Short educational lecture by Dr. Tabatha Barber explaining the steroidogenic pathway: cholesterol is the biochemical backbone that is enzymatically converted into steroid hormones (pregnenolone, progesterone, androstenedione, testosterone, estradiol, cortisol, aldosterone, DHEA, etc.). The speaker links how enzyme activities (e.g., 5α-reductase, aromatase, cytochrome P450) are influenced by factors such as insulin, chronic stress/cortisol, alcohol, zinc deficiency, drugs, diet and liver/gallbladder function, and how these shifts produce clinical effects (e.g., excess DHT in insulin-resistant PCOS causing hirsutism/acne; aromatase activity increasing estrogen). The talk emphasizes restoring foundational cellular physiology rather than solely managing disease.
Chapters
This is the steroid genic pathway. Essentially all steroid hormones are made from a cholesterol backbone. This is what I learned in undergrad as a physiology major and then I relearned it in my first year of medical school. We had to memorize every little detail of this. And if you noticed, cholesterol in your body gets made into multiple things. Pregnenolone, progesterone, androstenedione, testosterone, estradiol, estrone, cortisol, aldosterone, all of these things, dhea. And so cholesterol is the backbone. That's what I was saying last week, that it's really important to support, support a diet eating healthy fats and to support your liver to make appropriate cholesterol and for your gallbladder to transport cholesterol properly with bile. So all of these are making these hormones. These arrows are all enzymes. So enzymatic reactions are how one hormone gets turned into another. And these enzyme reactions are affected by a multitude of things all of the time. So this is where you can actually create change in your hormones is on this pathway. So like a good example is chronically high blood sugar and insulin can cause 5 alpha reductase to make high amounts down this pathway right here, causing testosterone to be turned into dihydrotestosterone. This is why women with polycystic ovarian syndrome who have insulin resistance end up with acne hirsutism, like chin hair, male pattern hair on their stomach, a deeper voice, a loss of their periods because this pathway is excessively being stimulated and they're making too much dht. So we block that pathway with interventions and supplementation, diet interventions, lifestyle interventions, or this other example over here where you have alcohol, a zinc deficiency, chronic stress or cortisol and high insulin increase the production of aromatase. Aromatase converts androstenedione to estrone and testosterone to estradiol. You may have heard of an aromatase inhibitor like anastrozole. It's a drug. This blocks the conversion to estrone and estradiol so you end up with low estrogen levels and higher cholesterol levels. Does that make sense, you guys? Like, we're trying to either enhance these pathways or block them. And so essentially countless things affect these enzyme reactions. This is a super simplified version. Literally, according to the national institutes of health NIH, there's over 120 drugs that just interfere with cytochrome P450 alone. That's this first little enzyme reaction from cholesterol to pregnenolone, 120drugs can f up your hormones just by taking them. So I always want you to realize that whatever's going into your body, whether you're drinking it, eating it, inhaling it, rubbing it on, it's going to affect you and it's going to affect your hormones. So conventional medicine wants to dumb it down and make everything black and white act like things are an on, off, switch. Right? And because we've acted this way for so long, the doctors actually have forgotten what they learned in first year medical school. All this biochemistry, all this physiology, is the backbone to how your body functions. And this is only one pathway of probably 100 pathways. It's insane. It takes us to get back to the foundation of how your body works at the cellular level and understanding these processes for you to actually reclaim your health, to thrive and function properly. This is the complete opposite of managing disease.
