Methoxy-E1 and 4 -Methoxy-E1 is made. Methylation helps protect the body against the harmful effects of 4-OH estrogens. Furthermore, if they are not methylated effectively, the 2-OH and 4-OH estrogens can be converted to highly reactive molecules that can damage DNA.

16 alpha-hydroxyestrone (16- OH-Estrone (E1)

This is an unhealthy estrogen metabolite and is a powerful estrogen that stimulates target tissues. It is a metabolite of Phase I detox – hydroxylation.

2-Hydroxyestrone (2-OH-Estrone (E1)

This is a beneficial/protective estrogen metabolite and is a metabolite of phase I detox – hydroxylation.

4-Hydroxyestrone  (4-OH-Estrone (E1)

This is an unhealthy estrogen metabolite (linked with cancer) and is a metabolite of Phase I detox – hydroxylation.

2-Methoxyestrone (2- MeOE1)

This is a healthy estrogen metabolite and Protects against 4- OH carcinogenic estrogens that can be harmful. It has minimal estrogen activities and is a metabolite of Phase II detox – Methylation (2 OH estrone TO 2-methoxy estrone).

4-Methoxyestrone (4- MeOE1)

This does not usually require treatment if high and is a metabolite of Phase II detox – Methylation (4- OH estrone TO 4-methoxy estrone).

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