Estrogen 101
What is Estrogen?
Estrogen is a feminising hormone that both man and women have in the body (women just have more of). Estrogen is made out of testosterone and is important to maintaining healthy bones, skin, nails and cardiovascular health. It is an extremely important hormone to have but like anything, if we have to much it begins to be problematic.
Estrogen Dominance
Estrogen is proliferative, which means it stimulates growth. It stimulates fat growth so those that are estrogen dominant find it hard to lose weight especially in estrogen fat locations such as lower abdomen, love handles, hips, buttocks, thighs and backs of the arms and may show signs of blood clotting, fluid retention, poor circulation and headaches. Other signs being estrogen dominant are:
- Increased worry.
- Exaggerated response to stress.
- Heightened intuition ‘gut instinct’.
- Run on autopilot.
- Craves sugar and chocolate.
- Mood swings around menstrual cycle or moon phases.
- Bloated around abdomen, hip and thighs.
- Fluid retention and feeling of heaviness.
- Breast lumps and bumps.
- Abnormal results on pap smears and mammograms.
- Blood clots, Deep Veins Thrombosis, bruising.
- Cellulite.
- Sleep disturbances, emotional, nervousness.
- Endometriosis.
- Period pain.
- Heavy periods.
- Migraines.
- Thrush, urinary tract infections.
- Gynecomastia AKA the dreaded man boobs.
- Fat and fluid retention on abdominal, breast, hips, butt, thigh, back of arms and neck.
It is important to note that women and men can carry estrogen dominant fat in different locations. Please see below for a general guide:
Having high estrogen levels in the body can cause many problems therefore stripping out estrogen may be beneficial for both man and women. It is important to note that this does not involve blocking estrogen production or activity, we are referring to working with the body’s natural pathways to make and use estrogen for all of its essential health benefits and menstrual cycle and fertility etc. but then making sure it is efficiently detoxified and eliminated to be stripped from the body rather than accumulate.
To strip out excess estrogen from the body it must be metabolised and excreted. Estrogen metabolism and detoxification is a complex subject which requires many metabolites, cofactors and nutrients to create reactions in the body (see figure 1).
Improve Liver Detoxification Pathways of Estrogen
Phase I
During Phase I detoxification, toxins and metals that we are exposed to from food, water and air are converted into less harmful chemicals through reactions involving the Cytochrome P-450 enzymes. We can get an idea on how well this pathways works by the way you react to caffeine. If you have a cup of coffee in the afternoon and cannot get to bed at night, this pathway will be slow. If you take two cups of coffee in the evening and can sleep well, this phase may be over active.
Hydroxylation (breakdown) of estradiol and estrone rely on CYTP-450 for endogenous estrogens. This takes place at three primary sites yielding 2-hydroxyestrone (2-OH), 4-hydroxyestrone (4-OH) or at the 16α carbon (16α-OH). The 2-OH metabolites are termed the ‘good estrogen’ as it conveys weak estrogenic activity. The 16α-OH is known as the ‘bad’ estrogen as it conveys highly active estrogenic activity that has been linked to migraines, clots, irregular and painful periods and breast cancer. In summary, we want our liver to be converting more of the good 2-OH and less of the bad 16α-OH.
Phase II
Once toxins have turned into water-soluble substances after Phase I, they now enter one of 6 different pathways involved in Phase II to be excreted from the body. Without getting to in depth into the 6 pathways, we will focus on the three pathways estrogen goes down which is sulfation, methylation and glucoronadation. These three pathways require specific vitamins and minerals to function correctly. There are many tools that you can use such as nutrition, herbal medicine and lifestyle modification that you can put into place today to help strip estrogens out of your body.
Nutritional Approach
Dietary and nutrient modification can be just as powerful as medicine as they have the ability to influence estrogen synthesis, receptors, and detoxification pathways. Incorporating the following nutritional supplements have profound effects in reducing estrogen-related diseases:
Insoluble Fiber
Insoluble dietary fibers such as psyllium husk and flaxseeds can bind to unconjugated (free) estrogens in the digestive tract, which are then excreted in the faeces. This is particularly useful at interrupting the internal circulation of estrogens by binding and stripping out the estrogen and inhibiting reabsorption in the intestinal tract.
Insoluble fibre can also beneficially affect the composition of intestinal bacterial and reduce intestinal β-glucoronidase activity. This results in a reduction of reabsorption of estrogen by intestinal bacteria that can cause a vicious cycle of estrogen reabsorption.
Furthermore, lignans that are rich in fibre are found in flaxseeds and other oil seeds, legumes and vegetables. They also inhibit aromatase activity thereby decreasing the conversion of testosterone and androstenedione into estrogen in fat and breast cells. Foods high in lignans are pumpkin seeds, sesame seeds, barley, rye, granola, carrots, cauliflower, green leafy vegetables, broccoli, red cabbage, strawberries and pink grapefruit. To have a therapeutic effect from insoluble fiber I recommend my patients to add in a heaped teaspoon of psyllium husk, flaxseed or inulin in their morning smoothie, over granola or yoghurt.
Magnesium
Magnesium is required in two key liver detoxification pathways of methylation and glucoronidation. Magnesium can optimise methylation and excretion of synthetic estrogens by increasing the COMT enzyme which is required in Phase II methylation. Magnesium can also increase the activity of glucoronyl-tranferase which increases Phase II detoxification glucoronadation. Eating foods high in magnesium such as spinach, chard, pumpkin seeds, kefir, almonds, figs, banana, avocado and dark chocolate can increase your levels of magnesium.
B Vitamins
B Vitamins such as B3, B6, B12 and folate are important cofactors in the phase 2 conjugation reactions. Decreased levels of B vitamins can significantly disrupt the detoxification of estrogen and increase symptoms of estrogen dominance. Folate in particular is needed in the methylation of catechol estrogen, unfortunately synthetic folate can cause more interferences in the body therefore it is important to take a wholefood supplement or increase particular vegetables such as broccoli, avocados and dark leafy greens.
Calcium D-Glucarate
Calcium D-Glucorate is a natural compound that works in the detoxification of estrogen as well as regulation. It inhibits β-glucuronidase and increases the activity of glucoronidations. In other words, it stops the reabsorption of estrogen in the digestive tract and promotes detoxification Phase II pathway. It is one of the most effective supplements to strip estrogen out of the body safely and sufficiently. Dosage ranges can vary from 200-500mg twice per day.
Kelp (Bladderwrack / focus vesiculosis) also works to inhibit beta glucuronidase to keep the estrogen bound and conjugated until it is leaves the body.
Herbal Medicine
Curcumin Longi
Turmeric has been used for centuries for its powerful systemic effects in the body such as being a powerful antioxidant, anti-inflammatory, immune regulator, liver protectant, reduces anxiety and raises mood and conveys a sparing effect on the adrenals and HPA axis. Curcuminoids which are the active constituents in turmeric, increases hepatic levels of glutathione and induces glutathione-S-transferase (GST) and glucuronyl-transferase which are important in Phase II detoxication of estrogen. For many of my patient’s turmeric has become a staple in their kitchen and they benefit from the multitude of benefits. Turmeric is best absorbed when taken with fat so add a teaspoon to scrambled eggs, frittatas, roasted vegetables with olive oil, soups, rice and smoothies.
Chrysin
Chrysin is a bioflavonoids compound that is found in propolis, honey and high levels are found in a particular herb called Oroxylum indicum. Chrysin works by inhibiting aromatase activity and thereby reducing cell proliferation effects of estrogen. This constituent can be extremely effective in estrogenic areas such as the lower abdominal, butt, hips, thighs, love handles, back of arms, back of neck and pecks (for men only of course). These areas can be resilient to exercise and diet because there is poor blood flow to the area and these fat cells produce more estrogen which tell neighbouring fat cells to also produce more estrogen and the cycle can go on. Using Chrysin on these particular body parts transdermally can have a profound effect at reshaping the body by blocking estrogenic activity in local fatty tissue.
Rosemary Officinalis
Rosemary extract works to balance Phase I and Phase II liver detoxification pathways. It modifies Phase I detoxification pathways to switch off the bad 16α-OH pathway and up-regulate the 2α-OH pathway. Rosemary can also enhance Phase II detoxification by enhancing glutathionation and glucoronadation. Rosemary is another staple herb in many of my patient’s kitchen that not only improves liver function but can also improve cognitive function and have powerful antibacterial and antioxidant properties. You can add rosemary to savory muffins, roasts vegetables and meat and salad dressings.
Brassica Oleracea
Broccoli oleracea are the species of plants that include cabbage, broccoli, cauliflower, kale, brussel sprouts and collard green. They contain beneficial phytonutrients, activated vitamins and cofactors that modify CYP450, increasing the good 2α-OH and reducing the bad 16α-OH. Broccoli sprouts contain a chemical called sulforaphane which is one of the most potent detoxification and antioxidant substances found in nature. One study found that 500g/d of broccoli can shift the 2:16 ratio values in humans showing the powerful effects of food being medicine!
Lifestyle Modification
Like it or not our bodies are exposed to many different chemical compounds, including xenoestrogens (XEs) that can be found in the environment, food, air, cosmetics and other substances. These XEs have a negative impact on our health and have been linked to cardiovascular diseases, metabolic diseases, immune deficiency and cancer. These disease states are partly due to how these compounds interfering with the signalling of pathways in response to estrogens. XEs are a vast group of natural and synthetic compounds which act like estrogen in the body adding to an increased estrogenic activity and disrupt the body’s endocrine system (hormonal systems). Avoiding xenoestrogens can significantly reduce the risk of estrogenic disease and reduce the exposure to your family in the process.
Harmful Endocrine Disruptors
Bisphenol A (BPA)
BPA is an endocrine disruptor that leach into your food from plastic bottles, containers and metal cans that’s have the plastic interior. BPA has raised many health concerns in particular to pregnant women as BPA crosses the placenta where it is exposed to the fetus. There may also be concerns in BPA being linked to structural damage in the brain, hyperactivity, increased obesity, altered immune function, changes in gender-specific behaviours, early puberty, infertility, stimulation of prostate cancer cells and decreased sperm production.
Reduce your exposure to BPA as much as possible. Absolutely no microwaving food in plastic as this increases the BPA to leach into your food!
Phthalates
Phthalates can be found in almost everything such as household cleaners, food packing, fragrance, cosmetics and personal care products. Recent research has linked this chemical to asthma, attention deficit hyperactivity disorder, breast cancer, obesity, Type II diabetes, low IQ, neurodevelopmental issues, autism, altered reproductive development and male fertility issues. Phthalates may also affect the activity of aromatase which converts testosterone into estrogen. This can directly increase androgenic activity in the body causing weight gain, acne and mood swings. To reduce your exposure start buying fresh organic whole foods from grass fed organic meats and as much fruit and vegetables organic. Start using natural cleaning products and switch or natural toiletries including shampoo, toothpaste, deodorants and cosmetics.
Exercise
There is nothing more powerful than allowing our body to do what it is designed to do, move. The benefits of physical activity are profound. Physical activity can help strengthen your bones and muscles, improve your mental health, reduce obesity and risk of cardiovascular disease and improve longevity. Because exercise can systematically impact every organ, every cell and every functioning in your body, it is by far the best lifestyle modification that you can start implementing today to help improve your hormonal levels and strip out estrogen. If you are new to exercise start by walking 30 minutes in the morning each day. Embracing movement such as Pilates and Yoga for both men and women can also have profound benefits on longevity.
References
Hall, D 2001, Nutritional Influences on Estrogen Metabolism, Applied Nutritional Science Reports,
Bronowicka-klys, D et al 2016, The role and impact of estrogens and xenoestrogens on the development of cervical cancer, Biomedicine and Pharmocatherapy, vol.84, pp.1945-1953.
Rochester, J 2015, Bisphenol S and F: A systematic review and comparison of the hormonal activity of Bisphenol A subsitutue, Environmental Health Perspectives, vol.123, no.7, pp.643-50.
Fowke, J et al 2000, Brassica vegetable consumtption shifts estrogen metabolism in healthy postmenopausal women, Cancer Epidemiol Biomarkers Prevention, vol9. Pp.773-779.
Blog written by ATP Naturopath Racheal Lee