Melissa Kaplan's
Chronic Neuroimmune Diseases
Information on CFS, FM, MCS, Lyme Disease, Thyroid, and more...
Last updated January 1, 2014

I first found out that there was a problem with my estrogen levels when I told my doctor that it was time to retest my thyroid function as I was starting to experience early acute thyroiditis symptoms again: hair loss, and weak and tearing finger nails, are early signs for me that my thyroid medication needs to be tweaked again. As we were talking about other things during that visit (abnormally heavy periods, very tender breasts pre-menstrually, some of my other symptoms that I associated as being part of my CFS and MCS), he said that it we should test my estrogen and testosterone levels. I already knew that my DHEA was low, but I can't take enough of it to raise my serum levels to what is normal for my age because I start breaking out and getting facial hair at anything over 10 mg a day (why couldn't it be head hair instead of facial hair?!)

So, off to the lab I went, and the results were, to say the least, interesting. Because of having acute thyroiditis (Hashimoto's thyroiditis, which requires more extensive testing than is normally done when doctors order a CBC or thyroid test, which is why this thyroid disorder is in the top five underdiagnosed diseases in the U.S.), it was interesting to see that my thyroid, with its current level of .1 mg of Synthroid was working just fine. My estrogen, however, was off the map - way high, while my testosterone was extremely low.

The testosterone was easy: because the testosterone pill manufacturers do not make the dosage I needed, my pharmacy gave me a choice: they could compound a cream or troques (sublingual lozenges) to apply or take on a daily basis.

Not all pharmacies will compound drugs any more since most insurance plans won't reimburse them because for some reason they can't figure out a reasonable cost formulary to reimburse the drug and labor involved, despite the fact that my parents' drug plan that they developed and administered for a wide range of corporate and insured clients, starting in the early 1960's through the 1980s, did that quite well and to the satisfaction of both the pharmacies and patients, as well as the plan insurer or administrator. But I digress... You may have to check around town for a pharmacy who will compound; another alternative is the online pharmacies who will compound to your doctor's prescription. Or, just bite the bullet and pay for it yourself rather than submitting it fruitlessly to your drug insurance carrier.

I thought that would be that, but the problem wasn't that my estrogen was too high in relation to the testosterone, it was too high, period. It turns out that there is a charming little bacteria that lives in our gut that was ripping the estrogen off of its glucuronide escort that it attached to in the liver, and so frees the estrogen to recirulate rather than letting it be escorted out of our bodies through our waste elimination system. (Actually, the unbinding is caused by ß-glucuronidase, a glucuronide-destroying enzyme produced by one or more of the more than 500 species of gut bacteria that inhabit a healthy gut.*) For some reason, my bacteria were running rampant, pillaging the glucuronides, so glucuronidation had essentially stopped. Thus, not only was the new estrogen my body was producing naturally being circulated, but so was the estrogen from my birth control pills AND all the internally manufacturered estrogen that should have been eliminated. Since I was tested after I'd been off the pill for over a month (and had experienced no abatement of the symptoms), the high estrogen test results showed that it was my naturally occurring estrogen - both the new estrogen being made by my body as well as the used estrogen that was being recirculated instead of being glucaronidized that was causing the problem.

The answer was not progesterone, but calcium d-glucarate. Available in tablet/capsule form, I took it three times a day for about six months; when my next test showed that my serum levels were back within normal ranges for my age, I dropped down to one a day. I had already been taking milkthistle to help support my dysfunctional liver; I continue taking it as the liver helps detoxify xenoestrogens and other toxins. I also take chlorella or spirulina to help rid my system of circulating mercury as part of my mercury detox efforts, in addition to IV treatment.

The reason I mention the liver and mercury is that symptoms can mimic those of thyroid disease as well.

Update, Late 2001: Well, my estrogen, testosterone and other hormones are where they should be now, I continue to take the calcium d-glucarate because of the low levels of n-butyrate in my gut, but the problems with horrific periods continued. My doctor, as we were talking about my lab results (including negative pelvic and vaginal ultrasounds), he mentioned that what doctors used to call polycystic ovaries (and pretty much shrugged off doing anything about it, since it was a "female" thing) really seems to be related to hyperinsulinemia - elevated levels of insulin due to problems with the diet and/or an enzyme that the liver should be producing to knock out unneeded insulin, but isn't (or not producing enough of it). With this percolating in the back of my mind, my eye was caught by a very interesting article, The Prediabetic Epidemic (Syndrome X). I read it, made some more dietary changes (and reduced the "many small meals a day" so many doctors and health sites recommend to four "not as small meals a day"), added some new supplements, increased amounts of others, and there have been some positive changes with my periods over the past three months...and I lost 20 lbs without even trying. So, while insulin/glucose processing isn't the whole answer (still losing hair, but that could be telogen effluvium from the diet changes I've been putting into play over the past year), it is part of the puzzle.

2002 Update: I retested my gut again to see if there has been any change. There hasn't been: still no beneficial bacteria, still excessively high amounts to beta-glucuronidase (the enzyme that breaks the glucuronidation/estrogen bond), and still too alkaline. So, I will have to continue to take FOS, beneficial bacteria (various -dophilus and -bacillus organisms), along with digestive enzymes and hydrochloric acid/betaine. My doctor and I talked about why the friendly bacteria is absent in my gut and what could be instrumental in the excessive production of glucuronidase, an the answer may be the same thing: anaerobic organisms. The gut digestive test that he uses (Great Smokies Diagnostic Lab's Comprehensive Digestive Stool Analysis) does not look for anaerobic organisms (other than E. coli which, in "normal" amounts, is healthy), so we don't know which are present or in what numbers. Anaerobic organisms, such as E. coli, Bacteriodes, and Clostridia, are known to induce the formation of glucuronidase.

To see if we can change the situation, along with everything else I'm taking, I will be adding Sacchromyces to my daily regimen, for 3 weeks, to see if that helps quash the overabundance of anaerobes. I am also now taking a daily dose of grapefruit seed extract, known to have antifungal and antibacterial properties. As a result of still having abnormally heavy periods despite the progesterone I'm using to create a new cycle (7 d@100mg/day; 7 d@200mg/d; 7 d@300mg/d; 7 days off), they still aren't "normal".

I also just had a dicey mammogram with a recall in six months to recheck the abnormalities seen in this one (for which I was called back for magnification and ultrasound). I've always had fibrous breast tissue. That, along with the estrogen dominance due to the usual unavoidable culprits (xenoestrogens) and the elevated circulating estrogen due to the elevated glucuronidase, my doctor has me starting on DIM (Diindolylmethane). DIM is a phytonutrient found in cruciferous vegetables including broccoli, brussels sprouts , cabbage, cauliflower and kale. Unlike other plant nutrients such as soy isoflavones, diindolylmethane has unique hormonal benefits: it works on the estrogen metabolites, enhancing their conversion to nonproliferative function rather than proliferative. IOW, it increases the level of "good" estrogens (2-hydroxy-estrogen ) while reducing the level of "bad" estrogens (16-hydroxyestrogen). The 16-hydroxyestrogen is involved in breast and uterine growth, which is fine when you're going through puberty - it isn't when you're an adult with fibrocystic breasts, excessive uterine lining, and estrogen dominance. So, I will take it for six months and repeat the CDSA test and mammogram, and see what effect, if any, the additions to my daily regimen have.

Articles on Estrogen, Estrogen Dominance, and Xenoestrogens
While some of the following sites are selling product, my purpose for including them here is because they provide information about ED which is easily understood and will help readers understand what the disorder does to the functioning - or dysfunctioning - of the body. Progesterone itself, natural or otherwise, is not necessarily the "cure" for having too much estrogen, so despite the fact that some of the following sites promote various forms of progesterone, please know that this is something you need to discuss with your physician in the course of evaluating test results and what they mean to you.

Journal and other articles related to environmental estrogens (xenoestrogens), estrogen dominance, and elevated serum estrogen levels:

Estrogen Dominance Syndrome, Ronald Hoffman, MD, 1999

Unwanted HRT playing havoc with songbirds, New Scientist, March 2002

Breast Cancer and the Chlorine Connection (Organochlorines), September 1994

Industry Addiction to Estrogen Mimickers & Endocrine Disrupters, 1996

DDT, Other Chlorine-Based Chemicals Were Banned for a Reason, St. Louis Tribune 2002

Hormonal Sabotage: Synthetic chemicals in the environment may be wreaking havoc with the endocrine systems of humans and animals. Natural History, 1996. This one is probably the scariest of them all...

Environmental Estrogens, American Scientist, 1996, John A. McLachlan and Steven F. Arnold

Estrogens in Unexpected Places: Possible Implications for Researchers and Consumers, Environmental Health Perspectives 103, Supplement 7, October 1995, David Feldman and Aruna Krishnan

Why Are So Many Women Depressed? Scientific American, Ellen Leibenluft, M.D.

Estrogen, Progesterone Implicated in Provoking PMS, by Kenneth J. Bender, Pharm.D., M.A.

Pheromones in Humans: Myth or Reality?

Editorial. Does Estrogen Receptor Expression in Normal Breast Tissue Predict Breast Cancer Risk? Journal of the National Cancer Institute, Leslie Bernstein, Michael F. Press

Correlation of Menstrual Cycle at Time of Breast Cancer Surgery to Disease-Free and Overall Survival. Southern Medical Journal, 1997, VW Vanek MD, TF Kadivar, MD, and CC Bourguet, PhD

Androstenedione Use May Increase Testosterone And Estrogen Levels (Male and female body-builders beware...)

What cautionary tales can Lake Apopka tell us?
Anna Marie Gillis, Zoogoer, 1995.

Sun block: Gender-bending chemicals that mimic oestrogen
From New Scientist. Just when you thought it was safe to go back into the water...

PubMed Search: organochlorine +estrogen

Articles related to estrogen, progesterone, pre-menstrual syndrome and menorrhagia:

Estrogen, Progesterone Implicated in Provoking PMS

 Articles appearing at product-related sites:

Hormone Heresy: Part I and Part II, Sherrill Sellman

Tamofaxin: A Major Medical Mistake? Sherrill Sellman. See also What is Tamofaxin?

Sites and literature related to calcium d-glucarate:
Glucuronidase (beta-D-Glucuronoside glucuronosohydrolase) is an enzyme that hydrolyzes a glucuronide, especially the beta form of a glucuronide. It is widely found in the liver and spleen. One of its functions is to bind estrogen to assist the body in eliminating, making room for the new estrogen the body makes on a regular basis. Bacteria in the gut break this bond, freeing the estrogen to recirculate, thereby increasing serum and organ levels of estrogen throughout the body. Calcium d-Glucarate blocks the activity of this bacteria.

Calcium D-Glucarate

Of Related Interest

Thyroid.About.com

BreastCancer.About.com

Testosterone, Aggression and Green Iguanas

National Resources Defense Council's FAQ on Endocrine Disruptors

Glucuronidation

Effect of Human Intestinal Bacteria On the Metabolism of Estrogen Hormones

Other Endocrine Disruptors: Smoking, Arsenic

Sun block: Gender-bending chemicals that mimic oestrogen

Safety Concerns with Sunscreens - these products pose a threat to some breast cancer survivors

Chemical Industry Whines
The Media's War on Essential Chemicals: Targeting Chlorine, 1994

Activism

Disability

Pain

Books

Drugs

Pets

Chemical Sensitivity

Finding Support/Doctors/Attorneys

Resources