Gut Health and Hormonal Imbalance: How Your Microbiome is Influencing Your Hormones

We all know chronic stress, improper diet, infections, and medications like antibiotics can all create poor gut health, but did you know your gut health may also be impacting your hormones? The reason for this starts with our gut microbiome (aka the collection of bacteria in the gastrointestinal tract), and maintaining a healthy microbiome is essential to hormonal health, as the two are closely intertwined. 

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Microbiome and Estrogen, aka ‘The Estrobolome’ 

When it comes to hormonal regulation, the microbiome has various functions, including 

• Improving the synthesis of neurotransmitters and hormones
• Influencing the absorption of micro and macronutrients (which are often cofactors or hormones and neurotransmitter production and function)
• Regulating the immune system
• Aiding in estrogen’s clearance through the digestive tract
• Influencing the metabolism and absorption of cholesterol, which is the backbone to all sex steroid hormones 
• improves insulin sensitivity which benefits weight management and prevents type II diabetes
• More specifically, there is a collection of bacteria present in the gut that serve to modulate and regulate the body's elimination of estrogen levels, termed ‘the estrobolome’. Evidence shows that the bacterial influence of estrogen’s metabolism can impact everything from mood, weight, and libido, as well as endocrine disorders like PCOS, endometriosis, and even breast cancer. ​

To understand the relationship, we must first understand estrogen’s life cycle. The adrenal glands and ovaries create estrogen after puberty. It circulates through our bloodstream and binds to receptors to communicate with our brain, reproductive organs, bones, heart, etc. It is then carried to the liver to be broken down and excreted with bile into the gut to be eliminated. However, estrogen in bile comes into direct contact with the microbiome, and an enzyme known as beta-glucuronidase is made by these bacteria. Beta-glucuronidase plays an important role in carbohydrate digestion, micronutrient absorption and bilirubin resorption and hence influences how metabolized estrogen is reactivated and resorbed into our system. Imbalances in these flora result in imbalances in this enzyme, an ultimately secondary excesses or deficiencies in the body’s estrogen levels, which is where symptoms begin to arise.

Signs Your Gut Health May be Impacting Your Hormones 

Although gut health and hormone imbalance are popular topics, many people may not recognize the symptoms. Here are some of the first signs that your hormonal symptoms may be attributed to an unhealthy gut:

• Weight changes, especially weight gain
• Digestive issues such as gas, bloating, constipation or diarrhea
• Fatigue, despite good sleep 
• Food sensitivities or intolerances
• PMS symptoms, painful cycles or heavy bleeding
• Anxiety, depression or extreme mood swings
• Acne
• Bloating and water retention 

In men, estrogen helps in sperm maturation and libido maintenance, and imbalances may correlate to infertility, low sex drive, depression, weight gain and fatigue. In women, estrogen regulates body fat and weight gain and is vital for cardiovascular health, brain function, and bone health. 

For women, gut health and menstrual cycles are closely intertwined. When the gut is healthy, the astrobleme produces optimal levels of beta-glucuronidase. However, too much of this enzyme causes the body to resorb excessive amounts of estrogen and may contribute to estrogen dominance symptoms. Too much estrogen in the body can lead to fluid retention and bloating and in some cases, may attribute to worsened PMS symptoms like heavier periods, cramping, bloating, and mood swings. 

How to support a healthy gut and hormones

#1 - Start by incorporating gut-friendly foods into your daily meals: Some of the best foods to eat for a healthy microbiome are fermented foods that are rich in pre and probiotics, like sauerkraut, kimchi, yogurt and kefir. Ditch the kombucha. There's usually too much sugar.
#2 - Keep up with fibre: Fibre is food for the good guys, helping to increase colonisation of the bacteria most helpful in metabolising and eliminating hormones. It also increased production of a short chain fatty acid called buyrate, which reduces inflammation & colon cancer risk, improves insulin sensitivity, protects your brain and heart, and prevents gastrointestinal problems. 
#3 - Stick to unsaturated fats: Eating a diet full of healthy fats is important for your endocrine system, since all hormones are synthesised from fats. Foods such as olive oil, nuts, chia seeds, and fresh fish have an ample amount of healthy fat.
#4 - Ditch the sugar: You heard me right. Sugar promotes inflammation which has been shown to negatively impact our healthy microbiome, and also doubles as a food source for bad bacteria and yeast. A higher sugar diet has been directly correlated to a more imbalanced microbiome, as well as endotoxemia - the absorption of toxins through the gut due to a compromised barrier (aka leaky gut).
#5 - Eat your greens: Not only does a diet rich in dark leafy greens help to reduce inflammation, but research suggests that consuming dark leafy greens can help promote the development of good gut bacteria as they contain a specific type of sugar called sulfoquinovose. This sugar is used as an energy source to promote heal, thy bacteria grow. grow any greens also contain numerous antioxidants and sulforaphane which help with healthy phase I and II detox of hormones through the liver. 

When to consider Naturopathic Medicine 

Try cleaning up the diet and lifestyle factors to see if you can balance out your symptoms, but it is essential to consult with your doctor before supplementing products. Taking the wrong probiotics or trialling with supplements before knowing that a hormonal imbalance exists may actually have negatively impacted your estrogen levels and gut health. 

Dr. Courtney Holmberg ND, is a Naturopathic Doctor in Toronto who offers several methods of testing to determine issues with gut microbiota and reflective hormonal imbalances to ultimately correct bacterial imbalances and hormonal symptoms and improve your quality of life. Contact us at 647-351-7282 to book an appointment and learn more.

References:

Chen Z, Radjabzadeh D, Chen L, et al. Association of Insulin Resistance and Type 2 Diabetes With Gut Microbial Diversity: A Microbiome-Wide Analysis From Population Studies. JAMA Netw Open. 2021;4(7):e2118811. doi:10.1001/jamanetworkopen.2021.18811

Kwa M, Plottel CS, Blaser MJ, Adams S. The Intestinal Microbiome and Estrogen Receptor-Positive Female Breast Cancer. J Natl Cancer Inst. 2016 Apr 22;108(8):djw029. doi: 10.1093/jnci/djw029. PMID: 27107051; PMCID: PMC5017946.

Samantha M. Ervin et al. Gut microbial β-glucuronidases reactivate estrogens as components of the estrobolome that reactivate estrogens. PROTEIN STRUCTURE AND FOLDING. VOLUME 294, ISSUE 49, P18586-18599, DECEMBER 2019

https://www.unimelb.edu.au/newsroom/news/2016/february/sweet-discovery-in-leafy-greens-holds-key-to-gut-health#:~:text=%22SQ%20is%20the%20only%20sugar,but%20abundant%20in%20biological%20organisms.