Estrogen Metabolism Explained (and how to support it nutritionally)
Why is estrogen important?
Beyond regulating female reproduction, estrogens also control cell growth, gene regulation, bone density, cholesterol production, cardiovascular function, mood & emotions, memory, body temperature, immune function, and aging. Therefore, imbalance in estrogen hormones & metabolites can have profound impacts on the body as a whole.
What are the 3 types of estrogens?
ESTRONE (E1)
precursor to metabolites
predominant post-menopause
ESTRADIOL (E2)
most active
predominant reproductive years
ESTRIOL (E3)
predominant in pregnancy
ESTROGEN METABOLISM
PHASE I
occurs in liver
E1 converts to 3 metabolites:
2-OHE1
anti-inflammatory
This pathway is promoted by I3C, DIM, & flax.
4-OHE1
carcinogenic, inflammatory
This pathway is promoted by environmental toxins and decreased by citrus peel & flax.
16a-OHE1
encourages cell proliferation
This metabolite is very potent, almost as active as E2. It promotes cell growth, which is helpful for proper bone density but not for cancer. Too much contributes to estrogen dominance.
This pathway is promoted by inflammation and decreased by I3C, DIM, grapefruit, soy, & flax.
———
PHASE II
occurs in liver
phase I metabolites (2OH and 4OH) convert to 2 methylated metabolites:
2-OMeE1
anti-inflammatory, anti-carcinogenic, promotes DNA repair
4-OMeE1
anti-inflammatory
These are both methylation reactions. Support with sulforaphane (in broccoli sprouts), Ca-D-glucarate, & glutathione promoters (NAC, ALA, Se, B2, B6, Zn).
———
PHASE III
occurs in gut
phase II metabolites (2MeOH and 4MeOH) have 2 potential fates:
excreted
ideal outcome
Support a daily BM with adequate hydration, movement, gallbladder function (healthy fats, artichoke, beets, dandelion root, lemon water), and microbiome health (variety of plant foods, cruciferous vegetables, psyllium husks).
recirculated
by beta-glucaronidase enzyme from gut microbes
Dysbiosis in the gut can contribute to estrogen imbalance by recycling metabolites back into the bloodstream.
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References
Cui, J., Shen, Y., & Li, R. (2013). Estrogen synthesis and signaling pathways during aging: from periphery to brain. Trends in molecular medicine, 19(3), 197–209. https://doi.org/10.1016/j.molmed.2012.12.00
Total Estrogen Load: Why Just Measuring Estradiol Isn’t Enough. retrieved from: https://physicianslab.com/total-estrogen-load-just-measuring-estradiol-isnt-enough/
Jones, D. S., Bland, J. S., & Quinn, S. (2010). Textbook of Functional Medicine. Institute for Functional Medicine.
Gaby, A. R. (2017). Nutritional Medicine (2nd ed.). Fritz Perlberg Publishing.