Do you have a family history of breast cancer? Do you have difficulty sleeping or experience hot flashes? If so, it may be because your estrogen levels are out of balance. Estrogen metabolism and detoxification is the process by which the body breaks down estrogens to prevent leftover estrogen metabolites causing problematic side effects and increasing the risk for breast cancer for postmenopausal women.
Estrogen detoxification is important for supporting overall health, especially in relation to how it impacts breast cancer risk. When this process becomes disrupted, it causes side effects of estrogen dominance like painful breasts, fibroids, and hot flashes. This blog post will discuss how healthy estrogen metabolism impacts breast cancer risk, what type of estrogens there are, which types of estrogen metabolites are harmful, and lifestyle behaviors that support healthy detoxification pathways.
The Link Between Breast Cancer and Estrogen
According to the American Cancer Society, breast cancer affects about 1 in 8 women at some point in their life (1). The focus is often on detection (think mammograms and biopsies) and treatment (like surgery or medication) yet there is much too little mention of prevention, and how hormones influence breast cancer risk.
What factors in your life support breast and hormone health? What estrogen metabolites are favorable for postmenopausal women? And are there any changes you can make that will impact breast cancer development, or breast cancer recurrence?
The answer to mediate many breast cancer risk factors may lie with the hormone estrogen, and how it interacts with your body and breast tissue.
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Most breast cancers are driven by factors that are NOT genetic
Only about 5 to 10 percent of breast cancers are estimated to be genetic, including variants on the BRCA1 or BRCA2 genes (2). The risk of developing breast cancer is highest for postmenopausal women, though evidence suggests that premenopausal women are more likely to have more advanced or aggressive types of breast cancer (3).
Not every woman who has a genetic likelihood of cancer will have breast cancer, and factors like age, environment, lifestyle, and other factors can greatly influence the odds you’ll develop breast cancer.
One of the least talked about but most risk factors in this respect is estrogen detoxification and how estrogen metabolites influence different cells and breast tissue.
How estrogen drives cancer
In the U.S., high levels of circulating estrogen and estrogen metabolites are associated with an elevated breast cancer risk (4).
About 80% of breast cancer diagnosis originate as a type referred to as estrogen receptor positive (ER+). This means this type of cancer uses estrogen to grow. About 65% of those types of breast cancers are also progesterone receptor positive (PR+) (5).
Two out of three types of breast cancers possess at least one of these receptors. Additionally, cancers linked to estrogen metabolism tend to have a slightly lower risk of recurrence. Breast cancer that uses estrogen and progesterone receptors may respond very well to treatments known as hormone therapy, which reduce the amount of hormones available for the cancer cells to grow.
Estrogen dominance is one common hormone imbalance which affects many modern women, and that can contribute to estrogen-sensitive cancer growth, such as breast cancer.
Support healthy estrogen levels with calcium D-glucarate.
Estrogen Dominance and Breast Cancer
Estrogen dominance is one of the most common hormone imbalances for modern women. It happens as a result of excess estrogen, insufficient progesterone, or an abundance of xenoestrogens coming from our environment.
Estrogen dominance can also occur as a result of less-than-favorable estrogen metabolites–more on this in a moment.
There are 3 main types of estrogen:
- Estrone (E1) – highest in menopause
- Estradiol (E2) – highest while in the reproductive years
- Estriol (E3) – highest during pregnancy
Women possess all three forms of estrogen at all times, but in varying ratios. The ovaries make most of the body’s estrogen, but fat cells, and other tissues also make some amount of estrogen.
The body also makes estrogen metabolites:
- 2-hydroxyestrone (2OH)
- 4-hydroxyestrone (4OH)
- 16-hydroxyestrone (16OH)
The most favorable is 2OH, and the other can result in elevated breast cancer risk when in excess (6). The liver is where estrogen metabolites are created, which is why supporting liver health and detoxification is such an important part of estrogen metabolism and its role in breast cancer development.
How are estrogen metabolites interacting with breast and other tissues? Find out by having them tested>>
Testing for Estrogen Metabolites
Some estrogen metabolites produced in the liver can be antagonistic concerning cancer cells–which means they cause breast cancer cells to grow or proliferate.
Your integrative medicine doctor can order testing to find out how estrogen metabolites are interacting in your body.
One of the breast cancer risk tests performed is a blood test called 2:16 hydroxyestrone which measures the relationship among two estrogen metabolites to determine breast cancer risk.
Other saliva or blood tests include:
- estrogen to progesterone ratio
- COMT or MTHFR genetic testing
- 2-hydroxyestrone and 2-hydroxyestradiol
Read more: Breast Cancer FAQs
Signs of Estrogen Dominance
Women may notice signs of estrogen dominance as a result of a relative imbalance of estrogen to progesterone, or when estrogen metabolites aren’t properly eliminated after being processed in the liver. This leads to a variety of symptoms which can affect women in their reproductive years, as well as those who are transitioning through menopause. Symptoms include:
- Weight gain
- Mood changes
- Brain fog
- Low sex drive or libido
- Hair loss
- Difficulty sleeping
- Hot flashes
It’s important to also remember that estrogen detoxification isn’t just about reducing the risk for breast cancer, but in supporting overall health as well.
Supporting estrogen metabolism is crucial in order to avoid other symptoms commonly associated with hormone imbalance, including mood swings and irregular periods.
Related: 10 Signs You Have Estrogen Dominance
Natural Ways to Balance Estrogen and Help Prevent Breast Cancer
While there is not (yet) a cure for breast cancer, studies show that a nutrition and lifestyle can be beneficial in all aspects of health, including reducing breast cancer risk factors.
Women who have a family history, or certain SNPs in their genetic profile may benefit even more from changes in lifestyle and diet which promote overall health. We can shift focus to include prioritizing prevention as well as treatment to dramatically reduce the risk of breast cancer and other very serious diseases.
How do I detoxify from excess estrogen?
Throughout a woman’s life, the types and ratios of estrogen production fluctuate naturally. But estrogen and other hormones also need a way to leave the body to avoid the problematic effects of recirculation of harmful metabolites.
Certain foods can help metabolize excess estrogen, as will supporting liver health and detoxification pathways. Discontinuing behaviors like smoking, as well as avoiding drinking to excess also support healthy estrogen metabolism.
You can also leverage the help of natural supplements to support favorable estrogen metabolites.
DIM helps promote healthy estrogen levels and favorable estrogen metabolites.
The modern woman is virtually swimming in a sea of environmental estrogenic compounds. These are substances which mimic estrogen, but don’t actually perform the same function, and can actually be harmful to health.
Xenoestrogens can be found in plastics in the form of BPA, as well as in the food you eat and the water you drink. Tips for avoiding chemical estrogen exposure:
- Use glass, stainless steel, or silicone for food storage.
- Filter your tap water and indoor air.
- Cook on cast iron or ceramic cookware (avoid non-stick and Teflon).
- Use hormone-friendly cosmetics which are low in endocrine-disrupting compounds.
Make more of the “good” estrogen
You can promote more of the “good” or favorable types of estrogen metabolites by following a healthy diet that includes lots of fresh produce, whole grains, and healthy fats.
Other lifestyle tips to reduce estrogen metabolite include reducing stress levels through exercise or meditation activities. Exercise improves the liver detoxification of estrogen by stimulating beneficial microflora in your digestive tract, while also helping you maintain a healthy weight (7).
Supplements for estrogen balance
Some supplements also contain ingredients such as black cohosh and red clover that have been shown to promote healthy estrogen metabolites while supporting overall hormone balance. These types of herbal remedies are considered by some experts to be safe for long-term use, but others recommend combining them with lifestyle modifications to optimize their benefits.
Diindolylmethane (DIM) is a phytonutrient found in cruciferous vegetables such as broccoli, cabbage and cauliflower. It works to support estrogen detoxification by (8):
- shifting production toward “favorable” estrogen metabolites
- supporting phase 1 liver detoxification enzymes
DIM may be beneficial for premenopausal and postmenopausal women to support healthy estrogen metabolism.
Sulforaphane, which also comes from vegetables like broccoli, is a compound that supports the normal detoxification of estrogen and other harmful metabolites.
Calcium d-glucarate increases estrogen elimination in the gut. It works by inhibiting the enzyme which impedes the healthy estrogen detox process (9).
Support liver detoxification
The liver is where estrogen metabolites are made. So, it’s important to support liver health in order to maximize estrogen detoxification.
Dandelion and burdock root contain beneficial phytonutrients which mediate oxidative stress in the liver by scavenging free radicals which may contribute to reduced liver detoxification and some types of cancers (10). These herbs can be purchased as a tea or in capsule form to support estrogen detoxification.
Liver-boosting herbs include NAC and turmeric root. These can be consumed as teas or supplements. Other nutrients that support the function of the liver are found in foods such as artichoke and garlic cloves.
Read more: NAC for Your Liver, Lungs, and Longevity
Limit NSAID use like acetaminophen, which is the leading cause of liver failure in the U.S. This risk is even greater if consuming alcohol at the same time.
Plant-based diets and estrogen
There is some evidence that vegetarians have lower levels of estrogen metabolites in their systems, but this effect isn’t universal.
The best course is to eat a healthy plant-based diet with lots of fresh produce and whole grains as well as getting regular exercise. If you do include meat or other animal products in your diet, try to stick with pasture-raised or organic sources whenever possible.
Balancing estrogen levels to reduce the risk of breast cancer
High levels of estrogen metabolites have been shown to increase an individual’s risk for breast cancer. Awareness about how estrogen metabolism and detoxification impacts health is important because it can lead people to make positive changes in their diet, exercise habits and behaviors that may help reduce the risk for breast cancer.
Bioidentical progesterone or hormone therapy
Hormone replacement therapy may be an appropriate option for some people.
Bioidentical progesterone is a natural hormone that can also help estrogen dominance by opposing estradiol.
However, studies show some association between combined hormone replacement therapy (estrogen and synthetic progestin) and breast cancer. The use of bioidentical progesterone may be a better option for women who can’t or don’t want to take other types of hormone support supplements.
Keep reading: Hormone Replacement, A Holistic Guide
Eating more fiber
Dietary fiber has been shown to be protective against estrogen-dominance related issues by promoting healthy gut bacteria which help metabolize excess estrogen in the digestive tract. In fact, a meta-analysis shows that breast cancer risk decreases as fiber intake increases in post-menopausal women (11).
Some of the best sources of fiber are fruits, vegetables (especially leafy greens), whole grains and legumes such as lentils or black beans.
Reduce or avoid processed meats
Preserved and/or processed meats like deli meats, cured bacon, sausage, and hot dogs have been shown to increase the risk for estrogen-related cancers. So it’s best to limit or avoid these foods.
Alcohol consumption is one of the more significant risk factors for developing breast cancers. Beer, wine, liquor, and other types of alcohol place stress on the liver, which interferes with healthy estrogen metabolism.
In some studies, alcohol has been shown to raise circulating estrogen levels by as much as 10% (12).
Breast Cancer, Estrogen, and Integrative Medicine
High estrogen levels are one breast cancer risk factor for postmenopausal women. Supporting estrogen metabolism and detoxification may help lower this risk. Supplements such as DIM or calcium-d-glucarate support favorable estrogen levels, while eating a healthy diet and avoiding alcohol might also decrease your risk for developing breast cancer.
If you are concerned about your own estrogen levels–or you want to find out how your estrogen metabolites are interacting with your body–contact CentreSpringMD today for testing options and guidance on how to live an estrogen-friendly lifestyle.