dutch Flashcards
overall (not pre or post)
What ages is the dutch test made for? females and males.
females: 20 years +
Males: 18 +
do andogrens decline or increase with age
decrease
Progesterone metabolite that modulates gamma-aminobutyric acid (GABA) receptors in the central nervous system (CNS) and can lead to improvements in mood
and sleep.
a-pregnanediol
Most prominent progesterone metabolite, however, doesn’t modulate GABA receptors.
b-pregnanediol
moderate strength estrogen
estrone E1
most potent, biologically active estrogen
estradiol E2
least potent, weak estrogen derived from estradiol and 16-OH-E1
Estradiol (E3)/16-OH-E2
Phase 1 estrone (E1) metabolite; 2-OH metabolites are the most stable phase 1 metabolites.
2-Hydroxy-Estone (2-OH-E1)
phase 1 estradiol (E2) metabolite; 2-OH metabolites are the most stable phase 1 metabolites.
2-Hydroxy-Estradiol (2-OH-E2)
Phase 1 estrone (E1) metabolite; 4-OH metabolites are the most carcinogenic phase 1 metabolites.
4-Hydroxy-Estone (4-OH-E1)
Phase 1 estradiol (E2) metabolite; 4-OH metabolites are the most carcinogenic phase 1 metabolites.
4-Hydroxy-Estradiol (4-OH-E2)
Phase 1 estrone (E1) metabolite; proliferative estrogen that may contribute to breast tenderness and heavy bleeding, etc.
16-Hydroxy-Estone (16-OH-E1)
Phase 2 metabolite that is much more stable than its precursor 2-OH-E1.
2-Methoxy-E1 (also known as 2-Me-E1)
Represents the sum of all estrogen markers.
total estrogen
sulfated and circulating form of DHEA
DHEA-S
Alpha DHEA metabolite that is roughly seven times weaker than testosterone; can be used to estimate androgen activity in the tissues.
aldosterone
weak beta DHEA metabolite
Etiocholanolone
major circulating androgen
testosterone
Alpha metabolite of testosterone and the most potent androgen; roughly three to four times more androgenic than testosterone.
5a-DHT
The best marker of 5a-DHT formation and activity in the tissues; can be used to estimate androgen activity in the tissues.
5a-Androstanediol
Weak beta androgen metabolite of testosterone that does not contribute to symptoms of androgen excess.
5b-Androstanediol
Not an androgenic hormone but produced in approximately the same amount as testosterone by the testes. Can be used to distinguish a truly low testosterone from a falsely low measurement due to the UGT genetic variant, see “UGT Deletion” on page 23 for more information.
Epi-testosterone
A compound that is produced from the metabolism of creatine from the kidneys and excreted in the urine. In order to provide the most accurate results, the DUTCH Test uses creatinine excretion to control for hydration status.
creatinine
Daily diurnal (circadian) rhythm of active cortisol that is normally highest in the morning and lowest at night.
free cortisol diurnal pattern
An HPA axis resiliency marker, an anticipatory marker of upcoming daily events, and a surrogate marker for HPA axis plasticity/reactivity.
Cortisol Awakening Response (CAR)
Alpha cortisol metabolite.
a-Tetrahydrocortisol (a-THF)
Beta cortisol metabolite.
b-Tetrahydrocortisol (b-THF)
Beta cortisone metabolite.
b-Tetrahydrocortisone (b-THE)
Sum of all cortisol and cortisone metabolites.
Metabolized Cortisol (THE + THF)
Metabolic byproduct of the citric acid cycle that elevates with vitamin B12 deficiency.
Methylmalonate (MMA)
Metabolic byproduct of tryptophan metabolism that elevates with vitamin B6 deficiency.
Xanthurenate
Metabolic byproduct of tryptophan metabolism that elevates with vitamin B6 deficiency and inflammation.
Kynurenate
An intermediate in glutathione recycling and production that elevates with glutathione deficiency.
Pyroglutamate
Marker associated with biotin deficiency.
b-Hydroxyisovalerate
Metabolic byproduct of tryptophan metabolism in the gut that elevates with intestinal dysbiosis.
indican
Primary dopamine metabolite.
Homovanillate (HVA)
Primary norepinephrine and epinephrine metabolite.
Vanilmandelate (VMA)
Metabolic byproduct of tryptophan metabolism and neurotoxin that elevates with neuroinflammation and general inflammation.
Quinolinate
Marker associated with oxidative stress and DNA damage.
8-Hydroxy-2-Deoxyguanosine (8-OHdG)
steroid medications can suppress what activity?
HPA-axis
*thus can affect adrenals for 4-12 weeks while they’re recovering.
*steroid meds can affect androgen levels such as DHEA and testosterone
Cycling females may consider collecting in their midluteal phase, between days
___ and ___ of a 28-day cycle, If the cycle is different than 28 days
in length, simply subtract ___-___ from the cycle length. For example: collect on days 17-20 for a 26-day cycle. If there are irregular cycles, consider collecting 5-7 days after ovulation. Ovulation can be determined by following BBT and with an OPK, see Figure 1.11 as well as “Basal Body Temperature (BBT)” and “Ovulation Predictor Kits (OPKs)” below, to learn how to use BBT and OPKs. It may be helpful to collect in the luteal phase to understand if ovulation has occurred, if the corpus luteum is making adequate progesterone, and if estrogen is well balanced with progesterone.
19 and 22 , 6-9
Preovulatory BBTs range from about ___-___ degrees Fahrenheit. After ovulation, BBT rises to about 97.8 degrees or higher. This is because after a female ovulates, the follicle that released the egg turns into the corpus ____ and begins making progesterone. Progesterone is thermogenic meaning it increases body temperature.
97.0 to 97.7 , luteum
which pathway is carcinogenic for estrogen
4-OH-estrogen
studies, which have found that ___-___ mg of oral or 45-90 mg of vaginal progesterone, nightly, protects the endometrium.
100-200
The alpha androgen metabolites (5a-DHT, 5a-androstanediol and androsterone) best reflect androgen activity
at the _____ level, whereas the beta androgen metabolites (5b-androstanediol and ______) have little to no androgen activity
tissue, etiocholanolone
If excessive testosterone replacement therapy (TRT) is used, symptoms of androgen excess (facial hair growth, body hair growth, scalp hair ____, acne, mood changes, etc.) will often manifest.
loss,
What are the 5 androgens
1- 5a-DHT
2- 5a-androstanediol
3- andosterone
4- etiochalone
5- testosterone
what are the 5 estrogens
estrone, estradiol, phase 1 estrogen metabolites, and 2-methoxy-E1
DHEA-S may be increased by: Spironolactone, dexamethasone, ___ _____St. John’s Wort, forskolin.
DHEA-S may be decreased by: Low cysteine, _____ LPS, ketoconazole, progestin, _____
bile acid,
inflammation,licorice.
5a-Reductase is best known because it makes androgens like _____ more potent. It is also responsible for metabolizing progesterone and cortisol. If up- regulated, it may cause high _____ symptoms in men (thinning hair, prostate) and women (as in PCOS, thinning hair, acne, facial hair growth). 5b-Metabolites are less androgenic (weaker).
testosterone . androgen
5a may be increased by: Insulin resistance, obesity, ____ supplementation, PCOS.
5a may be decreased by: Saw palmetto and beta-sitosterol, reishi, ___ root,
pygeum africanum, polyunsaturated fats (PUFAs), and EGCG.
5b may be increased by: Insulin resistance, ____ , PCOS.
5b may be decreased by: .
DHEA, nettle
high triglyceride, Licorice
Cortisol is metabolized by 5a/5b-reductase (and 3a-HSD) to a/b-THF & THE for excretion. Metabolism may be increased in obesity, high ____ and hyperthyroid. It may be slowed in cases of hypothyroidism, _____, cholestasis, or poor liver function.
insulin. anorexia,
DHEA converts to DHEA-S with hydroxysteroid sulfotransferase while DHEA-S converts to DHEA with steroid sulfatase; these interconvert in different locations within the body.
DHEA-S may be increased by: Spironolactone, dexamethasone, bile acid, ___ ___ ____, forskolin.
DHEA-S may be decreased by: Low cysteine, inflammation, LPS, ketoconazole, ____ licorice.
St. John’s Wort, progestin,
CYP-1b1
May be increased by: ______, smoking, PAHs.
May be decreased by: Flavonoids, resveratrol.
Inflammation,
May be increased by: Cruciferous vegetables, DIM/IC3, ______,____ fish oil, rosemary extract, thyroxine, flaxseed.
May be decreased by: High sugar diet, moderate alcohol consumption, ______, pterostilbene.
caffeine, soy
resveratrol
Day one of the menstrual cycle (and day one of the follicular phase)
is marked by the onset of menses. During the follicular phase, follicle stimulating hormone (FSH) stimulates multiple follicles to grow
within the _____. While this is happening, _____ ______ stimulates ovarian theca cells to make androgens and FSH stimulates the aromatase enzyme to convert these androgens to estrogens in the ovarian granulosa cells. A single, dominant follicle is selected around cycle days ___-____ This selected follicle will go on to release an egg later in the cycle. The other follicles that were not selected degenerate.
ovary.
luteinizing hormone (LH)
5-7.
The follicular phase is followed by the ovulatory phase. During the ovulatory phase, surging estradiol released by the dominant follicle signals the pituitary to release a large amount of LH. About ____-____ hours after LH peaks, ovulation occurs, and an egg is released from the follicle.
The remaining part of the follicle becomes the corpus _____
a temporary endocrine structure that produces progesterone through the end of the menstrual cycle. If pregnancy occurs, the corpus luteum will continue to make progesterone until the placenta takes over at the end of the 1st trimester. If there is no pregnancy, then _____ and _____ levels decrease, triggering menstrual bleeding and starting the next cycle.
10-12.
luteum,
estradiol and progesterone
what builds the endometrium for possible pregnancy
estradiol (E2)
which is beneficial for bone health, insulin sensitivity, healthy weight-management, neurotransmitter balance, sleep, mood, concentration, memory, hair, skin, vaginal pH, vaginal lubrication, and cardiovascular health.
estradiol (E2)
