HSA | FSA CARDS ARE NOW ACCEPTED

Understanding NQO1 and Estrogen Metabolism

Estrogen plays a central role in reproductive health, menstrual cycles, and overall hormone balance. The NQO1 gene makes an enzyme that helps detoxify harmful estrogen byproducts, especially estrogen quinones, which can cause oxidative stress and damage to DNA if not cleared effectively. Variations in the NQO1 gene influence how well this enzyme works and can affect the body’s ability to safely process estrogen metabolites.

How this affects health

  • Lower NQO1 activity can allow estrogen quinones and other reactive compounds to accumulate, increasing oxidative stress.
  • When detoxification is reduced, people may be more prone to estrogen-dominant symptoms such as heavy periods, severe PMS, fibroids, or other hormone-related concerns.
  • Environmental toxin exposure, rapid phase I estrogen metabolism, low antioxidant status, and poor liver or gut health can amplify effects of reduced NQO1 function.
  • Even with optimal NQO1 function, lifestyle and diet choices help maintain balanced estrogen metabolism and protect long-term health.

General goals to support healthy estrogen metabolism

  • Promote phase II detoxification and antioxidant defenses to neutralize estrogen quinones.
  • Support glutathione production and recycling, a key intracellular antioxidant.
  • Enhance liver and gut health to aid elimination of estrogen metabolites.
  • Reduce exposure to environmental toxins and limit alcohol to lower overall toxic load.

Practical diet, supplement, lifestyle, and testing recommendations

The suggestions below are educational and intended to help you discuss options with your healthcare provider. PlexusDx does not provide medical advice. Always consult your healthcare provider before starting supplements or making major diet or lifestyle changes.

Diet

  • Eat cruciferous vegetables daily: broccoli, kale, Brussels sprouts, cabbage, cauliflower and bok choy supply glucosinolates that support phase II detoxification pathways.
  • Increase antioxidant-rich foods: berries, cherries, dark leafy greens, and green tea provide polyphenols that reduce oxidative stress.
  • Support glutathione precursors: garlic, onions, asparagus, avocados, and sulfur-containing foods help the body produce glutathione.
  • Focus on high fiber: whole grains, legumes, fruits, vegetables, and seeds promote gut elimination of estrogen and improve bowel transit time.
  • Limit alcohol and processed foods: alcohol increases liver burden and can worsen estrogen imbalance.

Supplements to consider with your provider

  • N-acetyl cysteine (NAC) to support glutathione synthesis and antioxidant defenses. Discuss appropriate dosing with your provider.
  • Vegetable-based glucosinolate or sulforaphane supplements if dietary intake of crucifers is limited.
  • Alpha-lipoic acid and milk thistle to support liver antioxidant capacity and detox pathways where appropriate.
  • Vitamin C and E in food-first amounts to bolster antioxidant status.
  • Methylation and B vitamin support if indicated by testing, because methylation influences detox pathways.

Lifestyle

  • Reduce toxin exposure: choose low-toxin household and personal care products, avoid unnecessary plastics and household chemicals, and limit pesticide exposure where possible.
  • Maintain a healthy weight and body composition to reduce estrogen production from adipose tissue.
  • Prioritize regular exercise: aim for a mix of aerobic and resistance training to support hormone balance and metabolic health.
  • Improve sleep quality: 7 to 9 hours of consistent sleep helps hormone regulation and detox pathways.
  • Manage stress through mindfulness, breathing practices, or gentle movement to reduce hormonal disruption from chronic stress.

Blood tests and clinical monitoring to discuss with your provider

  • Complete hormone panel relevant to symptoms: estradiol, progesterone, and relevant cycle-timed measures.
  • Liver function tests to ensure safe detox capacity.
  • Thyroid panel as thyroid function affects hormone metabolism.
  • Oxidative stress or antioxidant markers when clinically indicated.
  • Comprehensive metabolic panel and nutrient status tests if considering supplements long term.
2 effect alleles (AA) — very reduced NQO1 activity

You carry two copies of the effect allele. This genotype is associated with very reduced NQO1 enzyme activity, which limits your body’s ability to detoxify estrogen quinones and other metabolic toxins. With lower enzyme function, potentially damaging compounds may not be cleared efficiently. This can increase risk for estrogen-dominant symptoms such as heavy periods and PMS, and may raise susceptibility to hormone-related conditions including fibroids, breast or uterine concerns, and increased oxidative stress. The effects are most pronounced when environmental toxin exposure is high or phase I estrogen metabolism is rapid.

Actionable strategies

  • Maximize cruciferous vegetable intake daily to support alternative detox pathways.
  • Prioritize glutathione support through dietary sulfur foods and consider NAC under provider guidance.
  • Increase antioxidant foods like berries, green tea, and dark vegetables to reduce oxidative stress.
  • Optimize fiber and gut health to enhance elimination of estrogen metabolites.
  • Reduce alcohol and minimize exposure to environmental toxins and hormone disruptors.
  • Discuss targeted testing with your provider, such as hormone panels and liver function, if you have symptoms.
1 effect allele (AG) — moderately reduced NQO1 activity

You carry one copy of the effect allele. This genotype is associated with moderately reduced NQO1 enzyme activity. Your detoxification of estrogen quinones may be slower than someone with two non-effect alleles, which can modestly increase risk for estrogen-dominant symptoms and oxidative stress if other risk factors are present. Lifestyle and dietary choices can substantially offset this genetic difference.

Actionable strategies

  • Include cruciferous vegetables several times per week and emphasize a colorful, antioxidant-rich diet.
  • Support glutathione with foods and consider discussing NAC or other liver-support supplements with your provider.
  • Maintain high fiber intake and strengthen gut health with fermented foods or targeted probiotics as advised.
  • Limit alcohol and environmental toxin exposure to reduce cumulative detox burden.
  • Consider periodic monitoring of hormone levels and liver health if symptoms arise.
0 effect alleles (GG) — full NQO1 activity

You carry two copies of the non-effect allele. This genotype is associated with full NQO1 enzyme activity, providing efficient clearance of estrogen quinones and other metabolic byproducts. Robust NQO1 function helps protect DNA from damage and reduces oxidative stress, supporting balanced estrogen metabolism and potentially lowering risk of estrogen-related issues.

Actionable strategies

  • Continue a diet rich in cruciferous vegetables, antioxidants, and fiber to sustain liver and hormone health.
  • Keep toxin exposure low, limit alcohol, and maintain physical activity and healthy sleep patterns.
  • Routine care and preventive testing as advised by your provider will help maintain long-term balance.

Final notes

Genetics is one piece of the health puzzle. Lifestyle, environment, other genes, and clinical factors all shape hormone balance and overall risk. The recommendations above are educational and meant to help you discuss practical steps with your healthcare provider. PlexusDx does not provide medical advice. Always consult your healthcare provider before making changes to your diet, starting supplements, or pursuing medical tests or treatments.