Estrogen plays a key role in our body. It is involved in everything from prepping for reproduction to keeping bones strong and eyes healthy. It improves insulin sensitivity and facilitates the export of lipids from the liver. It protects the heart and modulates cholesterol. Estrogen controls everything from the smoothness of your skin to where your body stores fat. Declining estrogen is driving an epidemic of fatty liver among postmenopausal women.
Reduced Estrogen and Your Liver
Many women are all too aware that declining estrogen levels result in hot flashes, mood swings, thinning of the hair, osteoporosis, and weight gain. But when estrogen drops, there’s no longer enough of it to steer where your fat goes-and so the fat goes where the body can most easily store it — the liver. This is turn antagonizes the metabolic and inflammatory alterations that trigger and boost a harmful condition called non-alcoholic fatty liver disease (NAFLD).
Early-stage NAFLD does not usually cause any harm, but it can lead to serious liver damage, including cirrhosis. Having high levels of fat in your liver is also associated with an increased risk of other serious health problems, such as diabetes, high blood pressure, and kidney disease.
Researchers at the University of Vermont found that decreasing estrogen levels are associated with an 82% increase in fat stored in the liver and other organs.[i]
By the age of 40, up to 90% of women are battling a fat-clogged liver, and post-menopausal women are developing NAFLD 60% faster than men of the same age.[ii] The buildup of fat in the liver also often leads to a pileup on pounds on the waist, hips, and thighs. Elevated ALT and AST on lab reports may be indicative of a fatty liver, especially if ALT is significantly higher than AST.
Lack of estrogen is associated with increases in cellular toxicity in the presence of abnormal fat accumulation, which can result in cell death, pro-inflammatory cytokines, and oxidative stress, and with decreases in anti-inflammatory cytokines.[iii]
It is becoming increasingly clear that once women reach menopause, they are exposed to increasing risks of developing complications due to a decrease in estrogen-related protective effects. Among the numerous protective effects of estrogen, preventing liver fat accumulation is important due to its role in the development of insulin resistance, atherosclerosis, and cardiovascular diseases.[iv]
“It’s never too late to turn the tide and eliminate liver fat”, Fred Pescatore, M.D.
What you can do NOW!
Cut down on fats and Fructose Results from animal studies indicate that high dietary fat (including nut butters and tahini) or fructose (eat fruit, skip fruit juice and certainly no high fructose corn syrup) intake can synergistically enhance the effects of estrogen deficiency, leading to exaggerated effects on liver injury and fat accumulation.[v]
Over the past century, the increased intake of added sugars (fructose in particular) is associated with increased incidence and progression of NAFLD and liver inflammation. Fructose enhances liver cell destruction, macrophage accumulation, and progression of fibrosis, all negative effects that can be reverted by estrogen supplementation. While bioidentical estrogens may not be a good option for many women (and synthetic estrogen is never a good idea), intentionally inhibiting estrogen may not make sense.
Lose weight and exercise. The rising trends in obesity has been linked with the increase in the incidence and severity of NAFLD. Currently, 74% of Americans over the age of 20 are either overweight or obese. In Europe the number is 60%, with 30% among children (up from 61% and 50% respectfully) Normal-weight postmenopausal women with lipid and glucose and insulin levels within normal range are at a lower risk of developing NAFLD.
Therefore, efforts to emphasize healthy diet and regular physical activity should be especially emphasized in middle-aged women as they approach menopause to prevent the development of NAFLD. Exercise seems to exert an estrogenic-like effect not only on expression of genes involved in lipid accumulation but also on expression of genes of inflammation in the liver.[vi]
Eat more protein. It is important to get sufficient protein, something we need more of as we age. A high protein (lower carb) diet can help switch off the genes responsible for storing fat in the liver (but not necessarily the Keto diet which is often too restrictive for optimal health and may include harmful processed meats such as bacon). Researchers reporting in the journal Liver International found that eating a high-protein diet cuts liver fat in half (a low-protein diet didn’t change liver fat).
Another study found that the genes responsible for liver-fat storage were less active in high protein dieters. “Amino acids are the building blocks of all proteins and boosting your intake of amino acids has been shown to help speed metabolism and fat burning,” explains Dr. Fred Pescatore in Fit for Women magazine.[vii] Animal-based proteins contain something calling branched-chain amino acids (BCAAs), which appear to be the most crucial to both weight loss and eliminating liver fat. More specifically, the branched-chain amino acid leucine, for example, instructs the body to burn the deep visceral fat that collects in the liver, while valine helps remove toxins from the liver. This lightens the load on the liver so it can focus on eliminating fat buildup. Studies show that following a high-protein diet for just two weeks can dramatically reduce liver fat. Protein also keeps you full longer so it may help with weight loss or management.
While the basic recommendation is to load up on protein, variety is helpful. While plant-based proteins are fine for most people, animal proteins contain all the BCAAs that are most crucial to eliminating liver fat (and encouraging weight loss). Wild-caught fish is a great option, alternating with grass-fed meats. You can even change up the amino acid profile by eating different types of fish and different cuts of meat. Full fat dairy is another option as it has a high concentration of BCAAs. Full-fat dairy is also rich in carnitine, which helps the body convert fat into energy, helping to eliminating liver fat (all dairy products should be organic and from pastured animals, never conventionally processed). The more carnitine, the more quickly fat gets burned.
Eggs, while controversial, are an excellent source of choline, a B vitamin that heals and energizes liver cells. Choline may help reduce your risk of fatty liver disease and interferes with progression. Choline deficiency is associated with liver dysfunction.[viii] (Choline is also found in meat, poultry, fish, dairy, cruciferous vegetables, and potatoes.)
While many studies show a beneficial role exerted by high-protein diets in reducing body weight and in reverting fatty liver disease, other studies suggest that high-protein diets can instead promote the development of NAFLD. Hence, don’t go overboard on protein—balance it out with a lot of vegetables and some fruits. Even too much of a good thing is not good and excess protein not a good idea for other reasons.
Eat your vegetables. For copious reasons, vegetable should be eaten throughout the day. They provide phytochemicals that keep inflammation in check so the liver can function optimally. Cruciferous veggies are particularly helpful as they are rich in indole, which helps break down liver fat. Also helpful are avocados, coconut, dandelion greens, mushrooms, okra, and squashes.
Get some sun. Unprotected sun exposure can also be helpful (no sunscreen) as UV light prompts the skin to make vitamin D, which switches on the liver enzymes that burn trapped fats for fuel. Get more sunshine or take vitamin D3.
Cut back on carbs. This is key to preventing future fat build up in your liver.
Supplement with Milk Thistle. Milk Thistle has been found to spur the growth of new liver cells damaged by fat buildup. The remarkable silymarin in it increases the body’s levels of liver detox enzymes dramatically. Studies confirm that milk thistle can protect liver function, prevent liver damage, and normalize elevated liver enzyme levels. Like silymarin, vitamins A, C, and E act like an antioxidant and support the live- just be sure not to take too much vitamin A.
Breast Cancer and Aromatase Inhibitors
This begs the question as to why oncologists are so bent on further reducing estrogen in postmenopausal women with hormone-sensitive breast cancers. This issue is indicative of many medical professionals. In my opinion, the goal should be to concentrate on estrogen metabolism and not reduction. Thus, it is up to you, the person whose goal is to keep the entire body healthy, and to make choices that best fit your needs. Taking hormone-blocking drugs is a choice, but any decision made from fear is likely not a good one. Please do your own research so there are no regrets.
To learn how to better manage hormones if you are in a cancerous state or have healed from hormone-related cancers, please visit my website or read my article Natural Alternatives to Anti-Hormone Therapies for Breast Cancer: What Your Doctor May Know but Cannot Recommend. To learn more about detoxification and estrogen, please visit my webpage on that.
Elyn Jacobs does not provide medical advice. The information provided is for general information only. No online site should be used as a substitute for personal medical attention.
Excerpted in Part from First for Women Magazine
[i] https://www.pressreader.com/usa/first-for-women/20210607/281539408793660
[ii] https://www.pressreader.com/usa/first-for-women/20210607/281539408793660
[iii] https://www.frontiersin.org/articles/10.3389/fendo.2020.572490/full
[iv] https://www.hindawi.com/journals/jnme/2012/914938/
[v] https://pubmed.ncbi.nlm.nih.gov/29751074/
[vi] https://www.hindawi.com/journals/jnme/2012/914938/
[vii] https://www.pressreader.com/usa/first-for-women/20210607/281539408793660
[viii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601486/; https://my.clevelandclinic.org/health/drugs/22202-choline-supplement
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In your everlasting good health,
Elyn
~~If you don’t know your options, you don’t have any~~
Elyn Jacobs is a breast cancer survivor and holistic cancer strategist who helps people make healthier, less-toxic choices for their healing. She emphasizes the importance of not just surviving cancer but surviving well and reducing the risk of recurrence. She is a Contributing Editor for The Truth About Cancer and is on the Medical Advisory Board for BeatCancer.Org and the Advisory Board to the Radical Remission Project. Elyn has written for numerous journals and publications. She was the former Executive Director of the Emerald Heart Cancer Foundation and the creator and host of the Survive and Live Well Radio Show. To contact Elyn, visit www.elynjacobs.com. Elyn offers consults via Skype, phone, or in-person. Elyn does not provide online advice.
DISCLAIMER:
Elyn Jacobs does not provide medical advice. The information provided is for general information only. No online site should be used as a substitute for personal medical attention.
This information is for educational purposes only and is not a recommendation to forgo medical advice and treatment. This post is not intended to treat, cure, prevent, or diagnose any disease or condition. This post does not represent medical advice nor should it be considered to be medical advice or a replacement for medical advice. I encourage you to discuss this information with your integrative oncologist, naturopathic doctor, or conventional oncologist. The information provided is from my research and not to be taken as scientific evidence.
Important Disclaimer: Elyn Jacobs Consulting, Inc. does not provide endorsement for the content, claims, or products discussed in this article. This information is for educational purposes only and is not a recommendation to forgo medical advice and treatment.
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Elyn Jacobs is a breast cancer survivor and holistic cancer strategist who helps people make healthier, less-toxic choices for their healing. She emphasizes the importance of not just surviving cancer, but surviving well and reducing the risk of recurrence. She is a Contributing Editor for The Truth About Cancer and is on the Medical Advisory Board for BeatCancer.Org and the Advisory Board to the Radical Remission Project. Elyn has written for numerous journals and publications. She was the former Executive Director of the Emerald Heart Cancer Foundation and the creator and host of the Survive and Live Well Radio Show. To contact Elyn, visit 
elyn jacobs 