If you have estrogen dominance symptoms, the first thing I ask when you sit down with me as a patient is, “why”.  Why are your estrogen levels above the normal range? Do you have low progesterone accounting for the symptoms? Or is there another underlying hormone imbalance all together? 

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When excess estrogen is discovered, poor estrogen detox is often part of that answer.  

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In Part 1 of this series, I discussed Phase 1, Phase 2, and Phase 3 pathways of estrogen detoxification as a background to today’s conversation about estrogen dominance treatment.  

Keep reading to learn more about: 

• A functional approach to estrogen detoxification protocol.
• Specific foods and supplements that support each phase of estrogen detoxification. 

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Estrogen Detoxification Protocol: 

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The functional medicine approach to supporting estrogen detoxification is highly personal. We begin by building a complete picture through intake and advanced testing which includes DUTCH hormone testing and functional stool analysis.  It’s important to keep in mind that each woman’s treatment protocol is different, and that your protocol will not look the same as someone else’s. 

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The pathway to estrogen detoxification starts with Phase 1 and 2 in the liver and then ends with Phase 3 in the gut.  When we look at your treatment, we want to work in reverse. First, we want to optimize gut health and therefore promote estrogen clearance.  Otherwise we run the risk of estrogen recirculating.  

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Think about it this way—if you want to drain dirty bathwater, you first need to make sure the drain is clear.  Likewise, before we push detoxification in the liver, it’s important to clear the drain (the colon).  

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Estrogen Dominance Diet, Nutrition and Supplements

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Remember that each woman has unique needs and that it is very important to test instead of guessing. Always be sure to receive guidance from a qualified practitioner with knowledge about the estrogen detox process.  

Here are some tips and tools to consider to support optimal function during each phase of detoxification.  

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Step One:  Support Phase 3: 

• Open pathways of excretion. In other words, make sure you are having regular bowel movements. Also be sure you are urinating regularly and sweating so that toxins and estrogen can get out of the body.  
• Optimize your microbiome. An abundant and diverse population of microorganisms living in the gut is required for optimal health.  By optimizing the microbiome, you optimize the estrobolome (because it is the bacteria in the gut, and the estrobolome, that affects estrogen levels, which in turn can impact weight, libido and mood).

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Increasing whole plant foods and fermented foods are important dietary approaches combined with supplements such as probiotics. 

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Step Two, Support Phase 2

• Check your COMT. We use the DUTCH Test Plus which is a simple genetic test looking at the code for the COMT enzyme (which basically helps us break down catechol-estrogens).  Knowing this helps us understand how much methylation support you may need to optimize Phase 2 detoxification.  
• Consider methylation support. Nutrients and compounds that donate methyl groups can help to keep COMT with a full supply to provide efficient function. 

Estrogen detox supplements 

• SAMe
• Trimethylglycine (TMG)
• Choline
• Methyl Folate
• Methyl B12

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• Increase Magnesium. Both magnesium rich foods and magnesium supplements are helpful as this mineral is an important cofactor for COMT. Without enough magnesium this enzyme cannot do its job.  
• Try an estrogen detoxification diet.  Food is powerful medicine when it comes to liver support and estrogen metabolism.  In Phase 2 consider foods rich in choline (such as beets and eggs), foods rich in folate (such as greens, avocado and lentils), along with a good source of vitamin B12 daily.  

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For more information about how to use a plant-forward diet for estrogen clearance, read: Plant Based Promotes Estrogen Detox. 

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Step Three, Support Phase 1

• Use estrogen dominance supplements. The right choices here will depend upon your unique Phase 1 pattern, but some helpful options are DIM (diindolylmethane), and sulforaphane. Both are compounds found naturally in cruciferous vegetables such as broccoli, brussel sprouts, mustard, and kale.  DIM helps to lower overall estrogen, where sulforaphane helps shift detoxification to the more protective 2-OH pathway.  
• Use food as medicine. An estrogen detox diet is supportive here as well.  Foods including cruciferous vegetables, raw carrots, flax seed, and organic soy help in the modulation and balance of estrogen.  

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Your body is striving for balance.  When estrogen levels are high, supporting the body’s ability to clear the excess estrogen is an important piece of the picture.  Understanding the phases of detoxification and how to support them naturally with food and lifestyle is nothing short of life-changing for many women.  

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If you would like support making these ideas work for you and your unique hormones, please reach out to The Fork Functional Medicine. We would be happy to help you find your balance and reach your health goals.  

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References 

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1. Calcium-D-glucarate. (2002). Alternative medicine review : a journal of clinical therapeutic, 7(4), 336–339.
2. Bastos, P., Gomes, T., & Ribeiro, L. (2017). Catechol-O-Methyltransferase (COMT): An Update on Its Role in Cancer, Neurological and Cardiovascular Diseases. Reviews of physiology, biochemistry and pharmacology, 173, 1–39. 
3. Vanduchova, A., Anzenbacher, P., & Anzenbacherova, E. (2019). Isothiocyanate from Broccoli, Sulforaphane, and Its Properties. Journal of medicinal food, 22(2), 121–126. 
4. Abdull Razis, A. F., Konsue, N., & Ioannides, C. (2018). Isothiocyanates and Xenobiotic Detoxification. Molecular nutrition & food research, 62(18), e1700916. 

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