In recent years, a growing body of research has unveiled the complex and dynamic interaction between the gut microbiome and our hormonal health, fundamentally altering our understanding of many chronic conditions. This connection is proving to be a pivotal factor in the onset and management of several hormonal imbalances and diseases, ranging from polycystic ovary syndrome (PCOS) and breast cancer to thyroid disorders, acne, and endometriosis. The intricate relationship between our gut health (estrobolome) and hormonal regulation is reshaping the approach to these widespread issues, suggesting that an unhealthy gut may be more influential than previously thought.

The gut, often coined as the “second brain,” harbors trillions of microorganisms that work tirelessly to perform critical functions, such as digestion, nutrient absorption, and immune system regulation. New insights suggest that these tiny inhabitants profoundly influence hormonal signaling pathways, playing a crucial role in maintaining the delicate balance required for optimal health.

When this balance is disrupted, it can lead to a cascade of issues, culminating in the manifestation of conditions like PCOS and even impacting the risk of developing more serious ailments such as breast cancer.

In today’s article, we will dive into the fascinating realm of the gut-hormone connection, examining how an unhealthy gut as well as imbalances in the estrobolome can trigger these complex hormonal disruptions.

Whether you are dealing with skin issues like acne, psoriasis, or navigating more complex conditions like thyroid disease, PCOS, endometriosis or breast cancer, understanding the connection between your estrobolome and your hormones, might be the key to unlocking new approaches to treatment and prevention.

The Effects of Unhealthy Gut Health on Sex Hormones

Did you ever think that the health of your gut could influence all the different hormones your body makes? And that when gut health suffers so will hormone balance?

Well….. If I piqued your interest, stay tuned! Hey there, I’m Dr. Hagmeyer, and if you are struggling with the symptoms of a hormone imbalance or you are currently on some kind of hormone replacement, I think you are going to find today’s video super interesting.

Today I’m going to unpack five common female hormone problems (diseases) and the connection those problems have with a bad gut. I’ll also talk about some simple steps that you can make from a dietary standpoint to start the process of rebuilding your gut for better hormone balance.

How you think, how you feel, your happiness, your mood, your energy, and your mental health are closely tied to your hormone health specifically the balance of your hormones. …but what controls your hormones?

Believe it or not, many hormone problems can begin inside your gut. This is because the gut microbiome–the trillions of bacteria that live in our digestive system–plays a critical role in regulating hormones (*).

When the gut microbiome is unhappy and unhealthy, it can cause problems with estrogen-related diseases, thyroid problems, PCOS, endometriosis, Insulin Resistance, and diabetes. Let’s review how gut health affects your estrogen levels.

#1 The Gut-Hormone Connection and Estrogen

Recent research has shed light on the intricate relationship between gut bacteria and the regulation of estrogen, one of the key hormones in the body. (*). Healthy estrogen levels are important for women in every single stage of life.

Estrogen regulates weight, fertility, cardiovascular health, mood, bone health, mental health, and so much more. I want to introduce you to something called the estrobolome and how disruptions in the estrobolome can lead to female hormone problems.

The Estrobolome: A Key Player in Estrogen Metabolism

The Estrobolome is a critical piece of the puzzle when it comes to hormone Health. When we talk about hormone health—especially estrogen—most people think only about the ovaries and if their is a problem with estrogen levels- hormone replacement therapy. But there’s another major player that often gets overlooked: the estrobolome(*).

The estrobolome is the collection of bacteria in your gut microbiome that are specifically involved in processing and regulating estrogen. In other words, it’s the part of your gut ecosystem that helps decide how much estrogen stays in circulation and how much is safely eliminated.

Here’s how it works. Your liver takes “used” estrogen out of circulation, packages it up (a process called conjugation), and sends it into the bile so it can move into your intestines and eventually leave the body through your stool. That’s the ideal scenario. But certain gut bacteria produce an enzyme called beta-glucuronidase.

When this enzyme is overactive, it can unpack or “deconjugate” that estrogen, freeing it up so it can be reabsorbed back into your bloodstream. When that happens, you can wind up with too much active estrogen cycling through your system again and again.

This is where the estrobolome becomes so important. A balanced estrobolome supports healthy estrogen clearance.

A disrupted estrobolome—often due to dysbiosis (an imbalance between beneficial and harmful bacteria), frequent antibiotic use, chronic constipation, inflammatory diets, alcohol, or toxin exposure—can drive estrogen back up.

A properly functioning estrobolome ensures that estrogen levels remain balanced(*). Problems with the estrobolome can lead to estrogen-related diseases like breast cancer, endometrial cancer, PMS, polycystic ovarian syndrome (PCOS) and many other hormone imbalance symptoms experiencd by woman(*).

Estrobolome Gone Wrong

Unfortunately, things never go as planned! When Liver/Gut/intestinal dysbiosis is present, something very different happens. Unfriendly opportunistic bacteria start increasing production of this enzyme called beta-glucuronidase, Beta-glucuronidase breaks the tight bond between glucuronic acid and estrogen in the intestines. That’s a really bad thing! Essentially what this this beta-glucuronidase does is it takes the estrogen that was meant to leave the body and re-activates the estrogen in your gut.

Re-activated estrogen then re-enters your body and causes a variety of problems related to excess estrogen. We call this estrogen dominance.

Things like irregular periods, changes in mood, anxiety, depression, headaches, weight gain, headaches, bloating, and other digestive ailments. The beta-glucuronidase that once upon a time was binding up toxins, allows them to re-enter your body and cause problems like fatigue, brain fog, depression, inflammation, headaches, and joint pain.

If this sounds confusing or you are a bit of a nerd like me, You can learn more about High Beta Glucoronidase levels and how we can test for them here.

Lets take a look at gut health and its connection to PCOS and cystic acne.

#2 The Gut-Hormone Connection and PCOS

The gut is home to a vast community of microorganisms, good bacteria, bad bacteria, opportunistic bacteria and yeast. Collectively this is known as the gut microbiome. Some of these microorganisms play an essential role in digestion, nutrient absorption, immune function, and even hormone regulation. A balanced gut microbiome is crucial for overall health, but an imbalance, known as gut or intestinal dysbiosis, can contribute to a host of health issues, including PCOS and cystic acne. If you suffer with PCOS or hormonal acne, let’s take a closer look at the gut health and PCOS connection.

PCOS is a hormonal disorder that can cause missed periods, weight gain, excess hair growth, and acne, and is one of the main causes of infertility. But what you might not know is that PCOS and Insulin resistance can be caused by a leaky gut as well as gut dysbiosis.

Research indicates that woman with PCOS have alterations in their gut microbiome compared to those without PCOS (*), (*). Chronic inflammation is common in both gut-related issues as well as PCOS.

An unhealthy gut can contribute to systemic inflammation, insulin resistance, and hormone imbalances all of which can aggravate PCOS symptoms. Poor gut health can be a contributing factor to insulin resistance, a key feature of PCOS that can lead to elevated blood sugar levels and weight gain.

Connection Between Gut Health and Acne

Acne is a common and often frustrating skin condition, affecting millions globally. While many factors contribute to acne, one surprising aspect emerging from recent research is the role gut health plays in skin health.

The Gut-Skin Axis: How Gut Health Influences Acne

The gut-skin axis refers to the intricate relationship between the gastrointestinal system and skin health. It highlights how the condition of your gut impacts your skin

This connection highlights how gut inflammation and dysbiosis can contribute to skin conditions, including acne. Inflammation in the gut can activate pathways that lead to increased sebum production, inflammation in the skin, and cystic acne.

Gut bacteria have roles in metabolizing hormones like estrogen. An imbalanced gut can interfere with hormone regulation, possibly affecting sebum production in the skin and contributing to acne formation.

Hormonal Acne and Leaky gut: Leaky gut is often seen in women with PCOS. can contribute to an increase in acne. A well-balanced gut microbiome can help regulate these hormones, potentially alleviating hormonal acne.

PCOS and Leaky Gut

Leaky gut syndrome refers to increased intestinal permeability, where the gut lining becomes compromised. This allows larger molecules, toxins, and partially digested food particles to pass into the bloodstream, potentially triggering inflammation and immune responses throughout the body.

In both PCOS and leaky gut syndrome, inflammation plays a central role. Chronic inflammation may exacerbate the symptoms of PCOS, and leaky gut syndrome can contribute to systemic inflammation by permitting unwanted substances into the bloodstream.

Several recent studies in the European Journal of Endocrinology have found that women with PCOS often have elevated blood markers of something called Zonulin and Occludin which are indicators of a leaky gut.

Zonulin and Occludin are proteins that hold the gut lining or gut cells together and testing for this biomarker is an indicator that you have a leaky gut (*). If you test positive for Zonulin antibodies that’s the indicator that you have a leaky gut.

Chronic Gut Inflammation, Leaky Gut, and PCOS

Here’s what that means to you and why this is so important. When you have chronic inflammation in the GI tract, your gut becomes leaky and this leakiness or increased permeability allows a large number of LPS bacterial toxins to enter the bloodstream- this creates even more inflammation but it also creates an overactive, overzealous immune system.

For women with PCOS who are trying to conceive, an overactive immune system and increased amounts of these inflammatory markers are linked to recurrent miscarriage and infertility (*).

This leaky gut and inflammation also inactivate the insulin receptors on your cells preventing glucose from getting into cells to be used as fuel.

As a consequence, of insulin resistance, Glucose levels start going up and up in your blood, and your pancreas tries to produce more and more insulin, so your insulin goes up and up, and now with increasing insulin levels, you start laying the groundwork for things like heart disease, fatty liver disease, metabolic syndrome, and type 2 diabetes.

Those high insulin levels, also reduce the Sex Hormone Binding Globulin (SHBG) which allows more free testosterone to exist throughout the body. A woman with too much testosterone develops acne, facial hair, irritability, and many of the other PCOS symptoms.

So, this is how a leaky gut and intestinal dysbiosis can cause all the problems and symptoms that we see with PCOS including acne (*).

Here’s some good news if you have an unhealthy gut and acne. If we can correct chronic gut inflammation, fix the leaky gut and improve the health of the microbiome, we can also improve PCOS and acne.

#3 The Gut-Hormone Connection and Endometriosis

Gut health and endometriosis are interconnected in several ways. Endometriosis is an estrogen-dependent, chronic inflammatory disease where tissue similar to the lining of the uterus implants on organs outside of the uterus.

Both gut health and endometriosis are associated with inflammation. An imbalance in the gut microbiome—known as dysbiosis—can lead to increased systemic inflammation, which may exacerbate endometriosis symptoms.

If you are a woman who has endometriosis, you should know that Endometriosis has a significant overlap with Irritable Bowel Syndrome (IBS)(*). Women with endometriosis have a two-fold to three-fold increased risk of having IBS (*)

The key takeaways here are that women who have endometriosis have

1. Too much estrogen (estrogen Dominance)
2. Too much inflammation
3. Dysfunctional gut microbiome. (*)
4. Activation of mast cells, (*)
5. Stimulation of pain receptors,
6. Dysbiosis (*), and leaky gut [*].

Addressing gut health through diet, probiotics, prebiotics, and other lifestyle changes could potentially help manage endometriosis symptoms, although it is not a cure. It’s important for individuals to consult with healthcare professionals for personalized advice and treatment options.

#4 The Gut-Hormone Connection and Cancer

If you are wondering about the gut hormone connection wiht cancer, you should know that here again, there is a strong link between gut/intestinal dysbiosis and various types of cancer, especially ovarian, breast, and cervical cancers (*),(*),(*).

About 80% of breast cancers are “ER-positive” which means they use estrogen to grow (*).

Earlier, we learned about the gut microbiome the estrobolome. We learned that it is the estrobolome that assists in metabolizing excess estrogen. The estrobolome prevents excess estrogen from recirculating in the blood and increasing the risk for estrogen-sensitive cancers(*),(*),(*).

So, this is one way the gut microbiome plays a key role in removing harmful excess estrogen as well as preventing the recirculation of toxins that could potentially drive cancer(*).

But that’s not all, a healthy gut microbiome is also important for maintaining a healthy immune system, which is your body’s first line of defense against cancer.

We have talked about the unhealthy gut and how a bad gut can lead to chronic inflammation, an increase in Mast Cells, a Leaky gut, estrogen dominance and intestinal dysbiosis.

If you are starting to see the “Bigger picture” here then you can probably see how these gut problems all present themselves as significant risk factors for the development of cancer.

#5 The Gut-Hormone Connection and Thyroid Problems

A bad unhealthy gut also impacts thyroid function. A significant portion of the body’s immune system is located in the gut. The gut microbiome helps regulate immune responses, which is crucial because autoimmune conditions like Hashimoto’s thyroiditis or Graves’ disease are common causes of thyroid disease. A disrupted gut environment impact the conversion efficiency, affecting the levels of active thyroid hormone available to the body.

Now I have written numerous articles and have many videos on my YouTube Channel where I talk about various topics on the thyroid-gut connection So, I’m going to just give a quick overview on the thyroid-gut connection.  

1. The gut microbiome is critical in digesting food and absorbing nutrients necessary for thyroid function. Iodine, selenium, and zinc are vital for thyroid hormone production and function. A healthy gut promotes the efficient absorption of these key nutrients
2. Dysbiosis, or an imbalance in gut microbiota, can lead to inappropriate immune reactions, potentially exacerbating autoimmune thyroid disorders.
3. Unhealthy Gut microbiome could impact the conversion of T4 to T3.
4. Chronic inflammation stemming from a dysfunctional gut can negatively impact thyroid health. Inflammatory cytokines can interfere with thyroid hormone metabolism, receptor sensitivity, and autoimmunity, increasing the risk of thyroid disorders
5. An unhealthy gut can lead to compromised intestinal permeability (leaky gut.) This condition allows toxins and antigens to enter the bloodstream, potentially triggering systemic inflammation and autoimmunity, including thyroid-related autoimmune diseases.

When the gut barrier becomes permeable or “leaky” large protein molecules escape into the bloodstream. the body mounts an immune response and attacks them. Studies show that these attacks play a role in the development of autoimmune diseases like Hashimoto’s. (*)

We also know that the T3 thyroid hormone helps maintain the gut barrier in the stomach and the intestines. Low T3 can lead to leaky gut and fatty liver.

Tight junction proteins like Zonulin and Occludin are the proteins that maintain the integrity of the gut barrier- these proteins are influenced by thyroid hormones.

T3 and T4 have been shown to protect the gut mucosal lining from stress-induced ulcer formation (*). Several studies have looked at gastric ulcers only to find low T3, low T4, and abnormal levels of reverse T3 (*).

A sluggish gall bladder interferes with proper liver detoxification and prevents hormones from being cleared from the body, and hypothyroidism impairs GB function by reducing bile flow (*),(*)

Correct Your Hormone Imbalances With a Healthy Gut

Much of what controls whether your gut is healthy—or in a state of unhealthy inflammation—comes from your daily lifestyle habits. What you eat, don’t eat, what you drink don’t drink, what supplements you take and which ones you don’t, and finally medications that you are taking or have taken in the past. How you treat your gut, is how it will eventually treat you.

The key takeaway in this video is that a healthier gut means better hormone balance and a happier you. I talked a lot about the different hormone problems and got into the specifics but various gut problems including Leaky Gut, inflammation, gut dysbiosis, low stomach acid, bacterial overgrowth, sluggish liver, and gallbladder are the common gut problems that affect hormones in multiple ways.

If you fix these problems, you will be one step closer to better-balanced hormones and feeling good again. So what are some of the things you can do to improve your hormone health when it comes to your gut?

7 Tips to Improve Your Gut For Better Hormone Balance

Let me give you seven tips that I believe are super important when it comes to improving Your Gut For Better Hormone Balance.

#1 Eat More Fiber is Your Friend

One of the things you should consider if you have poor gut health and PCOS and especially acne is to consume more fiber. Fiber is a necessity when you have an unhealthy gut. Vegetables, fruits, nuts & seeds, and beans are great sources of fiber that provide fuel for healthy gut bacteria, they help your gut bacteria make short-chain fatty acids like butyrate. Studies show that butyrate production in the colon cannot be maintained without adequate intake of prebiotic fiber (*).

#2 Eat an anti-inflammatory Diet

Every gut hormone problem can be helped with an anti-inflammatory diet.  Anti-inflammatory diets are tremendously beneficial in treating and preventing Chronic gut inflammation.  The food you eat can either cause inflammation or promote inflammation. Eats fruits and vegetables that have color. Foods with color are loaded with antioxidants and polyphenols. Avoid trans fats and fried foods, avoid anything that says hydrogenated. High-fat, low-carb diets like Keto and Carnivore while initialy helpful, in the long run can be damaging to the gut microbiome as they starve the bacteria that produce butyrate and short-chain fatty acids. (*)

High Fat diets are damaging to the Gut Microbiome  (*)

#3 Add Fermented and Cultured foods.

Fermented foods contain active healthy bacteria called probiotics that help balance your overall gut microbiome. Research shows that people who eat a lot of yogurt, have more lactobacilli in their intestines. These people also have more Enterobacteriaceae, which is a type of bacteria associated with inflammation and several chronic conditions (*).

A balanced gut microbiome is important for hormonal balance. Yogurt, sauerkraut, kimchi, and kombucha are all sources of good probiotics.

#4 Consume more Prebiotics

Prebiotics are foods that promote the growth of beneficial bacteria in the gut. They are mainly fiber or complex carbs that human cells cannot digest. Instead, certain species of bacteria in the gut break them down and use them for fuel.

Many fruits, vegetables, and whole grains contain prebiotics, but they can also be found on their own. Resistant starch can also be a prebiotic. This type of starch is not absorbed in the small intestine and passes into the large intestine, where the microbiota breaks it down.

Many studies have shown that prebiotics can promote the growth of several types of beneficial bacteria, including Bifidobacteria (*).

Certain prebiotics have also been shown to reduce insulin, triglyceride, and cholesterol levels in people with obesity, which could be beneficial for the prevention of conditions like heart disease and type 2 diabetes (*, *, *).

#5 Take a probiotic supplement

S.boulardii is particularly helpful in combating the effects of dysbiosis and destroying the protective mechanisms (called biofilms) that bad bacteria use to disguise themselves from your immune system.

Probiotics promote the growth of good bacteria in your digestive tract as well as your vaginal tract.   I recommend this probiotics for woman who struggle with any of the hormone problems Ive discussed today.

#6 Eat More Polyphenols

Polyphenols are plant compounds that have many health benefits, including reductions in blood pressure, inflammation, cholesterol levels, and oxidative stress (*). Human cells can’t always digest polyphenols. Because they aren’t absorbed efficiently, most polyphenols make their way to the colon, where they are digested by gut bacteria (*, *).

Polyphenols from cocoa can increase the amount of Bifidobacteria and lactobacilli in humans and reduce the quantity of Clostridia (*). Furthermore, these changes in the microbiome are associated with lower levels of triglycerides and C-reactive protein, which is a marker of inflammation (*).

Recent studies indicate that the consumption of polyphenol-rich foods can favorably modulate the gut microbiota, including an increase in the abundance of Akkermansia muciniphila.

Akkermansia is known for its ability to improve gut barrier integrity by promoting the production of mucin. This activity has been shown to enhance the tight junctions (reducing leaky gut) in the gut lining, and reducing gut inflammation.

 

 

Foods Rich in Polyphenols Include.

• cocoa and dark chocolate
• red wine
• grape skins
• Pomegranate
• green tea
• almonds
• onions
• blueberries
• broccoli

Resources

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526216/
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3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337124/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059636/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/
6. https://pubmed.ncbi.nlm.nih.gov/29897462/
7. https://pubmed.ncbi.nlm.nih.gov/28778332/
8. https://pubmed.ncbi.nlm.nih.gov/12093827/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5017946/
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353203
11. https://www.frontiersin.org/articles/10.3389/fcimb.2022.834485/full

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