PMS

Estrobolome - The Gut-Hormone Connection

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Improving your digestion goes beyond keeping your gut happy. It is connected to a number of different “systems” in our body, one being your hormones, estrogen in particular. When this isn’t in balance it can affect mood, weight, cycle, libido, acne and even bone health. 

What is the Estrobolome?

The gut microbiome is the collection of bacteria, both good and bad, in the digestive system. Ideally there should be no imbalance in the bacteria, called a dysbiosis, but due to diet, antibiotics, stress, or environmental exposure it is common for an imbalance to occur. 

Among many roles, the gut microbiome plays a crucial role in regulating circulating estrogen levels. Specific microbes in the microbiome, called the estrobolome, specifically do this. The microbes in the estrobolome produce an enzyme called beta-glucuronidase, which deconjugates estrogens into their active forms. This increases estrogens that are reabsorbs and capable of binding to estrogen receptors in the body and influencing those hormonal physiological processes. This process is known as phase 3 estrogen detox and when there is the right amount of beta-glucuronidase, estrogen homeostasis is maintained. When dysbiosis occurs, the estrobolome up-regulates or down-regulates beta-glucuronidase leading to a deficiency or excess of estrogen in the body. I most commonly see an estrogen excess. 

Common signs of excess estrogen which can be influenced by estrobolome are:

  • bloating, especially before your period

  • irritability 

  • acne

  • breast tenderness

  • heavy periods

  • headaches or migraines 

  • PCOS picture 

Issues with deficient estrogens post-menopausal influenced by the estrobolome are:

  • increased risk of osteoporosis

  • increased risk of cardiovascular disease 

  • increase risk of obesity 

What affects the estrobolome?

Anything that disrupt the gut microbiome typically affects the estrobolome as well. 

  • Poor diet and lifestyle are the most common triggers for dysbiosis. Certain bacteria feed on certain food we eat (sugar and gluten as common examples), grow and in tern tell the brain to eat more of that food, causing an overgrowth. Studies have shown that a shift in the diet can induce microbial shifts within 24 hours. Focus on organic food when you can, cruciferous vegetables such as broccoli and brussels sprouts and fibre. 

  • Antibiotics and birth control pills both have been found to alter the microbiome and estrogen levels, leading us to believe it is affecting the estrobolome. 

  • A broad spectrum probiotic can influence the microbiome to shift positively. Antimicrobial herbs may be effective at eliminate an overgrowth. Talk to an ND like me to discuss if these are advised for you. 

  • Calcium-D-Glucurate is a supplement that is a beta-glucuronidase inhibitor. This allows estrogen to remain conjugated, in its inactive form, to be safely eliminated from the body. This is very handy for someone with known estrogen excess. 

This gut-hormone connection proves to me that gut health is again at the root of many health concerns. We don’t want to forget proper liver support or hormone support with certain herbs, but it is important to not skip the gut! 

In health & happiness,

Dr. Karen

PMS: Recognizing the Signs and Calming the Craziness

Do you feel like you could snap at anyone who looks at you some days? Or some days do you feel like you could burst into tears at any moment? I get it…I’ve been there! You aren't crazy. These emotions might seem out of the blue, however if you are tracking your menstrual cycle they may actually happen at the same time every month. You’ve got it…this is the dreaded premenstrual syndrome or PMS. 

I see this often in practice and believe it is important to note that even though symptoms of PMS are incredibly common this is not a normal response. There is usually a reason behind these feelings and symptoms and things that can be done to mitigate them, besides jump to the birth control pill. 

Common symptoms of PMS:

  • Very emotional - angry, teary, irritable
  • Fatigue
  • Breast tenderness
  • Cramps
  • Bloating
  • Food cravings
  • Back pain
  • Acne

What is causing PMS:

Throughout the month your hormones have a cycle and rhythm (See the graph to the right). There is a monthly increase and decrease of both estrogen and progesterone, but they happen at different times. We need proper nutrients, a low stress level, proper blood sugar balance and healthy liver detoxification for these cycles to happen properly. If your body, especially your liver, is not able to metabolism estrogen well an imbalance in the estrogen-progesterone occurs and the above PMS symptoms occur. If you pituitary gland, one of the control centres for your hormones, is not stimulated properly signals to your ovaries aren’t regular, again causing an imbalance in hormones. 

Natural Approaches to PMS:

There are many interventions to decrease PMS symptoms however these are some of my favourites to start with. 

Going with the Flow

By tracking your menstrual cycle you become aware of how your body is responding to these hormone cycles and what symptoms or emotions can be contributed to your cycle. Recognizing this may help you get through it more easily and understand why you may be feeling a little crazy at times. Take time for yourself before your period, take a nice bath, go for a massage or get a good sweat on. 

Magnesium and B6

The birth control pill actually depletes our body of both magnesium and B6. Both of these are vital to hormone regularity, therefore both helpful to decrease symptoms of PMS. Talk to your Naturopathic Doctor about the proper dose for you. 

Broccoli Sprouts

In chinese medicine it is believed that PMS is due to “liver qi stagnation.” This means there is stagnation, or a lack of movement, in the liver. Broccoli sprouts, or in particular sulporophane, up regulates an enzyme in phase II liver detoxification important in excreting excess estrogen. Basically, it gets things moving. Adding broccoli sprouts to a salad, smoothie or as a snack is a good addition to your diet. More liver support may be necessary, including turmeric, I-3-C or DIM depending on the severity of symptoms. 

Seed & Oil Cycling

Since there is natural ebb and flow to our hormones throughout the month, creating a similar cycle in our food helps to produce the proper hormones at the proper time. The seeds and oils carry certain oils, vitamins, and nutrients that can help support the body’s production, release, and metabolism of hormones. Some of the seeds used in seed rotation are flax and pumpkin for the first half of your cycle and sesame and sunflower in the second half. We also add omega 3 and evening primrose oil to the rotation. Adding seeds to smoothies, oatmeal or roll them into energy balls are some ideas to eat them daily. There is the most evidence on the benefits of flax to balance hormones and omega 3s to decrease inflammation. 

Acupuncture

Acupuncture is able to address "liver qi stagnation" specifically with certain acupuncture points. There are several studies supporting the use of acupuncture for improving menstrual function and reducing symptoms of PMS. "One study found that acupuncture was as effective as NSAID therapy for dysmenorrhea, a cycle with severe PMS symptoms, especially cramping."(1) I find this a very helpful adjunctive treatment for both myself and my patients. 

Again, these are some interventions I like to to start with for PMS. If your symptoms are causing you a lot of distress, please reach out to myself or your local ND for further support. Testing may be necessary to assess hormone levels, or look for any concurrent issues such as PCOS, endometriosis or fibroids. 

In health & happiness, 

Dr. Karen

From Around the Web

Summer sure has flown by! Here are some interesting links to keep you in the spirit of summer but also prep for school. 

1. Some great ideas for your children's lunches come September. 

2. Tips to enjoy summer fruit without eating too much sugar. 

3. How stress controls our sweet cravings. 

4. A guide to some hard-to-pronouce added ingredients in your food? Are they good or bad?

5. Strawberry cashew milk! Do this while the strawberries are still good. You could even make them into popsicles. 

6. Suffer from PMS? Its never a good time in the summer! Here are some natural remedies to fight it.

7. Take a break this summer. Studies show long working hours do not lead to more productivity.  

8. Finally, a great resource to get back on track with your weight and diet after indulging this summer.

In health & happiness,

Dr. Karen

(Photo credit: www.simple-balance.ca, www.hbr.org, www.realfoodwholelife.com)