Hormone and Urinary Metabolites Assessment Profile (HuMap)

Doctor's Data

Sample type: Urine

Requires fasting: No

At home test

Details

The Hormone and Urinary Metabolites Assessment Profile (HuMap) provides a comprehensive overview of steroid hormones, their metabolites, and the efficiency of the enzymes that metabolize these hormones. This non-invasive test requires only 4 or 5 separate urine collections. Because the breakdown of hormones relies so heavily on processes within the liver, this test can also elucidate areas of interest as it pertains to conjugation of each metabolite. Additionally, testing urinary hormone metabolites can contribute to further understanding of endogenous hormone secretion, supplemental hormone utilization, enzyme activity, oxidative stress, and insight into how your body metabolizes hormones.

Biomarker summary

4-Hydroxyestrone
2-Hydroxyestrone
Cortisone Night
Cortisone Evening
Cortisone Morning
Cortisol Evening
Cortisol Night
b-Pregnanediol
Estriol
Etiocholanolone
8-Hydroxy-2-deoxyguanosine
16-Hydroxyestrone
5a-Dihydrotestosterone
Epi-Testosterone
5b-Androstanediol
5a-Androstanediol
Androsterone
a-Pregnanediol
Testosterone
Estradiol, Urine
Estrone, Urine
Progesterone, Urine
Tetrahydrodehydrocorticosterone
5b-Tetrahydrocortisol
5b-Tetrahydrocorticosterone
5a-Tetrahydrocortisol
5a-Tetrahydrocorticosterone
21-Hydroxyprogesterone
Pregnanetriol
11-Hydroxy-Etiocholanolone
11-Hydroxy-Androsterone
Tetrahydrocortisone
Allopregnanolone
Dehydroepiandrosterone Sulfate
2-methoxyestrone (2-m-e1)
4-methoxyestrone (4-m-e1)
2-hydroxyestradiol (2-oh-e2)
4-hydroxyestradiol (4-oh-e2)
2-methoxyestradiol (2-m-e2)
4-methoxyestradiol (4-m-e2)
Creatinine (Urine)
Cortisol Morning
17-Hydroxyprogesterone, Urine
Corticosterone
11-Deoxycortisol
Androstenedione, Urine

Additional details

Estimated days for results: Results should arrive 5 to 7 days after the lab receives samples.

The comprehensive HuMap profile reports not only important markers and metabolites, but it also calculates the relationship of catechol estrogens (2OHE1, 4OHE1, and 16OHE1) representative of phase 1 detox as well as phase 2 activity of the COMT enzyme via methoxy estrogen ratios. Understanding how catechol estrogens break down as well as the rate of methylation, which renders potentially harmful metabolites inactive, can help mitigate risk and determine individualized treatment.

Useful for:

Female

Menopausal symptoms
Breast Health
Endometriosis
PCOS
PMS/PMDD

Male

Erectile dysfunction
Prostate health
Loss of muscle mass
Breast health

General

Metabolic syndrome
Thyroid pathologies
Inflammation
Oxidative Stress
Fatigue/insomnia
Libido
Mood or cognitive concerns
Family history of hormone-driven cancers
HRT/BHRT utilization
Weight gain

Another highlight of HuMap is the corticoids pathway, notably the relationship between cortisol and cortisone as well as their metabolites. The daily cortisol and cortisone output is graphed in a diurnal pattern displaying the influences of these analytes during the day. The cortisol/cortisone ratio reflects the activity of 11βHSD2 and aids in the understanding of its influence on both the active (cortisol) and inactive (cortisone). Because too much cortisol can be damaging, it’s important to have the correct balance between these two major hormones. To further explore this balance, the “daily metabolized cortisol”, a calculation based on the addition of cortisol (THF, 5αTHF) and cortisone (THE) metabolites provides the most representative estimation of cortisol output. Because metabolites are end products, this calculation is representative of what the body can process which is based on liver metabolism, thyroid hormone levels, and peripheral fatty tissues.

Determining the preference for 5-alpha vs. 5-beta is desirable for optimal health. 5α-reductase converts testosterone into the metabolite 5α-DHT which is three times more potent than testosterone. Symptoms associated with higher androgen levels (thinning hair, acne, etc.) are often seen when levels of 5α-reductase and its corresponding metabolites are elevated. Additionally, the activity of aromatase (CYP19) is an integral part of the health of both men and women. Aromatase is more active in peripheral tissues increasing estrogens in males as well as the main source of estrogens in the postmenopausal female. Determining the activity of aromatase can assist with understanding the root cause of lower testosterone as well as estrogen dominance.

Progesterone is found in the urine in very small quantities due to its molecular structure making it difficult to obtain. For this reason, it is often left out of urinary testing. The HuMap not only measures the metabolites of progesterone, (5α-pregnanediol and 5β-pregnanediol), but also progesterone itself. This level will be of particular interest to practitioners prescribing oral progesterone as they may now track the metabolism of progesterone which is often metabolized further down the pathway to allopregnanolone, a metabolite known for its GABA like effects for sleep and relief of anxiety. Additionally, 17 hydroxyprogesterone and 21 hydroxyprogesterone can also provide insight into endogenous cortisol and corticosterone production.

Extensive estrogen metabolites available: E1, E2, E3, 2-OH-E1/E2, 4-OH-E1/E2, 16-OH-E1, 2-Methoxy-E1/E2, 4-Methoxy-E1/E2
Comprehensive androgens and metabolites: DHEAs, androstenedione, testosterone, 5α-DHT, 5β-DHT, epitestosterone, androsterone, etiocholanolone, and more
Progesterone and metabolites: Progesterone, 5α-pregnanediol, 5β-pregnanediol, allopregnanolone, 21-OH progesterone, 17-OH progesterone
Daily cortisol (5)
Daily cortisone (5)
Metabolized cortisol: 5α-THF, THF
Metabolized cortisone: THE
Metabolized corticosterone: 5α-THA, THA, 5α-THB, THB
Key enzyme activity (COMT, 11βHSD2, aromatase, and 5α-reductase)
8-hydroxy-2'-deoxyguanosine (8-OHdG)
At-a-glance graphical summary of patient’s results, including key markers, pathways and ratios for added clinical utility

Much like a human fingerprint, metabolism is inherently unique to everyone. Understanding how the major hormones of the body are metabolized as well as the activity of the enzymes responsible for metabolism is a rare glimpse into a patient’s health.

HuMap Clinical and Therapeutic Considerations

There are several ways to test for hormones (saliva, serum, and urine). Urine is the only testing method for monitoring the metabolism of endogenous and supplemented hormones. Keep in mind that urinary metabolism is looking at the endpoint of metabolism and is not necessarily reflective of active tissue levels. If testing patients on BHRT, please refer to instructions for proper timing.

Collection Instructions
Best Practices for Specimen Collection

Average sample processing time

5–7 business days

Sample report

View here

Health categories

Add-ons

Add-on: Comprehensive Neurotransmitter Profile
Add-on: NeuroBasic Profile
Add-on: Urine Amino Acids

Patient instructions

BEFORE YOU START: Please read all of the instructions in the sample collection kit carefully.

Collect urine on days that are determined by you and your provider. We recommend that you adhere to your most common sleep schedule and collect your urine samples as close as possible to the times specified on page 5 of the instructions included in the sample collection kit. Shift workers should adapt the collection times in accordance with sleep schedule.

Patient FAQs and Best Practices for HuMap

Never discontinue prescription medications without first consulting your provider. Please do not send any medications with your kit.

Collection Schedule Summary

Please follow instructions included in sample collection kit.

Day 1 Collection
#1 Dinnertime: collect within 1-2 hours prior to eating dinner
#2 Bedtime: collect within 1 hour prior to sleep

Mid Sleep
Midsleep: collect only if you wake to urinate while sleeping

Day 2 Collection
#3 Waking: collect within 10 mins of waking
#4 Post-waking: collect after 2-4 hours

What days of the month should I collect?

Men, post-menopausal women, and those testing only corticoids: collect any day.
Women with menstrual cycles: begin the collection between days 19 and 23 of a 28-day cycle, counting the first day of your period as day 1.
If cycles are irregular, contact your provider for clarity about the timing of your collection.

Recommendations for women and men on hormones

72 hours prior and during collection: Discontinue oral and sublingual hormones.
72 hours prior and during collection: Do not use hormones vaginally, as this may directly contaminate the urine.
Other hormones such as topical creams and gels, injectables, and patches can be used on your regular schedule.
Do not skip doses of oral birth control pills unless instructed by your healthcare provider.

A baseline hormone level may require supplement usage to stop for a longer period of time. Call your provider with questions.

Additional Recommendations

Cortisol/glucocorticoid supplementation: Consult with your health care provider if you are taking glucocorticoids. Certain medications such as asthma inhalers and hydrocortisone contain cortisol. To evaluate natural cortisol production, it is recommended to stop cortisol containing products 5 days prior to sample collection.
24 hours prior and during collection: avoid alcohol, caffeine, tobacco or nicotine-containing products and strenuous exercise.
24 hours prior and during collection: for best results, minimize fluid intake (between 4-8 cups/1-2L).
The intent of this collection method is to create a urine test that closely represents a 24-hour collection. With this in mind, we want you to include as much urine as possible that is produced throughout a day and night. During the time period that urine is being collected it is important to collect urine from a full bladder as much as possible. It is more important to get a good representation of urine than it is to collect at a precise time.

Patient restrictions