In women, estrogen fluctuates throughout the month. However, in some cases, estrogen becomes unbalanced and there is too much of it in the body. This is known as estrogen dominance.
Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android
My guest today is Lacey Dunn. Lacey is breaking the mold in the “dietitian world” as a fitness professional, bodybuilder, and registered dietitian.
Her mission is to educate others on evidence-based nutrition by promoting a healthy, sustainable lifestyle through flexible dieting. She believes that there is no “one size fits all” approach, and that self efficacy in food choice is a driving force for fostering healthy habits and encouraging behavioral change.
Lacey is the owner of a thriving online coaching platform, UpliftFit Nutrition, as well as host and founder of UpliftFit Nutrition radio.
Lacey’s goal as a dietitian is to provide the tools that people need in order to achieve a healthy, and balanced diet while simultaneously helping them to grow and thrive in all aspects of their lives.
Join us as we discuss what estrogen dominance is and how it can affect the skin.
Have you ever dealt with estrogen dominance? Let me know in the comments!
In this episode:
- What is estrogen dominance?
- The importance of not self-diagnosing
- Why are daily bowel movements so important?
- Is it possible that gut dysbiosis is hijacking your estrogen clearance?
- Best testing for sex hormones
- Why is cholesterol important?
Quotes
“Estrogen dominance symptoms would be things like fatigue, breast tenderness, irregular menstrual cycle, heavy, heavy periods with cramps, headaches, mood swings, muscle and joint pains, digestive issues.” [3:29]
“If you have all these symptoms, don't let any doctor downplay them. Something's wrong, your body is screaming at you. Be your own advocate. Take control of your life.” [25:10]
Links
Lacey's No BS Guide to Healing Hashimoto’s and Hypothyroidism
Healthy Skin Show ep. 072: Sex Hormone-Skin Rash Connection w/ Dr. Carrie Jones
Follow Lacey on Instagram | Instagram
120: Estrogen Dominance Effect On Skin Problems w/ Lacey Dunn, MS, RD, LD, CPT FULL TRANSCRIPT
Jennifer: Hi everyone, welcome back. Today I've got a colleague of mine. I was on her podcast and a lot of you probably heard that episode. I invited her on mine, because she deals a lot with hormones. I thought this is a good topic to talk about, because hormones do, as you know, impact skin issues, especially estrogen.
Jennifer: My guest today is Lacey Dunn. She is breaking the mold in the dietitian world as a fitness professional, a bodybuilder and registered dietitian. Her mission is to educate others on evidence based nutrition by promoting a healthy, sustainable lifestyle through flexible dieting.
Jennifer: She believes that there is no one size fits all approach, which I completely agree with. I actually love watching her Instagram, and when she gets up on her soap box and that self efficacy and food choice is a driving force for fostering healthy habits and encouraging behavioral change.
Jennifer: Lacey is the owner of the thriving online coaching platform, Uplift Fit Health … Uplift Fit Nutrition, as well as host and founder of the Uplift Fit Nutrition radio, which I was a guest on. She is a dietitian, and she knows her stuff.
Jennifer: She is one that's not just telling the typical USDA party line of you should eat all these things. You are so much more practical and real than that, and that's why I love you, so I'm really glad to have you here, Lacey.
Lacey: Oh, thank you. That means the world to me. I'm honored to be on here. It's such an awesome opportunity, so thank you so much. Of course my soap box, I can just stand up there and … My problem is I do not hold anything back, so for your listeners, I am an open book.
Jennifer: That is very true.
Lacey: Hopefully you like that.
Jennifer: That is very true. I think actually they would appreciate a lot of your perspectives and opinions on things, because a lot of times I find myself going, “Yes, yes,” when you say things. I know that I like to share that type of information with my audience.
Jennifer: That's why I thought you'd be a really great fit to talk about this. Why don't we talk a little bit about what estrogen dominance is. My audience understands that yes, hormones play a role in a lot of these skin problems. Even things like eczema and psoriasis especially, because estrogen can play a role in autoimmunity.
Jennifer: It can play a role in histamine breakdown. There's a lot of different things that it can do, but estrogen dominance is something that they might have read about online, but they're not sure what exactly it is.
Lacey: Yeah, so I just want to start off by saying we have our two primary hormones as females, we have estrogen and progesterone. Both of these will fluctuate with where we are in our cycle. If we have a normal menstrual cycle, so in the first half of our cycle we have the follicular phase.
Lacey: That is when we are going to have the dominance of estrogen. Then we have progesterone in the second half of our cycle that is most likely going to dominate. Now with- Go ahead.
Jennifer: No, no, go ahead. I think that's actually important point, because there is that balance between the two as you were saying, because if they're out of balance now we have a problem, so continue on please.
Lacey: Yeah, so what can happen for many women is that throughout their cycle and throughout their lifetime, they can develop different levels of estrogen and progesterone that change up their hormones and their symptoms and how they feel and act.
Lacey: To give an example, things that are estrogen dominance symptoms would be things like fatigue, breast tenderness, irregular menstrual cycle, heavy, heavy periods with cramps, headaches, mood swings, muscle and joint pains, digestive issues.
Lacey: Now as we discussed before this podcast, those things, they sound like hypothyroidism. It's really, really, really important, whether you have these symptoms or not, you can't just diagnose yourself. You have to test, don't guess. If you don't really have estrogen dominance, and I'll talk about this later, and then you run to some estrogen reducing supplement, you can put yourself in some deep doo doo.
Lacey: You do not want to do that. I've seen so many people do that.
Jennifer: Would you say the first thing then would be to check the thyroid before assuming … I mean, I always think like there's an order to things. Even if you are going to check your sex hormones, the thyroid should also be checked as well. That would also be an important part, I would imagine, at least that's what I do in my practice, to get your thyroid thoroughly checked if you think you have these symptoms.
Lacey: Yeah, they go hand in hand. I'll dive more into that just so your listeners know. With estrogen dominance, what can happen is you could have high estrogen, which of course means estrogen is going to be higher and dominating, or your estrogen dominance, you might have normal estrogen, but your progesterone levels are low, making your estrogen levels more dominant than your progesterone levels.
Lacey: We want that fine balance, and we're going to have those fluctuations in your menstrual cycle. That's another thing to keep in mind when you're going to test. If you don't know where you are in your menstrual cycle when you go test, then what do those levels mean?
Lacey: They don't really necessarily mean anything, and they're not going to show up as clinically valid unless they're post-menopausal, like clinically low, so something to keep in mind. Now with the thyroid, estrogen dominance does increase thyroid binding globulin.
Lacey: What that's going to do is that is going to bind up the thyroid from being active. Many times a lot of women have estrogen dominance, they also have hypothyroidism. Not always, but they do go hand in hand.
Jennifer: Would it be wise if someone was diagnosed with Hashimoto's, for example, but they still are having these symptoms, would it be wise then to also check to see if estrogen dominance is also happening at the same time? Yeah.
Lacey: I always say do a full panel if you can. If you have issues, test as much as you possibly can. With that being said, even low vitamin D status and low iron, those things can even have the same, for many women, the same symptoms of estrogen dominance or hypothyroidism. That's why testing is key, it's critical.
Jennifer: The other piece too, I think that's also important to remind everyone is that before you go running out to the grocery store or online, you really should not buy your own hormones. That's not something to mess with on your own. I think that's a worthwhile point to make, because a lot of times there's companies that are promoting progesterone creams and progesterone this and estrogen.
Jennifer: I don't know, I don't work a ton with hormones, but you do. Is that also a danger here if somebody starts supplementing or applying these hormones to their body without knowing what their levels are and working with someone, I feel like there could be a real danger there.
Lacey: Yeah, because in turn that's going to affect your whole HPA access, your hypothalamic pituitary axis. Then you're looking at not only influencing your estrogen and progesterone, you're also looking at influencing your DHEA, your testosterone.
Lacey: You put yourself at risk for just creating a thyroid or a hormonal storm. When one is off, many times, another one likes to jump ship with it. You really have to make sure that you're working with a practitioner, you're going based off of your labs and you're not just having fun with it.
Lacey: I think what's really important with estrogen dominance is making note that because you have estrogen dominance does not necessarily mean that you need one of the key estrogen dominant supplementation strategies. We have different pathways of estrogen detoxification that are needed in order to process our estrogen in our bodies.
Lacey: We have phase one, which is going through the CYPA1 family, and estrogen can flow down various different pathways. You have to make sure it flows down CYPA1. You'll see things like Calcium D-Glucarate, NAC, glutathione. Those are things that help you slow down things when detoxification.
Lacey: They're pretty much what you see on the internet all the time. You have estrogen dominance, let's take this supplement. Okay, cool. Well, if you have problems with phase two detoxification, so there's phase two, phase three.
Lacey: Phase two is involved with methylation, so we have to methylate the estrogen in order to then phase three excrete it, AKA poop it. If you're having problems with methylation, whether that be you have a poor MTHFR enzyme, which means you're going to have trouble methylating, you have a nutrition deficiency, or you might have high levels of what's called beta glucuronidase, which technically in the gut it starts to unravel that estrogen and it prevents it from being excreted, that will stop you from being able to have proper phase two estrogen detoxification.
Lacey: Then if you had that problem with that phase two and you took things processing through phase one, that is pushing all of that estrogen through phase one. It's blocked at phase two, it's going to recirculate. You're just making your symptoms worse, and it becomes a vicious, vicious cycle.
Jennifer: For someone who's listening to this going, “Wait, this sounds really complicated.”
Lacey: It is complicated.
Jennifer: Yeah, the reality is it is. That's where you have to be careful, because hormones are signaling molecules. They're really important for the health and the wellbeing of your body. When you start throwing things in to tinker with them and you're not exactly sure all of these different facets of the puzzle so to speak, it can really cause problems.
Jennifer: Why don't we talk for a moment about … I want to actually talk about the pooping out the estrogen, because a lot of people don't realize that we poop out estrogen. It can get hijacked in the gut by gut bacteria. Do you want to talk a little bit about that?
Lacey: Yeah, so fiber is our best friend when it comes to our hormones, because we need that fiber. We need enough bile acid and we need proper body levels of cholesterol in order to properly flow that estrogen and get rid of it in our poop.
Lacey: If you are not pooping every single day, you have a lot of constipation issues, you have whether that be an overgrowth, low bile acids, low pancreatic enzymes. If you have bad digestion, that is going to potentially lead to having high estrogen.
Lacey: You really have to make sure you're pooping out your estrogen. Many times just getting women pooping the right way, having a happy poop life plays such an amazing role in regulating their hormones. That doesn't mean go take a fiber supplement.
Lacey: That means go eat your fruits and vegetables. Go eat your prebiotics, apples, avocados, nuts and seeds, leafy greens, all these things. It's not just the fiber too, it's the food synergy. Making sure you have all those nutrients that you need for all the processes in your body.
Jennifer: One thing that I found is that sometimes people, when they have dysbiosis, so the guts really out of balance, or sometimes they have infections that are present, you find in say stool tests, like the GI map, or GI effects, is that they will have elevations of beta glucuronidase from the bacteria that are living there.
Jennifer: Your bacteria in the gut are hijacking the process and they're just like, “Oh hey, I see some deactivated estrogen. Let me turn you back on,” and you're stuck with it. Which is not good, because I have a lot of clients to that struggle with itching.
Jennifer: If you're listening to this and you've tried Zyrtec, you've tried Benadryl and you're not finding that to really make a dent in the itching, the next thing to wonder is number one, do I have an infection that could also be driving that? Number two, is it possible that gut dysbiosis is hijacking your estrogen clearance?
Jennifer: Which high levels of estrogen as Dr. Carrie Jones has pointed out to us in previous interviews I've done with her, that will actually also block your histamine breakdown. Histamines linger a lot longer in the system than they should.
Jennifer: Let's talk a little bit about best labs testing, because this is not my wheelhouse. I know there's the DUTCH test, and I know I love the DUTCH test. I think it's a great test, but what should somebody do if they're really interested in this? Is it worthwhile to go to your doctor and get the blood labs run that test for estrogen and all the different sex hormones? What's your opinion?
Lacey: I say the first thing to save money, because I am team frugal, is figuring out, could my high estrogen, is it potentially related to low progesterone? If you have high cortisol, you're really stressed out, you're really anxious, you have a really crazy life, that could be the root issue.
Lacey: That's the first thing to ask yourself. Could it be stress and cortisol related? Could I be under eating? Could I be eating high inflammatory foods? Could it be my diet itself that I could try and fix first focusing on whole foods, lots of fruits and vegetables.
Lacey: Can I do all that before testing? Because many times with the progesterone, if you have low progesterone, you're going to have higher estrogen. That's the estrogen dominance, but the low progesterone could be due to the high cortisol. High cortisol doesn't necessarily steal the progesterone, but it does decrease the amount of natural progesterone that you have.
Lacey: You need progesterone in order to ovulate, in order to have a proper menstrual cycle. That progesterone builds up your uterine lining. No uterine lining, no cycle. Estrogen dominance could be all that's involved there. That's the first thing I like to say is try and reduce your stress.
Lacey: Another thing for the testing then that you can do is if you want to go through your primary care doctor, you want to get it covered by insurance. What you can do is you can ask them for estradiol, progesterone, testosterone. I do like saying DHEA sulfate, and then I do always ask people to do a comprehensive metabolic panel, a CMP.
Lacey: I like them to do B12, vitamin D, because vitamin D for many times is low and the symptoms are correlated, and thyroid, full thyroid panel. TSH, free T4, free T3 at least. Those are the things I like to see. If your doctor is not willing to order that, you can go to direct to consumer labs.
Lacey: Things like MyMedLab, Ulta Lab, DirectLabs, those are all great. You can get bundles, which makes them pretty cheap. I know I go there, because sometimes my doctor is a butthole and won't order what I want. I can get a good bundle for $160.
Lacey: If you want to go the whole detailed route, you want to check your methylation pathways, things like aromatase, the compact weight, the CYPA1, the phase one detoxification pathway. If you want to get all those details in, then you can go to something like the Dutch test.
Lacey: I am a huge fan of the DUTCH test. I use it with my clients. I love it. It is fabulous. There's many things that you can do. Something to keep in mind with the lab testing is if you have an irregular menstrual cycle, then you've got to be aware of that.
Lacey: When you go based on when your cycle is will influence those levels. If you look at the blood work panel, it'll say reference range, follicular phase, luteal phase, post-menopausal phase. You'll see that you have to keep in mind where you're at does affect your levels.
Lacey: The DUTCH is the same way. I always tell people try and get testing done when you think you could have your menstrual cycle, and go between five to seven days before your cycle. That is when estrogen and progesterone are normally at their mid peaks. Estrogen does a little raise five to seven days before your cycle and then drops letting progesterone take over.
Lacey: If you go between that five to seven day cycle, you get a really good picture, hopefully if your cycle is normal.
Jennifer: It would be five to seven days before the first day of your period?
Lacey: Before you bleed, correct.
Jennifer: Okay, and any thoughts, what if a woman's like, “Well I haven't had my period in six months, seven months, is there any suggestions of what they could do to potentially figure out where they are in their cycle?
Lacey: You can go based off of … It's a hit or miss for some women. Some women they might still have some cervical mucus. They might still have elevations in their body temperature. They might still have the cravings, the bloating that come with symptoms of PMS.
Lacey: You can go based off of that if you're tracking that. I know specifically for me, like I told you guys, I don't keep anything, I tell everything. I have never had a menstrual cycle all my life. I still have cervical mucus. I still have the bloating and the cravings.
Lacey: I go based off of that when I personally go to tests. That's something that I have my clients do as well.
Jennifer: I know I had a client who had a hysterectomy pretty young, and so she still has her ovaries, so she's still producing hormones, but has no idea what her cycle was. The suggestion, this was really helpful from the DUTCH test folks was to get the … You don't use the computerized sticks to test your urine for the hormone levels, you use just the basic pee sticks so to speak.
Jennifer: You test your urine, and when you see that beginning of, I think a line or whatever the demarcation is, you then know where the first day of your cycle is. You do it for 60 days, so you have that repeat, and you're like, “Okay, I know where day one is.”
Jennifer: That was a really great suggestion from them, because you never know. Sometimes a woman, she's had a hysterectomy and she's young, but still has hormone issues. It's good to know that there are some work arounds in order to help them.
Jennifer: I wanted to actually ask you a question. A lot of people … You mentioned cholesterol, and so there's this push amongst medical professionals to push the cholesterol down low, low, low. We want it super duper low, but I'm always like, “Wait, our body needs cholesterol to make sex hormones.”
Jennifer: Do you just want to share with everybody your thoughts on that? I think it's important, because you are … I mean, you're in tremendous shape. You're really into the science of this stuff. I think you'd be a great person to answer that question. Should everybody be so concerned about having cholesterol down around 120, 110, 100? I think that's too low, but what's your thoughts?
Lacey: Yeah, so cholesterol is very important on our bodies. We need it in order to have our healthy hormone levels. They are the basis, they are the foundation. Now are there some people that need to be wary of their cholesterol? Yes, yes. Specifically if they have genetic cholesterol defects.
Lacey: For the most part people need dietary cholesterol. In the body, it does create its own cholesterol. What people don't know for many times is that your dietary cholesterol has little impact on your natural cholesterol levels. If you aren't eating your dietary cholesterol, it's like all righty, well your body's just going to up regulate and create it anyway.
Lacey: Then you get into the vicious cycle of maybe having too low of cholesterol. These cholesterol containing foods, they have an amazing amount of fat soluble vitamins, things like eggs, an incredible amount of choline. As we see, a lot of women who have menstrual issues, they might have low choline.
Lacey: Low choline is terrible if you are trying to get pregnant. That is going to put your baby at risk for congenital defects and cranial abnormalities and all that stuff. I'm a huge fan of cholesterol. I think it's very important, and I don't think people should be scared of it unless they technically have high cholesterol.
Lacey: If you just have high cholesterol, there might be a reason why you have high cholesterol. Thyroid disorders, hypothyroidism, that spikes up your cholesterol. Does it mean that you necessarily have your own cholesterol issues? No, it just means your thyroid is screaming at you for help and it responds via cholesterol. I don't know the mechanism why, but it does.
Jennifer: It's amazing that we're still learning so much information. We think we know everything, but yet there's so much more for us to learn. It really is truly incredible.
Lacey: It changes all the time.
Jennifer: It does. It does. I've had a number of men who I've worked with on skin issues, and they have a lot of symptoms of fatigue and whatnot. When you go and you look at their cholesterol, it's so super low, because their doctor wanted them to push it really low.
Jennifer: I'm like, “Ooh, I wonder if you have low testosterone. You don't have the precursor. You may not have enough of the precursor to make your testosterone.” It's good information for people to dig into, so do some more of your own research.
Jennifer: If you've been wondering what an appropriate level of cholesterol is for you and maybe questioning why your doctor keeps asking you to push it lower and lower and lower and you just don't feel well. It does have an impact on all of this stuff, especially your hormone health.
Jennifer: Lacey, you have, … We talked a lot about how the thyroid plays a role here and that's a really important part to this. You have a great gift that you want to share with everybody that may help illuminate some of this for them and help them figure out the thyroid piece. Do you want to share what that is?
Lacey: Yeah, so thank you so much for letting me give this to your listeners. It is my no BS guide to hypothyroidism and Hashimoto's. It is all about providing you with the physiology of your thyroid. The things that are important, like the root causes of hypothyroidism and Hashimoto's. What are the differences?
Lacey: What are the key supplements that could help you and could be detrimental? I like to tell anybody who goes through this ebook, this is for educational purposes only. It really gets into the nitty gritty and what is most important with hypothyroidism and Hashimoto's.
Lacey: Just with estrogen dominance, just the skin issues, there's so much on the internet. It's like what is the truth? Help, and so that is my goal with this guide is to really go through, get into the nitty gritty and provide you with factual knowledge and practical takeaways.
Jennifer: Yeah, and especially because if you do think you have estrogen dominance, you do have to question what's going on with the thyroid. They are all connected. It's very important no matter whether we've got ladies listening. I know we've got moms listening for sure, and we definitely have some men and this can certainly be an important part of the process.
Lacey: For those men, do you mind if I tell them something?
Jennifer: Please, please.
Lacey: Okay, so I see a lot of men, they're trying to focus on their testosterone levels. They'll try block those aromatase pathway. Take things like saw palmetto. Sometimes that can increase their estrogen levels. Then they develop man boobs.
Jennifer: Yeah.
Lacey: I'm like, “Okay, guys, you need to test too. You need to be careful.”
Jennifer: Exactly. I think it's an important reminder that while this conversation seems very female heavy, it's actually not. It does still apply to men, and it can certainly have a … Man, men do not want elevated estrogen. I mean, that will definitely make you not feel well for sure.
Jennifer: Thank you so much Lacey. They can find you at upliftfit.org. You're also on Instagram. I love your Instagram account, @faithandfit, and @upliftfitnutrition. For any of my folks that are listening and who love following me on Instagram, please go follow Lacey.
Jennifer: I will put the link to everything including that thyroid guide in the show notes for today's episode. Lacey, thank you so much for joining us.
Lacey: Oh, thank you so much. It was such an honor, and to your listeners, I hope you guys are able to tackle your own health, be your own health advocate. If you have all these symptoms, don't let any doctor downplay them.
Jennifer: Exactly.
Lacey: Something's wrong, your body is screaming at you. Be your own advocate. Take control of your life.
