The Estrobolome: How Your Patient's Gut Is Recycling Estrogen

Let's talk about this kind of more in a clinical scenario.

Okay, so let's just say you have a female patient.

She comes in and is talking about her general health.

One of the things I need you to start asking your patients about, and most patients are pretty good at mentioning it, but a lot aren't, is their gut health.

Let's say she's 34, 35 years old, maybe otherwise healthy to some degree, but she complains about her gut health.

She complains about bloating.

She complains about constipation.

And again, it's not so bad she's ending up in the hospital or anything like that, but it's just something she's dealt with her entire life.

And in fact, if you don't ask her about it, she's probably not even going to mention it because again, it's not necessarily ruining her life, so to speak, but it's enough to where it's probably a little bit annoying, a little bit frustrating.

And maybe she just does some things on the side.

Maybe she takes a Miralax every now and then, or, you know, tries to keep up with her fiber to help with the constipation and the bloating.

She's just something she deals with.

You look at her estradiol levels, and they're normal.

They're totally fine.

In fact, we could just call them optimal, right? They're not extraordinarily high.

You've checked them maybe two or three times.

But her symptoms are not resolving the way they should or the way they ought to, and especially her gut health continues to remain the same.

What is going on there? Why is it that this patient is having so much issue with her gut? And why is it that she's also presenting with symptoms of estrogen dominance? She gets breast tenderness.

She bleeds really heavily.

Maybe she's been told she even has fibroids or things of that nature and around her uterus.

What is going on there, right? What about mood swings? What about just the feeling of irritability? Maybe she even feels kind of rageful around the time of her period.

How many of those women have you met in your clinic and maybe you're just scratching your head like what is going on there? And to be honest with you, it's because it goes way beyond even just HRT.

It really starts getting into more of the diet and lifestyle habits And to some degree, even just, again, the environmental factors that we discussed that are impacting our gut so tremendously.

So again, adding in things like progesterone and thyroid are massively important.

And they can really relieve a lot of the symptoms that are going on with that patient in and of itself, but it's not going to always fix the gut health issues.