Estrogen Detoxification for Hormonal Health

Estrogen Detoxification for Hormonal Health
Scott Resnick MD 2020

What is estrogen detoxification? So much of “adrenal fatigue” is associated with an estrogen/progesterone imbalance in women. I saw a comment on a post recently asking how to lower an elevated estrogen level, and I thought I’d offer my perspectives.

Incidentally, estrogen is super-important in men, too. It follows the “Goldilocks Principle”—we want it to be “just right.”

Think of estrogen as a necessary toxin

We need to be thinking of estrogen, in part, like a toxin in our body. Our body considers it as such, and runs it through the conventional “detox” pathways. It is subjected to Phase I, and then Phase II detox to eliminate the molecule from the body. This applies to estrogens made in the body (endogenous), and those which are applied through HRT, (exogenous).

Estrogen as a toxin? Sure. We know that elevated, unopposed levels of estrogen increase a woman’s (and a man’s) risk of breast cancer. Uterine cancer is increased, and so too is the risk of blood clots as the hormone promotes the liver to make more clotting proteins.

Estrogen can be found in different forms (estriol, hydroxy-estrones), which have their respective benefits and toxicities. But for clarity here I will use the term collectively.

Estrogen detox: First know your levels

The first thing that I recommend is to know your levels. In a person who is not using any exogenous hormones, a simple blood test works great. When we start using applications on our skin, we need to be thinking about checking these levels with saliva or bloodspot.

Many people seem to recommend the DUTCH test, which measures urine estrogen metabolites – the end product of hormone detox. I prefer to know the hormone levels at the tissue interface, and don’t use DUTCH for this reason (and others).

Fat cells, the ovaries and in the adrenal glands make our endogenous estrogens.  In an ovulating woman the effects are balanced with progesterone. The two hormones work together like Yin and Yang.

Estrogen dominance happens when there is too much Yin and not enough Yang. Think obesity, perimenopause with low progesterone levels, or unbalanced estrogen replacement. Either way, in this context estrogen begins to exert relative “toxic’ effects.

So how can we work to promote our estrogen “detox” pathways? Recall, these rules all apply whether the hormone arrives from within or without.

Three steps drive estrogen detoxification

To understand how to detox estrogen, we need to first focus on the basics of detoxification. To detox—anything—we need to be able to take less in and pull more out. This is easier if you are using the hormone via the exogenous route. Just lower your dose.

Step 1 is to ensure that all of the final pathways are intact. That means that you need to breathe, sweat, pee and poop regularly. After conjugation in Phase II detox, estrogen is primarily excreted in the stool. If you are having less than one poop daily, you are missing this opportunity to clear the molecule.

Poop regularly to detoxify!

I recommended psyllium or another insoluble fiber to all of my patients. This is my all-time favorite supplement. I use it daily, and have for more than a decade. It not only serves to hold water in the stool, but acts as a physical binder to toxins as well. Incorporate more fiber into your diet; ’nuff said.

For completeness, some people have a bacterium in their gut that secretes an enzyme known as glucuronidase—you may have heard of it. This enzyme uncouples estrogen from its carrier in the gut, and returns it to circulation. But that’s detox 404. We won’t cover that here.

Estrogen detox: Phase I processes

Step 2 is to promote Phase I detox. These are chemical pathways in the liver that convert the cholesterol-based estrogen to a water-soluble molecule. This is where supplements like DIM, chlorella and resveratrol work their magic.

But you don’t need to necessarily supplement to make the liver work well. Plant-based diets, cruciferous vegetables, and antioxidants all drive our body down a more efficient detox pathway.

What’s the best way to approach estrogen detoxification? Eat a primarily plant-based diet, plain and simple. Not only will you get the benefits of the phytonutrients, but also you will add more fiber to the gut (see Step1 above).

Estrogen detox: Phase II processes

Step 3 is to support Phase II detoxification. Here is where we take the modified, water-soluble molecule and conjugate it to a carrier protein for elimination. Critical nutrients are molecules like glutathione, sulfur groups (found in the cruciferous vegetables) and methyl groups (methylation, which requires B vitamins and methyl donors).

Additionally, we conjugate with various amino acids. So ensure that your diet includes the essential amino acids like the branched chain amino acids and tryptophan. A good amino acid supplement may benefit this biochemical pathway and others.

Final recommendations for estrogen detoxification

There is really no distinction between estrogen detoxification in pre and post-menopausal women. In a menopausal woman on HRT, all of these exogenous hormones are easily controllable.

My recommendations remain the same for a woman wishing to decrease either her risks associated with elevated estrogens, or her symptoms.

Risks, as mentioned, include blood clots, breast and uterine cancers. Symptoms are more vague, and range from heavy, cramping periods to weight gain, mood changes, headaches and breast pain.


First, activate your final detox pathways. Take deep breaths always, sweat daily, and drink plenty of water. When your urine is clear and you are pooping at least once—better yet twice daily– you are on track.

Second, drive those phase I and II detox pathways with organic, plant-based meals. And if you can’t do that, then consider adding the supplements I suggested.

Men and women both need estrogen for healthy bodies and minds. What we don’t need is an estrogen overload. These simple steps will get you well on the way to optimal estrogen levels.

Want to learn more?

If you’ve read this far, you now have another valuable tool in your health and wellness toolkit. Strong work! Be sure to check out my website at for similar writings on fatigue.










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