97:: The hormone connection nobody is making for women! (hint: it has to do with your liver & alcohol!)

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Your liver is doing about 500

jobs right now, and filtering

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alcohol is just one of them.

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The one most women don't know about

is the more you regularly drink,

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the more estrogen that circulates,

and the more vulnerable your

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liver becomes to that next drink.

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It's a compounding cycle,

not just a one-off event.

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Alcohol doesn't just affect how you

feel the morning after like a hangover.

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It affects the hormonal environment

of your entire menstrual cycle.

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Your liver is doing about 500

jobs right now, and filtering

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alcohol is just one of them.

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The one most women don't know

about is clearing your estrogen.

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And that connection changes how

you should think about everything

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from your cycle to your skin,

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to your mood the week before your period.

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Welcome back to Wellness Books is the Pod.

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I'm your host, Dr.

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Kelsey Vic, a board certified

orthopedic doctor, physical therapy,

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and a pelvic floor physical therapist.

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And welcome back to week three

of our spring cleaning series.

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This April, we are diving into

spring cleaning, but health and

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wellness, brain and body style.

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The first week we covered the lymphatic

system, the system in charge of cleansing,

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cleaning, and your immunity for your body.

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The second week we talked about the

glymphatic system, . That's similar to

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your lymphatic system, but for your brain.

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And this week, because our brains

and sleep are so connected to our

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liver and alcohol, I decided what

better time than to dive into.

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the liver.

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Specifically today is our spring

cleaning series and the liver as it

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relates to our female physiology.

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As a general rule of thumb and an interest

of mine, I like to keep a pulse on.

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All sorts of different aspects on

the wellness industry, including

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some of the more woowoo aspects

of the wellness industry.

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And that's not a knock on the

people who promote more woowoo

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theories and woowoo techniques.

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I really do believe that those people

are sometimes ahead of the game.

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Research can take, five to 10 years

in order to become public knowledge.

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So the people who are talking about.

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All of these seemingly out there, concepts

in health and wellness are probably the

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ones that are influencing the research

and ahead of the game when it comes

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to where science has not caught up yet

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when it comes to what we believe

are certain out there things.

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I think some of these more woowoo

ideologies and the men and women promoting

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them are really at the forefront of what

is going to become the next big thing.

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And with all of this input that

I'm hearing from some of these more

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woowoo out there experts, the liver

is going to be a huge trend that

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we see over the next few years.

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From supplements to education to products,

I think the liver is going to be the next

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sort of switch that we see right now.

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I'd say it's, you know, gut

health and the gut brainin axis.

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We have been hearing so much of

that for definitely the last five

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years, maybe even the last 10.

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Gut health has been huge

and I think the next.

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Iteration of that is going to

be talking about the liver and

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what we can do for our liver.

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As a side note, I have interviewed Dr.

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Felice Chan, who is a traditional Chinese

medicine practitioner, and she talks

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about how the spleen is a very vital organ

in traditional Chinese medicine and one

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that she looks at often in her practice.

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From a western medicine perspective,

the spleen was just sort of.

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Thrown into our education, we

didn't necessarily prioritize that.

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So I'm very interested to see how

wellness culture shifts from what

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we know about the gut-brain access

and gut health to more of these.

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Just thrown in their organs that we

don't talk about nearly as much in

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western medicine education that they

might talk about even more in eastern

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medicine education, specifically

with traditional Chinese medicine.

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So I love seeing that shift and

getting to compare and contrast.

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And I know that there are surgeons

and physicians and western medicine

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practitioners who focus on the spleen

and the liver, But from a general

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standpoint, from a, a general.

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Medical professional education.

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I think the liver and the spleen are

two very slept on organs, which is

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why I wanted to cover the liver today.

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And of course, we can't talk about the

liver without also talking about alcohol.

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But I never want this

episode to sound preachy.

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I said this, I believe last week.

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I drink cocktails, I drink alcohol.

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I'm not coming at this from

a, I'm better than you.

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You should not drink alcohol standpoint.

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It's more of like, here's.

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What your liver does here is how your

female physiology affects the liver.

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Here's how alcohol influences that,

giving you that knowledge, that education,

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giving me that knowledge and education

to make informed decisions on the

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actions and behaviors that I choose

to participate in with that knowledge.

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and I think it's just a cool way

for us to learn more about another

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system in our body and our female

hormones that influence that system.

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I.

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So let's dive right in to

the male female perspective,

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specifically looking at alcohol.

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I know many of us have had that

experience where we have one drink and

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it seems to hit us harder than it does

our male friends or our male partners.

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And it's not necessarily a

tolerance issue or a body weight

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issue, although it could be.

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There's also a biological difference,

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and unfortunately, that

biological difference has real

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implications for how quickly damage

accumulates in our female bodies.

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And this is the part that

can get a little scary.

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Just like we covered last week,

women have a higher risk for

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developing Alzheimer's disease.

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Women also develop more severe cases

of alcohol associated liver disease.

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At lower levels than men.

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so let's look at some of the reasons why

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One of the reasons is

first pass metabolism.

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And you could think of this like

your body's pre-filter of alcohol.

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Before alcohol gets fully absorbed,

the stomach is supposed to take

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care of some of that filtering.

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It is supposed to pre-filter

some of that alcohol, helping us

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to break down a portion of it.

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Women's stomachs in particular

have significantly less of the

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enzyme that helps to do that.

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So our pre-processing systems are just a

little less active than our male friend

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or our boyfriend or our husband's.

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This means that our livers get

a larger, more concentrated

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load of alcohol to deal with.

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In the process of breaking down that

alcohol produces a very toxic byproduct

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that's actually more damaging to

liver cells than the alcohol itself.

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more alcohol arriving at the liver

because we don't have as much of that

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enzyme that helps us pre-filter the

alcohol in our stomach means that we have

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more of that toxic byproduct produced.

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And over time, that just compounds.

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There's also obviously

hormonal differences in how

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our bodies handle alcohol.

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Research shows that regular alcohol

use of one or more drinks per day

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is associated with elevated

estradiol levels in women.

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estrogen itself, the same

hormone being elevated

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also makes your liver more

sensitive to alcohol related damage.

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So it's twofold.

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The more you regularly drink,

the more estrogen that circulates

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and the more vulnerable your

liver becomes to that next drink.

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It's a compounding cycle,

not just a one-off event.

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There's also differences in liver immune

cell activation between men and women.

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these are called cup for cells,

but they're basically the

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immune cells of your liver.

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Their job is to scan everything

coming from the gut and neutralize

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anything that shouldn't be there.

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Alcohol does two things that

put these cells into overdrive.

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First, alcohol makes

your gut more permeable,

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meaning more bacterial byproducts

leak through the intestinal

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wall and flood the liver.

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Second, and this part is more specific.

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Estrogen makes these immune cells

more sensitive to those byproducts

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so they overreact trigger a

full on inflammatory response,

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and the liver takes collateral

damage in the process.

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And because as we mentioned before,

alcohol raises estrogen, which sensitizes

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these cup for cells, these immune cells of

the liver, which amplifies inflammation.

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It's the same compounding loop.

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Now, none of this means our bodies are

fragile as women, it just means that

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they're different and that they handle

alcohol a little bit differently.

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So we deserve knowledge and action

that is based on some of those

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biological differences and how our

bodies actually handle something

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like wine, beer, or a cocktail.

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the alcohol research that helped

to set the guidelines for alcohol

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consumption was primarily based on men.

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So it's nice to have a little bit

of knowledge on how our bodies are

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different to know how to adjust those

guidelines for our female physiology.

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Now let's dive a little bit deeper

into that hormonal liver connection.

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That connection that not a lot

of people are talking about

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the week before your period.

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When everything feels amplified, your

PMS, your bloating, your emotional

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reactivity, your moodiness, your liver

is actually a part of that story.

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It's responsible for helping to

clear estrogen from your body.

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And alcohol makes that job way

harder in ways that can actually

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show up in your menstrual cycle.

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Alcohol doesn't just affect how you

feel the morning after like a hangover.

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It affects the hormonal environment

of your entire menstrual cycle.

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The severity of PMS, the

regularity of your ovulation

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and the downstream effects on things

like your skin, your mood, and that

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second half of your menstrual cycle.

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So how does this work?

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One of the functions of the

liver is to clear estrogen.

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However, when alcohol is present,

the liver prioritizes alcohol.

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It sees it as more of a foreign invader

or a toxic compound that needs to be

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taken care of over estrogen, so it

prioritizes the metabolism of alcohol

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over that clearance of estrogen.

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Alcohol also increases the

levels of estrogen in our body.

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By stimulating the enzyme that converts

androgens like testosterone to estrogen.

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So not only does alcohol increase

estrogen, but it also deprioritizes the

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clearance of estrogen in the liver because

the liver now favors alcohol clearance

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and alcohol metabolism Over one of its

normal functions of clearing estrogen.

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So how might this present

within our bodies?

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As we've talked about before, our

menstrual cycles are cyclical.

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It is this.

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Rhythmic fluctuation and dance

between the different hormones

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within our bodies, going from high

hormone phases to low hormone phases.

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It is this song and dance throughout

our 28 day plus or minus menstrual

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cycle When this dance becomes out

of whack, we can start to experience

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menstrual cycle related challenges.

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So when the estrogen progesterone balance

starts to shift more towards estrogen

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dominance, we can start to experience

things like heavy and painful periods,

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bloating, fluid retention, mood swings.

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irritability, breast tenderness,

and sleep disturbance.

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Okay.

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And the liver is only part of the story.

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Alcohol also affects us a little

more centrally in our hormonal

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control center of the brain.

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Our brain sends signals to our

ovaries to release certain hormones

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at certain times of the month.

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Based on that delicate balance,

that delicate dance and those

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hormone fluctuations that happen

throughout our menstrual cycle,

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alcohol interferes with that signal.

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which primarily affects the

amount of progesterone produced

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in the second half of our cycle.

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which brings us back to that estrogen

and progesterone balance, where alcohol

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is not only amplifying the amount of

estrogen we have in our bodies, but

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it's also decreasing the amount of

progesterone we have in our bodies,

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which only further pushes us a little

bit more towards that estrogen dominance.

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We end up with too much estrogen

circulating because the liver is backed

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up because it's prioritizing alcohol

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and not enough progesterone being

produced because the hormonal signaling

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was disrupted from our hormonal control

center in our brain due to that alcohol.

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the estrogen piece of this puzzle

is well supported in human research.

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The progesterone and hormonal

control center in the brain

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axis is more mechanistic and

confirmed with animal studies.

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The biology makes sense.

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The animal data is consistent, so

it's not a reason to disregard.

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That mechanism in how alcohol

works in our female bodies.

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But it is a reason to say maybe that the

research suggests rather than the research

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actually proves this is happening.

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Here's something else I found

fascinating about alcohol.

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Our hormones as women, and when we

drink alcohol during the different

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phases of our menstrual cycle,

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the timing of when you drink

alcohol during your menstrual

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cycle actually matters.

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Research suggests the luteal phase

or that second half of your cycle

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is when our overall hormonal environment,

that song and Nance, between estrogen,

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progesterone is more sensitive

to alcohol's effects on estrogen.

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this is also when most women

might report drinking your blood

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sugar's a little outta whack.

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You might have more cravings.

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You might have PMS symptoms where

you turn to alcohol to help.

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So the timing of it all just compounds.

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You might be more likely to drink

during the phase of your cycle

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where the effects of alcohol

intensify on your hormonal system.

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This research is still developing.

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It's not perfectly consistent, But I

thought it was an interesting point

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to bring up as something we might be

finding in the future when it comes to

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when doctors, physicians, dieticians,

and fueling professionals actually

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educate us more on the effects

of alcohol on the female body.

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And I wanna reiterate,

this is not about fear.

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This is more just about information

and sharing research and science

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with you so that you have an idea of

why you might be feeling a certain

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way and being able to link it back.

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Oh yeah, that's right.

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I went to happy hour with my friends

a little while back, so this might

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be why I'm feeling a little bit more.

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Out of whack at this certain

time in my menstrual cycle.

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we've done a lot of episodes on

the importance of friendship and

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community and the overall importance

of friendship and community on

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our lifelong health and happiness.

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And it is actually the number

one predictor of your health

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and happiness long term Is the

quality of your relationship.

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So I know I mentioned Happy Hour and it

does relate to alcohol, but Happy Hour

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is also a way to enjoy time with friends.

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So I always try and approach some of

this education and information with a

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good amount of balance and real life,

but I wanted to throw that in there

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because I do feel like this can be.

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One of those things that people

take too far to the extreme.

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And it's something that I have

taken too far to the extreme where

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I saw the effects of alcohol on my

physiology and I would cancel any

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sort of alcohol related plans or plans

surrounding alcohol because of the

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results it would have on my physiology.

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And you can totally do that.

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But for me it was less of a balanced

mindset and more of a restrictive mindset.

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So I found that if I can.

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Approach alcohol and cocktails

in a community aspect.

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I feel better about it because

I know that this is a way that I

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can spend time with my friends.

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This is a way that I can use food and

drink to gather around a table, build

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community, build quality friendships,

versus it being something that I have

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to restrict because my female physiology

and my heart rate and all of that is

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going to freak out after one drink.

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So this education just helps me to be

more mindful of when I do drink versus

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when I don't, and actually be able to

make a choice that when I do have a

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cocktail, I know how it's affecting

my body and I'm still okay with that

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risk benefit ratio, knowing that I will

be able to build community and have,

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have fun at a happy hour with

friends, even though it is.

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Incorporating alcohol in some way.

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I can still feel good about that overall

activity without feeling so guilty

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and ashamed that I'm having alcohol.

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But it's definitely a constant

work in progress for me.

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Another component of alcohol that we've

heard is that alcohol can help you sleep.

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Wind down.

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To wind it down is a very common phrase,

and I feel like a lot of the time on

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planes, especially a lot of people will

drink alcohol or take a sleeping pill

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to help them crash out on the flight.

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Although it's technically true that

alcohol can help you get to sleep,

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it doesn't necessarily help the

quality of sleep that you have, and

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it actually can worsen the quality

of sleep that you're getting.

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It also might be why you're waking

up at 3:00 AM after having a

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few classes, Even if you don't

remember having trouble sleeping.

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So alcohol primarily affects rapid eye

movement sleep, or REM sleep And REM

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sleep is where our brain is working

on emotional memory consolidation, the

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regulation of cortisol for the next day.

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A lot of the integration of

some of the things that we've

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learned throughout the day.

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There's a lot that happens in REM sleep.

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Alcohol also disrupts slow wave sleep

in the second half of the night.

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Which, as we talked about last week,

is when the brain's glymphatic system,

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or its primary waste management and

cleansing system is primarily active.

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So if you listen to our glymphatic

episode last week, you know

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exactly why this matters.

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The people that get the best quality

of deep sleep have some of the best

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clearance of some of the markers

associated with Alzheimer's disease.

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So this deep sleep phase is

super important and alcohol

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affects that in a negative way.

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So alcohol as a sleep aid is one of the

more pervasive, I guess, wellness trends

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out there, but it is also one of the

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trends that has a lot of

misinformation around it.

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Okay, alcohol produces sedation,

not restorative sleep, and

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there's a meaningful biological

difference between those two things.

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So even one to two drinks a few

hours before bedtime meaningfully

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changes your sleep architecture.

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In ways that affect your next

day's mood, cognition, and energy.

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Even if you don't consciously register

that you had a bad night's sleep, I.

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So how can we actually support

our liver, whether it's related

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to alcohol or our hormones?

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What can we actually do with what I am

hypothesizing is the next big organ that

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a lot of people and supplement companies

and products will be targeted towards.

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Your liver should be doing its

job continuously and effectively

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and doesn't necessarily need any

of these liver detox protocols.

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If

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We can optimize the function of

our liver and what we're actually

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requiring the liver to clear out

our livers should be perfectly fine.

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There are evidence-based things we

can do to support our liver that

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don't include a $120 liver cleanse.

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Our job is to continuously support

the function of the liver of

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24 hour cleansing all the time.

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It does cleanse 24 hours a day.

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We don't necessarily need to

be giving it anything else

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that can help that cleansing.

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Our job is to support the process that

it's already doing and try to reduce what

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could possibly be burdening it, Not to

periodically shock it into a performance

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that it's already doing on its own.

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And hint a lot of these recommendations

and ways that we can support

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our liver cost almost nothing.

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Number one, cruciferous vegetables,

so things like broccoli, cauliflower,

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Brussels sprouts, kale, all

support, liver detoxification.

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In women specifically, it was found

that these cruciferous vegetables.

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Are associated with lower

pro-inflammatory markers, but overall

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fiber diversity is super important.

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Getting a lot of different.

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Food sources that have fiber as

a component is super important.

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the two other things you can do to

help support the liver are adequate

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hydration, and of course sleep quality.

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So the concept of liver cleansing

or liver detoxification through

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a supplement stack or a juice

cleanse is not a clinical category.

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The liver detoxes

continuously 24 hours a day.

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We just need to be able to do the things

that support it and reduce the things

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that we're eating or the behaviors that

we're doing that might be burdening it.

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So I hope you enjoyed this

episode on the liver Alcohol, our

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hormones, our female physiology.

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I feel like it's a fun

take to look at this.

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Oregon that not a lot of people talk

about, but I really do hear about it a

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lot from some of the more woowoo wellness

and health educators and influencers

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and business owners that I hear on

different podcasts or substack articles

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but they all seem to think the liver

will be the next thing that we all start

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to care about, just like we all are.

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Becoming more and more aware of our

gut health and the gut brain access,

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and all of the things that current

supplements and culture are promoting

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in the wellness industry.

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So thank you for listening.

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I hope you enjoyed this episode, and

I'll see you guys next week As we

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talk about spring cleaning, the system

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that is in charge of why you

pick up your phone, out of habit

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and just start scrolling without

actually realizing you're doing it.

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So I'll see you next week on Wellness Fix.

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Is the pod okay?