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Estrogen Balance: Hormone Imbalance and the Liver

Holtorf Medical Group

Estrogens are steroid hormones derived from cholesterol. There are actually three forms of the hormone (estradiol, estrone, and estriol) of which estradiol is the most common. Produced primarily in the ovaries, estrogen is also produced in the adrenals and fat tissues. When “dominant”, it doesn’t necessarily mean the body is making too much. Proportion is the key. When it’s not in proper proportion to the hormone that balances it, (primarily progesterone), estrogen can be dominant even if levels are low. Estrogen stimulates cell growth, while progesterone keeps it in check. Without sufficient progesterone available, unregulated tissue growth can generate diseases, such as breast cancer. Other factors can disrupt the balance too; some add estrogen to the body, some mimic it, and some are related to poor hormone metabolism. While hormone therapies are obvious suspects for tipping the balance, impaired liver, and detoxification processes also come into play.

Estrogen and the Liver

Any impedance of the detoxification process resulting from poor diet, alcohol, drugs, or toxins can cause estrogen dominance. Just think of the guy with “man-boobs” who abuses alcohol. His liver function is impaired and estrogen is excessive. The biology behind this example can be explained with the liver’s two-step detoxification process, which filters hormones and toxins in the bloodstream. In phase I, the liver converts substances into toxic free radicals before they are converted to a water-soluble form in phase II. If phase II isn’t operating sufficiently, the toxic free radicals build up. Both phases must be in balance so proper elimination of waste can occur via sweat, urine, stool, or vapor from the lungs.

The liver also produces bile, which aids in elimination as it carries estrogen, and other waste via dietary fiber out of the body. If fiber isn’t available due to dietary deficiency, the risk of toxic estrogen build-up is increased. Sometimes it takes several passes through the detoxification process for substances to be metabolized, adding extra stress to the liver. Furthermore, if the liver is overloaded and can’t fully metabolize estrogens and toxins, the body may store them in fat. Fat cells also produce estrogen, which is why levels diminish with weight loss.

With this discussion in mind looking at the estrogen-related conditions below makes more sense. Not only are uterine fibroids, and women’s reproductive health issues listed (as women naturally have more estrogen than men), but also noteworthy is estrogen’s connection to poor gut health (note autoimmune diseases are also understood to originate in the gut). Adding to the gut’s significance is the fact that the liver receives blood directly from the intestine via the portal vein.

Conditions Associated with Estrogen Dominance:

  • Autoimmune diseases: Hashimoto’s, multiple sclerosis, rheumatoid arthritis, ulcerative colitis, etc.
  • Thyroid dysfunction
  • Endometriosis
  • Fibrocystic breasts
  • Uterine fibroids
  • Gallbladder disease
  • Infertility
  • Leaky gut
  • Obesity
  • PCOS
  • PMS

What Can’t Be Modified and What Can

With any health issue, there are factors that can’t be modified and those that can. Estrogen dominance is no exception. The key is to offset factors that one can’t control, such as DNA. Genetics can leave a person more susceptible to excess estrogen, thus increasing the risk of related diseases. Highlighting the role of DNA relative to other influencing factors in the case of the BRCA gene, known for breast and ovarian cancer risk. In the 1940s risk of developing breast cancer with the BRCA genes was only 24% whereas the estimated risk is almost 85% today. Though it’s not possible to avoid all the contributing factors a person is exposed to; with awareness, one can minimize exposure while also employing ways to offset it.

Dietary Factors

Nutrition is a major determinant in hormonal balance. Keeping in mind the detoxification process, the following dietary practices have a negative impact:

  • High sugar levels can lead to insulin resistance, pre-diabetes, PCOS, and low SHBG levels, all of which are linked to estrogen imbalance.
  • High fructose (sugar) leads to leaky gut causing an added burden on the liver.
  • High dairy and meats are hormone rich.
  • High gluten impairs estrogen metabolism.
  • High saturated fats promote liver damage and central fat storage.
  • Low fiber leads to constipation, inhibits hormone excretion.

Environmental Factors

In addition to the list above, there is a host of chemicals known as endocrine disruptors, which do just as the name suggests, disrupt. Phthalates in plastics, i.e. BPAs; herbicides, PCBs and heavy metals are all examples. Many of these contaminants are found in foods, unfiltered drinking water, as well as cosmetics, to name a few. The synthetic hormones used in hormone replacement therapy and contraception are also modifiable, as well as alcohol, cigarettes, and stress. Stress raises cortisol and reduces progesterone.

What You Can Do

There are many ways to mitigate estrogen dominance and many of them are common sense good health practices. Considering the impact toxic overload has on the liver it is understandable why liver cleanses and detoxification diets are beneficial. Though difficult at first, they generally leave one feeling refreshed and energized. Other positive modifications include the following:

  • Eat organic foods as much as possible with at least 5 servings of fruits and vegetables per day. Include cruciferous vegetables, i.e. Brussels sprouts, broccoli, and cauliflower.
  • Maintain ideal body weight and exercise regularly.
  • Optimize gut health.
  • Minimize stress.
  • Drink plenty of filtered water daily (half of body weight in ounces, i.e. 150 lbs = 75oz).
  • Support the liver with supplements such as: B vitamins, vitamins C, D, and E, magnesium, selenium, calcium d-glucarate, N-acetylcysteine (NAC), milk thistle, taurine, and probiotics.

It may seem there is no escaping all the toxins impacting the liver and hormone balance, which is true. However, by being aware of the culprits, as well as the ways to offset them, estrogen dominance can be eliminated and balance can be restored. To target the best approach and supplements for your specific needs, guidance from a qualified professional is recommended.


  1. Arrigo T. Leonardi S. Cuppari C. Manti S. Lanzafame A. Role of the diet as a link between oxidative stress and liver diseases. World J Gastroenterol. 2015 Jan 14;21(2):384-95.

  2. Hoffman, R. Intelligent Medicine. Dr. Ronald Hoffman Center. Estrogen Dominance Syndrome. Available at:

  3. Melegari M. Scaglioni P. Pasquinelli C. Baldinin G. Estrogen receptors in the human liver. Medicina (Firenze). 1990 Apr-Jun;10(2): 154-7.

  4. Memorial Sloan Kettering Cancer Center. BRCA1 & BRCA2 Genes: Risk for Breast & Ovarian Cancer. Memorial Sloan Kettering Cancer Center. Available at:

  5. Petrone, A. Gatson J. Simpkins. Reed, M. Non-Feminizing Estrogens: A Novel Neuroprotective Therapy. Mol Cell Endocrinol. 2014 May 25; 389(0): 40-47.

  6. Pizzorno J, Katzinger, J. Clinical Pathophysiology: A Functional Perspective. Coquitlam, BC Canada: Mind Publishing; 2012.

  7. Samavat, H. Kurzer M. Estrogen Metabolism and Breast Cancer. Cancer Lett. 2015 Jan 28; 356(200):231-243.

  8. Soldin, O. Makambi, K. Soldin S. O’Mara, D. Steroid hormone levels associated with passive and active smoking. Steroids. 2011 Jun; 76(7): 653-659.

Holtorf Medical GroupThe Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease. We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.

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