The Liver-Hormone Link

Your liver is estimated to have over 500 different functions, and it impacts virtually every organ system. It is most well-known for its role in detoxification and digestion, but it does so much more.

Among its many functions, our liver:

– regulates most chemicals in the body

– processes all the blood leaving the stomach and intestines

– breaks down, balances, stores, and creates nutrients

– expels bile to carry away waste

– produces proteins that regulate metabolism, signaling compounds, and various bodily processes

– metabolizes drugs and harmful compounds (from the environment and internally) into non-toxic byproducts to be excreted

In my previous article, I discussed the many wonders of the liver and a key area that is often overlooked regarding it… how it influences hormonal balance. Many are unaware of this complex, bi-directional relationship between our liver and our hormones.

The liver regulates and metabolizes hormones, and hormones impact liver processes. Within this liver-hormone interaction, the gut microbiome also interplays through assisting estrogen recycling via its connection to the liver.

To summarize, the liver modulates hormonal levels in the following ways:

(1) It makes proteins which carry bound hormones throughout the blood. This affects their availability for cellular uptake and regulates their actions.

(2) It interacts with estrogen recycling through its relationship to the gut microbiome.

(3) It is the major site of hormone metabolism.

(4) It converts thyroid and other hormones into their active and inactive forms.

(5) It influences many other processes that impact hormone levels, such as nutrient storage and blood sugar balance.

This means that one key area to address in any hormonal issue should be your liver.

In this post, I will review how to recognize various hormonal imbalances. Then, I will detail how I help one regain hormonal harmony by addressing liver health using naturopathic and functional medicine.

Let’s get started.

The Mind-Body Systematic Effects of Hormones

The endocrine system uses hormones to control and coordinate many interactions in the body. These chemical messengers are powerful, specific, and their impact is far-reaching. For example, hormones play a role in regulating:

• metabolism (e.g., maintaining homeostatic balance via blood pressure, blood sugar, temperature, cellular energy, etc.)
• reproduction, fertility, and sex drive
• growth and development
• responses to injury, stress, infections, and/or environmental factors
• mood

Due to the impact of these tiny chemicals, their production, transport, utilization, and removal from the body have many tight control mechanisms. (R, R) This is why the health of the liver is paramount, as it is a key site for hormone activation, inactivation, and metabolism.

Symptoms of Hormone Imbalance

Your body makes over 50 different hormones, all regulating a variety of different biological processes. Therefore, depending on the hormone imbalance, you could experience various symptoms. Below are some of the most common symptoms, though they are not exclusive to endocrine dysfunction.

Metabolic Imbalances

• Alterations in heartrate
• Weight and body fat distribution changes
• Fatigue
• Digestive issues, including constipation, diarrhea, and increased stool frequency
• Numbness and tingling in the hands
• High cholesterol
• Depression or anxiety
• Intolerance to cold or warm temperature
• Course and dry hair
• Thin and moist, or dry and course skin
• Skin darkening in the armpit, back, or side of neck (acanthosis nigricans), a sign of high cortisol and insulin
• Small skin growths (skin tags)
• Excessive thirst
• Frequent urination

Female Sex Hormone Imbalances

Biological females can have an imbalance in estrogen, progesterone, testosterone, or androgens. Common symptoms include:

• Acne on face or body
• Loss of hair
• Heavy periods
• Excess body hair (hirsutism)
• Hot flashes
• Menstrual cycle irregularities
• Changes in libido (interest in sexual intercourse)
• Fertility issues
• Vaginal dryness or atrophy
• Sleep issues
• Brittle bones

Male Sex Hormone Imbalances

Biological males can have an imbalance of testosterone and other hormones. Symptoms include:

• Decrease or loss of body hair
• Erectile dysfunction (ED)
• Enlarged breasts (gynecomastia)
• Fertility issues
• Decline in muscle mass
• Infertility
• Lower libido

Testing Liver and Hormone Health

You doctor may choose to run some or all the following tests to explore the role of the liver in hormonal imbalances. It is important to note that labs should be used in conjunction with a full health history and comprehensive exam. They do not replace these vital steps.

Tests for Liver Health

Liver enzymes and liver function tests can be separately ordered or found in a Comprehensive Metabolic Panel (CMP). These tests can evaluate the health of the liver and determine if inflammation or other pathological processes are present.

A lipid profile may also be helpful to obtain. This is due to the liver’s role in fat metabolism and the fact that cholesterol is a precursor to hormones. For example, if cholesterol levels are abnormally low, it could compromise hormonal production. Furthermore, if cholesterol is too high, thyroid hormone, which helps regulate lipids, may be a factor.

Comprehensive Stool Test

Due to the fact that the gut microbiome impacts hormone clearance and liver function, comprehensive stool tests may be considered. These give a complete look at gut health by measuring pathogens and analyzing digestion, nutrient absorption, inflammation, and immune function. All these aspects impact digestive function and symptoms, which mediates the health of the liver-gut axis and estrogen levels.

Hormonal Panel

Hormones can be measured using blood, salvia, and urine.

A dried urine test can help determine how a woman breaks down hormone metabolites and assess forinflammatory estrogens (indicating issues in the estrobolome). These markers are influenced by the gut-liver axis.

Promoting Liver Health for Optimal Hormonal Health

Diet, microbiota, microbial metabolites, and bile acids all regulate metabolism and shape a healthy liver-gut axis with resultant hormonal output. Below are some tips to assist these key areas for a healthy liver and balanced hormones.

Lifestyle

Living a healthy liver lifestyle includes:

1. Avoiding toxins in food, cleaning, and personal care products

Eating organic, incorporating the “Clean 15” (produce with the least amount of pesticides), replacing plastics with glass, using natural skin care and cleaning products, and filtering your water can cut down on the chemical overload on your liver.

You may also want to consider looking up purchases prior to buying them on the Environmental Working Group’s (EWG) website which assesses their safety. (See this post for more resources on living green and clean.)

2. Moving your body

Moderate exercise has been shown to positively alter the microbiome and impact the production of beneficial metabolites which support gut health. This enhances the liver-gut axis.

3. Be mindful of certain medications

Medications can impact liver health. For example, high doses of Tylenol can be toxic to the liver.

4. Drink coffee

Studies show those who drink moderate amounts of coffee have a lower risk of liver disease. However, do not drink caffeinated coffee if you are sensitive to caffeine and/or if you are a slow metabolizer of it.

5. Get Sleep

Proper amounts of restful sleep have been found to positively modify the microbiome, improve hormone levels, and support the function and diversity of gut bacteria. This can aid in optimizing the estrobolome and promote healthy hormone clearance.

6. Avoid Too Much Stress

Excessive stress can increase levels of stress hormones, such as cortisol, which can negatively impact the ovaries and sex hormones. Stress can also impair liver function and can damage the inner lining of the intestinal wall. This is detrimental to the liver-gut axis.

Meditating, exercising, breathing techniques, journaling, and essential oils (aromatherapy) can help reduce stress levels.

Nutrition

Foods That Love Your Liver

1. Plant Foods

Eating a diet rich in green, leafy vegetables can positively influence liver detoxification and hormone metabolism.

Cruciferous vegetables such as broccoli, cauliflower, and mustard greens, contain phytonutrients (glucosinolates, which are converted to bioactive isothiocyanates) that regulate liver enzymes involved in detoxification.

Polyphenols, compounds found in fruits and vegetables, also favorably affect liver metabolism, particularly in estrogen processing.

2. Nutrient, Antioxidant-Rich Foods

Human clinical research suggests that diets that include amino acids (compounds found in protein sources), vitamins, minerals, phytochemicals, and whole foods can enhance glutathione, an essential liver enzyme. Those with higher levels of this antioxidant enzyme have been found to have a decreased risk of liver diseases compared to those with lower levels.

3. Gut Friendly Foods

Fermented, polyphenol-containing (cocoa, green tea, etc.), and fiber-rich foods help to nourish the gut microbiome and support healthy digestive function. This can help promote liver health through the liver-gut axis.

4. Low Toxin Foods

Hormones, antibiotics, and pesticides that are found in processed foods can negatively impact hormones and liver health.  Opting for a diet that is lower in chemicals, preferably organic, and rich in whole foods can help to remedy the harms of endogenous exposures that can alter hormonal levels.

Eating plant foods, as noted above, provides antioxidants, fiber, and anti-inflammatory nutrients. These have been found in studies to ward off the effects of chemical stressors and environmentally-induced diseases.

Nutrients and Supplements

Several key nutrients and supplements have been found to support liver health and protect it from inflammatory mediators during the detoxification process.

Key nutrients include:

(1) the carotenes—lycopene, B-carotene, lutein, zeaxanthin, and astaxanthin

(2) ascorbic acid (vitamin C)

(3) tocopherol (vitamin E)

(4) selenium

(5) copper

(6) zinc

(7) manganese

(8) thiols, found in garlic, onions, and cruciferous vegetables

(9) bioflavonoids

Other nutrients and herbs that may be helpful as supplements include:

(1) N-acetylcysteine (NAC)

(2) a-lipoic acid

(3) polyphenols such as those found in pomegranates, green tea, and raspberries

(4) anthocyanins found in blueberries and blackberries

(5) curcumin

(6) silymarin (milk thistle)

(7) pycnogenol

(8) coenzyme Q 10

Probiotics are also important for liver health. They have been found to prevent dysbiosis, which is linked to liver disease. For example, a meta-analysis on the use of probiotics in those with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic nonalcoholic steatohepatitis (NASH) reported improved liver enzymes, hepatic inflammation, hepatic steatosis, and hepatic fibrosis. Since the liver’s health is important for hormones, these diseases compromise hormonal balance.

Herbal Highlight

Milk thistle has clinical evidence for supporting liver health. In twenty-one clinical studies, with a total of 2,430 participants with liver pathologies, all but two studies demonstrated positive effects in those with various liver diseases. Pathologies reported to improve included cirrhosis, alcoholic liver disease, hepatitis, and psychotropic drug-induced liver damage.

Essential Oils

Some essential oils may be helpful to protect the health of our liver. These oils are high in antioxidants and have several mechanistic studies that are promising:

1. Mint oils – there are many properties of mint oils that can support overall body vitality and liver health, including its antioxidant properties.

2. Clove – a powerful antioxidant and potential metal chelator. (I wrote about its antioxidant properties and other helpful uses here.)

3. Rosemary- another potential chelator and a DNA protector, as evidenced in one in-vitro study.

4. Lemongrass – this oil has been shown to modulate phase II detoxification in the liver in vitro.

5. Fennel oil – in a rodent study, fennel oil protected their little livers from induced toxicity from a medication. It also prevented liver damage from carbon tetrachloride in another group of rats.

Summary on Supporting Liver Health for Hormonal Harmony

The liver is a key organ for a variety of body processes. There is a complex, bi-directional relationship in which the liver regulates and metabolizes hormones, and hormones influence liver function. Within this interaction, the gut microbiome aids the recycling of hormones through its connection to the liver.

Various lifestyle practices, nutrients, supplements, herbs, and essential oils can be used to optimize liver health and function. This, in turn, will also support hormonal health and overall vitality.

I hope this series has spurred to prioritize a healthier liver lifestyle!

Naturopathic Medicine and Holistic Resources for Hormonal, Mood, and Digestive Support

• Free resources and more education on essential oils and mind-body wellness are available to you here.
• An Integrative Mental Health and Stress Resource Guide.
• Tools for coping with isolation and separation.

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Many blessings.

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