• Pears vs. Apples – Eat Right for Your Estrogen and Insulin
Posted by Joseph F. McWherter, MD on August 19, 2013
“Does estrogen replacement cause weight gain?”
This is a question I’m frequently asked. The question arises most often as a result of the sudden weight gain around the midsection that begins with the onset of menopause. Is the “mid” in mid-life synonymous for “mid-drift bulge”?
We commonly describe the mid-life body shape changes as that of a curvaceous “pear” transforming into a bulging-waisted “apple”. How often I hear of the 5 to 10 pounds per year increase which leave many women weighing more than at the time of their pregnancy! Since many women start hormone replacement at menopause, an association often is made between hormone or estrogen replacement therapy and the sudden unwanted accumulation of midsection visceral adipose tissue fat (VAT).
“Did my estrogen replacement cream cause me to gain (VAT) weight around my waist?”
The answer is no. Excessive levels of estrogen, such as those found in older forms of birth control pills and in pregnancy, result in an increase in “pear” (hips and breast) shaped fat deposition, not an apple waistline. Starting menopausal estrogen replacement can result in certain tissues such as in the breasts to experience rapid fluid overload, which may manifest as swelling and water weight. This is temporary and does not involve waistline expansion; it may result in an increase in overall body weight. Occasionally, a woman will complain of bloating (waist expansion) after starting replacement therapy. Most often this results from excessive yeast overgrowth in the intestines, which resolves with improved diet and supplements containing oreganol, rosemary, and clove oils.
The underlying causation for mid-life weight gain (which actually is multi-factorial) primarily resides with insulin mediated hypoglycemia resulting from eating excessive amounts of grains or sugar. Eating these foods spikes your insulin levels, leading to a reactive hypoglycemia (low blood sugar – manifested by feeling sleepy, tired, having a foggy memory, a racing heart, or being flushed one to two hours after eating). This causes a woman to become a “winterized” polar bear that stores but does not burn.
Estrogen plays a pivotal role in maintaining insulin sensitivity, which prevents food-induced hypoglycemia thwarting the apple deposition of fat. The sudden loss of estrogen at the time of menopause worsens insulin resistance and makes a woman more sensitive to weight gain after eating grains and sugar. Estrogen deficiency (low levels in menopause) promotes obesity, type 2 diabetes, and metabolic syndrome – large waistline, high triglycerides, low HDL (good cholesterol), high blood pressure, and elevated fasting blood sugar. I recommend the use of transdermal estrogen replacement to my patients as a factor in the best weight control.
A recent article in the highly-respected Endocrine Reviews discussed the role of estrogens in controlling energy balance and glucose levels. Estrogen – which is part of our hormone replacement program – acts in your skeletal muscles (so always add weight training to your exercise program, along with testosterone balancing), liver (it is best to keep the liver detoxed – I recommend Intest Restore), adipose tissues (the fat cells kept to minimum levels with Paleo diet and chewing your food well), and immune cells (avoid gluten, cow’s milk and other potential allergens, take a 24 hours news fast, smile at least eight times a day) to reduce the accumulation of fat and lower chronic inflammation.
Other hormones, such as elevated cortisol and lowered thyroid levels, have also been implicated in weight gain. Cortisol levels reside inside the cell, not the bloodstream. Elevated cortisol levels originate from insulin dysregulation as discussed above. A slowing of metabolism often attributed to the thyroid occurs with aging but can be corrected by following this FEM Centre program:
- Control of and diminishing chronic inflammation
- Results in weight reduction and regulation
- Balance hormones: examples include measuring serum Testosterone, DHEAS, TSH, Free T3, Free T4, Estrogens, Progesterone, IGF-1, Pregnenolone, Vit D 25OH, HgA1C and salivary Cortisol.
- Detoxification: stabilize the extracellular matrix, maintain alkalinity, insulin regulation.
- Results in weight reduction and regulation
Accomplish with Long Term Compliance:
- Moderate persistent supplementation
Regardless of what diet plan you decide upon, your waist line circumference( a better way to assess excessive fat accumulation) depends upon the hormonal balancing of insulin and estrogen. Remember – “Eat Right for Your Estrogen and Insulin”.