Episode 70: Your Microbiome Controls Your Estrogen
Estrogen is a misunderstood but widely recognized hormone that can make you either happy or miserable, depending on whether it’s in balance. Excess estrogen - a common problem for many women - can contribute to everything from PMS to cancer, endometriosis to infertility, mood, heart disease, heavy periods, and so much more.
This mini-episode features nutritional therapy practitioner Andrea Wien and Emily Sadri, founder of Holistic Women’s Cleveland and certified nurse midwife, talking about what estrogen is, why Emily sees this excess of estrogen in her practice, and the importance of the microbiome in keeping estrogen in check.
Infographic shared with permission from Nourished Natural Health. Check out her article on natural ways to reverse estrogen dominance.
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Andrea Wien: Welcome to the Microbiome Report powered by BIOHM Health. I am your host, Andrea Wien, and today for our mini episode, we have Emily Sadri, a certified nurse midwife on the line to talk to us about estrogen.
Emily, welcome to the show.
Emily Sadri: Thank you so much for having me. It's great to be here.
Andrea Wien: This is really meant to be just a quick overview on why we see so much estrogen dominance and what you see in practice with your patients. We'd love to just get a quick overview on what estrogen is, what it does and what you really see day-to-day.
Emily Sadri: Sure. Estrogen is one of the major female hormones that governs all kinds of processes in the body. We know a lot about it in terms of the menstrual cycle. That's sort of what the general lay person knows about it in relation to as well as pregnancy. It is a hormone that is produced primarily by the ovaries under influence from the anterior pituitary gland in the brain. Like all hormones in the body, it works on a feedback loop. So ideally if it is working well and in concert with your pituitary, your ovaries will know not to produce too much.
It also can be produced by fat cells, which comes into play for so many of my clients who are struggling with unwanted extra weight on their body. So we work on that a lot in terms of what are all the different ways that estrogen is being produced in the body. It is a sex hormone, so it does govern part of the menstrual cycle. It also just contributes to lots of other feelings in the body. Excess estrogen contributes to breast tenderness and mood and sex drive and all kinds of things. When it's in good balance, it's a lovely hormone. It's a hormone of passion and a hormone of connection, but when it's an excess, it can produce all kinds of unwanted feelings and side effects.
Andrea Wien: Why do we see an excess of estrogen, and what role does the microbiome really play in keeping estrogen in check?
Emily Sadri: Yeah, such a good question. There are so many reasons why we see estrogen dominance, which just means that there is too much circulating estrogen in the body. We can see that in sometimes serum, like a blood test, you can see elevated levels above what the normal median levels would be in the general population. You could also see it in hormone metabolites and what our body's excreting in urine and saliva.
We ideally should be able to handle a little bit of maybe extra exposure to estrogen in the environment. You can be exposed to estrogen via parabens, things in your beauty products. Those are pro estrogenic. You can also be exposed to pro estrogenic or pseudo estrogen, things that act like estrogen in our body, in plastics and all kinds of products that we use that are in packaging. Even food wrapped in plastic wrap. Even using plastic dishware. These are especially released if your dishware, or what's containing your food, is heated releases that a lot stronger. So BPA being one of the major drivers of that, which is a major component of plastic as you know.
Andrea Wien: What about in food? I think people sometimes think that tofu or soy, which can be a form of phytoestrogen is bad. Is that the case, or is that being misunderstood for things that are more of like the plastic estrogens that you're talking about?
Emily Sadri: Yeah. That certainly gets talked about. There have been some case studies of say young children or men who are eating a diet very, very high and soy. I really only see it come into play in clinical practice where we remove something and see a benefit when we're talking about very processed soy and in particular the GMO soy, so genetically modified soy. But traditionally, the phytoestrogen or pseudo estrogen that you see activity from tofu or other kinds of soy products is not problematic and can actually be beneficial. And those things we recommend to women who are postmenopausal actually for supporting endogenous estrogen activity in the body.
Back to your other question about the microbiome, really the role of the gut by way of the liver as well, is to help us get rid of anything that is imbalanced in the body, so whether that's toxins or excess hormones. Estrogen is the really big one here, because the major ways to improve estrogen and hormonal balance in the body is really just to have a healthy excretory system. So having regular bowel movements, and not just having daily bowel movements, but having bowel movements that are complete. So a diet that's not rich in fiber may not really be capturing all that the liver is kind of dumping into the bowels to get out of the body. If we're not getting that out of the body, then that can be reabsorbed, especially if you don't have good integrity in the gut lining.
Andrea Wien: What is the role of beta-glucuronidase in this whole process? That's an enzyme that helps to keep these estrogen levels in check, but do we know how that functions with the gut bacteria?
Emily Sadri: Right. When there's an imbalance in gut bacteria, some of the gut bacteria that we don't want around, or if they're growing in excess, can produce excess levels of an enzyme called beta- glucuronidase. Very nice that you brought that up. That enzyme basically un-packages wrapped up estrogen that the liver has said, "Okay, we have enough of this. We're going to sort of package this up, tie a neat little bow on it and send it to the stool." And it's just going to end up going all the way down that highway and out of the body. Well, what happens is if you have too much beta-glucuronidase, it's basically unwrapping that package and releasing this estrogen that the liver knew we didn't need. So the body really cleansed itself.
The way to really deal with that from a very upstream approach is to balance your microbiome health and balance the bacteria. But in a short term, a lot of times what I'll do is if we've been working with someone who's got a lot of estrogen dominance while we're cleaning up the gut, in order to alleviate some of those hormonal symptoms due to excess estrogen, we will give a supplement called calcium D-glucarate, which doesn't get rid of beta-glucuronidase it just blocks the action.
We'll do that for three or six months. In the meantime, hope to clean up the diet, add back more fiber, maybe add some other support to help with estrogen detox. We're always working in multiple areas to hopefully get the result that you want and take away things as the body's mechanisms come back and are more self-sufficient basically.
Andrea Wien: I think too, people who are listening to this and think how big of a deal can it really be. I just maybe use Tupperware or some different plastics. Even receipt paper has a lot of BPA on it. So elevated beta-glucuronidase…try to say that three times fast…those levels are associated with everything from PMS, obesity, cancer, endometriosis, infertility, mood, heart disease. The list really goes on and on. It's not a small problem, right?
Emily Sadri: No. No, it's not. A lot of times people will come to me and they don't even think that estrogen is the driver of what's going on for them. In an allopathic model in general medicine, we know that things like getting your period earlier and going into menopause later and having heavier periods and not breastfeeding are all risk factors for estrogen-driven cancers. And the reason for that is because the longer that you are cycling, the more estrogen your ovaries are producing over the course of your lifespan. The less that you're breastfeeding, the less you're basically turning that system off and pausing ovarian output of estrogen.
We know that there's this large correlation between cancer growth and excess estrogen, and the way that we deal with it in an allopathic model is encouraging people to breastfeed would be one, but the major thing is for people who have very heavy, long cycles where we on a functional space know that that is driven by imbalance in hormones, we suppress that by giving birth control methods that especially have progesterone to really block and suppress that action of estrogen. But truly, if we look back, there has to be other things going on that we should be dealing with besides just treating them with exogenous hormones.
Now I can't even remember what your question was because I got on a little soapbox about this idea…we really do understand that estrogen is damaging, but we are not dealing with it from a multi-system, multifactorial approach in the general population. And that general approach would be so much more than just blocking that action with a pharmaceutical, but really looking at the whole body and saying, "Why is there not good excretion? And what are these exposures that are driving this?" Like you said, it's so many things in our daily life. Even our water has plastic particles. Even the fish that we eat has plastic particles, because our oceans are so polluted with plastic. Even if you think you have a really clean lifestyle, you're doing all of the things, you may still need some extra support around detoxing extra plastic and estrogen exposures just by means of being a human on this planet.
So then you take the average person who is using Tupperware, and then maybe they work in some kind of sales position where they're touching receipts all day, and then they're drinking water out of a plastic water bottle, that by itself, you throw in a little bit of baseline stress, which 99% of people in my practice have, then you throw the whole thing way out of balance. It doesn't seem like a lot, but when you're already starting from a place where the body is working extra hard just to deal with the planet the way that it is, you throw those extra things in and you've got a really systemic problem.
Andrea Wien: Yeah. We did an episode with Josh Gitalis, where he talked about obesogens, which ties into this whole discussion, people who are drinking out of plastic water bottles, why they can't lose weight, and it really ties into this whole estrogen conversation. There's also a new term that I've heard, the estrobolome. That's really the collection of bacteria in the gut that is helping to metabolize and modulate what our body is circulating in terms of estrogen.
So if anyone wants to learn more, this is just our little mini episode, we'll be doing more on estrogen, the microbiome, metabolic syndrome, menopausal women, all of those topics in the next couple of months. So stay tuned. But if you want to check out the show notes for this episode, see some of the spelling of a few of these things, I'll put some different graphics and things up there. You can go to BIOHMHealth.com/pages/podcast.
Emily, thanks so much for joining us.
Emily Sadri: Thank you.
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