How Oestrogen Can Be Connected to The Gut Microbiota with Test Pairing

Relying on a single test can create more questions than answers. In this instance for example, we look at coupling two different tests to investigate how oestrogen related conditions can be connected to the gut microbiota.

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How Oestrogen Related Conditions Can Be Connected to The Gut Microbiota with Test Pairing

Relying on a single test can create more questions than answers. In this instance for example, we look at combining results from two different tests to investigate how oestrogen related conditions can be connected to the gut microbiota.

Oestrogens are eliminated from the body by metabolic transformation into inactive metabolites and eliminated through urine and/or faeces. This process occurs during the 3 phases of detoxification, which starts in the liver before being excreted via the intestines and bladder.  

During phase I, oestrogens undergo hydroxylation, catalysed by cytochrome P450 enzyme to become 2-OH, 4-OH and 16-OH. A variety of nutrients to both support enzymatic activity and neutralise harmful molecules known as free radicals. During Phase II 2-OH and 4-OH undergo methylation and glucuronidation by the enzymes COMT & UGT, creating safer by-products that will not react with DNA (Y. Tsuchiya et al 2005 & K. Bachmann 2009).

Glucuronidation is a crucial detoxification pathway and, through the conjugation of glucuronic acid, makes oestrogens more water soluble to promote excretion via kidneys or bile (Phase III). However, glucuronidated oestrogens can be unbound into free oestrogens by the oestrobolome: gut microbial b-glucuronidase enzymes can unbind glucuronidated oestrogens, already excreted to the intestine via bile. By removing the glucuronic acid, the original molecules are reabsorbed by the intestines back into the liver. This may result in sex hormone dysregulation, liver congestion, weight regulation issues and inflammation (J. Fuhrman et al 2014 & M.Ervin et al 2019).

Two key tests to assess how oestrogens are being metabolised are the DUTCH Hormone test and a Microbiome test that covers beta-glucuronidase. This allows for a more complete picture to understand how the glucuronidation and oestrogen pathways are functioning at each phase which will lead to improved strategy success when treating.  

If a hypothetical patient had high oestrogens, for example, but their metabolism looks fine within the liver, we might naturally turn our attention to plastics and phytoestrogen consumption. But without consideration of their excretion of the processed toxins, we may be missing a trick. If we do not look at testing this, we can often be left with unanswered questions. 

"The Omnos platform allows a user or practitioner to assess how data points from multiple tests, symptoms and genetic data coalesce into health outcomes. By evaluating where data from different tests agree, we can either accentuate or dilute scores based on the probability a certain result likely exists. We can also add symptoms into the mix to give further confidence and use genetics to assess your sensitivity and risk to a certain result." Christian Thomson - Director of Product

Omnos gives a unique opportunity to see how tech is revolutionising the way we can make connections between data. As noted above, looking at a single test alone can often leave us with plenty of questions and force us to make educated assumptions. When we combine data sets, we create a greater sense of clarity on the extended pathways. This exposes convening issues which are often better indicators of what needs treatment than any one test alone.

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Tsuchiya Y, Nakajima M, Yokoi T. Science Direct. Cytochrome P450-mediated metabolism of estrogens and its regulation in human. [Online] Available from: [Accessed 1-10 August 2022]

Bachmann K. Science Direct. Chapter 8 - Drug Metabolism. [Online] Available from: [Accessed 1-10 August 2022]

Ervin SM, Li H, Lim L, Roberts LR, Liang X, Mani S, Redinbo MR. Science Direct. Gut microbial β-glucuronidases reactivate estrogens as components of the estrobolome that reactivate estrogens. [Online] Available from: [Accessed 1-10 August 2022]

Endocrine Society. Science Daily. Diverse gut bacteria associated with favorable ratio of estrogen metabolites. [Online] Available from: [Accessed 1-10 August 2022]

This article is written for and published in the IHCAN Magazine September 2022 issue with the original title: Why test combination is the future of health-tech?

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