Some History and Estrogen Shocker #2
Part one of this series explained what the progesterone to estrogen ratio is and that estrogen is the problem in 95% of cases regardless of what your lab tests tell you and that estrogen detoxification is critical.
If you read between the lines on that statement, then you may have realized that in my professional opinion, saliva and blood tests don’t seem to be as accurate as we hoped they would be.
How did I arrive at this conclusion?
Women kept coming in to the office with symptoms of hormonal imbalance and yet their physician said they were just fine. By carefully utilizing my A.S.K. (Anderson Specific Kinesiology) approach in my office, I repeatedly found what indicated a metabolism problem with estrogen.
Over time, regardless of what the standard labs would indicate I would treat what I found through my in-office protocol, my other diagnostic examination findings as well as signs and symptoms as the patient described them. This meant that I would treat estrogen dominance in most cases regardless of the patient having “normal” labs.
What did I find? Based upon the treatment, my patients and I observed that detoxification of estrogen improved most if not all symptoms, time and time again.
If I would have gone off of the lab tests alone, these women would have been classified as “normal” or in many cases, their “undetectable” estrogen levels that the lab tests showed would indicate a need to actually add MORE estrogen by using hormone replacement therapy (HRT). Which would have been the opposite of what they needed.
Current Estrogen Testing Methods
What I didn’t reveal in part 1 is there are currently only two ways that I feel are reliable for providing accurate information regarding the status of ones estrogen. The first is using the A.S.K (Anderson Specific KinesiologyTM) approach to treating patients. This is the most time efficient and cost effective way for me to look at a patient’s hormone status. (In my opinion it is also the most accurate and effective).
The second that I have found recently is the “Dutch Test” by Precision Analytical. The Dutch Test is a simple dried urine test that looks at hormones and their metabolites a little closer than other methods.
Why do I like the Dutch Test? Simply because I have found that when patients bring in their profiles, it matches what I find clinically, what the patient says symptomatically and through the A.S.K. (Anderson Specific KinesologyTM) approach.
Note: Sometimes in today’s world of functional medicine and as testing truly is getting better, patients and practitioners alike get caught up in lab values, but these lab values do not always reflect what a patient is describing as their symptoms. In fact, the art of a thorough history and connecting the dots in ones health history is all but lost these days. (But that’s another article.) For now, just know that a clinician that can piece together the puzzle of your history and symptoms is an invaluable find.
How To Detoxify Estrogen
Let’s FINALLY get started on the detoxification of estrogen and how that works. A quick warning that some of this might be a little technical, but at the end I will simplify it enough that you will have some easy steps and supplements to decrease your estrogen! Yay!
Phase 2 Liver Detoxification
The first step in the detoxification of estrogen is called hydroxylation. For simplicity, we refer to hydroxylation as phase 1 liver detoxification. (Although it also occurs in breast tissue, ovaries, pancreas, etc.)
Too much phase 1 activity and you will end up with too many free radicals, inflammation and tissue damage. Too little phase 1 and you won’t be able to detoxify estrogen and other toxins fast enough.
Genetics
I am the last person that is going to tell you that your genetics determine your fate, but I will say that certain people, based upon their genetic profile have to be a little more careful with developing estrogen dominance.
Your genetics can alter your detoxification rate of both phase 1 and phase 2 liver detoxification processes. So, if you are someone that says, all the women in my family have breast cancer, PMS, cramping, bloating, etc. you may already know that you need to be very careful with the factors that lead to estrogen dominance. (Click here for some of the causes of estrogen dominance.)
Phase 2 Liver Detoxification of Estrogen
Phase 2 liver detoxification is the most common place that I see estrogen metabolism fall apart. The reason for this is that it is easily overburdened with pesticides, birth control, bio-identical hormones, food additives and preservatives, cleaning chemicals, unhealthy gut infection toxins, GMOs and much more.
Let’s focus on estrogen detoxification in the liver for a second. In my experience, 90% of women appear to have estrogen in excess and phase 2 liver detoxification is overburdened by the large amounts of estrogen.
If we then choose to add hormones to the body, even progesterone, then the liver has MORE hormones to detoxify in an already overburdened system. Testosterone therapy is another common form of HRT also being used for women.
In women testosterone is quickly converted to estrogen and thus the load of estrogen increases even more. At first you will see all the improvements from testosterone like increased libido, mental clarity and stamina, but over time the slow trickle in to estrogen can be very problematic.
Optimizing Phase 2 Pathways
In phase 2 liver detoxification, there are 3 major pathways that need to be considered when detoxifying estrogen. These 3 pathways are methylation, glucuronidation and sulfation. (Don’t be afraid of the big words!) Arguably there are many other pathways that detoxify estrogen as well, but for some reason those pathways appear to be less of the cog in the wheel in my experience.
Methylation of Estrogen
Methylation acts to convert estrogen into safe metabolites. Most of the time it acts as the intermediate step in the detoxification of estrogen and then sulfation and glucuronidation do a lot of the rest. Methylation converts estrogen into certain forms of estrogen that can be both beneficial and/or harmful. 4OH and 16OH estrogens have been linked to detrimental effects in the body and much of the carcinogenic activity of estrogen we often hear about.
If you know you have elevated 4OH or 16OH hormones, I often find that by utilizing DIM or indole-3-carbonol you can restore balance to the system. For long-term success, you may also need specific methylation support with nutrients such as betaine TMG, methyl-B12, 5MTHF, methionine, etc.
Sulfation of Estrogen
The sulfation system is critical for detoxifying drugs, food additives and toxic byproducts from bacteria. It is the main pathway for the elimination of steroid hormones (estrogen), brain neurotransmitters and thyroid hormones.
The first and most important thing to do to optimize sulfation is to eat enough protein. 90 grams of protein per day is the minimum I require for my patients to help them recover if they are experiencing any symptoms at all of hormone imbalance. The protein provides sulfur donor proteins like methionine and cysteine that are required for detoxification
To support sulfation in my patients I often use L-cysteine. Often times if methylation is working properly, B6(P5P) is needed to convert homocysteine into cysteine. Cysteine is also the rate limiting step for glutathione production, the body’s “master antioxidant.”
Glucuronidation of Estrogen
By far, metabolic regulation of glucuronidation is the most common estrogen metabolism issue I see in my office. The simple reason is because it requires glucose (aka sugar) to properly function. You may be thinking….”I eat tons of sugar!” And that is the problem :)
For glucuronidation to work properly, you must have a healthy glucose and insulin balance that is steady and stable without frequent peaks or troughs. If you eat too much refined carbohydrates or added sugar you will have a problem, if you don’t have adequate protein you will have a problem and if you don’t have any carbohydrates in your diet you will have a problem.
For many (maybe most) people, their carbohydrate consumption is too high. Consumption of high-fructose corn syrup or other unnatural sweeteners will also throw off your glucose balance, even if they are calorie free. The current fad of gluten-free foods also spike insulin levels and create blood sugar instability.
For others they may be missing a critical vitamin such as chromium, vanadium, magnesium or B vitamins to help with blood sugar stabilization. Still in others, excessive stress throughout the day from training, work and relationships elevate their cortisol causing blood sugar highs and lows. Lastly, food allergies can disrupt blood sugar metabolism via their effect on cortisol also.
The most common solution here is figure out how to balance your blood sugar and use short term support in the form of a supplement. The most potent herb to detoxify estrogen that I use in my office is Artichoke Extract from AMG Naturals. With estrogen detoxification it doesn’t happen overnight, so I ask women to use their hormonal symptoms as guides to how much artichoke they may need. With estrogen detoxification it is also important to start slow as detoxification symptoms can occur.
With artichoke extract many women start with as few as 2 capsules per day, but may work up to 6 capsules over the course of 1-2 weeks if no negative symptoms are found. Also, even at 6 capsules per day, if your symptoms are pretty severe, you may need to complete 2 or 3 bottles of the artichoke. After that, if symptoms remain, it is unlikely to be related to this liver pathway.
Enviromental Estrogens
Belly fat is a large source of estrogen production and high estrogen also leads to belly fat accumulation a self-perpetuating cycle. If you have over 15 lbs of belly fat that won’t go away, then you can almost guarantee that you have more than enough estrogen in circulation.
To keep the “theme” going, many women come to my office after being on hormone replacement therapy and can’t figure out why they can’t seem to lose weight. The first reason is due to increasing estrogen and the second reason is often because they are taking testosterone and have increased their overall body mass. (Side benefits/effects they weren’t warned about.) In an effort to be transparent, I personally haven’t seen weight gain correlate as directly with progesterone, but there are some women that report it.
The herb artichoke extract in low doses is a great herb to help with estrogen detox as you work on decreasing extra body fat. It has also been shown to help regulate insulin response, which may be why it is so useful.
Estrogen Conclusion
To simplify the detoxification of estrogen I will tell you that the two most important factors I find in my office are to firs stabilize your blood sugar by eating 90 or more grams of protein per day and second to support liver detoxification, for which I use Artichoke Extract from AMG Naturals.
L-Cysteine is a common supplement I use for sulfation support also, but if you have digestive problems, it will likely cause more symptoms than help. The most common vitamin deficiency I see in females with regards to hormone imbalance is B6(P5P). This is usually due to depletion from long-term exposure to birth control or other medications, but also helps with estrogen detoxification in all phases of liver detox and can give your brain an added boost.
Back to fixing your sugar handling. Whether feel you can tolerate processed carbs or not, sticking to complex carbohydrates and eating over 90 grams of protein per day will help you to balance your glucose. Eliminate stress as much as possible and simply eat whole foods rather than things in packaging.
Part 3 will cover increasing your progesterone, but it is not nearly as critical as detoxing your estrogen in most cases. Remember that 9 out of 10 women that suffer from hormonal symptoms have too much estrogen and progesterone is like the icing on the cake!
Which you shouldn’t be eating due to your estrogen problem :)
By addressing estrogen detoxification in a natural way instead of adding hormones and mucking up your liver detoxification, you can see lasting results. You won’t have to go and get your hormones checked every 6 months to a year and if you do see any of the nasty estrogen symptoms coming back, listening to our body and taking a few supplements can help reverse those symptoms more quickly in the future.
Click Here For Dr. A’s Top 3 Favorite Supplements For Female Hormones
If you have questions or need a recommended practitioner, please schedule a phone consultation above.
REFERENCES :
- Barbieri R.L. (2014) The Endocrinology of the Menstrual Cycle. In: Rosenwaks Z., Wassarman P. (eds) Human Fertility. Methods in Molecular Biology (Methods and Protocols), vol 1154. Humana Press, New York, NY PMID: 24782009
- Grodin, J.M., et al.(1973). Source of estrogen production in postmenopausal women. J. Clin. Endocrinol. Metab. 36(2): 207-14.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138025/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063249/
Excellent article Thanks! I’m working through this very issue, and it’s a really big deal 😩
Claire, thanks and keep up the good work!