Metabolism of Steroid Hormones

Dr. Joe Klassen, ND

 Meet Joe Klassen, ND

Dr. Joe Klassen, ND 2017

Lab Testing 101: Reference Values

Dr. Joe Klassen, ND 2017

 Lab Testing 101: Lognormal Distributions

Probability Density Function

0.4

0.36

0.32

0.28

0.24
f(x)

0.2

0.16

0.12

0.08

0.04

0
10 15 20 25 30 35
x

Histogram Lognormal

Dr. Joe Klassen, ND 2017

 Hormone review

Estrogen
E1, E2, E3, hydroxylation
Purpose
Fate:
2-OH, 4-OH, 16-OH
2-Me, 4-Me,

Dr. Joe Klassen, ND 2017

Estrogens

Dr. Joe Klassen, ND 2017

 Estrogens

The final E1 and E2 pathway; COMT

Dr. Joe Klassen, ND 2017

 Hormone review

Progesterone
A, b pregnanediol
Urine, fecal release

Dr. Joe Klassen, ND 2017

Progesterone

Dr. Joe Klassen, ND 2017

 Hormone review

Testosterone
Epi-T, androgens
Serve as precursor for estrogens
Urine, fecal release

Dr. Joe Klassen, ND 2017

Androgens

Dr. Joe Klassen, ND 2017

 Hormone review

Cortisol
A-THF, THF

Cortisone
THE

Dr. Joe Klassen, ND 2017

Cortisol

Dr. Joe Klassen, ND 2017

 Hormone metabolism

Metabolism
Phase I
Oxidation/reduction
Phase II
Conjugation
Glutathione
Sulphate
Glycine
Glucuronide conjugation

Biliary release, entrapment, defecation

Gut deconjugation, enterohepatic recirculation
Thyroid status

Dr. Joe Klassen, ND 2017

 Enterohepatic recirculation

In patients with obstructive disorders of the biliary tract

significant
increases in urinary pregnanediol may occur, suggesting that in
biliary
obstruction and interference with this pathway of excretion
more pregnanediol is excreted correspondingly in the urine.
Nov-
Dec;6(6):513-22.

Dr. Joe Klassen, ND 2017

 Sterolbiome

the gut sterolbiome represents an important class of
enzyme encoding genes that give gut microbiome the
ability to act as an endocrine organ with far-reaching
effects in the host. Perturbing effects of the
sterolbiome, such as diet, antibiotics, probiotics, and
so forth, have the potential to affect many
physiological effects.
Ridlon JM, Bajaj JS. The human gut sterolbiome: bile acid-microbiome endocrine
aspects and therapeutics. Acta Pharmaceutica Sinica B. 2015;5(2):99-105.
doi:10.1016/j.apsb.2015.01.006.

Dr. Joe Klassen, ND 2017

 Thyroid Status

Gordon GG, Southren AL. Thyroid-Hormone Effects on Steroid-Hormone Metabolism.

Bulletin of the New York Academy of Medicine. 1977;53(3):241-259.

Dr. Joe Klassen, ND 2017

 Common patterns

Dr. Joe Klassen, ND 2017

 Common patterns

Dr. Joe Klassen, ND 2017

 Common patterns

This patient has

known snp in
this pathway

Dr. Joe Klassen, ND 2017

 Common patterns

Dr. Joe Klassen, ND 2017

Intro to Lab, including Lab Basics

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