As a naturopathic doctor, one of the first and major areas I focus on is gut health because it has such a profound impact on hormones and the rest of the body. Understanding what symptoms are present, like pain, gas, and bloating, and how often there is a bowel movement, can give many clues as to what is going on at a deeper level. It is rare to see a patient with physical symptom concerns and no gut symptoms.
Determining what’s common versus what’s normal
Sometimes, people live with symptoms for so long that they become common. It is important for us to differentiate “common” versus “normal.” Experiencing gas and bloating after eating is common, but not normal. Having a bowel movement a couple times per week is common, but not normal. When these common symptoms are addressed, we see improvements throughout the body.
Why gut health deserves so much focus
Gut health is the foundation for overall health. When there is an imbalance or inflammation, it can cause body-wide symptoms. Although it is not recognized in the medical community as a diagnosis, many people have heard of the term “leaky gut,” which is a presentation of inflammation. Leaky gut causes include chronic stress, frequent antibiotic use, toxins, a diet high in sugars and low in fiber, among others.
Symptoms of leaky gut
It’s important to remember that the inflammation in the gut can show up as symptoms throughout the body. Symptoms of “leaky gut” can be:
- abdominal pain
- constipation and diarrhea
Other symptoms that indicate a gut problem
Symptoms of poor gut health can also look like:
- post-nasal drip and sinus congestion
- skin issues like eczema and acne
- joint pain
- PMS symptoms
- anxiety and depression
- aggravated or flared autoimmune conditions
The gut health and hormone connection
The gut, including its organs and microbiome, is intricately connected to hormone balance. Both exhibit effects on the other. Problems with this connection usually start in the gut, which is why we first focus on gut health to improve hormone dysfunction. Jumping straight to hormone replacement therapy or birth control to “fix” the problem may not address the underlying cause.
Hormones can impact gut function. Progesterone slows down transit time. Estrogen speeds it up. Many have seen this through bowel changes, such as constipation or diarrhea premenstrually. Or, through constipation during pregnancy.
How the liver influences hormone regulation
One of the most important organs with respect to hormone regulation is the liver. The liver is a major organ of detoxification, turning toxic compounds into non-toxic compounds so they can be excreted safely from the body. It processes everything from the food you eat, to the air you breathe, to the things you drink, and your hormones. The liver plays a role in hormone balance, particularly with estrogen, because of this processing role. When the liver is not able to clear estrogens appropriately, it can contribute to an estrogen imbalance.
Estrogen imbalances from gut issues
Estrogen is primarily produced in the ovaries, adrenal glands and fat tissue. It circulates in the blood stream and undergoes metabolism in the liver to be conjugated. Conjugated estrogens are excreted in urine or through the feces. Once in the digestive tract, the conjugated estrogens are exposed to the microbiome and can be de-conjugated by certain bacteria with beta-glucuronidase activity.
This leads to estrogen reabsorption into circulation. Dysbiosis and low bacterial diversity can result in changes to beta-glucuronidase levels, thus creating changes in circulating estrogen levels.
When estrogen dominance occurs
Estrogen dominance is one of the most common hormonal patterns we see today. Increased estrogens can be linked to conditions like endometriosis, PCOS, obesity, and metabolic syndrome. However estrogen is not bad. It plays a role in bone health and cardiovascular function.
Estrogen dominance symptoms can include:
- breast tenderness
- fibrocystic breasts
- irregular periods
- mood swings
- trouble sleeping
- hot sweats
- premenstrual headaches
- weight gain in the belly and hips
- memory issues and brain fog
- low libido
Gut health and other hormone conditions
The goal with hormones is to achieve balance. We don’t want them too high or too low. Gut health plays a part in how hormone balance.
Many different types of organisms make up your gut microbiome. Research shows certain conditions like PCOS may be associated with specific changes to the bacteria. (Specifically, the elevated androgens in PCOS.) All this suggests that sex hormone levels correlate with the bacterial diversity in the gut. The amount of bacteria in the gut is equally as important as the different types of bacteria. So, to treat hormonal conditions, we also need to address gut health.
How to improve gut health to have happy hormones
With gut health and hormones so connected, taking steps to improve one also helps improve the other.
Eat whole foods
Eating foods in their whole form will automatically reduce exposures to added sugar, food coloring, and preservatives which can negatively impact health. Also, familiarizing yourself with the EWG’s Dirty Dozen and Clean 15 list can help make decisions on what foods to buy organic. The dirty dozen are the produce most heavily sprayed with pesticides, which is yet another thing that the liver has to work to detoxify.
Remove food sensitivities
Food sensitivities contribute to inflammation and leaky gut symptoms.
Reduce environmental exposures
Reducing toxins through environmental exposures can reduce the burden on the liver and allow it to metabolize hormones appropriately. (Access my free guide on how to get started.)
Seed cycling regulates and promotes the health of your menstrual cycle by supporting hormone production, binding, and metabolism through the use of seeds and oils. For anyone interested in seed-cycling basics, I offer an overview on how they can help balance hormones.
Much of the research supports the use of broad-spectrum probiotics for everything from IBS to mental health conditions. Probiotics may not be beneficial or appropriate for everyone, so please discuss it with your doctor.
Try my gut reset program (starting soon!)
As with all my patients, this program starts with treating the gut. I created my online Gut Reset Program as a step-by-step approach to understand and address gut health from a holistic perspective. The program includes education on where and how things can go wrong, and how to fix them from a diet, lifestyle, supplement and mindset perspective.
A turning point for my practice occurred when I started acknowledging the role that the mind and mindset plays in disease. Research recognizes a gut-brain connection with certain bacteria reducing mental health symptoms, and clinically I have seen mindset work to reduce physical symptoms. The Gut Reset Program helps individuals build their own personal treatment toolbox.
- Gut health and hormones: Dr. Lewis’ holistic advice - April 1, 2020