Natural Ways to Help Normalize Elevated Estrogen Levels
Written by Willie Hernandez, CNS
What is Estrogen?
Estrogen is a sex hormone needed for women’s sexual and reproductive health and to give women physical characteristics like breasts and pubic hair. It is the hormone that causes girls to develop into adults during puberty and is crucial to fertility. Estrogen is very important, as it is needed in numerous functions throughout the body, like bone formation and cardiovascular health to name a few. Though both women and men have estrogen in their bodies (men in much smaller amounts), estrogen has been studied in the maintenance and control of cholesterol levels and to protect the brain and skin, as well.
What role does estrogen play in the body?
In the body, estrogen is primarily synthesized by the ovaries (which produce a women’s eggs), the adrenal cortex (adrenal glands located at the top of your kidneys), and adipose tissue (fat cells).1 Within these tissues is an enzyme called aromatase that converts androgens (i.e. testosterone) into estrogen. Estrogen is then transported by a protein called Sex Hormone Binding Globulin (SHBG), synthesized by the liver and transported throughout your body. But in order for estrogen to be able to exert its force, it must be able to circulate freely to estrogen receptors (ER) throughout the body and must not be attached to SHBGs. The body has many estrogen receptors but is heavily concentrated in estrogen sensitive tissues, like in the breast and uterus. Estrogen receptors are like a special lock that only estrogen has the key to activate.2
Estrogen is metabolized by the liver by two primary phases known as Phase I and Phase II. Phase I is the main metabolic pathway in which estrogen is further broken down into three other pathways – the 2, 4, and 16 pathways. The preferred pathway is the 2-hydroxy pathway, which produces a weak estrogen. The 4 and especially the 16 pathway produces a very potent estrogen able to provoke estrogen sensitive tissue like the breast and uterus and make it more susceptible to health risks and cancer.2 The Phase II pathway involves the attachment or conjugation of a molecule called glucuronide to the estrogen that travels into bile and the gut to be eliminated.1
Higher estrogen production
While estrogen plays an important role in overall health, some women and men will develop elevated estrogen or estrogen dominance. This can lead to health problems due to changes in estrogen production, metabolism and elimination provoked by being overweight, excess adipose tissue, elevated blood sugar, poor diet, sluggish liver and poor elimination, low progesterone, medication, and xenoestrogen.1
Because estrogens prime function is to stimulate cell growth, too much can contribute to abnormal tissue proliferation as seen in uterine fibroids, endometriosis, and cervical dysplasia; it can also influence cancer in the ovaries and breast and prostate in men. One approach to help normalize estrogen levels in the body is to reboot our body system through lifestyle modifications to help reduce estrogen production (aromatase inhibitor and downregulate estrogen receptors), optimize the liver, and increase elimination.
Lower estrogen production and receptor activation
You can reduce estrogen production by lowering aromatase activity. Aromatase is the rate- limiting enzyme that synthesizes estrogen in both women and men in two ways - converting androstenedione to estrone (E1) and testosterone to estradiol (E2). The more aromatase the body has, the more estrogen is made. One way to reduce aromatase activity is to take specific key nutrients such as Chrysin, Lignans from Flaxseed, Green tea (EGCG) and Zinc.2
Secondly, blocking estrogen receptors (especially in estrogen sensitive tissues) helps stop tissue growth. Pharmaceutical drugs such as tamoxifen and raloxifene, known as selective estrogen receptors modulators (SERM), have been shown to be able to block estrogen receptor actions.2 However, there are natural compounds known as phytoestrogens able to influence estrogen receptors. The two main phytoestrogens are lignans from flax seeds and isoflavones from soy. Lignans and isoflavones are not estrogen but they have similar structures to estrogen and are able to take up the same estrogen receptor blocking estrogen, which blocks the estrogen from going in and activating it. Both lignans and isoflavones are able to stimulate SHBG production, reducing active circulating estrogen.3
Optimizing liver pathways
There are nutrients that can influence healthy estrogen metabolism in the liver. There is a class of vegetables known as cruciferous vegetables such as broccoli, brussel sprouts, and radish which contain compounds called indole-3-carbinol (I-3-C). The body converts I-3-C into many important metabolites but the most promising is diindolylmethane (DIM).4 In the body, I-3-C and DIM can induce liver enzymes to favor the 2 pathways and upregulate the tumor suppressor breast cancer (brca1) gene5, to name a few.
The longer the conjugated estrogen from the bile lingers in the gut, the higher the chances it is able to uncouple and recirculate back into the blood. An unhealthy gut flora (healthy bacteria) secretes an enzyme called beta-glucuronidase. This enzyme is able to uncouple the glucuronide molecule from estrogen, making it active again. This allows estrogen that is supposed to be eliminated in stool, to be reabsorbed back into the blood through the enterohepatic pathway.1
The first method to ensure a healthy gut is to increase probiotic and prebiotic consumption as a nutritional intervention, which can help elevate good bacteria in the gut, lowering beta-glucuronidase enzyme synthesized.2 The second method is an oral supplementation of calcium –D; glucarate has been shown to inhibit the enzyme beta-glucuronidase. It has been shown that when calcium-D-glucarate is metabolized to D-glucaro-1,4-lactone in the gut, is able target and inhibit beta-glucuronidase activity excreting estrogen before they can become reabsorbed, ultimately decreasing risk of cancer and other health risks.6
By adhering to a healthy diet that is high in fiber, eating vegetables (especially cruciferous vegetables), having an ideal weight, exercising, managing your stress, controlling your blood sugar, eliminating as much xenoestrogen (i.e. hormone replacement therapy contraceptive, PCB, BPA and growth hormones in meats) and taking specific nutrients, you are able to not only lower estrogen but lower the risk of fibroids, endometriosis and many other diseases and conditions.
1. Evans,MD, J. M. (2008, November). An Integrative Approach to Fibroids, Endometriosis, and Breast Cancer Prevention. Integrative Medicine, 7(5), 28-31.
2. Nutritional Influences on Estrogen Metabolism. (2001, January). Advanced Nutritional Publications, Inc., 1-8.
3. Lord, R. S. (2002). Estrogen Metabolism and the Diet-cancer Connection [Abstract]. Alternative Medicine Review, 7(2), 112-129.
4. Antoine, E., DO, FACEP, ABIHM,IFMCP. (2016). The Steroidogenic Pathway: Understanding what Influences Each Step [PDF]. Genova Diagnostics.
5. Auborn, K. J. (2003). Indole-3-Carbinol is a Negative Regulator of Estrogen. The Journal of Nutrition, 2470s-2475s.
6. T. (2002). Calcium-D-Glucarate Monograph. Alternative Medicine Review, 7(4), 336-339.