By now you probably know a lot about endometriosis – the intense pain, and severe fatigue. Inflammation, and high estrogen levels. And you know it’s fairly common, affecting over 5 million women in the US. But what you might not know is the role of endocrine disruptors in endometriosis and how you can detox from them to support the healing process.
Avoiding these endocrine disruptors supports healing, increased energy and pain relief. But we’re not always able to avoid them. That’s where detoxifying comes in. To understand how we need to take a deeper look at what endocrine disruptors really are.
Endocrine Disruptors and Endometriosis
Endocrine disruptors are chemicals in the environment that are either man-made or natural. They mimic the production, release, metabolism, and action of hormones. Because hormones are responsible for so many jobs in the body, including reproduction, homeostasis, and development, endocrine disruptors have the potential to do real damage to the body. And, unfortunately, we’re exposed to them everyday – through plastic food containers, cosmetics, pesticides in food, and through drinking water.
Because these molecules were originally made for consumer products, they’re long-lasting and break down slowly. So, they accumulate in the body, meaning exposure can become even more hazardous over time. Research shows that even small exposures to endocrine disruptors is unsafe. And they’ve also found they play a role in the development and progression of endometriosis.
The endocrine disrupting chemicals that mimic estrogen are called xenoestrogens. I’ve got a whole blog here about xenoestrogens and their impact on endometriosis. Basically, these xenoestrogen molecules mimic estrogen and impact endometriosis by binding to estrogen receptors alpha and beta, known as ESR1 and ESR2.
Common xenoestrogens or endocrine disruptors include:
- BPA, or bisphenol A, is found in many plastic products.
- Perchlorate, is a by-product of pharmaceuticals and is often found in drinking water.
- PFAS, or perfluoroalkyl and polyfluoroalkyl substances, used in non-stick pans and paper.
- Phthalates, are widely used in plastics, toys, food packaging, and cosmetics. They help keep plastic flexible and prevent breakage.
- Triclosan, is found in some personal care products like body wash.
- Dioxins, accumulate in the fatty tissues of animals in the food chain.
Endocrine disruptors like xenoestrogens work in several ways. They can decrease or increase hormone levels in the body, mimic how a hormone works, or alter the production of other hormones being produced in the body. Because of their ability to impact hormones, xenoestrogens play a role in endometriosis via the immune system and epigenetics, or changes caused by modification of gene expression.
So what’s a woman to do? When endocrine disruptors mimic estrogen they need to be detoxed from the body – but how?
The Phases of Estrogen Detoxification: How Estrogen Moves Out of the Body
Think of estrogen detoxification like a bathtub. We want to make sure our bathtub is filling up with the right water (estrogen metabolites), the drain is working properly (the methylation process), and the sewer line is flowing (the intestines). When water is flowing into the bathtub, we want to know what estrogen metabolites are being made and how fast or slow it’s happening. Next, we want to know about the drain – is it open or closed, and how efficiently is methylation happening? This is important because it’s how our body gets rid of free radicals. Lastly, the sewer lines are like the intestines – is there any dysfunction or backup happening due to constipation, candida, a microbiome issue, or a small intestinal bacterial overgrowth (SIBO)?
These three steps are the three phases of estrogen detoxification – estrogen metabolism, estrogen detoxification, and the excretion of estrogen from the body. Let’s look at each phase.
Phase 1 of the Estrogen Detoxification Pathway: Estrogen Metabolism
In phase 1, estrogen is broken down by the CYP enzyme family into 3 different metabolites – 2OH, 4OH, or 16OH. The preferred pathway is 2OH because it’s protective, less carcinogenic, and anti-proliferative. Anything that can push estrogen down the 2OH pathway is best.
4OH is a less desirable pathway and more carcinogenic than 2OH. 16OH, on the other hand, is considered very estrogenic. When high amounts of estrogen go down this pathway, it can lead to heavier periods, tender breasts, and worsening endometriosis symptoms.
The estrogen is metabolized in phase 1 by specific enzymes in the CYP family. Once broken down, the metabolites are free radicals and can cause damage in the body so it’s important to move from this phase into the next to minimize free radical damage.
How to Optimize Phase 1 of Estrogen Detoxification
I3C or DIM
Indole-3-carbinol, or I3C, is a molecule that’s found in the brassica family of vegetables. Di-Indolymethane, or DIM, is the most common form and works by increasing the conversion of estrogen in the 2OH pathway by binding to a specific receptor. The recommended daily intake of DIM is between 100 -300 mg/day. While you can get DIM from eating brassicas, you’d need to eat such a large amount – at least 600 grams/day for several years – to achieve the same benefit as taking a supplement.
While DIM can be a great option, it should be used with caution in those where low estrogen is a problem, like amenorrhea or menopause, because it pulls estrogen from circulation causing further depletion.
Quercetin also supports estrogen detoxification in phase 1, working by lowering the amount of estrogen that goes down the 4OH pathway. It reduces histamines and inflammation.
N-acetyl-cysteine provides estrogen metabolism support by preventing DNA damage by inhibiting the formation of quinones, which are present when detoxification is unbalanced. NAC is metabolized in the liver and helps make glutathione.
A powerful antioxidant, glutathione supports estrogen detoxification but requires specific cofactors to do its job best – selenium, vitamin C and E, B6, and B12, ALA, CoQ12, magnesium, zinc, and folate.
Found in cruciferous vegetables, sulforaphane activates enzymes within the estrogen detoxification pathway. It’s important to choose a supplement with both glucoraphanin and myrosinase for the most benefit. You can also get sulforaphane from broccoli sprouts, but they need to be chopped, cut, or chewed to release the molecule.
A natural phytoestrogen, resveratrol has anti-inflammatory effects and encourages estrogen to go down the 2OH detoxification pathway. It suppresses misplaced cell growth, like endometrial cells outside of the uterus. It’s available over the counter in high doses, but can also be found in red wine, berries, soy, and grapes.
Phase 2 of Estrogen Detoxification: Estrogen Methylation
The next step in estrogen detoxification turns the harmful free-radical metabolites from phase 1 into molecules that can be excreted. To neutralize these free radicals, they go through the methylation process.
Catechol-O-methyltransferase, or COMT, is an essential enzyme in this process. COMT’s job is to support methylation and aid in neutralizing free radicals. To do its job, COMT requires a donated methyl group from S-adenosyl methionine or SAM. SAM is the main co-factor in this phase, and requires magnesium to properly bind. There’s also evidence that zinc helps the binding process as well. COMT is slowed down by infections in the gut, genetic variants, environmental toxins, and changes to serotonin levels.
How To Optimize Phase 2 of Estrogen Detoxification
There are underlying genetic variants that can make this process unique for everyone, so it’s essential to support COMT in estrogen detoxification. SAMe, a main methyl donor, is a significant player in this phase and can be taken as a supplement to support COMT. Magnesium is another supplement that improves this phase since magnesium is required for COMT to bind properly. Zinc, methionine, choline, and methylated B vitamins also support this process.
Phase 3 of Estrogen Detoxification: Excretion
The third stage happens in the gut since the body moves estrogen by-products out through the intestines. If your gut or intestines aren’t healthy – just like the sewer – things can’t move like they need to!
The estrobolome helps with this. It consists of bacterial genes in your gut that make enzymes required for estrogen detoxification. Your estrobolome is influenced by many things like stress, your diet, and your gut health.
One specific enzyme that’s important is called GUSs – gut bacterial beta-D-glucuronidases. This enzyme works in your large intestine to remove glucuronic acid from estrogen and reactivates it so it can be absorbed back into your body. But, too much of GUSs is a problem and can lead to obesity, endometriosis, and even cancer. Eating high amounts of sugar, processed foods, and alcohol increases the body’s concentration of GUSs.
The best way to fix estrogen detoxification in phase 3 is through diet. It only takes 24 hours to create significant, notable changes to your microbiome. That means what you ate yesterday is making an impact right now on your gut microbiome.
How to Create Microbiome Shifts To Promote Phase 3 Estrogen Detoxification
- Eat prebiotics and resistant starch, things like artichoke, jicama, chicory root, dandelion greens, and pectin. Raw, unpeeled carrots have high levels of pectin in the carrot cell wall.
- Choose fermented foods and take probiotics.
- Reduce toxin exposure
- Avoid antibiotics when possible
- Reduce or eliminate alcohol. Since alcohol is detoxified in the liver, it beats out estrogen in the detoxification process, causing estrogen to get recirculated by the body and restart the detoxification pathway.
- Consider taking Calcium-d-glucarate. This can be an inhibitor so estrogen doesn’t float around freely. 500mg/day is effective and should be discussed with your practitioner.
Why does all this matter? When endocrine disruptors mimic estrogen, they need to be metabolized, detoxified, and removed from the body. The estrogen detoxification pathway helps with this.
But, we need to focus our efforts first in phase 3 – prioritizing our gut health – then move on from there. Without healthy intestines – or an open sewer line – it doesn’t matter what else we do because we won’t be able to excrete anything. Start at phase 3 and move backward from there.
Learn Where Estrogen Detoxification Isn’t Effective For You
The DUTCH test, or dried urine test for comprehensive hormones, provides a robust evaluation of the sex and adrenal hormones, including metabolites. It looks at estrogen in your body and offers a clear picture of where your estrogen detoxification pathway isn’t working as efficiently as it could be. This is the gold standard for hormone testing and can guide you on where to focus your efforts and identify gaps in your estrogen detoxification. These tests have proved invaluable for our clients in figuring out the missing pieces and avoids months or years of trial and error.
Other Ways To Detox From Endocrine Disruptors
Reduce Dietary Exposures
A majority of exposures to endocrine disruptors come from the diet.
- Choose organic fruits, vegetables, and meats whenever possible
- Thoroughly washing fruits and vegetables before consuming them.
- Filtering your water to minimize contaminants found in tap water.
- Choosing wild seafood and eating fish with high omega-3 fatty acids like sardines, mackerel, and herring. Avoid larger predator fish, as dioxins and other xenoestrogens build up in them.
- Avoid anti-inflammatory foods like sugar, dairy, alcohol, and caffeine.
Detoxify Your Home
Along with diet exposures, you are exposed to endocrine disruptors in your environment all the time. Unfortunately, that’s the world we live in. But there are ways to help.
- Vacuum often to reduce dust, as it often contains endocrine disruptors. Better yet, use a vacuum with a HEPA filter.
- Use a HEPA filter to clean the air inside your home.
- Choose natural cleaning products, fragrance-free lotions, and cosmetics. The Environmental Working Group has great resources to help you with this.
- Reduce your usage of canned foods with BPA .
- Avoid storing or heating up foods in plastic. Use only BPA/BPS free glass or metal containers instead.
Let’s Beat Endometriosis
I know what it’s like to struggle with your period each month. To schedule your life around it. To try anything that might help, only to be more disappointed when it doesn’t.
But there’s a way out. You need to understand your endometriosis triggers, learn how to detox estrogen naturally, and get to the root of the problem. That’s where I can help.
When I finally beat endo, it was because I prioritized detoxification – a detox from toxins in my home, food, and life. I read so many books, did so much research. While it wasn’t easy, I finally started living a life without pain. And I know you can do it too.
Join our next FREE Detox Workshop HERE
Rooting for you in health,
- Endocrine Disruptors
- Endocrine disruptors and endometriosis
- Environmental Endocrine Disruptors and Endometriosis
- Endometriosis Diet Booklet
- Progesterone and Estrogen Signaling in the Endometrium: What Goes Wrong in Endometriosis?
- Endometriosis: Where are We and Where are We Going?
- Nutritional Protocol for Endometriosis
- Oestrogen Detoxification
- DUTCH Test