The human body makes three estrogen compounds (estrone, estradiol, and estriol). Our cellular systems are geared toward receiving messages from just these three hormones. However, there are hundreds of toxic estrogen lookalike molecules, and to the extent that these gain entry into the human body, they can "jam" estrogen receptor sites on the surface of the cells and cause cancer.

Overstimulation of estrogen receptors by toxic estrogenic compounds disrupts the DNA based messages that control breast cell growth. If this overstimulation continues for several years, the risk of cancer goes up.

The most common exogenous estrogenic compounds come from two sources: 1.) pesticides such as DDT and PCB and other estrogenic environmental chemicals, and 2.) unnatural hormones such as Premarin and Provera.

Until recently, medical scientists failed to recognize a third--and unexpected--source of toxic, carcinogenic estrogenic compounds: the human liver!

It has been discovered that we have the potential to make our own cancer causing chemicals in our livers, from where they are sent back out to the target organ: breast, ovary, uterus, cervix, prostate.

How could this be? Normally, our livers grab used up estrogen from the bloodstream and convert it into an innocuous compound called 2-hydroxyestrone, which is promptly removed from the body. Aging, stress, illness, and genetic factors prompt the liver to change the way it metabolizes estrogen. Whereas most liver estrogen metabolite would be the harmless 2-hydroxyestrone, the liver shifts gears and starts manufacturing a highly toxic and carcinogenic compound known as 16-alphahydroxyestrone, a compound whose carcinogenicity has been compared with that of the highly cancer forming chemicals used in lab experiments to create breast cancers in rodents. In other words, it's nasty, and we are making it for ourselves. Postmenopausal women with breast cancer were found to have dramatic elevations of 16-alphahydroxyestrogen. Women who have high levels of the 16 estrogen metabolite are at much greater risk of sex hormone related cancers--breast, ovary, uterus, and cervix. Men with elevated 16-alphahydroxyestrone levels are more likely to get prostate cancer, which is also caused by estrogenic overstimulation.

The 2:16 Estrogen Ratio

The 2:16 Estrogen Ratio is simple saliva or urine test you can do at home that will help you determine your risk of several cancers. These are the cancers closely associated with disruption of the sex steroid hormone system: breast, ovarian, uterine, and prostate.

To understand the value of this test it is necessary to know a little about how your body breaks down estrogen. The liver uses two main pathways for metabolizing estrogen. The first pathway produces a harmless metabolite, 2-hydroxyestrone (2-OHE1). The second pathway generate a very toxic and carcinogenic estrogen breakdown product known as 16alpha-hydroxyestrone (16 alpha-OHE1). This metabolite can damage chromosomes, overstimulate estrogen receptors, and is carcinogenic.

So, for a lower risk of these cancers, we want more of the good 2-hydroxyestrone and less of the bad 16 alphahydroxyestrone. The 2:16 ratio is a way to determine risk, based on the ratio of good to bad estrogens. A high ratio (more of the good and/or less of the bad) indicates protection from sex steroid related cancers. A low ratio indicates there is a predominance of the carcinogenic estrogen, so the risk of cancer is increased.

I recommend this test to all of my patients over age 50.

Preventing and Reversing a Low (Bad) 2:16 Ratio

Diet and lifestyle have profound effects on these estrogen hepatic hydroxylation pathways, which means that you can change the way your body breaks down estrogen, shifting the ratio to a higher level (more of the good "2" compound and less of the bad "16"). Here's how to do it:

• vigorous exercise
• healthy thyroid hormone balance
• estrogen use (natural, of course)
• consumption of at least two servings of cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, cabbage--see lists in Renewal) and/or...
• Indole-3-carbinol (I-3-C) with Diindolemethane (DIM) (the active ingredients in cruciferous vegetables that reverses liver 16-alphahyroxyestrone production)
• flaxseed oil (an excellent source of omega-3 fatty acids and lignans)
• soy isoflavones
• Marine Fish Oil
• avoid alcohol consumption
• non-sedentary lifestyle
• low-carbohydrate diet
• low-fat diet
• decreas body mass (lose weight)
• eat only organic foods (pesticides on conventionally grown produce are bad estrogens)

Optimum levels of Vitamin D have been shown to significantly reduce the risk of breast cancer.

Green tea extract has been shown to prevent breast cancer. The polyphenols in green tea provide potent protection against a broad array of cancer types, including that of the breast. Numerous studies have shown that green tea polyphenols thwart cancer development by blocking the proliferation and spread of tumor cells, by inhibiting the growth of tumor-nurturing blood vessels, and by reducing the metastasis (spread) of cancer cells. Green tea polyphenols can also deactivate enzymes that cancers need for growth. The green tea polyphenol most strongly associated with cancer prevention is epigallocatechin-3-gallate, or EGCG. Even after cancer has been diagnosed, green tea has the potential to halt its progression and even reverse it.