Hi Friends,
Hormonal imbalances are often blamed for a range of unexplained symptoms, but did you know that estrogen dominance is one of the most common and overlooked culprits? This imbalance occurs when estrogen levels are too high relative to progesterone, or when the body struggles to properly metabolize and eliminate estrogen.
As an integrative medicine physician, I regularly measure hormone levels through blood tests and frequently see sky-high estradiol levels in both men and women. I've seen women with estradiol levels > 500 (normal is 150-250 pg/mL) and men with estradiol levels > 70 (normal is < 39 pg/mL).
Common Symptoms of Estrogen Dominance
For women, estrogen dominance manifests in several ways, including:
- Breast cysts, fibrocystic breast changes, dense breasts and breast cancer
- Uterine fibroids
- Endometriosis
- Endometrial cancer
- Heavy periods
- Thyroid nodules
- Ovarian cysts
- Weight gain, particularly in the hips and thighs (pear-shaped body habitus)
- Premenstrual syndrome (PMS) and mood swings
- Migraine headaches
Women who are not ovulating regularly due to PCOS or due to perimenopause are also frequently estrogen dominant due to the lack of progesterone.
Men are not immune to estrogen dominance either! Due to exposure to xenoestrogens (chemical estrogens) from non-organic meat and dairy, plastics (BPA, phthalates), and environmental toxins, men can experience an increase in estrogen levels. Additionally, testosterone can be converted to estrogen through a process called aromatization in fat cells. This can lead to gynecomastia (male breast tissue), weight gain, and fatigue.
Understanding Estrogen Metabolism: The Three Phases of Detoxification
The body processes estrogen through a sophisticated detoxification system:
- Phase 1 (Liver Detox – Hydroxylation): Estrogen is first processed in the liver. The goal is to favor the production of 2-hydroxyestrone, a "clean" metabolite, over "dirty" metabolites like 16-hydroxyestrone, which is linked to estrogen-driven cancers.
- Phase 2 (Conjugation – Methylation & Glucuronidation): The liver then prepares estrogen for excretion through methylation, dependent on the COMT enzyme, which requires Magnesium.
- Phase 3 (Gut Elimination – The Role of the "Estrobolome"): Once estrogen is metabolized by the liver, it travels to the intestines. However, an unhealthy gut microbiome, or dysbiosis, can lead to high levels of beta-glucuronidase, an enzyme that recycles estrogen, sending it back into circulation rather than eliminating it.
Why Conventional Treatments Are Often Limited
Most doctors prescribe birth control pills as a solution for symptoms caused by estrogen dominance, as a way of shutting down your body's natural estrogen production. While birth control can help regulate cycles, it does not aid the body in metabolizing and eliminating excess estrogen. Additionally, it may cause unwanted side effects such as weight gain, B vitamin deficiencies, mood changes, low libido, and disruptions to the gut microbiome.
How to Naturally Balance Estrogen Levels
A functional medicine approach focuses on supporting estrogen metabolism and detoxification through targeted lifestyle changes and supplements:
1. Key Supplements for Estrogen Detoxification
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Estrogen Balancer: Like a "broccoli pill", it contains Diindolylmethane (DIM) and Indole-3-Carbinol (I3C) which promote the breakdown of estrogen into "clean" metabolites.
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Calcium-D-Glucarate: Inhibits beta-glucuronidase, ensuring estrogen is properly eliminated through the gut rather than being recycled.
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Magnesium: A cofactor for COMT, the enzyme that helps detoxify estrogen through methylation in the liver.
- Zinc: Helps inhibit aromatization, reducing the conversion of testosterone to estrogen in fat cells.
- Vitamin D3 with K2: Research shows that low Vitamin D levels are associated with symptoms of estrogen dominance like fibroids. Optimizing vitamin D level is critical to balancing hormones.
2. Minimize Alcohol
Alcohol impairs liver detoxification and increases estrogen levels, worsening symptoms of estrogen dominance. Eliminating alcohol can significantly improve hormonal balance.
3. Prioritize Organic Meat and Dairy
Conventional meat and dairy contain hormone residues that contribute to estrogen overload. Choosing organic, grass-fed, and pasture-raised options helps reduce xenoestrogen exposure.
4. Eat More Cruciferous Vegetables
Broccoli, cauliflower, Brussels sprouts, kale, arugula and cabbage are rich in DIM and I3C, supporting healthy estrogen metabolism.
5. Ensure Adequate Fiber Intake
Daily bowel movements are essential for estrogen elimination. Aim for 25-35g of fiber per day from vegetables, chia seeds, and whole foods to prevent estrogen from being reabsorbed into circulation. Supplement with Prebiotic Fiber if needed.
6. Clean Up Personal Care Products
Many cosmetics, skincare products, sunscreens and household cleaners contain xenoestrogens that mimic estrogen in the body. Look for paraben-free, phthalate-free, and BPA-free products, and opt for natural alternatives whenever possible to reduce exposure to these hormone-disrupting chemicals. You can check your products on the Environmental Working Group's website (ewg.org)
Final Thoughts: Take Control of Your Hormones
Estrogen dominance is a very treatable condition! By eating a healthy diet, supporting liver detoxification, and reducing xenoestrogen exposure, you can restore hormonal balance naturally.
If you're experiencing symptoms of estrogen dominance, please watch my video for a step-by-step guide to learn the most effective strategies for restoring balance naturally. By addressing the root causes with an integrative and functional medicine approach, you can naturally support your body's ability to balance hormones and feel your best.
Broccoli 🥦 is a cruciferous vegetable that has sulforaphane, which has anti-cancer properties. It’s also a rich source of diindolylmethane (DIM), which has estrogen-metabolizing properties.
This is one of my favorite soups in the cooler winter months!
Spicy Broccoli Soup 🥦
Ingredients:
Instructions:
Thanks for reading this week’s newsletter! If you found this information valuable, consider sharing it with a friend or loved one who may benefit—especially those struggling with hormonal imbalances. Your support helps spread awareness and empower others on their journey to better health.
Warm regards,
