This YouTube transcript (Dr. Tabatha Barber) explains the three main estrogens — estrone (E1), estradiol (E2) and estriol (E3) — and their liver metabolic fates. Estradiol is the primary reproductive growth hormone and can be converted to estrone or estriol. Estrone is produced by ovaries and adipose tissue (fat cells) and is increased by aromatization of testosterone in fat, linking obesity to higher estrone and elevated breast/uterine cancer risk. Estrone/estradiol metabolites follow three phase‑I pathways: 2‑hydroxy (protective, facilitates excretion), 16‑hydroxy (an intermediate that may be carcinogenic and subject to reabsorption), and 4‑hydroxy (forms quinones that can damage DNA and raise cancer risk). The speaker cites a DUTCH test pie chart for pathway distribution and states that >11 (percent implied) down the 4‑hydroxy/red pathway is undesirable. Clinical/supportive recommendations include increasing antioxidants (NAC, glutathione support), eating cruciferous vegetables (sources of DIM and indole‑3‑carbinol), and using DIM/INDO3 supplements to favor the protective pathways.
Chapters
You can make your estrogens. So you have three main forms. Estrone E1, Estradiol E2, and Estriol E3. Those are the three main hormones that are running our bodies. Estradiol is that growth hormone that's responsible for reproduction. So it grows the lining of your uterus every month. And hopefully you have progesterone to keep that in check. But as you can see, it can go in turn into estriol or estrone. Estrone is also not only made by your ovaries, but also by your fat cells. And too much estrone is a bad thing. So we want to make sure that we don't have too much estrone around, because that can go down to increase our risk of breast and uterine cancer, as I'm going to explain in a minute. And if you notice on this picture here, testosterone can get aromatized to estradiol or estrone. And in fat cells, it almost always gets aromatized into estrone. So women who carry extra fat cells on their body and can't release that weight, they are more prone to having too much bad estrone. And that is why obesity is a risk factor for uterine cancer and breast cancer. It's this situation right here. So you're making these levels. In this sample case, it's way too much. You should not be all the way far to the right. If you look all the way far to the left, you see this purple area that is a menopausal level. And so that would be super low. So what happens is estradiol, or main reproductive hormone, gets turned into estrone. Estrone goes down one of three pathways. That's what we're going to talk about. Or estradiol gets made into estriol and can go down this intermediate pathway of 16 hydroxy estrone. Things are always shifting and changing your hormones when you do blood work. Oftentimes a doctor will just measure an estrogen level for the lab that you get drawn at. That could mean they're measuring all three of these estrogens. Or it might be just the estradiol. It's sometimes hard to know. You can specifically ask for estradiol, estrone and estriol, and those will give you the levels. So what we see here is estrone gets metabolized down this two hydroxy estrone pathway, which is the most protective pathway. That means it went through phase one of the liver detoxification process appropriately, and your body inactivated it so that you can hopefully remove it from the body. It can go down this blue pathway, which causes this intermediate of 16 hydroxy estrone. This intermediate can be a bad carcinogenic intermediate form. And so we don't like it to be too high in this case because then it can get reabsorbed. So we don't want too much reabsorption either. And we don't want to go down the red pathway, which causes 4 hydroxy estrone. 4 hydroxy estrone can damage the DNA in our cells and increase our risk of cancer. So this Dutch test shows a nice pie chart with the different percentages of how your estrogen got metabolized during the phase one process of your liver. And you do not want more than 11 of that going down the red pathway. If that is the case, we need to get you on some major antioxidants. We need to be eating brightly colored vegetables and fruit and taking NAC and helping glutathione production. Glutathions are major antioxidant that goes around and cleans house, gets rid of all that broken DNA and damaged cells so they can't go rogue and cause cancer. So. So if this quinone reaction is happening down this toxic pathway, it's really important to know and take action. You can also support this green pathway, this phase one detoxification through the liver by pushing this four hydroxy estrone over to the green pathway. And you do that by making sure that the. For hydroxy. I'm sorry, you make sure by making sure the liver detox pathway is functioning well. And that looks like eating enough cruciferous vegetables like broccoli, brussels sprouts, cauliflower, cabbage, bok choy, because they have compounds in them called diindomethane and indole 3 carbinol. Those compounds help phase one of the liver so that you can get your estrogens through that process to get deactivated. So I encourage women, if you have too much of this four hydroxy or too much estrogen overall with symptoms of estrogen dominance, to take DIM and INDO3 carbinol. DIM, diandyl, methane can be found in supplement form and it can be very effective at pushing more estrogens down the green pathway so that fewer are going down the red pathway.
