Estrogen Dominance with Magdalena Wszelaki: Rational Wellness Podcast 196
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Magdalena Wszelaki discusses Estrogen Dominance with Dr. Ben Weitz.
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Podcast Highlights
2:10 Magdalena’s personal health journey was highlighted by being diagnosed with both hyperthyroidism and hypothyroidism at the same time along with estrogen dominance. She was first diagnosed with hyperthyroidism when she started having a rapid heartbeat, anxiety, and hair loss and she was placed on a thyroid blocker. But seven years later when she was living in Shanghai, it came back with a vengeance. She noted that she had a lot of food sensitivities when she was growing up and she had eczema and cystic acne. Magdalena also pointed out that she was not breast fed and she ended up being hospitalized during her first month of life with pneumonia and she was prescribed a broad range of antibiotics. She also grew up with a narcissistic and nervous mother.
6:00 Magdalena was diagnosed with hyperthyroidism and was put on thyroid blockers and six months later she was declared cured. But nobody looked for the root cause and a few years later it came back with a vengeance. Magdalena learned that gluten can cause acne, so she eliminated gluten. She discovered that she had other food sensitivities, including diary and eggs, which she also eliminated, which put her on the path to starting to feel better. She also had terrible PMS and swollen lymph glands and water retention related to estrogen dominance. Her PMS was so bad that she would have to take a few days off work or school and be in a fetal position with multiple pain killers. Her lymph would be so swollen that if she took a flight and took her shoes off, she could not get her shoes back on. She also had a lot of thyroid nodules, which she said is a sign of estrogen dominance.
10:25 When a woman experiences one hormonal imbalance, like estrogen dominance, they are much more likely to have another hormonal imbalance, like thyroid problems. Your hormonal system is like a symphony orchestra and all the instruments must play together for it sound good. When you have too much estrogen, your sex hormone binding globulin, which tends to increased your thyroid binding globulin, which binds your thyroid hormone and makes it inactive. This is why you want to measure your free T3 and not just your total T3, because the free T3 is the one not bound by the thyroid binding globulin, thus it is the one that is bioavailable.
13:10 Magdalena breaks down estrogen dominance into 3 categories or types: 1. Excess estrogen to progesterone. 2. Unhealthy estrogen metabolism. 3. Estriol (E3), the weaker form of estrogen, is low compared to Estrone (E1), and Estradiol (E2), the stronger forms of estrogen. One of the reasons for estrogen levels being high compared to progesterone is that we get exposed to many forms of environmental estrogens, such as from skin care products with parabens, phthalates, air fresheners, pesticides, flame retardant chemicals sprayed on our mattresses, our furniture, and our car seats.
18:50 The second form of estrogen dominance is unhealthy estrogen dominance, which means that you break down your estrogen in an unhealthy way, into either clean or dirty estrogens. The best way to analyze estrogen metabolism is with DUTCH testing (dried urine testing) that will report on the 2, 4 and 16 hydroxyestrogens, and you cannot see these metabolites on blood tests. This estrogen metabolism takes place in the liver and as we get older, our liver tends to get more taxed. We need to do proper detox on our liver with foods and supplements on a regular basis to maintain our liver health. If there is constipation, then your estrogen is not being excreted and it will be recirculated.
24:19 The third form of estrogen dominance has to do with the ratio of E1, E2, and E3 and E3 being low compared to E1 and E2, which are the stronger forms of estrogen, with estradiol being the most aggressive.
25:10 Strategies to reverse estrogen dominance. One of the most important things is to support the liver and not by doing a severe, deep detox by taking a large amount of detox powder that contains a lot of sugar, and then going back to eating unhealthy once the detox is over. It is better to support the liver on a daily basis, including by eating bitter foods like radishes, arugula, kale, etc. or by taking herbal bitter supplements. We also want to support liver detoxification by supporting the sulphation, glucuronidation, and methylation pathways. Ground flax seeds can help with estrogen detoxification due to the lignans.
Magdalena Wszelaki is a nutrition coach, certified herbalist, a bestselling author, speaker, and educator. Magdalena is the founder of Hormones and Balance, a thriving online community dedicated to helping women balance hormones naturally. Magdalena offers several programs, including Estrogen Reset.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com.
Podcast Transcript
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge information. Subscribe to the Rational Wellness Podcast for weekly updates. To learn more, check out my website drweitz.com. Thanks for joining me and let’s jump into the podcast. Hello, Rational Wellness Podcasters.
Our topic for today is estrogen dominance with Magdalena Wszelaki. Estrogen dominance, which is typically described as having too much estrogen in relationship to progesterone, can lead to many symptoms, including mood swings, anxiety, decreased sex drive, worsening PMS symptoms, heavy periods, irregular periods, infertility, bloating, weight gain, hair loss, insomnia, brain fog, hot flashes, and night sweats. It can also lead to various health conditions including ovarian cysts, fibroids, endometriosis, and fibrocystic breasts among others. Magdalena Wszelaki is the founder of Hormones Balance, a thriving online community dedicated to helping women balance hormones naturally.
Magdalena is a nutrition coach, certified herbalist, a best selling author, speaker, and educator. She has a long history of hormonal challenges. Her health crisis was a direct result of a highly stressful life in advertising. Starting from Graves’ and Hashimoto’s Disease, autoimmune conditions causing thyroid failure, to total burnout in estrogen dominance. Today, she is in full remission and lives a symptom-free life and teaches women how to find their hormonal balance with her books and programs. Magdalena, thank you so much for joining me today.
Magdalena: Thank you so much for having me and for spreading the word about estrogen dominance.
Dr. Weitz: Absolutely. Can you tell us about your personal health journey and how you ended up having both hyperthyroidism and hypothyroidism at the same time along with estrogen dominance?
Magdalena: Yeah. So I think the pivotal moment for me was in 2008 when I was diagnosed with Hashimoto’s Disease and I was living in Shanghai in China at that point. We didn’t have as many resources as we do now. Today, you google Hashimoto’s and you have so many websites coming out, you don’t know where to get started. Back in the day, there was absolutely nothing. So that put me on a journey of trying to figure out why am I having a autoimmune disease and what’s going on. I suspect I did have Graves’ Disease seven years before that and so that wasn’t really diagnosed as such, but it was diagnosed as-
Dr. Weitz: What were the symptoms that made you suspect that?
Magdalena: Of hyperthyroidism?
Dr. Weitz: Yeah.
Magdalena: Yeah, I was actually diagnosed properly with hyperthyroidism and put on thyroid blockers. The symptoms were waking up in the middle of the night with an anxiety attack, your heart pounding so much so you can see your shirt actually bouncing off your chest, sweaty palms all of the time, losing it with the people you love the most. So going to a restaurant where the server screwed up your order and you yell at the person, and you think, “That’s not really me.” Then beginning to have a lot of hair loss at that point with… Even though people think it’s hypothyroidism or low thyroid that causes hair loss, it doesn’t have to be. You can also lose a lot of hair with hyperthyroidism. But with a lot of allopathic medicine, I wasn’t treated from the root cause perspective. I was just put on a thyroid blocker and six months later declared cured. Of course, it all came back with a vengeance a few years later, seven years later, when I was living in Shanghai. I was really lucky to be diagnosed really quickly. I did tell my doctor that I have a history of thyroid problems. She happened to measure my antibodies and that’s where things proved… Proof was in the pudding, if you will, with those antibodies. But I think more importantly, we always talk about our stories from the onset of the symptom or from the time of diagnosis. But when I think about it, it really starts much earlier in your life, right? So not being a breast-fed child, I ended up in the hospital the first month already with pneumonia and a broad range of antibiotics. Grew up with a very narcissistic and nervous mother, so that could be a contributing factor.
Had a lot of food sensitivities right from the beginning. I remember being covered with eczema. My mom was… I think she had enough foresight to realize that eggs were causing my issues, but like with a lot of food sensitivities, that it turned into cystic acne. So in my 20s until I was about 28, 29, I was covered in cystic acne, not just the face, but also my chest, my back. I used to have it behind my ears. On my butt even. When you’re in your 20s, this is your prime time of dating and having romantic relationships. It really takes a toll on your self-confidence. The pivotal moment was when my girlfriend was getting married and she designed these beautiful dresses for us, but fully open everywhere. I’m like, “I can’t wear this.” She’d be like, “You just put makeup on.” I’m like, “I can’t cover up these volcanoes on my back. It’s going to show.” That’s when I started searching. Mind you, 25 years ago, or 20 years ago, this was revolutionary. I remember this article popped out and said, “Gluten causes acne.” I was like, “Wow.” So this is really where my journey started. As I eliminated gluten, it turned out not only did my acne started clearing out, but my headaches were gone, my bloating was gone, and then I discovered that I had a lot of other food sensitivities, including dairy and eggs were my problem. So that put me on that path, but I’m pretty sure it all started much earlier.
I have these photographs. I grew up in a tropical country called Malaysia. I just found the other day photos of being in a schoolyard. I’m wearing this really, this kind of sweater-like top. Like a sweat top, sweatshirt, but it’s thick. I’m thinking, “What am I doing with a sweatshirt in a tropical country right after exercising?” But I was cold all the time. That’s already telling you it was a low thyroid. It was just brewing right from the beginning. Then the estrogen dominance part, which we appear here to talk about, I’ve always had swollen lymphs where I couldn’t take off my rings. I’ll go on a flight. I couldn’t put my shoes back on because my lymphs were so swollen. My PMS was so terrible that I had to take one or two days off from school or later work and be in a fetal position with multiple painkillers to just get me through the day.
Dr. Weitz: Wow.
Magdalena: Always lumpy breasts. A lot of issues with thyroid nodules, which is also another symptom of estrogen dominance. So interestingly, on both sides of my family, I have aunts who passed away from estrogenic cancers. So when I had my genetics done and went to see my functional doctor here in Boulder, Colorado where I live, I printed out a whole stack of my results. She’s flipping through it as we chat and she says, “Have you had breast cancer?” I said, “No. Why would you say that?” She said, “Well, patients with your kind of genetics would have had breast cancer by now.” I was 45 at that point, so this was a few years ago. So genetically, a perfect candidate for estrogenic cancer. As you mentioned in your introduction, estrogen receptor positive breast cancer, but also uterine cancer, ovarian cancer, thyroid cancer, and lung cancer. Nonsmokers, most of the time, are fueled by estrogen or the excess estrogen or the dirty estrogen.
Dr. Weitz: Interesting. I just was reading an article in the news about the increase in nonsmokers getting lung cancer.
Magdalena: Yeah, yeah. People go, “I never smoked,” right?
Dr. Weitz: Right.
Magdalena: In men, mind you, I know probably your audience is majority women, but I will say almost every woman has some kind of a male partner or a brother or a father, and let me say prostate in men, both prostate cancer and prostate problems, inflammation of the prostate as well as man boobs and man boob cancer, all estrogenic too. So a lot of times when women embark on this diet that I advocate, which is nothing crazy, I mean, it’s just a way to metabolize your estrogen, to support your body through that, and they ask me, “Can my husband eat this?” I’m like, “Actually, it’s going to probably help his boobs too. Yeah. So that’s the story.
Dr. Weitz: Yeah, no, it’s definitely the case that we’re awash in toxic estrogens in this society and we’ve talked about that quite a bit.
Magdalena: Yeah. Absolutely. Just to wrap up my part of the story is that I think that in some ways, I dodged a bullet with estrogen dominance and not going the path of developing estrogenic cancer, and I hope not to. But I think it’s because of the work that I do and it’s just the amount of effort that I put in. The genetic testing also created a lot of forgiveness and kindness to myself, just to understand that I’m much more prone to developing these symptoms versus somebody who doesn’t have these genetic SNPs. So let’s always remember genes are not your destination. It’s just you’re just inheriting a loaded gun. But something needs to pull the trigger, right? There’s a lot of things that we can do to prevent that trigger being pulled.
Dr. Weitz: Yeah, certainly heard that analogy quite a bit. What is the mechanistic connection between estrogen issues and thyroid?
Magdalena: Yeah, so that’s really interesting that a lot of… Let’s just say, first of all, most of the time, when a woman experiences one hormonal imbalance such as, for example, a low thyroid issue, she also would experience, or most likely experience, these other hormonal imbalances. So it hardly ever is just one. So it’s good to think of our whole endocrine system as this really beautiful orchestra that plays really nicely. If you’ve been to a high school concert where the guy with the trumpet screws up at the back, everybody is just like a domino effect. Everybody gets completely dysregulated, right? So with hormones, it’s a little bit like that. But specifically since you’re talking about thyroid and estrogen dominance, it’s really interesting how many women who have Hashimoto’s or low thyroid function also happen to have estrogen dominance with also coupling up the symptoms where you talked about earlier.
The mechanism that happens is the biggest thing is that when you have excess estrogen that you referenced earlier, what happens is your thyroid binding globulin is also gets higher. So estrogen bumps up your thyroid binding globulin. It’s the form of a protein. As the name applies, binding globulin, thyroid binding. So when you have too much of that protein, it basically, whatever thyroid hormone your thyroid produces, that protein binds out that thyroid, making it unavailable for your body to utilize effectively. This includes even women who are on synthetic thyroid… It’s not really medications. It’s thyroid hormone replacement. Like Synthroid as an example. So it’s a lot of times, when you go and see your endocrinologist and you say, “Doc, the Synthroid isn’t working anymore,” and what do they do? Just increase your dose. A lot of times, that dose increase doesn’t really do anything. A lot of times actually kind of flips them the other way when they become hyperthyroid, but they’re still tired and they’re still losing hair. They’re still putting on weight and all these other… They still have depression, anxiety. All those typical low thyroid function. That’s because estrogen could be the cause of binding.
Dr. Weitz: So you got to look at the thyroid binding globulin and you need to look at free T3?
Magdalena: Absolutely. Absolutely. So free T3 is your working horse, right? That’s where you can have the-
Dr. Weitz: That’s the active form of thyroid-
Magdalena: That’s the active hormone. I mean, that’s what gives you beautiful hair, beautiful skin, healthy nails-
Dr. Weitz: And the free one is the one that’s not bound up by the globulins.
Magdalena: Correct.
Dr. Weitz: Okay. So you break down estrogen dominance into three types or categories. I mentioned one of them which is this estrogen-progesterone ratio. Maybe you can talk about these three categories and explain them for us.
Magdalena: Yeah, so let me start of with… Because it can get a little bit complex, I’m going to try to make it really simple for folks to understand. Let’s talk about maybe… I’ll mention all three, but I think the first two are really good to remember. So the first one, as you said, is excess estrogen to progesterone. Now, one thing I would like for our listeners just to realize is that we are not here to demonize estrogen in any way, okay? As women, we need estrogen to function properly. If you’re still in your pre-menopausal, you’re still cycling, you wouldn’t cycle without estrogen. You wouldn’t get pregnant without it. We wouldn’t sleep. We wouldn’t have healthy bones, good cognitive function, beautiful skin. It’s like we need it in order to function, right?
Dr. Weitz: Yes.
Magdalena: So let’s not demonize it. The problem is in the detail, right? So it’s very nuanced in some way. So the nuance here is that, like you said, is specifically the estrogen that we are looking at is estradiol. It’s the most aggressive form of estrogen and you need it-
Dr. Weitz: So let me just clarify for some who don’t know. Our bodies, men and women, contain three different forms of estrogen and you have E1, which is estrone, and you have E2, which is estradiol, and you have E3, which is estriol. Now, you’re specifically talking about the E2, estradiol.
Magdalena: That’s right. For example, part of the reason why estradiol has become a real problem is because it’s not only that your body is producing it on its own, but you’re also coupling it up with, for example, if you are using conventional skincare products that are full of parabens, phthalates, all these nice smelling things, all these various chemical, many of them are estrogenic-
Dr. Weitz: I just went to the bathroom and they had one of these air fresheners, which is filled with phthalates and-
Magdalena: Please, if you have that in your house, throw it away right away. I assume that it is your landlord who provides that-
Dr. Weitz: Yeah, of course. Actually, I couldn’t tell what smelled worse, that or the pesticides that they just sprayed to kill bugs. It was just the whole bathroom was awash in toxic chemicals.
Magdalena: So that’s-
Dr. Weitz: That’s with somebody who’s trying to do everything right and there’s all these things you can’t control.
Magdalena: Right. I mean, what you can control is just don’t use it at home, don’t use it in your car, right?
Dr. Weitz: Of course not, of course not.
Magdalena: You get into Uber, Lyft, ask the guy to take it off. I always tell them I’m allergic and I get a headache from these smells. I’m like, “I’m so sorry you have to take this down. It makes me sick.” So we are invaded by estradiol externally as well. So the body doesn’t really recognize the difference between those two, so that’s why many women are so excessive in that form of estrogen and progesterone. So effectively, there is not enough progesterone to oppose it. Think of estradiol and progesterone like two dancing partners. Have you ever seen a dancing competition? If the woman is overly beautiful and exuberant and the guy is timid and lacks presence, they don’t look good as a couple. They’ll never win an award. So we’re looking for a balance here. A lot of women ask us, when they do a quiz on my site, they ask us, they say, “Your quiz sucks. You have all these errors on your website because I’m in menopause and your quiz tells me I’m low estrogen, which is correct, but you’re also telling me, according to your quiz, I’m also estrogen dominant. How is that possible?” It’s a plausible comment although it can be hurtful to hear sometimes. We do explain in the result of it, most people don’t read them in full, is that you can have both estrogen-progesterone dropping, but the percentage of how much of estrogen to progesterone you have can be unbeneficiary. The problem is the progesterone drops a lot quicker, especially for women after 45, as compared to estrogen. So this is the reason why, if you think about it, this is a reason why who develops breast cancer. The biggest demographic are women from 55 to 75. These women are very low on estrogen, but guess what? They are even low on progesterone. This is where the imbalance can play a role. Second-
Dr. Weitz: Hang on one second.
Magdalena: Sure.
Dr. Weitz: I’ll get you right back on track, but I want to take us down a detour for a second. I know that you mostly treat women, but when it comes to men, do you ever consider adding progesterone for men? I treat a number of men as well as women and I very frequently see the progesterone levels extremely low.
Magdalena: Yeah. So I don’t treat men and I’m not in private practice anymore, but whenever I attend conferences where there are practitioners who do recommend and there are case studies presented, yes, I have seen multiple times, same as you, practitioners prescribing very small doses of progesterone to men. That actually helps them balance estrogen dominance, which we said, when men can also experience.
Dr. Weitz: Okay, good. So let’s go back to the three categories of estrogen dominance.
Magdalena: Yeah, so the second kind of estrogen dominance is what I call a ugly breakup. An ugly breakup basically means is that your estrogens get broken down to metabolites. Guess what? The most important organ that this happens at is your liver. The liver breaks down, a lot of people know, is all the alcohol. Some people know about coffee. But there’s actually a lot more. It breaks down a lot more, including hormones. You mentioned thyroid at the beginning. Thyroid also, like your Synthroid, also gets converted from T4 to T3. The liver’s important. So the liver, in the context of estrogen, is so fascinating that it breaks it down to these metabolites. Just for simplicity, I call them clean or dirty estrogens. Some of those dirty estrogens are those metabolites that are causing the problem. So as you can see, that goes back to the first type of estrogen. You can be low on estrogen, but even in spite of being low, you’re still breaking down those estrogens in an unfavorable way. I suspect part of the reason is because, as we get older, our liver gets more and more taxed. If we don’t do proper maintenance on a regular basis and don’t do foods and supplements that really help us gently detox on a regular basis, then we are not as effectively breaking down those estrogens. What makes it even worse is women and constipation. I looked around your website and I suspect you do work with a lot of women with hyperthyroidism and Hashimoto’s, right?
Dr. Weitz: Yeah.
Magdalena: Constipation is one of the biggest issues women experience due to a low thyroid problem. This where, again, the estrogen comes in, because you’re not pooping out your estrogens on a regular basis. Those metabolites I’m talking about aren’t getting popped out, and when they don’t, they reenter your blood stream making estrogen dominance worse. So that’s the-
Dr. Weitz: So I just wanted to ask you. I know in one of your articles in your book, you mentioned the 2:16 hydroxy-estrone ratio. There’s some controversy now over whether that really holds up or not. There have been some review articles saying while it’s not really a good predictor for breast cancer, where do you think we are in terms of understanding those estrogen metabolism pathways?
Magdalena: Yeah, so that’s a really good question. The 2:16 is a little bit of a old-school of doing it by testing. You have a lot more accurate testing these days. One of my favorites is definitely DUTCH. Do you use that in your practice?
Dr. Weitz: Yes, I do. The Dried Urine Testing, yeah.
Magdalena: Right. So it’s a wonderful test. Then you’re looking at not just 2 and 16, but the 2, 4, and the 16. I mean, the biggest functional medicine practitioners in our industry use that. I certainly have seen women correlating their symptoms with the results, with the diagnosis they got, and find it very accurate. Far more accurate than blood testing, which is completely useless for steroid hormones such as these.
Dr. Weitz: I mean, it can be helpful for getting levels, but it doesn’t tell you about metabolism at all.
Magdalena: Right. Exactly. So yeah. I mean, I still find it very effective. I think, like any good practitioner, you always want to overlay the results of lab testing like that with the symptoms and the health history and the family history of a person. If your mom has had a history of fibroids and you are suddenly having really heavy periods and sex is really painful, very likely might be a fibroid. You don’t want to get it tested and you get it tested, let’s just say that your results don’t show, just for the sake of argument, show that you are not really estrogenic as such. You don’t have estrogen dominance, but your symptoms are screaming that you are. I mean, are you not going to do something about it? The other interesting thing about testing I find is that every woman needs a different range in order to feel really good. My levels of progesterone might be needing to be on a much higher side for me to feel good as compared to someone else, but the range tends to be very broad.
Dr. Weitz: What range in particular for yourself do you find to be effective?
Magdalena: Well, I mean, depends what you’re using for measurement, right? I don’t remember the ranges right now and I typically, for progesterone, I wouldn’t use DUTCH. I would use saliva testing because, yeah, DUTCH only predicts progesterone. It’s a prediction, not an actual number. So I use saliva. If I remember correctly, it was like 600 to 1,200, was the range. It’s a broad range. If you think about it, it’s 400 to 1,200. That’s three times more.
Dr. Weitz: They did the same thing with testosterone. They say the range is 150 to 900, which is ridiculous.
Magdalena: Right, exactly. But if I’m bleeding in the middle of my cycle, that’s a classical low progesterone symptom. If I’m suddenly waking up in the middle of the night, I can’t go back to sleep when I used to be a really good sleeper before, then you’re going to, yeah, it looks like I might need more progesterone supporting nutrients or do bioidentical progesterone. Just because it shows me that I’m okay on a lab test, that’s a little incomplete view, if you will.
Dr. Weitz: Yeah. Okay. Then let’s go over the third form.
Magdalena: The third form is there’s three different types of estrogens as you alluded. E1, E2, E3, so estrone, estradiol, and estriol. Every one of them has a little different function. So estradiol, like I mentioned, is the most aggressive one. There is an equation that’s used for looking at the number and determining the relationship of those three. That’s typically done through saliva. So I don’t typically talk too much about this kind of estrogen dominance because I have found that if you do DUTCH and you combine it with your symptoms, it’s very telling. I think those first two that I mentioned, the estrogen to progesterone ratio and the metabolites, the clean and dirty estrogens, I think that paints a pretty good picture of then what do you need to do in order to help yourself.
Dr. Weitz: Okay. Sounds good. Let’s talk about some of the approaches for each one of these. So why don’t we start with the dirty estrogen, the estrogen metabolism. What types of strategies can we use to promote healthy estrogen metabolism?
Magdalena: Yeah, so I mentioned liver, right? As a nutrition person, I’m a chef also and a herbalist. Obviously I love to support the liver in the first place through a lot of nutritional changes. One thing I will say is that, especially I find that it’s very true in America, and as you know, as you can probably hear, I’m not American. One of the interesting things that I found when I moved here is how people go very intensely into something, like doing, for example, a very severe, deep detox. Some of them are great and some of them are terrible because of just the amount of product that are put in there and how much sugar is in them. Then they come out of the detox and they go back to the old way of doing things because they deserve it. I find that kind of… It’s like as if you were deciding to do a cleanup of your house on your unboxing day and maybe on spring day again, on the first day of spring, and otherwise, you never clean your house. I think that’s the best analogy I can give.
So there’s a lot of things you can do on the daily basis to really support your liver. One of the big things is incorporating bitter foods into your diet. So things like turnips, radishes. Throw away the lettuce that you’re making your salads with. Switch to something like arugula or baby kale. They have a lot of bitter qualities. Every time you eat something bitter, what happens? You produce a lot of saliva. Well, guess what? That creates a big cascade of enzymatic production in the body. Not only are you going to extract a lot more nutrients from your food, but the liver loves bitter. The liver gets stimulated. All those detoxification pathways that are responsible for evacuating estrogen. So the sulphation pathway, the glucuronidation pathway, methylation pathway. All those pathways work really hard and they love bitters in order to… Also, you can stimulate that. Another one that I-
Dr. Weitz: Bitters also stimulate bile production. A lot of these toxins are put into the bile and that’s how they’re excreted.
Magdalena: Thank you so much for mentioning that. Absolutely. I did something a few months ago where I posted on our Facebook page saying, “Who here had a gallbladder removed? Did you notice any correlation with symptoms of estrogen dominance later on?” It was a very emotional post. A lot of women came on and said, “Now that you say it, I realize that ever since I had my gallbladder removed, my estrogen dominance symptoms, whatever that might be, I suddenly developing fibroids, my breasts are so lumpy.” A few women came on, said that they were convinced that breast cancer… I mean, I’ve never found a study. I did search when I was working on my book to find a correlation between gallbladder removed and breast cancer. I haven’t found that. But I think it’s very plausible. To your point about gallbladder source bile, the bile also binds out those dirty estrogens we talked about. It’s tragic because doctors don’t tell you the consequences of removing your gallbladder and they are and hormones could be one of them. So back to supporting the liver, and there’s a lot of things also you can… So yeah, so bitters also stimulate your bile production, which is awesome, and release of bile. So that’s a really wonderful thing to do.
Dr. Weitz: You can take herbal bitters in a concentrated form, like in a supplement?
Magdalena: Absolutely. Not everybody loves those, but they are super beneficial. They’ve been around for centuries. Like if you think about it, if you go to France or if you go to… You have pastis, which is a very bitter drink, anise seed. It’s derived from anise seed.
Dr. Weitz: It’s actually common in restaurants here a number of years ago to have them at the front.
Magdalena: Oh, really?
Dr. Weitz: Yeah.
Magdalena: Huh. Okay. There you go. You go to North Italy, you have Campari, right? You go to Denmark, you have… I grew up in Denmark too, so they have those digestive called Gammel Dansk. Old Danish, it’s called. You have that before and after a meal, so it’s there for a reason. It’s not to get drunk or high. It is just to get those bitters in. They just happen to be extracted best in alcohol, so that’s why a lot of times in alcoholic form.
Another great way of really moving your liver is flax seed. I thought I’d mention that as well because I think it’s an interesting food because it’s naturally high in estrogens. So this is another source of a lot of controversy in our community, especially for people who first joined. We get this email saying, “You are crazy. You don’t know what you’re talking about. You are suggesting flax seed is estrogenic. I’m already very estrogenic. Why would I do that?” So I think again, it’s a plausible question. But I just refer back to what I was saying earlier is that how you break down those estrogens is the issue. Here’s the beautiful about flax seed. I think hemp is the magical food, and I know you believe in nutrition and food as well and the biochemistry of it. So one of the beautiful things about flax seed is that, yes, it is a phytoestrogen. So actually, if you’re low on estrogen, like you’re having severe hot flashes, flax seed can actually really help you. But at the same time, guess what? The lignans, which is in the fiber of the flax seed, they block those receptors from those dirty estrogens from coming through. So again, so it’s like a dirty estrogen blocker. How amazing is that, right?
Dr. Weitz: Yeah, well, actually, it’s common for these phytoestrogens… This has been a debate in years we’ve been having now in the functional medicine community. The food people often talk about is soy, which is high in these phytoestrogens. Do these phytoestrogens increase your risk of breast cancer? Are they, in a sense, estrogenic? It’s kind of similar to when you were talking about the estriol, estradiol. So I think, at least, my understanding so far of the literature is that these phytoestrogens for the most part are weaker estrogens, so they glom onto these estrogen receptor sites and they can potentially block the toxic estrogens like the estradiol or the toxic estrogens from pesticides, et cetera?
Magdalena: Absolutely. You’re right about soy. You have research showing both sides. Again, it’s very nuanced. One of the things that studies do not show, do not state, and I’ve contacted a couple of them and I never heard back, is that what kind of soy were they using? I think that’s a very big difference if you’re using organic soy versus nonorganic GMO kind of soy on testing someone or giving them that over prolonged period of time. So that is never disclosed in any of the studies. I think it’s a lot more nuanced. I tend to stay away from soy just because of the variety of having both kind of results. All my meal plans and just generally diet is free of soy for that reason. But one more think-
Dr. Weitz: I think another thing has to do with if you grow up eating soy as a regular part of your diet and if it’s part of the natural area where you live, it’s part of the natural diet there because there’s something to eating in accordance with where you’re from, I think the body handles it a lot differently than, say, maybe an American woman who has never eaten soy and all of a sudden, at age 50, she starts pounding down all the soy milk and her body’s really not used to dealing with it.
Magdalena: Yeah, I think that’s a very plausible argument and a lot of people argue that. That’s based on your genetics, what you should be eating. Yeah. I think it’s a very interesting point. To build on top what you’re saying, it’s also most of the soy products in the United States are highly processed. So tofu’s highly processed. Soy milk is highly processed. So it’s not as natural as what you find, for example, living in China or Japan. Mind you, when they make, for example, soy tofu in China, they sell it from a big pot and it’s hot and you’ve got to eat it within a couple of hours because then it goes bad. So it gives you an idea, like how much preservatives they need to put in in order to preserve that soy, that tofu. Going back to flax seed, I just want to say one more thing.
Dr. Weitz: Yeah, sorry.
Magdalena: Because that’s one of my favorite foods to add. One of the also amazing things is it’s full of fiber. So you both have the soluble and insoluble fiber in flax seed. So insoluble fiber is superb for really helping your gut, but the insoluble fiber, there’s a roughage, if you will. It’s like a broom that sweeps through your colon and it really helps a lot with constipation. It specifically has an affinity towards removing estrogens from the colon. So it’s just a really wonderful food to add on when you’re supporting your liver, on top of all the things that-
Dr. Weitz: So where do you get the flax seeds and how much per day for the average woman?
Magdalena: Yeah, so don’t buy flax meal because that stuff is already pre-ground and it gets oxidized really quickly. If you notice, for example, in a supermarket, flax seed oil is always sold in a fridge. That’s because it gets oxidized really quickly in dark bottles. I’m not advocating oil. The lignans are found in the fibers, so you’ve got to have the actual flax seed. So buy it in full seeds. Whether it’s yellow or brown, it doesn’t really matter. So grind it yourself at home. Just use your, not a coffee grinder, but a dedicated coffee grinder so it doesn’t smell of coffee, and just grind it up for a few days and keep it in a fridge in an airtight container. Two tablespoons a day is what seems to produce really great results for women.
Dr. Weitz: Great. So can you talk about some of the supplements like DIM and calcium-d-glucarate that promote detoxification of estrogens?
Magdalena: Absolutely. I will mention, let me lead to this just by saying one thing that… One of the super foods for estrogen dominance, and there’s actually studies that were done using broccoli sprouts for women with breast cancer, for example, and the incredible work that sulforaphane does. Sulforaphane is super high in broccoli sprouts. It’s also high in all the cruciferous vegetables, so all your Brassicaceae family. So the cabbage family. So cabbage is kale, collared greens, all part of that. However, it depends on the variety, but it’s between a 20 to 100 times more sulforaphane is found in broccoli sprouts than in actual broccoli head. The problem-
Dr. Weitz: So DIM also comes from those cruciferous vegetables too, right?
Magdalena: It absolutely does. Yes. So if you are incorporating… That’s why I said earlier throw away the zucchini and the lettuce and bring in all those cruciferous because they really can help you. This is the way I’m talking about that long-term every day detox that you do instead of those severe detoxes that people do and then they go back to eating trash. So yeah. So the interesting thing was we were working with our formulator on producing sulforaphane because of its efficacy in helping with estrogen dominance. I’ll explain in a second where does that fit in the picture with DIM because it does have a very different role than DIM does. So what happened was we realized, and we came across this study and then we realized that broccoli sprouts can have sulforaphane from negligible to all the way being super high. So it was very disappointing to see because I would just love to get all my sulforaphane from broccoli sprouts instead of having to rely on a supplement. But the thing was whether you bought it from Trader Joe or Whole Foods or you went to a farmer’s market, the content sulforaphane was all over the map. So there was no concentration that you were guaranteed on that. So I still think-
Dr. Weitz: I just want to stop you right there. I think that’s a really important point. Of course, we want to eat as many of these natural foods, these cruciferous vegetables and these other health promoting fruits, vegetables, et cetera. Those were all super beneficial. However, if you want to know that you’re getting a concentrated therapeutic dosage of some of these nutrients, the only way you can know for sure is to add some nutritional supplements to your overall health regimen. Does that mean you can have a terrible diet and just take a few supplements? No. But, on the other hand, if you think you’re getting a specific amount because, say, you look in some book and it says that a carrot on the average has so many milligrams of beta-Carotene, that’s an average. If you looked at 20 different carrots, some have way less, some have way more. So if you really want to be accurate and scientific and make sure you’re getting a minimal necessary amount to have a therapeutic effect, this is one of the reasons why supplementation on top of healthy diet is really the only way to do it.
Magdalena: Yeah, thank you for mentioning that. One of the things I have in my book is this pyramid that shows food at the bottom. It’s food is first and always. Then herbs the second. Then third is supplements because it really is there to supplement our diet. Unfortunately, it has become unnecessary these days. So back to sulforaphane. I still want to encourage everybody to eat their broccoli sprouts. Whether that’s through your salads, your soups, and such. But if you want it standardized, let’s say, 7%, 8% of sulforaphane in the supplement, you do have to rely most likely on a supplement. So you mentioned calcium-d-glucarate, sulforaphane, and DIM. So I just want to contextualize it a little bit because one of the things I think DIM manufacturers have done a great job in terms of marketing is to develop the perception that DIM is the estrogen buster. So it’s like take DIM and all your estrogen dominance symptoms go away. It can initially. Most of the women will feel like it either works initially and then it stops, works initially and then makes them sicker, or just makes them sicker right upfront. So the question is why?
The interesting thing is that your liver has got two parts of the detoxification process, phase one and phase two. What DIM does is upregulates your phase one liver detoxification, which is actually quite dangerous because you are just upregulated that part of the liver that’s actually just released a lot of the toxins. Phase two of detoxification is going to be now coupling them up, marrying them, with different compounds, whether it’s sulfur, whether it’s methyl groups, et cetera. So DIM upregulates that. If you don’t have something to support your phase two liver detoxification in the form of foods and supplements, that’s the reason why women start feeling so bad and their symptoms actually get worse with estrogen dominance.
So the way to provide a full estrogen detoxification protocol, this is the way you can start looking into sulforaphane and calcium-d-glucarate. Sulforaphane, both of them work on phase two liver detoxification. Some practitioners, I also know, who like to also work with things like NAC, Resveratrol. All play a very big role in a phase two liver detoxification. So I think you can play around with all these supplements. I personally love using… I’ve had the best results with sulforaphane and calcium-d-glucarate just because they work on different pathways. Sulforaphane tends to work a little bit more on the sulphation pathway. That’s one of the pathways that is used to neutralize estrogen and get rid of it. Then the second one is the glucuronidation pathway where calcium-d-glucarate plays a role.
Dr. Weitz: Cool.
Magdalena: Yeah.
Dr. Weitz: We were talking about progesterone. Do you ever use chasteberry or Vitex to stimulate progesterone production?
Magdalena: I love your questions, I will say.
Dr. Weitz: Thank you.
Magdalena: It’s so great that you’re asking that question because in Germany where, by the way, herbal medicine is covered by the insurance and so is homeopathy, which is… I hope the United States comes to that point one day.
Dr. Weitz: Let’s hope not. Because that means you’ll get three cents reimbursed and [crosstalk 00:42:05]-
Magdalena: Right. Well, I was talking more from a patient’s perspective. But I hear you, yeah.
Dr. Weitz: Yeah. Let’s just [crosstalk 00:42:12] and homeopathy, like they have in Australia.
Magdalena: Right. So the interesting thing is when you have a woman who walks into, say, a OB-GYN in Germany and says, “I can’t get pregnant,” or, “My periods are super irregular,” or, “I’m having lumpy breasts,” so whatever and it’s a clear progesterone deficiency, the first thing that a German doctor will prescribe is guess what? Vitex. So absolutely, Vitex is phenomenal at just helping boost progesterone. So that’s definitely one of my absolutely favorite herbs. Coupling that up with a couple of vitamins and minerals. So zinc, vitamin E and vitamin C can be just also, just give a really beautiful boost to the corpus luteum to produce its own native progesterone. So I like combining them together and I find that just works really well. Just a little thing just to share with you. Because of COVID, I upped my vitamin C levels. So I’m 48, so I’m certainly headed for perimenopause. My luteal phase, so from ovulation to period, now it’s suddenly become five days instead of being two weeks. So classical symptoms. I’m slowly getting into it. Nothing dramatic, nothing crazy. It’s just there. It’s coming. So when I upped my vitamin C levels because of COVID, guess what? My luteal phase just suddenly became two weeks again. I’m like, “Ooh, do I really want this?” I actually, “Go away.”
Dr. Weitz: Interesting. I wanted to go back to the seed thing because you mentioned flax seeds and pumpkin seeds as both helping with estrogen and, what was it? Sesame seeds and-
Magdalena: Sunflower.
Dr. Weitz: … and sunflower seeds as helping with progesterone. Can you talk about that for a minute?
Magdalena: Yeah. Seed rotation is something that I discovered many years ago. I had a very difficult patient. This was back in the day when I was in private practice. I had a very difficult patient and her hormones were all over the place. Super estrogenic. I remember doing a consult with the lab where we got the results from and there was a naturopath who was consulting me on this case. She said, “Have you tried seed rotation?” I was like, “No.” So she explained it, which I’ll tell you in a second, and I’m thinking to myself, “How?”
This woman, her hormones were all over the place. I’m thinking, “How are these little seeds going to help this poor woman?” But she was game. She was down. She didn’t want to take supplements. That was one of those challenges. But she was willing to do the seed rotation. So the results were amazing. One of the things that really changed for her was that her fibroids shrank. So this woman had these huge fibroids, very heavy periods, severe anemia because of all of that. So her fibroids shrank just significantly within two months. So that was my aha moment to seed rotation.
So seed rotation can be used for both women who are still cycling as well as women who are perimenopausal and menopausal. We view our cycling… You’re basically studying the first part, which is you want to boost your estrogen levels as you said, and you can do that by using flax seed and pumpkin seeds. You do that for two weeks and it’s basically one tablespoon of each, freshly ground. Then you switch over around your ovulation. So if your cycle is, let’s say 28 days, then after 14 days, you switch over to the second combo, which is now going to be helping more with… So it’s vitamin A and vitamin E rich, so you’re switching to sesame seeds and sunflower seeds. Then again, you’re doing one tablespoon ground each until you get your period. Look, it’s not a magic bullet. Some women try it and swear by it, including women who have hot flashes.
So if you’re menopausal, your period has stopped, basically you can pick two weeks anytime you want. You can do it with the moon, so doing the seed rotation with the moon. Meaning when it’s full moon, it’s like as if you were having ovulation. So that’s when you start your progesterone boosting seeds, your sesames and sunflower seeds, and do that for two weeks. Some women report amazing results. But I feel like with everything else, is homeopathy a answer to everything? No. Is nutrition alone the answer to everything? No. Is chiropractic care, like getting adjusted, an answer to every single pain in your body? No. So I feel like it’s just one tool in a toolbox that we have. Look, let’s be honest. If somebody’s super inflamed, you’re still eating gluten, you’re living on coffee your whole day, you don’t sleep properly, you’re having three glasses of wine at night, but you do seed rotation and you expect to have great results, well, I’m so sorry to say ain’t going to work, right?
Dr. Weitz: Yeah, you-
Magdalena: So combine it with anti-inflammatory diet. Make it a Point to go back to sleep. Do all the things that helps you sleep better, et cetera, et cetera. Incorporate magnesium. I’m a fanatic for magnesium and women’s hormones. What a change it can make. Your breast health, your PMSs, your sleep quality. Then adding seed rotation, I think, can generate some really nice results.
Dr. Weitz: Right, you mentioned alcohol and I saw in your book, you’re pretty outspoken that the evening glass of wine is not a good thing for women for breast cancer risk.
Magdalena: Absolutely. I mean, there is hard, solid studies that show connection between women who drink more than three glasses of alcohol a week and a connection to breast cancer. But I think there’s more to it. I mean, do we have to look at drastic things like breast cancer? Just look at the quality of your life. One thing I will say is that I have a big chapter on sleep as well. One of the things I do wear, and I took it off right now because it’s charging, but I use the Oura Ring. With the Oura Ring, I’ve been experimenting a lot on my own sleep because my sleep has been… Now I’m 48. I certainly feel like my sleep is not as deep and I don’t get it as easily as I did in my 20s. You can have like five tequilas at night, go and party, look a screen all day long, and go to sleep and wake up, and you’re resting and ready to conquer the world. Ain’t going to happen now, right? So when I use my Oura Ring, it just shows me… And I’ve been experimenting a lot.
So I would encourage everyone to… Everyone has got a little different tolerance since we’re talking about alcohol. Let me say, if I have… That’s probably also, I think, I also have a problem with histamine a little bit, so I don’t degrade histamine as quickly as probably… Also, it’s partly genetic. Partly, it’s probably just because stress and things like that. But alcohol is a source of histamine as well, which can mess up your sleep. So that glass of alcohol could just mean that from sleeping deeply and beautifully and not waking up in the middle of the night, now you were just waking up at 1:00 and you can’t sleep until 3:00, and then you wake up and you’re not rested. I mean, it can make a huge difference in that way. So for that reason, I am very cautious of alcohol. Same as with caffeine too. I’m a bit of a caffeine Nazi too.
Dr. Weitz: Oh, okay.
Magdalena: Coffee, rather. Not caffeine overall, but coffee.
Dr. Weitz: Okay. So let’s talk about hormones, all right? Hormone replacement therapy.
Magdalena: Yeah. I will say that’s not really my primary jam because as a herbalist and as a nutrition person and a chef, I’m just like, “Hey, here’s a great recipe. Here are some beautiful herbs you can incorporate.” But the way I look at it is if you decide to go the hormone path, make sure it’s bioidentical hormones that you’re working with. You don’t want to be working with your OB-GYN and taking progestins in any way or form.
I’m interesting to hear your perspective on this, but again, because I’m not in private practice anymore and I’m not licensed to prescribe hormones to women, but one of the things that I think is a something to be cautious is a lot of women are told that bioidentical estrogen, for example, is super safe. I have come across a few women who really bought into this belief, but they never did any regular testing, like with DUTCH for example, to see how they could breaking down those estrogens. A number of them have developed breast cancer. So have the developed breast cancer because they were taking that bioidentical estrogen? I don’t think so. I think the problem was that their liver just wasn’t breaking it down properly. They were not eliminating these estrogens properly. But I’m curious to know what you think.
Dr. Weitz: Well, obviously there’s lots of controversies and as a chiropractor, we don’t prescribe hormones either. But it does look like bioidentical hormones are quite a bit safer. Theoretically, there is every reason to think they should be safe because if they’re basically virtually identical to your natural hormones, why should your natural hormones cause cancer or heart disease? On the other hand, the long-term studies that were done, they show that synthetic hormones look like they increase the risk of breast cancer and heart disease in women who take them, especially starting 10 years after menopause. So that’s another whole factor with the Women’s Health Initiative, are problematic. We don’t really have the large long-term studies with bioidentical, but we have every reason to think that they are safer. But I would still say I don’t know if we really 100% know. On the other hand, there are plenty of women who get breast cancer who never took hormones. So your point about how they metabolize their estrogen, how their body handles it, toxic estrogens from the environment, are probably more important factors. And-
Magdalena: Yeah, I will say, if I come to a point in my own health journey that I feel like my estrogen is dropping so much so that through nutrition I can’t support it anymore, my cognitive function is declining, my bones aren’t as strong, et cetera, et cetera, and I decide to go that path, I will certainly every six months be doing DUTCH to see how I’m breaking down those estrogens because I think that’s really, really important as part of the equation for sure.
Dr. Weitz: Yeah, yeah. One of my friends is Dr. Felice Gersh and she’s come on the podcast a number of times. She is such a huge advocate for estrogen. When she talks about all the benefits for cardiovascular and brain health and all these other things, I was ready to start taking some estradiol myself. One last thing, I just wanted to ask you about using topical progesterone versus oral progesterone. Bioidentical, of course. Most of the functional medicine practitioners who prescribe hormones in my circle feel that oral is the only way to go. That when you use the topical, you just don’t get the levels in the system that you really need.
Magdalena: Yeah. So that’s an interesting debate. Again, I speak purely through the experience of my colleagues and through conferences, endocrine conferences, functional endocrine conferences, that we used to go to before ‘rona took over the world. So another way of looking at this is that the oral progesterone tends to work on the GABA receptors in the brain, so it’s got a really nice, calming effect and helps tremendously with sleep and anxiety. A lot of my colleagues maintain that if you don’t apply it topically, you don’t get the same benefits of what progesterone can give you beyond just feeling calm and sleep. Those benefits can go anywhere from opposing estrogen to helping you with HDL cholesterol, helping with cardiovascular health, helping with sex drive. It’s a much longer list of these two. Again, I really wish I could show you studies that prove that. I don’t think there are any of those. But it’s just more of anecdotal. But I don’t want to dismiss anecdotal because if you have thousands of doctors who are in practice with hundreds of patients who come back and report that this is your oral versus this is a topical effect that I’m getting, then that’s something to be, I think, reckoned with. So I personally, whenever I travel and I’m going through a stressful time, progesterone tends to… We burn through progesterone a lot more. We get depleted because cortisol steals progesterone. I mean, a lot of women relate to this when I say when you go through a really stressful time, suddenly your period becomes really terrible or you just can’t sleep. Progesterone can be due to that, due to the progesterone steal, if you will, that happens. So whenever I do experience that, I definitely do my topical and I do feel way, way better. So yeah.
Dr. Weitz: Awesome. So this has been a great podcast, Magdalena. How can our viewers find out more information about you and access your programs and your book?
Magdalena: So my book is called Overcoming Estrogen Dominance. It’s available on Amazon right now. Yeah. If estrogen is something that folks are struggling with or if somebody you know who’s struggling with the symptoms that we talked about here, there’s so many things you can do nutritionally through supplements. A lot of women are opposed to bioidentical hormones, so I just touch on them in the book. But really the meat of the book is herb supplements and nutrition. Yeah.
Dr. Weitz: Great. Then your website is what?
Magdalena: My website is hormonesbalance, hormones with an S, hormonesbalance.com.
Dr. Weitz: Excellent. Thank you so much.
Magdalena: Thank you so much for having me.
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