When talking about female hormones, we often discuss estrogen. However, many people are unaware of the multiple types of estrogens. Estrone is a type of estrogen and is the primary estrogen in postmenopausal women. This article will discuss estrone, how to test for it, and integrative treatments to ensure balanced levels.  

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What is Estrone?

There are three main types of estrogen: estradiol, estrone, and estriol. During reproductive years the developing eggs in the ovaries are the major producer of estradiol, the dominant estrogen. Once a woman goes through menopause, characterized by the depletion of eggs, the level of estradiol declines, and estrone takes over as the dominant estrogen. Estrone is made in the peripheral tissues, primarily fat tissue, and by converting dehydroepiandrosterone (DHEA), an adrenal hormone. Estriol is a weak estrogen, usually only elevated during pregnancy.

In order to discuss the importance and effects of estrone, we must talk about estrogen receptors. Hormones, like estrone, work with receptors like keys and locks; the hormone is the key, and the receptor is the lock. For a hormone to elicit an effect, it must bind to, or lock into, its receptor. There are two types of estrogen receptors in the body, ER alpha and ER beta. In the breast tissue, ER alpha causes the growth of tissues, while ER beta activation balances it and can cause regression of growth. Estrone's affinity to bind to ER alpha is significantly greater than its affinity to bind to ER beta, meaning it causes tissue growth. Estradiol has an equal affinity to bind to ER alpha and ER beta, while estriol has a higher affinity for ER beta. The overactivation of the ER alpha receptor is thought to play a role in breast cancer. This is why some deem estrone as the "bad" estrogen.

In addition, these estrogen receptors are located all over the body, including the cardiovascular, neurological, and skeletal systems, meaning estrone can also play a role in modulating these systems.

The metabolism, or breakdown, of estrone, occurs in the liver. Like other estrogens, this three-step process takes estrone, makes it water-soluble, and then excretes it into the stool or urine for disposal. However, the first step can potentially transform estrone into a metabolite with possible cancer-causing attributes. The formation of these metabolites is largely dependent upon enzymatic activity, which can be influenced by specific nutrients and is ultimately controlled by genes.  

High Estrone Symptoms

Uterine fibroids, fibrocystic breasts, irregular periods, heavy periods, mood changes, low libido, weight gain, especially in the hips and thighs, severe premenstrual syndrome (PMS), and fatigue can all be symptoms of high estrone.  

What Causes Estrone to Be High?

High estrone levels can be due to genetic reasons. Genetics determine how we produce hormones, including estrone, and influence how we break them down. Since estrone is made in fat tissue, obesity can also lead to higher estrone levels. Lastly, breast cancer can cause estrone levels to rise as well.

Can Estrone Be Too Low?

While it's possible for estrone to be low, low estrone is not considered clinically significant. This is because estradiol is the primary estrogen with active properties and shares the receptors with estrone. So, low estrone would be masked by sufficient estradiol. If estradiol is also low, hormone replacement therapy options for estradiol are typically discussed along with functional medicine options.

Functional Medicine Labs to Test for Root Cause of Estrone Imbalance

DUTCH

The DUTCH test, by Precision Analytical, is a urine metabolite test showing how hormones are being broken down while also giving the hormone levels. As discussed above, proper metabolism of estrone is critical, as certain metabolites may raise the risk of cancer.  

Salivary Hormone Panel

A salivary hormone panel, such as the Salivary Profile III by ZRT Laboratory‍, will show the tissue level of hormones. Differing from blood testing, tissue hormones are unbound (free), meaning they are completely active. Salivary testing can be extremely important for assessing estrone levels since estrone is primarily made in the tissues.  

Blood Hormone Panel

Estrone will likely have to be ordered as an add-on or made in a custom panel for a blood hormone panel, as it is not commonly a part of hormone panels. This test will assess the level of estrone circulating in the blood at the time of the blood draw.

GI-MAP

GI-MAP, by Diagnostic Solutions, is a stool test that assesses gastrointestinal functioning. By assessing levels of beta-glucuronidase, this test shows how well estrogen, including estrone, is leaving the body, which is considered Phase III of estrogen metabolism.

Integrative Medicine Treatment for High Estrone

Cruciferous Vegetables

Cruciferous vegetables, such as kale, cabbage, and cauliflower, can aid in the healthy metabolism of estrone. These vegetables contain compounds that can help with two out of the three phases of estrogen metabolism. The fiber content in cruciferous vegetables can also help in the third phase of metabolism, making these vegetables a wonderful dietary addition for those looking to support estrone metabolism.

Indole 3 Carbinol (I3C)/DIM

I3C is a compound found in nuts, seeds, and fruits. I3C converts into DIM and both forms can significantly affect estrones metabolism. In Phase I of metabolism, estrone can go down three different pathways. Two out of three pathways can cause estrone to convert into potential cancer-causing metabolites. I3C and DIM can help push estrone away from those harmful pathways.

B Complex

B vitamins are important for the second phase of estrone metabolism. This phase encompasses the process of methylation to make products from Phase I water soluble so they can enter into the stool or urine for excretion. B vitamins function as cofactors in the methylation process, meaning they help it to run efficiently.

Calcium-d-glucarate

Calcium-d-glucarate can aid in the third step of estrogen metabolism. The large intestine houses a group of microbes coined the "estrobolome." These microbes take estrogen byproducts from Phases I and II and package them up to be put into the stool. However, these microbes can release an enzyme, beta-glucuronidase, which causes estrogens to be recycled, re-entering into the bloodstream. Calcium-d-glucarate will block the activity of beta-glucuronidase, thus allowing the proper elimination of estrogens.

Exercise

Since obesity can cause high estrone levels, adequate exercise for maintaining a healthy weight can aid in lowering estrone levels.

Avoid Environmental Exposures

Xenoestrogens are chemicals that can bind to estrogen receptors in the body, giving estrogen-like effects. Personal care products and pesticides can function in this fashion, so it's important to assess these products as they may influence estrogen activity in the body.

Summary

While not as popular as its sister estrogen, estradiol, estrone is an essential hormone for women's health, especially post-menopausal women. High estrone can cause symptoms and be a risk factor for certain diseases, including cancer. Functional medicine testing can help to evaluate why estrone is high and help to create a treatment plan targeting the source of the elevation.