There is a growing body of research showing that it is not simply the amount of total estrogen circulating in your body that is critical to your health. How estrogen is broken down, or metabolized in the body may also play an important role in the cause of a variety of estrogen-dependent conditions such as osteoporosis, autoimmune disorders, and cancer. The metabolism of estrogen can change as a person ages and goes through natural changes in cycle etc. Estrogen is metabolized in your body through two major pathways. One involving 2- hydroxyestrone and one involving 16-hydroxyestrone.
2-hydroxyestrone is sometimes called the “good” estrogen. It does NOT stimulate your cells to divide which can cause damage to your DNA and tumor growth. Furthermore, by latching onto available estrogen cell receptors, 2-hydroxyestrone may exhibit a blocking action that prevents stronger estrogen products from gaining a foothold in your cells. Therefore, 2-hydroxyestrone is suggested to be anti- cancerous. The other major pathway whereby estrogen is metabolized is 16-hydroxyestrone. This metabolite is much more active and powerful. It has a strong stimulatory effect. 16-hydroxyestrone binds strongly to special receptors inside your cells that can increase the rate of DNA synthesis and cell multiplication. Consequently, 16-hydroxyestrone is associated with a higher rate of cancer.
Therefore, if you metabolize a larger proportion of estrogen through the 16-hydroxy pathway you may be at a higher risk for breast cancer than if you breakdown more estrogen through the 2- hydroxy pathway. A recent study of postmenopausal women who went on to develop breast cancer showed that they had a 15% lower 2/16 hydroxy estrogen ratio than those in control groups. Likewise, in women who already have breast cancer, the survival rate is greater than in women with higher ratios.
It is very important to know the levels of 2-hydroxy and 16-hydroxyestrone as well as the ratio between these two metabolites and the goal is to normalize your estrogen metabolism. You can measure your urinary metabolites through the newly developed Estronex test by Metametrix. And ladies this is not just for older women! Even if you are in your 20’s, 30’s or 40’s you should have your hydroxyestrone levels measured to see if you are at risk so that you can modify your diet and supplement regiment accordingly.
Below are some things that can raise your good (2- hydroxyestrone) estrogen levels:
- Moderate exercise
- Cruciferous vegetables
- Flaxseed
- Kudzu
- DIM (Dindolylmethane)
- High protein diet
- Omega 3 fatty Acids
- B6, B12, and folic acid
- Some soy in small amounts
One important factor on how your body metabolizes estrogen is your weight. Body fat, particularly belly fat, has a significant effect on estrogen production and storage. Being overweight increases the action of estrogens in three ways:
- Estrogen production and storage occurs in your fat cells.
- Concentrations of sex hormone binding globulin are decreased if you are heavy. This increases the amount of unbound estrogen available for usage by your body.
- Being overweight, decreases 2- hydroxyestrone and increases 16-hydroxyestrone production.
The second factor is the presence of xenoestrogens, chemicals that imitate estrogen. Researchers have identified 50 of such chemicals. Yes, that’s correct. I said 50 CHEMICALS! Some sources of xenoestrogens include:
- Pesticides
- Synthetic hormones fed to animals
- Plastics
- Additives in cosmetics
These xenoestrogens influence the ratio of 2/16-hydroxyestrone and may account for an increase in breast cancer.
In order for estrogen to be produced through the 2- hydroxyestrone pathway (the “good” estrogen), your body uses indole-3-carbinol which is present in cruciferous vegetables. Vegetables that contain indole- 3-carbinol are:
- Broccoli and Cauliflower
- Brussels Sprouts
- Cabbage
- Rutabaga and Turnip
- Collard
- Bock Choy and Watercress
- Horseradish
- Kale
- Mustard Seed
- Radishes
Some interesting facts about indole-3-carbinol:
- Studies have shown that people given indole-3- carbinol demonstrated a 50 to 75% elevation in the good metabolism of estrogen.
- If you overcook your vegetables, it destroys the indole-3-carbinol. Therefore, it is best to eat them raw or lightly steamed.
- Antacids interfere with the absorption of indole-3- carbinol. Consequently, I do not recommend the long term use of ANY antacid.
- Indole-3-carbinol may help protect obese women from the effect of excessive estrogen production.
Folate and Breast Cancer Prevention
Drinking alcohol significantly increases the risk of breast cancer, according to most research. However, among women who drink alcohol, those who consume relatively high amounts of folate in their diet have reduced risk of breast cancer compared with women who drink alcohol but consume less folate. In a similar report, consumption of folic acid containing supplements was associated with a lower risk of breast cancer in women who drank alcohol, compared with women who drank alcohol but did not take such supplements. The association between both dietary folate and folic acid supplements and protection against breast cancer in women who drink alcohol fits with our understanding of the opposite effects of these substances. As a result, nutritionally oriented doctors now recommend that women who wish to reduce their risk of breast cancer but are unwilling to totally avoid alcohol should supplement with 400-800mcg of folic acid.
Cancer Risk Higher with Western Diet
A western diet has also been implicated in greater incidence or breast cancer. Our unlimited access to countless varieties of food, from meats to rich desserts, has long been considered a privilege, but new research indicates that some of those indulgences create dietary patterns that increase the risk of breast cancer. A new study suggests the more Western your diet is, meaning heavy in meat, starch and sugar, the higher your risk for cancer may be.
The study followed older Asian women who had been placed on two separate diets: traditional cuisine rich in vegetables and fish and a Westernized diet heavy on red meat and sugar. Women who adopted the Western diet had higher rates of breast cancer. “Our study shows a Western-style diet seems to increase the risk of cancer in Chinese women, which traditionally is a low-risk population for breast cancer,” said Marilyn Tseng, a study researcher at the Fox Chase Cancer Center in Philadelphia. Breast cancer rates in China are a quarter of those in the United States. That is slowly changing however, as menus around the world, especially in urban areas are moving toward more Westernized foods.
Action to Take
Eating right and the above prevention techniques are great for reducing your chances of getting breast cancer but it is hard to know how much each person needs as we are all so different. Thus I am also very excited to have this tool and offer my patients the Extronex 2/16 Assay Urine Test. This test is important for women of all ages, even women who have previously had breast cancer. Some people may be more prone to bad estrogen metabolism and if that is the case there is a lot we can do to change it!
If you are interested in running this test, please contact us.