Oestrogen plays a vital role in health and well-being.
While it's crucial to have sufficient oestrogen levels, an excess can lead to complications; the total exposure to oestrogen we experience is about more than just how much is produced but also how it breaks down into various metabolites.
Too much oestrogen, or oestrogen that isn't adequately metabolised and eliminated, can lead to various symptoms and health issues, including an increased likelihood of developing breast or endometrial cancer.
Oestrogen is metabolised primarily in the liver and, to a lesser extent, in the gut, so allowing its inactive by-products to be eliminated.
However, this process is complex and subject to numerous influences. Detoxification can occasionally lead to an overproduction of potent metabolites, which exert a stronger oestrogenic effect.
When exploring hormonal imbalances and conditions influenced by oestrogen, understanding hormone metabolism is critical.
Detoxification of oestrogen occurs in three phases, aptly named phases 1, 2, and…3!
Phase 1 and 2 occur in the liver, and phase 3 in the gut.
Phase 1: Activation
Oestrogen is transformed into a form that must be further processed. This phase involves enzymes that modify the oestrogen molecule. It's like prepping a vehicle for a journey; the body is getting the oestrogen ready to be further processed and eventually eliminated.
However, this phase has its risks. The metabolites produced can sometimes be more reactive and potentially harmful if not managed correctly. This makes the next phase (phase 2) incredibly important.
Oestrogen in this stage can be converted into 3 different forms via different enzymes of the CYP family.
2-OH: This is considered the best as it creates a weak metabolite.
4-OH – not so good – this tends to push towards a DNA damage form.
16-OH – is more potent, is good for bone health, and can generate symptoms of oestrogen dominance.
It is possible to help 'push' oestrogen down the 2-OH pathway more through supplements, cruciferous veggies, raw carrots, and various lifestyle changes such as reducing alcohol.
However, the CYP enzymes do not just work on oestrogen, so it is essential to make sure that you work with a practitioner if you are using supplements.
Phase 2: Conjugation
Phase 2 is all about making the oestrogen water-soluble so it can be easily excreted from the body. This happens through a process called conjugation. Here, the liver adds a compound to the oestrogen metabolites, making them less harmful and easier to eliminate. It's akin to packaging waste to safely and efficiently dispose of it.
The effectiveness of Phase 2 is crucial. If sluggish or impaired, those reactive metabolites from Phase 1 might hang around longer than they should, potentially causing damage.
Phase 2 is primarily controlled by genetics.
These can be impacted by gut infections, green tea, and early life adversity. It is possible to support this process through supplements.
Phase 3: Elimination
Finally, Phase 3 involves the actual elimination of oestrogen from the body. This occurs through the intestines and the kidneys. In the intestines, oestrogen is bound to fibre and excreted through the stool, while the kidneys filter out waste and excess substances to be passed in the urine.
This phase is heavily influenced by your gut health, diet, and inflammation. For example, a diet rich in fibre can promote the elimination of oestrogen.
The Importance of a Smooth Operation
All three phases must function smoothly for oestrogen detoxification to protect and promote health. If one phase is sluggish or overactive, it can lead to a build-up of oestrogen or its harmful metabolites, contributing to various health issues.
As the diagram shows – think of this whole process as a bathtub filling and emptying. (This analogy is courtesy of Dr. Carrie Jones)
Phase 1 = filling the bathtub – you must drain it sooner or later.
Phase 2 = draining it – if this is too slow or not working correctly, the bathtub may fill up faster than you can empty it.
Phase 3: Even if phases 1 and 2 are working perfectly in harmony – if the outside drain is blocked – you are stuffed. Nothing will move.
The steps for working on detoxification are the opposite of the actual process.
We always work 3-2-1. This way – you don't get stuck by a 'blockage', and everything can move through the system smoothly.
Here's how you can support each phase:
Phase 1: Ensure a balanced diet rich in nutrients that support liver health, like B-vitamins, folate, and antioxidants found in colourful fruits and vegetables.
Phase 2: Check your COMT gene. If we understand this, we know the nutrients and compounds required to support this process.
Foods high in compounds like sulforaphane (found in broccoli and Brussels sprouts) and isothiocyanates (found in cruciferous vegetables) can support phases 1 and 2.
Phase 3: A diet high in fibre helps bind oestrogen in the gut and promotes its elimination. Staying well-hydrated also supports kidney function and the urinary elimination of waste.
Monitoring and Managing Oestrogen Levels
For those experiencing symptoms like irregular periods, menopausal symptoms, or fertility issues, understanding oestrogen levels can be crucial.
You can assess these phases through a DUTCH test. I most certainly don't use it on everyone. Still, if I have a woman who is struggling with PMS, has any symptoms of excess oestrogen, or is concerned about breast cancer, then I always test. It is an easy test and can tell us way more than just a figure for the actual levels of oestrogen.
The DUTCH test is scientifically validated, backed by peer-reviewed research, and there is a growing body of evidence highlighting its advantages.
Remember, any concerns about oestrogen levels or related health issues should be discussed with a healthcare professional for personalised advice and treatment.
Please schedule a complimentary call with me to discuss your experiences. This conversation is an opportunity to explore your symptoms and the possible ways to manage them with absolutely no obligation. Remember, understanding and then addressing your symptoms is vital to finding relief and improving your daily life.