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How does the gut influence our hormones?

Author: Becky Graham Nutritionist BA(Hons) Dip ION mBANT

November 14, 2022

Nutrition

Healthy foods

Experts have long worked on the basis that good health begins in the gut, and thankfully this idea is beginning to catch on. There is now emerging research into the relationship between our gut and hormone health, and the role that the gut microbiome plays in maintaining hormone balance.

Hormones are essentially chemical messengers that communicate between our various body systems and the bi-directional influence of the microbiome and endocrine system has wider implications for the whole body. This connection is especially important when it comes to oestrogen as the microbiome has a dedicated department responsible for its management known as the ‘estrobolome’, therefore promoting optimal gut health can support hormonal health as well.

How does the gut influence oestrogen metabolism?

The gut microbiome helps to regulate oestrogen metabolism using an enzyme called beta-glucuronidase, which through a process called ‘deconjugation’ transforms oestrogen into its active form and influences oestrogen-dependent physiological processes such as the growth, development, and physiology of the reproductive system [1] as well as the neuroendocrine, skeletal, adipogenic (the formation of fat cells) and cardiovascular systems.

An imbalance in gut microbes, such as lower diversity (dysbiosis) can impair the action of beta-glucuronidase, reducing or increasing the levels of circulating oestrogen and potentially increasing the risk of conditions such as obesity, metabolic syndrome, endometrial hyperplasia (thickening of the uterus wall), endometriosis, polycystic ovary syndrome, fertility, cardiovascular disease, cognitive function and cancer [2].

Which diet and lifestyle factors have a negative impact?

Oestrogen imbalances can be triggered by a poor diet, products we use, stress, insufficient sleep and environmental toxins. To manage these external influences, having a well-functioning detoxification system is key, and while our liver is the main player, dysbiosis in the gut may be negatively impacting the body’s ability to detoxify oestrogen efficiently. This is because the estrobolome is responsible for the metabolism of oestrogen through the liver as well as processing and eliminating oestrogen from the body and influencing circulating and excreted oestrogen levels.

Just as our diet can have a direct influence on our digestive health, it can have a similar impact on the estrobolome. For example, some foods contain plant-based compounds known as ‘phytoestrogens’ that exert a similar (but weaker) effect to human oestrogen and have been found to significantly impact the gut microbiome and the risk of oestrogen related disease [3]. Phytoestrogens have the power to adapt and are protective when consumed in natural food sources such as soya, legumes – lentils, beans, peas, and broccoli. However, some highly processed sources where soya protein is added to foods or soya supplements have been linked to the development of chronic disease [4] so moderation is key – current research is looking into whether this might be mediated by the estrobolome [5].

Additional lifestyle factors that can negatively impact the gut include the use of antibiotics and the contraceptive pill which have been shown to disrupt gut flora as well as oestrogen levels [6].

If hormonal imbalances are a concern, alongside any of the following, it’s worth taking a closer look at your gut health:

  • Bloating
  • Gas
  • Heartburn
  • Constipation or diarrhoea
  • Skin flare ups
  • Brain fog
  • Headaches
  • Frequent illness
  • Mood disorders
  • Feeling fatigued
  • Difficulty with weight management

Foods to support the gut and maintain hormone balance:

  • Fibre – fibre rich vegetables, lentils, beans, nuts, and seeds help to keep things moving, and are a source of prebiotics which provide the primary source of fuel for bacterial fermentation and energy production in our gut.
  • Cruciferous vegetables – such as rocket, watercress, broccoli, kale, cabbage and cauliflower, help to support the detoxification of oestrogen in the liver.
  • Fermented foods – Yoghurt, kefir, kimchi, sauerkraut, miso, tempeh and even sourdough bread contain probiotic bacteria that help to colonise our gut and increase diversity.
  • Healthy fats – hormones are synthesised from fats, making their inclusion in our diet essential for a healthy functioning endocrine system. Oily fish, olive oil, avocados, nuts, nut butters and seeds are all good sources.
  • Protein – every cell in our body is made from protein, it is vital for growth and immune health, and including quality sources at each meal can help to stabilise blood sugar, which in turn helps to maintain sex hormone balance.
  • Antioxidants and anti-inflammatory foods – ‘Eat the Rainbow’, including a wide range of colourful fruit and vegetables, herbs and spices such garlic, turmeric and ginger can help to combat stress a cellular level, promoting optimal health overall.

A closer look at probiotics

The use of probiotics in hormone regulation is an emerging field, but current research appears to indicate that it might be possible to modulate the estrobolome and reverse oestrogen-related pathologies by supplementing with specific strains of probiotics. For example, studies on the animal model have found that Lactobacillus can normalise the estrous cycle and reduce testosterone in PCOS [7], in endometriosis, Lactobacillus gasseri suppressed ectopic tissue growth due to high oestrogen [8], and in a menopausal model of osteoporosis, Lactobacillus reuteri prevented bone loss resulting from low oestrogen [9]. Lactobacilli has also been shown to have an anticarcinogenic effect in breast tissue, suggesting that supplementation may be useful for protecting against breast cancer [10].

While it is still early days for studies into the relationship between probiotics and the estrobolome, investing in our digestive system means laying the foundations for our health overall. Pre and probiotic foods and supplements are relatively cheap, and there is enough evidence into the relationship between our hormones and gut health to suggest that managing dysbiosis might help the metabolism of oestrogen as well.

Conclusion

Although more research is needed into the link between gut health and hormone health, having a diverse gut microbiome can only help support our hormone network as well as our overall physical and mental health.

Author: Becky Graham Nutritionist BA(Hons) Dip ION mBANT

This information has been medically reviewed by Dr Thom Phillips

Thom works in NHS general practice and has a decade of experience working in both male and female elite sport. He has a background in exercise physiology and has published research into fatigue biomarkers.

Dr Thom Phillips

Dr Thom Phillips

Head of clinical services