The Sex Steroid Metabolites + UDH II profile by ZRT Labs offers comprehensive insights into sex steroid hormone metabolism. This comprehensive test analyzes a panel of sex steroid metabolites including estrogen, progesterone, testosterone, and their metabolites, as well as urinary 8-hydroxy-2’-deoxyguanosine (UDH II), a biomarker of oxidative stress and DNA damage.
The clinical relevance of this profile lies in its ability to assess sex hormone metabolism and oxidative stress, offering insights into hormone-related conditions such as hormone-sensitive cancers, polycystic ovary syndrome (PCOS), and adrenal disorders. By evaluating sex steroid metabolites and UDH II levels, healthcare providers can identify metabolic imbalances, hormone dysregulation and oxidative damage, guiding targeted interventions for hormone optimization, disease prevention, and personalized treatment strategies. [2., 8., 9.]
The Sex Steroid Metabolites + UDH II profile by ZRT Laboratory tests for the following biomarkers in the urine:
1. Estrogen metabolites including 2-hydroxyestrone and 16α-hydroxyestrone.
2. Progesterone metabolites
3. Testosterone metabolites
4. Urinary 8-hydroxy-2’-deoxyguanosine (UDH II), a biomarker of oxidative stress and DNA damage.
The clinical meaning of these biomarkers is significant in understanding sex hormone metabolism and oxidative stress levels, which are associated with various health conditions.
For instance, estrogen metabolites play a crucial role in estrogen metabolism, and an altered ratio of 2-hydroxyestrone to 16α-hydroxyestrone has been linked to an increased risk of hormone-sensitive cancers, including breast cancer. [10.]
Similarly, abnormalities in testosterone metabolism may contribute to conditions such as polycystic ovary syndrome (PCOS) and androgen-related disorders. [1.]
Additionally elevated levels of urinary 8-hydroxy-2’-deoxyguanosine (UDH II) indicate increased oxidative stress, which has been implicated in the pathogenesis of various diseases, including cancer, cardiovascular disease, and neurodegenerative disorders. [5.]
By measuring these biomarkers, healthcare providers can gain insights into sex hormone metabolism, oxidative stress levels, and potential health risks, guiding personalized treatment strategies and interventions aimed at optimizing hormone balance and reducing oxidative damage.
Urinary testing involves measuring hormone metabolites excreted in urine to provide a comprehensive assessment of hormone metabolism over a period of time, often 24 hours. This non-invasive test is suitable for assessing metabolism and detoxification of hormones, and is an indirect marker of hormone levels in the body.
Urinary testing offers insights into a person’s likelihood of developing certain hormone-related conditions by assessing hormone metabolites, such as the 2:16α-hydroxyestrone ratio, which has implications for breast cancer risk, and testosterone metabolites, which have been implicated in the pathogenesis of conditions including breast cancer and polycystic ovary syndrome (PCOS). [1., 10.] However, urinary hormone levels may be influenced by factors such as hydration status and kidney function, and results may not always reflect serum hormone levels accurately.
Studies demonstrate that urine testing may be an appropriate method to monitor hormone replacement therapy for certain hormones, particularly estrogen. [11.]
Blood testing measures hormone levels in serum, providing a snapshot of total hormone concentrations at a specific point in time. It is widely used in clinical practice due to its convenience and reliability. Blood testing is useful for assessing serum levels of sex hormones, including estrogen, progesterone, and testosterone, and is commonly used for diagnosing hormone-related conditions such as hypogonadism, PCOS and menopause. However, blood testing may not capture fluctuations in hormone levels throughout the day and may be influenced by factors such as stress or medication use.
Saliva testing measures the unbound, biologically active fraction of hormones present in saliva, providing insights into hormone levels that are readily available to target tissues. Saliva testing is non-invasive and can be performed easily at home, making it convenient for patients. It is particularly useful for assessing free, bioavailable hormone levels, which may better reflect tissue-level hormone activity compared to serum levels. [6.] However, saliva testing may not accurately reflect total hormone levels.
The Sex Steroid Metabolites + UDH II profile by ZRT Laboratory is beneficial for individuals seeking a comprehensive assessment of sex hormone metabolism and oxidative stress levels. Specifically, it is suitable for:
Individuals with hormone-related conditions: Those experiencing symptoms related to hormonal imbalances, such as irregular menstrual cycles, infertility, mood swings, or symptoms of androgen excess or deficiency, may benefit from this test. Conditions such as polycystic ovary syndrome (PCOS), menopause-related symptoms, and hormone-sensitive cancers may also warrant testing. [1., 2., 8., 10.]
Individuals undergoing hormone therapy: Individuals undergoing hormone replacement therapy, particularly estrogen replacement, can benefit from monitoring their hormone metabolites to assess treatment effectiveness and ensure hormonal balance. [11.]
Individuals interested in preventive health: As hormonal imbalances and oxidative stress are associated with various health conditions including cancer, cardiovascular disease, and neurodegenerative disorders, people interested in preventive health and optimizing their overall well-being may benefit from this test to identify potential risk factors and guide preventive strategies. [3., 4., 7., 12.]
Those seeking personalized health management: Individuals interested in personalized health management and optimizing their hormone balance may benefit from this test to gain insights into their sex hormone metabolism and oxidative stress levels, allowing their practitioner to tailor interventions and lifestyle modifications to their unique needs to promote overall health and well-being.
Individuals struggling to lose weight: hormonal imbalances and oxidative stress can contribute to weight loss challenges. Research suggests that hormonal imbalances, including abnormalities in estrogen, progesterone, and testosterone levels, can impact metabolism, appetite regulation, and energy expenditure, potentially hindering weight loss efforts. [2., 13.]
Oxidative stress has been implicated in obesity and metabolic dysfunction, leading to insulin resistance and inflammation, which can further exacerbate weight management difficulties. [3., 4.] By assessing sex hormone metabolites and UDH II levels, the Sex Steroid Metabolites + UDH II profile can provide insights into hormonal imbalances and oxidative stress levels that may be contributing to weight management challenges.
Overall, the Sex Steroid Metabolites + UDH II profile is suitable for individuals seeking a comprehensive assessment of their hormone metabolism and oxidative stress levels, helping to guide personalized treatment strategies and optimize health outcomes.
Men, children, and non-menstruating women can collect samples any day.
Menstruating women have specific collection times based on their menstrual cycle; menstruating women should consult their healthcare practitioner regarding an ideal collection schedule.
Avoid vaginal hormones for at least 3 days before urine collection.
Individuals taking steroids should consult their healthcare practitioner regarding collection timing.
Men, children, and non-menstruating women can collect samples any day.
Menstruating women have different collection times based on cycle regularity.
Avoid vaginal hormones for 3 days before collection.
Individuals taking steroids should consult their healthcare practitioner regarding collection timing.
Individuals taking hormone therapy should consult their healthcare provider regarding collection timing.
Avoid eating, drinking (except water), or taking medications/supplements before first urine collection.
Collect samples at specified times: upon waking, mid-morning, before dinner, and before bedtime.
Dip filter paper into urine up to the top black dash line.
Ensure filter paper is fully saturated.
Hang or tape collection card to dry for at least 6 hours.
Repeat for each of the four collections.
Once dry, refold cards and place into baggie, seal, and return to test kit box.
Place dry, folded sample cards into baggie and seal.
Place baggie and completed test requisition form into test kit box.
Place test kit box into prepaid envelope and attach label.
Note tracking number for shipment tracking.
Results released to provider 3-5 business days after lab receives samples.
Provider will notify patient when results are ready and schedule follow-up appointment for review.
REFERENCES
[1.] Dhayat NA, Marti N, Kollmann Z, Troendle A, Bally L, Escher G, Grössl M, Ackermann D, Ponte B, Pruijm M, Müller M, Vogt B, Birkhäuser MH, Bochud M, Flück CE; members of the SKIPOGH Study Group. Urinary steroid profiling in women hints at a diagnostic signature of the polycystic ovary syndrome: A pilot study considering neglected steroid metabolites. PLoS One. 2018 Oct 11;13(10):e0203903. doi: 10.1371/journal.pone.0203903. PMID: 30308019; PMCID: PMC6181287.
[2.] Diamanti-Kandarakis E, Baillargeon JP, Iuorno MJ, Jakubowicz DJ, Nestler JE. A Modern Medical Quandary: Polycystic Ovary Syndrome, Insulin Resistance, and Oral Contraceptive Pills. The Journal of Clinical Endocrinology & Metabolism. 2003;88(5):1927-1932. doi:https://doi.org/10.1210/jc.2002-021528
[3.] Fernández-Sánchez A, Madrigal-Santillán E, Bautista M, Esquivel-Soto J, Morales-González A, Esquivel-Chirino C, Durante-Montiel I, Sánchez-Rivera G, Valadez-Vega C, Morales-González JA. Inflammation, oxidative stress, and obesity. Int J Mol Sci. 2011;12(5):3117-32. doi: 10.3390/ijms12053117. Epub 2011 May 13. PMID: 21686173; PMCID: PMC3116179.
[4.] Furukawa S, Fujita T, Shimabukuro M, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. Journal of Clinical Investigation. 2004;114(12):1752-1761. doi:https://doi.org/10.1172/jci21625
[5.] Graille M, Wild P, Sauvain J-J, Hemmendinger M, Guseva Canu I, Hopf NB. Urinary 8-OHdG as a Biomarker for Oxidative Stress: A Systematic Literature Review and Meta-Analysis. International Journal of Molecular Sciences. 2020; 21(11):3743. https://doi.org/10.3390/ijms21113743
[6.] Granger, D.A., et al. "Salivary bioscience: Foundations of interdisciplinary saliva research and applications." Monographs in Oral Science, vol. 24, 2009, pp. 1-17. doi:10.1159/000224224.
[7.] Guo, C., Li, X., Wang, R. et al. Association between Oxidative DNA Damage and Risk of Colorectal Cancer: Sensitive Determination of Urinary 8-Hydroxy-2′-deoxyguanosine by UPLC-MS/MS Analysis. Sci Rep 6, 32581 (2016). https://doi.org/10.1038/srep32581
[8.] Im A, Vogel VG, Ahrendt G, Lloyd S, Ragin C, Garte S, Taioli E. Urinary estrogen metabolites in women at high risk for breast cancer. Carcinogenesis. 2009 Sep;30(9):1532-5. doi: 10.1093/carcin/bgp139. Epub 2009 Jun 5. PMID: 19502596; PMCID: PMC2736301.
[9.] Lee JD, Cai Q, Shu XO, Nechuta SJ. The Role of Biomarkers of Oxidative Stress in Breast Cancer Risk and Prognosis: A Systematic Review of the Epidemiologic Literature. J Womens Health (Larchmt). 2017 May;26(5):467-482. doi: 10.1089/jwh.2016.5973. Epub 2017 Feb 2. PMID: 28151039; PMCID: PMC5446608.
[10.] Muti P, Bradlow HL, Micheli A, Krogh V, Freudenheim JL, Schünemann HJ, Stanulla M, Yang J, Sepkovic DW, Trevisan M, Berrino F. Estrogen metabolism and risk of breast cancer: a prospective study of the 2:16alpha-hydroxyestrone ratio in premenopausal and postmenopausal women. Epidemiology. 2000 Nov;11(6):635-40. doi: 10.1097/00001648-200011000-00004. PMID: 11055622.
[11.] Newman MS, Curran DA, Mayfield BP, Saltiel D, Stanczyk FZ. Assessment of
estrogen exposure from transdermal estradiol gel therapy with a dried urine
assay. Steroids. 2022 Aug; 184:109038. doi: 10.1016/j.steroids.2022.109038.
Epub 2022 Apr 26. PMID: 35483542.
[12.] Russell JK, Jones CK, Newhouse PA. The Role of Estrogen in Brain and Cognitive Aging. Neurotherapeutics. 2019 Jul;16(3):649-665. doi: 10.1007/s13311-019-00766-9. PMID: 31364065; PMCID: PMC6694379.
[13.] Vigil P, Meléndez J, Petkovic G, Del Río JP. The importance of estradiol for body weight regulation in women. Frontiers in Endocrinology. 2022;13:951186. doi:https://doi.org/10.3389/fendo.2022.951186
The Sex Steroid Metabolites + UDH II profile, formerly the Advanced Metabolites Profile, provides a broad view of sex steroid hormone metabolite levels and cortisol metabolism. It includes full diurnal melatonin and BPA measurements.
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On December 11th, join Dr. Terry Wahls in a 
