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4OHE • Fact remains that additional methylation support is needed Treatment Goals • Enhance methylation • Decrease Cyp1B1 activity • Increase E2:E16 ratio • Cruciferous vegetables Improve Methylation • Increase substrate for COMT (SAMe) • Add methyl donors • Folate, methylcobalamin (B12) • Trimethylglycine (Betaine) • Vit B6 (to discourage the accumulation of homocysteine and encourage the formation of glutathione via synthesis of cysteine) • There is no physiological mechanism to suggest an adverse interaction between methylation and the metabolism of either taxotere or cytoxan Improve Methylation COMT Cyp1B1 inhibition (ie: reduction of DNA adducts) • Reduce xenobiotic pollutant exposure • N-acetyl Cysteine • Sulforaphane (glucosinolate from broccoli) induces quinone reductase, which takes CEQs back to catechol estrogens, reducing the potential for the creating of DNA adducts