b'Because estrogen dominance is so prevalent, I recommend an estrogen detoxification protocol to many of my female patients. The protocol can help restore a better estrogen/progesterone balance, reduce undesirable estrogen breakdown metabolites, and help the liver move to more efficient estrogen metabolism. Balanced estrogen metabolism is a necessity for success in following the ketogenic diet.Estrogen is processed in the liver for elimination following phase I and phase II detoxification pathways. In that sense, an estrogen detox is similar to liver detoxification, with some modifications.Estrogen is the collective name for a group of female hormones: estrone, estradiol, and estriol.aims to help the liver metabolizepostmenopausal women with a history Estradiol is produced in the ovaries;estradiol and estrone more efficientlyof early-stage breast cancer. Nutr its the dominant form of the hormone.and minimize the time the badCancer. 2004;50(2):161-167. oi:10.1207/Estradiol affects libido and fertility; itmetabolites have to circulate and causes15327914nc5002_5] protects women against heart disease,damage. I also strongly encourage all my female osteoporosis, and cancer. Levels ofThe protocol I recommend supportspatients to get regular physical activity estradiol begin to drop when a womandetoxification and methylation byas a way to normalize their estrogen reaches her mid-30s; by the time shemaking sure the body has the neededmetabolism. [Smith AJ, Phipps WR, reaches menopause, estradiol produc- cofactors to help eliminate estrogens.Thomas W, Schmitz KH, Kurzer MS. The tion ceases.It begins with a high-fiber diet rich ineffects of aerobic exercise on estrogen Estriol is the form of estrogen producedcruciferous vegetables such as broccolimetabolism in healthy premeno- during pregnancy.and cabbage. High fiber alone has apausal women. Cancer Epidemiol Estrone is produced in the ovaries andpositive effect on estrogen metabolism,Biomarkers Prev. 2013;22(5):756-764. [Rose DP, Goldman M, Connolly JM,doi:10.1158/1055-9965.EPI-12-1325]is also produced by fat tissue. Its some- Strong LE]. High-fiber diet reduces times called the menopause estrogenserum estrogen concentrations inThe typical estrogen detox program because it continues to be produced inpremenopausal women. [Am J Clinlasts for 28 days before the implemen-fat tissue and from endogenous testos- Nutr. 1991;54(3):520-525. doi:10.1093/ tation of the keto diet. I prescribe to a terone, even after the ovaries haveajcn/54.3.520], while the indoles in cruci- 3-step approach, as depicted below.stopped producing estradiol. Estrone isferous vegetables help shift estrogenStep 1: Initial clearing. During the first often blamed for weight gain as womenmetabolism away from bad estrones.four days, patients gradually eliminate enter perimenopause and menopause[Fowke JH, Longcope C, Hebert JR.dairy, gluten, and high-carb sugary years.Brassica vegetable consumption shiftsand processed foods. Theyre replaced When estradiol is hydroxylated in theestrogen metabolism in healthy post- with high-quality protein, good fats, liver during Phase I detoxification, itmenopausal women. Cancer Epidemioland at least five half-cup servings a day converts to three different estroneBiomarkers Prev. 2000;9(8):773-779.]of cruciferous vegetables. During the metabolites that vary considerably inThese vegetables are also a gooddetox, patients avoid caffeine, alcohol, their biological activity. One metabolitedietary source of diindolylmethaneand soda. Instead, they drink lots of is generally considered to be good(DIM), a compound that is shown topure alkaline water. I also recommend estrogen because it has only weakpositively affect estrogen metabolism.a daily green drink and a daily detox estrogenic activity. The other twoFor those who find that cruciferoussupplement shake. The green drink estrone metabolites are bad becausevegetables are hard to digest,provides vitamins, minerals, and they are much more activeand aresupplements containing DIM arephytonutrients. The shake provides a potentially carcinogenic. When thean option as well. [Dalessandri KM,wide range of natural micronutrients, estrone metabolites are methylated inFirestone GL, Fitch MD, Bradlow HL,cofactors, fatty acids, and amino acids Phase II detoxification, however, theyBjeldanes LF. Pilot study: effect ofthe liver needs for the detoxification become less harmful.3,3-diindolylmethane supplementspathways to function efficiently.The estrogen detoxification protocolon urinary hormone metabolites in[KETO CONTINUED ON PAGE 24]www.njchiropractors.com I 21'