General Flashcards
(102 cards)
1
Q
What is the HPO axis and what does it do?
A
Hypothalamus-Pituitary-Ovarian Axis. Maintains hormonal balance within the reproductive system
2
Q
What stimulates the anterior pituitary gland to produce LH and FSH?
A
GnRH
3
Q
Raised oestogen and testosterone exert _______ feedback over FSH and LH secretion
A
negative
4
Q
What hormone is synthesised from cholesterol in steriodogenic tissues such as the adrenal glands, gonads, and brain by mitochondrial enzymes CYP11A1?
A
Pregnenolone
5
Q
Pregnenolone is synthesised from …?
A
Cholesterol
6
Q
What enzyme synthesises pregnenolone?
A
CYP11A1
7
Q
Where is pregnenolone synthesised?
A
Gonads,
Adrenal glands
Brain
By the mitochondrial enzyme CYP11A1
8
Q
Pregnenolone is a precursor of… ?
A
DHEA Testosterone Oestrogen Progesterone Cortisol
9
Q
Name 2 benefits of pregnenolone?
A
Anti-inflammatory
Neuroprotective
10
Q
Low levels of pregnenolone are caused by…?
A
Age (>30)
Statins
11
Q
Name some symptoms of low pregnenolone…?
A
Poor memory Declining concerntration and attention Fatigue Dry skin Joint and muscle pain Decreased libido
12
Q
What does DHT stand for?
A
Dihydrotestosterone
13
Q
What does DHEA stand for?
A
Dehydroepiandrosterone
14
Q
What can support healthy pregnenolone levels?
A
Sleep quality Stress management Healthyfats - avocado, flaz, chia, olive oil, walnuts B vitamins Vitamin K D3
15
Q
What can help balance DHEA
A
Maca Rhodiola Magnolia Perilla oil Tribulus
16
Q
High stress increases the use of pregnenolone for cortisol production, reducing the total amount of pregnenolone available for sex homrone production, what is this called?
A
Pregnenolone steal theory
17
Q
What is the pregnenolone steal theory?
A
High stress = Increases pregnenolone to cortisol conversion = reduced pregenolone for sex homrones
18
Q
Where is progesterone produced?
A
corpus luteum after ovulation
Adrenal cortex
Placenta during pregnancy
19
Q
Name the functions of progesterone
A
Maintains the endometirum for implantion and pregnancy
Increases cervical mucus
Relaxes smooth muscle
Supports bone and mammary development
20
Q
What conditions can see an imbalance in progesterone?
A
Perimenopause
PCOS
infertility
21
Q
Low progesterone leads to what?
A
Oestrogen dominance
22
Q
What are the causes of low progesterone?
A
Chronic stress
Synthetic progesterones
xenoestrogens
23
Q
What are the sings and symptoms of low progesterone?
A
Irritability
mood swings
insomnia
24
Q
Low progesterone can increase the risk of what condition?
A
breast cancer in perimenopausal women
25
Name ways in which progesterone can be balanced?
```
Supporting oestrogen detoxification
Increase fibre
3 balanced meals a day
No snacking
avoid alcohol
Mg
Vitamin C
B6
Zn
Vitex Angus castus
Exercise
Box breathing
```
26
Name the 3 types of oestrogen
E1 - Oestrone
E2 - Oestrodoil
E3 - Oestriol
27
How are oestogens produced?
Conversion of androgens via aromatase
28
Which oestrogen is ost active during the reproductive years?
E2 - oestrodiol
29
What are the functions of oestrogen?
```
Reproductive tract development
Menstural cycle
Promotes cell proliferation
Glucose homeostasis
Immune robustness
Bone and cardiovascular health
```
30
Name 3 oestrogen receptors that oestrogen binds to...
Er(alpha)
ER(beta)
GPER
31
What does GPER stand for?
G-protein coupled oestrogen receptor
32
What is aromatase?
CYP450 enzyme
33
What is oestrogen dominace?
A state of excess oestrogenix activity encompassing some or all of;
elevated oestrogen relative to progesterone (HIGH O:P despite normal oestrogen)
Elevated specifc types of oestrogen or metabolites due to poor detoxificatin and elimination
Exceess oestrogen induces overexpression of ERa and ERb
34
Oestrogen dominance is assocaited with;
```
firboids
endometriosis
PMS
firbocystic breasts
dysmenorrhea
infertility
miscarrigaes
perimenopause
breast/ovarian/endo cancers
insulin resistance
thyroid dysfunction
brain fog
anxiety
depression
```
35
What can cause/affect oestrogen dominance?
```
Syntehtic HRT
OCP
Xenoestrogens
Heavy metals
Obesity
Poor liver detoxification
Constipation
SNPs - COMT
Intestinal dysbiosis
Chronic srtress
```
36
Dicuss the phase 1 oestogen biotransformation...
CYP450 enzymes convert E1 into 1 of 3 metabolittes;
2-OH-E (CYP1A1)
4-OH-E (CYP1b1)
16a-OH-E (CYP3A4)
37
What is 2-OH-E and what CPY450 enzyme metabolises it?
CYP1A1
weakest form
Protective
COMT deactivates 1-OH-E1 to protective 2-MeOE1
38
What is 4-OH-E and what is the CYP450 enzyme that metabolises it?
CYP1B1
pro-carcinogenic
Neautralised by COMT into proetcitve 4-MeOE1 metabolites
39
What is 16a-OH-E and the CYP450 enzyme that metabolises it?
highest binding affinity for oestrogen receptors with high proliferative effects. High = higher risk of esteigen dependant conditions such as breast cancer, fibroids and endo
40
What are quinones?
Organix aromatic-derived compounds
41
Describe phase 1 oestrogen
Biotransfomration using CYP450 enzymes
42
Describe phase 2 oestrogen metabolism
Uses sulphation, methylation and glucuronidation pathways
43
Which pathway do 2-OH-E and 4-OH-E undergo during phase 2 of oestrogen metabolism?
Methylation via COMT
44
Poor methylation increases conversion of 4-OH-E to WHAT which will increase oxidative damage to DNA?
quinones
45
What increase in oranic aromatic-derives compound is assocaited with cancer when thinking about oestogen metabolism?
quinones
46
16a-Oh-E metabolises E3 which undergos metabolism on which pathway?
Sulphation
47
2-OH-E and 4-OH-E undergo which pathways?
Methylation
Sulphation
Glucoronidation
48
What nutritional support can be given to phase 1 oestogen metabolism?
```
I3C
cruciferious veg
antioxidants
glutathione
turmeric
resveratrol
berries
roobios tea
celery
```
49
When supporting phase 1 oestrogen metabolism, what should be avoided?
CYP450 inducers; paracetamol
PCBs
smoking]
grapefruit
50
How can phase 2 oestrogen metabolism be supported?
Conjugation pathway support - cruciferious veg, allium veg, Mg, antioxidants
Methylation support - folate, B12, B6 SAMe, choline
51
What should be avoided when supoprting phase 2 oestogen metabolism?
OCP
high alcohol
high cortisol
mould exposure
52
What is the oestrobolome?
collectio of microbes capable of metabilisng oestrogens
53
the oestrobolome bacteria produce which enzyme?
Beta-glucuronidase
54
What is beta-glucoronidase?
an enzyme which deconjugates (reactivates) oestrogen that were conjugated for elimation
55
deconjugated oestrogens can be reabsorbed via the...
enterohepatic circulation
56
What can increase chances of enterotoxigenic circulation of oestrogens?
Dysbiosis
low fibre
poor bile flow
57
Imbalances in beta-glucuronidase can promote conditions such as;
```
endo
breast cancer
ovarian cancer
PCOS
Endo cancer
Endometrial hyperplasia
```
58
Discuss the obersvations seen with beta-glucuronidase in endo andPCOS;
```
Endo = larger numbers of beta-glucuronidase (high circ. oestrogen - oestogen dominace)
PCOS = low beta-glucuronidase = reduced oestrogen and higher andrgoens
```
59
How to maintain healthy beta-glucuronidase levels;
High levels =
Low levels =
High levels =
increase fibre
calcium D-glucarate
glucaric acid-rish foods such as mung bean sprouts, apples, crucierfous veg, milk thistle, Lactobacilli and bifidum bacertia
LOW =
probiotics and/or probiotic foods
60
Where is testosterone produced in women?
Ovaries and adrenal cortex
61
What is testosterone converted to?
E2 and DHT
62
What are the functions of testosterone in women?
Ovarian density
Libido
Bpnoe strengthmood
cognition
63
List 2 testosterone imbalances
Andrgoen dominace in PCOS
| Low testosterone
64
What is the more potent form of testosterone?
DHT
65
converts testosterone to DHT?
5a-reductase
66
List ways in which the testosterone to DHT pathway is upregulated;
insulin
Inflammation
obesity
67
List ways in which the testosterone to DHT pathway is downregulated;
```
Nettle
Saw palmetoo
Lycopene
Turmeric
Green tea
Zn
GLA and EPA
```
68
How do sex hormones travel around the body?
in the blood bound to SHBG
69
Where is SHBG produced?
Ine the liver
70
What are the functions of SHBG?
to oestadoil, testosterone, DHT
| only unbound hormones are biologically active
71
Only ____________ sexx ormones are bilogically active
unbound
72
Low levels of SHBG are assciated with which conditions?
```
Hypoinsulinemia
Metabolic syndrom
T2DM
hypothyroidism
PCOS
```
73
High levels of SHBG are asscoaited with;
```
anorexia
Pregnany
Androgen deficiency
hyperthyroidism
liver disease
```
74
What is prolactin?
Key hormone controlled by oestrogen and dopamine
75
what 2 hormones control prolactin?
oestrogen and dopamine
76
What are the functions of prolactin?
lactation
breastmaturation
inhibitsmenstruation
77
What is hyperprolactinaemia?
Occurs naturally in pregnancy and lactiation but can also occue in non-pregnant women
78
What is hyperprolactinaemia asscoatied with?
```
Pregnancy
Lactation
Infertility
Menstural irregularities
low libido
```
osteopenia
breast pain
vaginal dryness
79
What increases Prolactin?
```
High cortisol
Circadian rythmn disruption
Pituitary tumours
Renal failure
vitamin D deficiency
drugs - dopamine antagonists
```
80
What are EDCs?
Endocrine disrupting Chemicals
Exogenous agents that interfere with the production, release, transport, metabolism, binding, action or elimination of bodily hormones
81
List ways in which EDCs can affect hormones
```
binding
metabolism
elimination
production
release
transportation
action
```
82
List some EDCs
```
BPAs
PCBs
Phthalats
heavy metals
pesticides
herbicides
fire retardants
dioxins
drugs
tap water
```
83
What can alter homrone receptor signalling, production, secretion and metabolism of homrones and well as induce oxidative stress, mitochondrial damamge and epigentic alterations?
EDCs
84
What adverse health effects are associated with EDCs?
```
Cancer
PCOS
Early puberty
Gynaecomastia
infertility
cognitive defects
obesity
```
85
What is the critical window of susceptibility of EDCs becoming an issue?
in utero
neonatally
childhood
puberty
86
What are xenoestrogens?
sub-category of EDCs. Structually similar to oestoogen and can bind to oestrogen receptor sites
87
Name some examples of xenoestrogens
```
Pesticides
herbicides
dioxins
parabens
phthalates
BPAs
preservatives
tap water
```
88
When can xenoestrogens build up?
Fat of meat, fish, dairy and human fat cells with age
89
How can someone be exposed to xenoestrogens?
Ingesting via food and drink
inhaled
skin or mucus membranes
90
Why is dairy considered an endocrine disruptor?
It contains E1,E2 and E3 steroid hormones
| Includes IGF, PCBs, dioxins insecticides, bovine growth hormone
91
What are phytoestogens?
NAturally occuring palnt compunds strcutually similar to 17beta oestradiol (E2)
Produce weak anti-oestoengic effect on high or low endogenous oestrogen
reduces circulating bioavailability of E2
Disrupts aromatase - favours 2-OH pathway
Oestrogen modulators
92
List some benefits of phytoestrogens
```
lower risk of;
menopausal symptoms
CVD
obesity
metabolic syndrome
T2DM
breast cancer
```
93
List some naturally occuring phytoestrogens
flavinoids
lignans
flavones
94
What phytoestrogen has been shown to inhibit breast cancer cell growth and is neuroprotective?
Apigenin
95
List soybean products;
Tempeh
soy paste
miso
natto
96
Is soy products are consumed they should be...
fermented
97
Why is consumption of soyban in western societies deemed as unhealthy?
include soya oil
flour
GMOs
98
What is necessary for fermentation of phytoestrogens?
a healthy microbiome
99
List some herbs which are considered good forms of tea/tinctures which contain phytoestrogens;
black Cohosh
agnus castus
red clover
dong qui
100
List ways in which hormone imbalance can be driven by;
```
blood glucose dysregulation
high or low body weight/fat percentage
chronic low-grade inflammation
poor digestion
Microbiome health
detoxification and eliination
thyroid and adrenal health
High toxic load
Chronic stress
disrupted sleep
Nutritional deficincies - B vitamins, Mg, Zn
```
101
List ways which can support hormone balancing from a Naturopathic perspective;
```
avoid;
processed and microwaved foods
stimulants
refined sugars
table salt
artifical sweeteners
cow's dairy
Focus on;
local, seasonal, while, fresh and organic foods - vegetables, fruit, legumes, whole grains, nuts, seeds, water, herbal teas, oily fish and meat
Make sure food combining principles are followed
Consider energetics
Appropriate digestion - chew foods well, keep fluids away from meals, avoid snacking
```
102
List ways to imrpove blood glucose and weight management;
avoid processed foods
