Feeling like you need a little more energy? May be some dietary changes can help. Our vitality depends on keeping our hormones optimally functioning and in balance. In today’s world, our hormonal health is challenged on many fronts, such as environmental chemicals, stress, poor diets, aging, sedentary lifestyles, and more. There are many lifestyle choices we can make to help us with that, such as adequate sleep, good stress management, regular exercise. In this article we are going to focus on some dietary practices that can make a difference for you. All of our hormones are critical to out our everyday functioning, such as adrenal, thyroid, and sex hormones, and they affect one another (see hormones 101). These dietary guidelines can be helpful with all hormones, but we are going to focus primarily on the sex hormones which affect people of all ages, but especially perimenopausal women.

With all the daily bombardment of factors that impact our hormones, here are 5 key things that you can do to gain an advantage and work to balance your hormones naturally.

1. Eat Organic

Why are organic foods important to hormonal health?

Most of the thousands of chemicals we are exposed to in our environment have to be processed by our liver. The liver is our primary detoxification organ. Some chemicals can be passed through the kidneys or sweat out through the skin, but most have to be acted on by the liver and passed into the gut, the gastrointestinal tract, to be passed out of our body with our waste products. Our liver is also largely responsible for metabolizing our hormones. In fact, the same pathway that metabolizes our estrogens is the same pathway that processes many medications and environmental chemicals.

Let’s discuss a little bit about why this is so important and break down some science.

Detoxification

There are three phases to detoxify any chemical to prepare it for excretion. (See image below)

Phase one: it has to be activated. This often involves changing it from a fat soluble substance to a more water soluble substance.
Phase two: it is conjugated. This means another chemical molecule is attached to make it able to be excreted, either through the bile into the intestines or into the blood to leave via the kidneys.
Phase three: it is removed. This is the process where it actually leaves the body via the feces or urine.

Phase one and two often take place in the liver.(1) Phase three is outside the liver and requires good hydration and bowels that work properly.

The detoxification process is very energy demanding and takes a lot of nutrients to work properly. Some of these nutrients include B vitamins, minerals such as iron, magnesium, zinc, copper, and molybdenum, vitamin A, amino acids such as cysteine, methionine, serine, glycine, taurine, glutamine, arginine, also sulfur containing foods, phytonutrients, and antioxidants.

Heavy chemical exposure puts a heavy burden on our bodies to process the chemicals and when they cannot be processed, they are often stored in our fat and do damage to our bodies, especially our liver. This process also utilizes many nutrients that could be used elsewhere in our body. Food can be a major culprit of bringing chemicals into our bodies. By eating organic foods, it helps eliminate part of the heavy load of chemicals to detoxify.

Hormone metabolism

Our sex hormones are produced, used, and then broken down. Testosterone is converted to estradiol, our main estrogen, and this is further broken down in the liver (2). There are three pathways it can follow. The 2-hydroxyestrone pathway is the healthiest for our bodies. One of the pathways, the 4-hydroxyestrone pathway, is associated with increased risk of breast cancer (3) and prostate cancer (4). All of these pathways are taken into further steps to render them harmless and able to pass out of the body safely.

Since we are continually making hormones and breaking them down, if your liver is clogged up and the pathways are broken down from a heavy burden of toxic chemicals, such as pesticides, herbicides, and food additives, then your hormone metabolism will be affected. Eating organic foods, as much as possible, helps reduce that burden.

Xenoestrogens

Another reason to eat organic foods is that some of the environmental toxins act like foreign estrogens called xenoestrogens. These chemicals can stimulate estrogen receptors, but do not function like your own hormones would (5). They are not under your own natural feedback loop that controls hormone levels. These xenoestrogens can come from pesticides, herbicides, plastics, food additives, skin and hair care products, other industrial chemicals, medications, and naturals sources, like mycotoxins from fungus and plant estrogen like in soy. The phytoestrogens (naturally occurring xenoestrogens in plants) are generally not as harmful, but still have their effects on our hormones.

Many water containers now say “BPA free” on them. This is because Biphenol A (BPA) is a chemical found in the plastics that acts like a xenoestrogen. These estrogenic compounds from outside the body have been implicated in infertility and precocious sexual development in children, as well as undesirable environmental effects, especially in fish. By eating organically, some of these chemicals can be avoided.

Figure 1 Phytoestrogens compared to 17 beta estradiol

These outside chemicals can affect our hormones primarily in three ways. First, they can act like an estrogen (xenoestrogens) and cause imbalance. Secondly, some xenoestrogens modify the receptors to act differently. For example, there is a class of medications called SERMs which are Selective Estrogen Receptor Modulators used in breast cancer treatment. These turn off estrogen receptors in the breast, while trying to preserve the estrogenic effects on bone metabolism. Thirdly, they can upregulate or downregulate our natural hormone metabolism pathways.

Action: Choose Wisely

Eat organic foods as much as possible. If you struggle with the increased cost, go to the Environmental Working Group’s website www.ewg.org and check out their annual list of the Dirty Dozen, which is the most important foods to buy organic, because otherwise they are loaded with herbicides and pesticides and artificial fertilizers. They also list the Clean Fifteen, which are the fruits and vegetables that are the least likely to be heavily contaminated. In addition, they have information on skin and hair products and other household items to help you find cleaner options for personal use.

2.Regulate Blood Sugar

Why is it important to regulate blood sugar?

Regulating blood sugar is important for many reasons. If our diet is high in refined sugars and flours, this stimulates our bodies to make more insulin to bring down the blood sugar. Some of us are genetically programmed to make lots of insulin, more than we need. This causes spikes of insulin and subsequent large drops in blood sugar. This makes us feel shaky and hungry, so we eat more sugar. We then send out another insulin spike and this cycle keeps repeating itself. High insulin levels lead to insulin resistance which is the body’s attempt at stabilizing this roller coaster blood sugar (6). Unfortunately, the pancreas keeps cranking out more insulin to overcome the resistance.

Insulin Resistance and Obesity

Obesity has been on the rise in this country for decades, and with this increase, many health problems have risen. Insulin resistance is associated with increased obesity, high blood pressure, diabetes, cardiovascular disease, dementia, and some types of cancer (7). To moderate our blood sugars we need to reduce carbohydrate (sugar and starch) intake, and eat adequate protein and healthy fats. We also need to eat adequate fiber and stay active.

Adipose tissue (fat tissue) is necessary in the body for energy reserves and insulation. Our normal fat is mostly subcutaneous, that means a layer under our skin. But in excess, fat can be stored in places that are not healthy, such as in the liver or around our abdominal organ. This called visceral fat and it is especially metabolically active. Adipose tissue can produce hormones such as estrogen, leptin, adiponectin, and resistin (8).

The production of estrogen by the adipose tissue may be the connection for increasing some kinds of cancer. Estrogen excess or dominance (out of balance) is associated with increased risk of endometrial cancer or breast cancer. On the other hand, estrogen deficiency (out of balance the other way) when combined with insulin resistance is associated with an increased risk of breast (9), ovarian, and endometrial cancers. This shows the importance of having our hormones in balance and a healthy diet can assist in this.

The Most Common Liver Disease

Non Alcoholic Fatty Liver Disease (NAFLD) is on the rise. Decades ago, a fatty liver was a condition found in alcoholics that was a precursor to developing cirrhosis. Now it is more common to find it in non alcoholics and it is thought to be associated with the high carbohydrate intake, especially fructose (think high fructose corn syrup, found in so many food products these days.

Sucrose is common table sugar and it is made up of fructose and glucose combined. Your body has enzymes to split sucrose into its individual components. Glucose can be burned by all of our cells, but fructose is taken down a different pathway, very similar to alcohol. The majority is processed in the liver and turned directly into fat because it is harder for it to go down the usual energy production pathways. It is not under the same regulation as glucose because it does not stimulate insulin. It is relatively low in natural diets. It is found in honey, some fruits, and some root vegetables, like yams. These foods are usually eaten in moderation and have fiber and other nutritional components. Most of the high fructose syrups used today are stripped of other nutrition and used in products consumed in large quantities, such as soft drinks. This excess fructose consumption is not only adding to our obesity epidemic, but believed to be contributing to the development of NAFLD (10).

Action: Eat natural, unprocessed foods

Eating a more natural diet of whole foods and avoiding highly processed foods with excessive sugars and very little nutrition can help us balance our blood sugar and lower the risk of obesity and insulin resistance that leads to conditions that complicate our hormonal health. When improving your diet, it’s important to balance the macronutrients (carbohydrates, fat, and protein) with low to moderate carbohydrates, moderate protein and adequate healthy fats and fiber (11)

3. Eating Cruciferous vegetables

Vegetables in the Brassica family, also called cruciferous vegetables, have special properties that confer health. They contain several phytonutrients that help decrease cancer and promote healthy hormone metabolism. Intake of these vegetables has been the subject of many studies around the world. Higher consumption has been shown to reduce the risk of breast (11), prostate (12), pancreatic (13), lung and colorectal cancers (14 ).

This family includes broccoli, cabbage, Brussels sprouts, cauliflower, bok choy, turnips, rutabaga, wasabi, kohlrabi, watercress, radishes, horseradish, and greens such as turnip, mustard, collard, and kale. This means it is easy to eat cruciferous vegetables frequently and still have variety in your diet. The more servings you eat per week, the greater the benefits.

These vegetables contain several phytonutrients. One of the most important for hormonal health is diindolylmethane (DIM) which helps in hormone metabolism and reduces the risk of breast cancer. DIM acts like a natural aromatase inhibitor which is one of the classes of drugs used to treat breast cancer. This prevents estrogen excess and also promotes the healthy metabolism of estrogen. Estrogens can go down one of three pathways and the most desirable is the 2-hydroxyestrone pathway. An alternative pathway is known as the 4-hydroxyestrone pathway. Elevated 4-hydroxy estrogen metabolites are shown to be associated with increased risk of breast cancer in women (15). The third pathway, the 16-hydroxyestrone pathway is also being studied in regards to increased cancer and may be associated with increased prostate cancer in men (16). DIM encourages the 2-hydroxyestrone pathway.

Action: More is better

Chewing well, chopping, blending or juicing these vegetables releases more of these healthy nutrients, so add them to smoothies or soups. Cooking them does not decrease the benefits, so eat them raw or cooked, just eat them often!

Some have expressed concerns about goitrogens in the cruciferous vegetables that may have a harmful effect on the thyroid, but clinical studies have not show this to be clinically significant, compared to soy or certain medications (17). However, if you as an individual are particularly sensitive to this effect, then you may have to limit them or cook them well, which reduces the effect. For most of us, the more servings you eat per week the greater the benefits, so aim for 3 to 4 servings per week.

4. Vitamin D is vital

Most scientists now recognize vitamin D as a hormone that is very important for our health, but since it was originally discovered as a vital substance and labeled a vitamin, we will probably not see that designation changed in common understanding. Nearly every cell in the human body has vitamin D receptors and the effects of this are far reaching (18).

The need for vitamin D is so critical, it will be the subject of its own article, but here we will just touch on a few of the effects it has in regards to hormones.

Adequate vitamin D levels improve fertility outcomes (19)
Higher levels of vitamin D have been shown in young women to modulate their hormone levels
Deficiency of vitamin D is associated with higher levels of metastasis and death in breast cancer patients (20, 21)
Higher vitamin D levels are associated with more free testosterone in men and women, by lowering Sex Hormone Binding Globulin (22)

The Sunshine Vitamin

Sunlight is our main natural source of vitamin D. However, if you live north of the 40^th parallel, like I do in Oregon, there is not a sufficient quality to the sunshine to give adequate levels, especially in the winter. Many of us have indoor jobs and cannot get outside during peak sun time. We often have cloudy skies to limit our sunshine here in the Northwest. Darker skin pigments also naturally block the UV rays needed for conversion of the vitamin D. Tanning beds are less efficient at producing vitamin D because they have more UVA band wavelengths than the required UVB band.

A couple of important things about the science of vitamin D is that it undergoes transformation in our bodies, starting with the formation of the first stage in our skin when the UVB light acts on a form of cholesterol from our diet to form cholecalciferol, also called vitamin D3 or ergocalciferol, called D2. It then undergoes two more enzymatic conversions to become the most active form in our body, calcitriol, mostly in the kidney (23) which is why people with kidney disease are often vitamin D deficient. Calcitriol is the active hormonal form of vitamin D and is important in absorption of minerals such as calcium, magnesium, and phosphorus, which makes it very important for bone health and much more. The cells have vitamin D receptors, just as they have other hormonal receptors.

Other sources of vitamin D

Food sources of vitamin D include cod liver oil, some oily fish, egg yolks, mushrooms, and liver. Dairy products are supplemented with vitamin D, but this form is less efficiently used by our bodies than the naturally occurring forms. Most of us do not get sufficient quantities from our food. In my experience, close to 80% of Oregonians will need supplementation with vitamin D3.

Action: Know your number

Having a blood test done is the only way to know if your levels of vitamin D are adequate. Most labs give a reference range of 30-100 ng/ml for vitamin D 25-OH. Many providers feel the 50-80 is a more optimal range for health. There are so many factors that can affect your vitamin D level that there is no blanket recommendation for supplementation that will be adequate for everyone, but somewhere around 4,000 to 5,000 IU per day of D3 will get a lot of people in that range. Again, if you live in Florida, and spend a lot of time in the sun, you may not need any supplements, so I am giving a range for those in northern latitudes. I find some people need 10,000 IU per day for a while, if they are very deficient.

Adequate vitamin D is necessary for optimal health, so know your number and get it into a good range through sunlight, food, and supplementation, if needed.

5. Eating Healthy Fats

For close to fifty years, the medical community has been pushing “fat phobia,” teaching us that the fat in foods is the problem. But recent research is debunking that myth and showing us the elevated sugar and insulin resistance are associated with far more disease than elevated cholesterol (24). Cholesterol is actually a necessary nutrient and is a precursor in the formation of vitamin D and all of our sex hormones and several other steroid hormones.

We want adequate fat in our diet, but not just any fat. We want mostly plant based fats such as from nuts, seeds, olives, avocados, coconut, and the cold pressed oils from these.

The best animal sources are from wild (not farmed) cold water fish and wild game. Grass fed beef and dairy and pasture raised poultry and eggs are also acceptable (25).

It is important to avoid more conventionally raised animals and vegetable oils, such as corn, soybean, canola (which are now mostly Genetically Modified Organisms –GMO), sunflower, and some other oils that are usually heat and chemically processed and become oxidized and inflammatory (26).

The feed changes the fat

Animals fed grains develop a different fat profile than their naturally raised, pasture fed counterparts. Many of us have heard about omega -3 fatty acids, such as in fish oil. There are actually omega-3, omega-6, and omega-9 fatty acids. All are necessary, but the key is balance. We normally need omega-3 in balance with the omega-6 at a ratio of 1:1 up to 1:4, which is consistent with a primitive diet. Unfortunately, the current standard Western diet is around 1:15 or higher (27) . When animals are fed their native diets, such as grass for cows, the ratio found in their fat is around 1:2 to 1:5. However, if they are taken out of their natural environment, put into concentrated feed lots and fed mostly grains, such as corn and soybeans, then that ratio of omega-3 to omega-6 jumps up to around 1:19 (28 ).

Unhealthy fats can fuel inflammation

The major problem with this shift is that the omega-6 fats, when out of balance, are pro-inflammatory and associated with increases in cardiovascular disease, autoimmune disease, and poorer outcomes in cancer patients (29). Wild caught seafood, such as salmon and tuna, have very favorable ratios with more omega-3 fatty acids than omega-6. This is why fish oil is found to be anti-inflammatory. A pro-inflammatory diet, high in unhealthy animal fats or polyunsaturated vegetable oils, can lead to increased joint inflammation, autoimmune disease, and other health problems.

In relation to hormones, high fat diets increase circulating estrogens and decrease sex hormone binding globulins, the usual carrier protein in the blood that helps control how much hormone is available for immediate access (30). This can cause estrogen dominance by bypassing normal regulatory mechanisms and causing an imbalance that favors estrogen sensitive cancers, such as breast cancer.

Action: It is important for your hormonal health to eat healthy fats.

Examples of the best sources are:

Cold pressed olive oil
Coconut oil
Avocados
Pasture raised butter
Salmon
Raw nuts and seeds

If you can replace some of the excess carbohydrates with these healthy fats and high fiber foods to keep the blood sugar in balance, you will have a great equation for balanced hormones.

Here a few other tips for hormonal health

It is important to practice overall good self care.

Get plenty of quality sleep
Get regular exercise
Manage stress well by
- Learning to let it go, learning to say no
- Meditation, massage, prayer, yoga, EFT/tapping, etc.
Get some sunshine
Have a circle of friends

There are many things we can do to improve our health. What we choose to eat, how much we eat, and even when we eat, probably has more effect on our health than anything else. Choose well!

Eating For Hormonal Health: The Why, How, and What