The Liver-Hormone Connection

The liver wants you to know that it’s kind of a really big deal. It is the largest gland in the body, carries out over 500 essential bodily tasks, and is the only organ with the capacity to regenerate. It lives above and to the right of the stomach and below the lungs and weighs about 3.5 pounds, the second largest organ after your skin.1

And if that’s not impressive enough, your liver also has contact with everything you eat, drink, breathe, or absorb into your bloodstream. It functions primarily as the body’s detox mechanism, making it critical to your overall health, including proper metabolism and hormone function.2 Of course if you’ve been following my blog, you’re already aware of these facts as well as what happens when the liver isn’t doing it’s job. Today we’re going to specifically focus on the liver’s role in hormone function and what that means for those of us with thyroid dysfunction.

The Liver-Gut-Thyroid Connection

There are many different players in the T4 (inactive thyroid hormone) to T3 conversion. Approximately 20% of this conversion occurs in the gut via intestinal sulfatase. Leaky gut will interrupt this conversion process and cause T3 levels to be lower than normal.3 Similarly, the liver also accounts for 20% of this conversion from T4 to T3. If the liver is not functioning appropriately, it will not only decrease the conversion process, but it will also decrease the ability of the body to process and eliminate environmental toxins, causing an influx of toxins to remain in the body and affect other vital organs, including the thyroid. This could elevate thyroid autoimmunity conditions, such as Hashimoto’s.4 I go into T4 to T3 conversion in great detail along with giving you a way to increase your T3 levels in my book The 30-Day Thyroid Reset Plan.

Estrogen Clearance

Now we’re going to leave the liver for a just a moment.  Ladies, please join me on this brief intermission to discuss our primary sex hormone. Estrogen clearance is the ability of the body to break down estrogen and eliminate it from the body.  This may sound like the liver’s job, and yes, that means you at least read from the beginning to this point! Estrogen that is not metabolized effectively and removed can become highly toxic.5

Estrogen Dominance

I am not talking about the strong, independent women that I know you all are here. Estrogen dominance actually refers to elevated levels of estrogen or hormone imbalances that can occur in both men (testosterone/estrogen) and women (progesterone/estrogen). Common symptoms of estrogen dominance in females are: thyroid dysfunction/nodules, decreased libido, irregular menses, breast tenderness, fibrocystic breasts, fogginess, insomnia, fatigue, weight gain, irritability, depression, cellulite, headaches (usually related to PMS), and decreased metabolism.   Men also may experience some of the above symptoms, but may also notice larger hips, breast development, and mood changes, including excessive crying, and decreased testosterone.5

Factors That Contribute To Estrogen Dominance

Unfortunately, our modern lifestyle tends to lend itself to estrogen dominance.  Chronic stress, obesity, poor diet, lack of exercise, use of contraceptives/hormone replacement therapy,  environmental estrogen and more can all lead to elevated estrogen and/or hormone imbalances.

Chronic Stress

The adrenal glands are the primary player in the endocrine system related to our ability to handle stress by releasing cortisol (stress hormone) into the bloodstream. Prolonged, elevated cortisol levels guarantees that the liver is unable to discard and eliminate estrogen effectively. Elevated cortisol also leads to the depletion of progesterone via a process called “pregnenolone steal.”  Pregnenolone, a precursor hormone to progesterone, is redirected from sex hormone production to be used to make more stress hormone. This increase in estrogen caused by liver dysfunction combined with a decrease in progesterone will lead to signs and symptoms of estrogen dominance.5 This can all be brought on by stressful events like being unhappy in your job, unhappy in your relationship, or even having stress that is not emotionally driven like gut infections, viruses and more .

Body Fat and Obesity

Along these same lines, fat cells have an enzyme that can convert cortisol into estrogen – estrogen is stored in fat. When you lose weight, there will be more estrogen in your bloodstream, causing a temporary estrogen dominance until your liver can clear it out. In men, an enzyme in body fat called aromatase, converts testosterone into estrogen. Elevated body fat levels results in increased aromatase and therefore, increased estrogen levels.5

Poor Diet

Unfortunately, heading to the middle of the grocery store and loading up on boxed and processed foods increases levels of substances that mimic estrogen function, which results in elevated estrogen levels.6 Similarly, eating habits, such as skipping breakfast and plentiful sugar and caffeine all day long, also affect our ability to manage stress and will likely result in an estrogen-dominant state.  If you skipped “Chronic Stress” above, now would be a good time to head on back up the page!  Caffeine in general increases estrogen release and causes depletion of magnesium, vitamin C, and vitamin B, which are key nutrients in liver function for eliminating toxic substances from the bloodstream.5

Lack of exercise

Exercising regularly improves estrogen clearance by increasing metabolism, minimizing fat storage, balancing blood sugar levels (improving our ability to cope with stress), and decreasing risk of breast cancer. Lack of exercise can also result in increased risk of depression, weight gain, decreased digestive function, and decreased energy, in addition to putting us at more risk for estrogen dominance.5

Hormone Replacement Therapy

Conventional hormone replacement therapy typically prescribes estrogen-only hormone supplementation without the addition of progesterone. If you’re absolutely looking to stay in an estrogen-dominant state, then this is a really simple way to do it! But before you do, please see the symptom list of estrogen dominance above. It is very important that you decide on the appropriate hormone combination for you, so before trying anything, consult with a healthcare professional that can help you make the best choice for your body, especially if you are also dealing with thyroid concerns.5

Environmental Estrogens

Xenoestrogens are chemicals that are found in our environment that mimic estrogen once in our body, giving our liver a big time job, especially if we also are stressed, don’t have time to cook or exercise, and aren’t at an appropriate BMI. Constant exposure to these xenoestrogenic compounds will inhibit our body from clearing excess estrogen effectively.  There are many industrial chemicals, including plastics, especially when exposed to heat or acid, household products (fabric softeners, cleaning products), personal hygiene products (nail polish remover, surfactants found in condoms and contraceptive gels), and some makeup/perfumes that will function as estrogen once in our bodies. Heavy metal accumulation is something else to be considered.  Mercury, lead, and aluminum in excess, like what is found in tooth fillings, cans, and processed foods, can block liver function and result is poor toxin filtration and higher estrogen concentration in the blood.5,6


Estrogen and Thyroid Function

You guessed it: too much estrogen has an affect on the delicate thyroid gland.  Increased estrogen creates too many thyroid binding globulin proteins (TBG), which is the protein that transports thyroid hormones throughout the body via the bloodstream. Thyroid hormones bind to the excess TBG, resulting in a deficit of thyroid hormones to be used by the cells, which will present like a hypothyroidism. Thyroid dysfunction also results in inappropriate amounts of sex hormones being produced.5

The Role of the Liver in Estrogen Clearance

In order to properly eliminate excess estrogen from the bloodstream, the estrogen must be made water-soluble so it can be excreted via perspiration, urine, or feces. There are two pathways in the liver that will make this happen:

        Phase I pathway—A fat-soluble molecule (so estrogen in this case) enters the liver.  The liver modifies the chemical structure of the molecule in order to prepare it for excretion.

        Phase II pathway—Additional molecules are added to the modified compound from Phase 1 so it can be excreted safely.

If these pathways are not working effectively, then estrogen will circulate back into the bloodstream in a more toxic form, unable to be cleared.5

Liver Love

        And sometimes, no matter what you try, your body just needs a little additional support to achieve better liver-gut-thyroid harmony. I recommend Liver Love as a supplement to anyone struggling with thyroid imbalances, autoimmune conditions, elevated cortisol, poor blood sugar control, sluggish gut function, or any other liver or kidney conditions.  It is a synergistic formula designed to support healthy liver function. It contains a blend of botanicals and mushroom extracts, as well as N-acetyl-L-cysteine and milk thistle, both of which have powerful antioxidant and liver-protective functions.



        This is a precursor to a powerful antioxidant, which neutralizes free radicals and prevents toxin buildup.7 NAC has been shown to improve insulin sensitivity and help avoid post-meal spikes and crashes in blood sugar, which can assist your body in promoting a healthy stress response. Because of this, NAC also has a function in preventing autoimmune issues.8

        Milk Thistle

 Milk thistle contains a powerful antioxidant compound known as silymarin.  One study determined that silymarin increased gluthathione (the precursor for this is NAC) content in the intestines and liver by up to 50%.9  Salymarin also protects the body from gamma radiation, which can be a major risk factor in certain cancers and thyroid conditions.10

Do It For Your Liver!

 I think people sometimes just assume managing stress, eating healthy, and exercising are to avoid weight gain. But now, we can agree that it is so much more than that. There are so many factors you can control related to your hormone and thyroid health.  Take Debby (please note: she is made up). Debby is a full-time lawyer with 3 kids with diagnosed hypothyroidism. She is stressed out of her mind (+1 estrogen, chronic stress) and has been for 3 weeks since she started working on a particular case the same week her 16 year old kid got suspended from school. She has been trying to come home from work to work more while also trying to help her 11 year old with her homework, resulting in her eating cans of Chef Boyardi for dinner (+2 estrogen, poor diet and environmental estrogen). She barely has time to cook, much less exercise—the last time she stepped foot in a gym was in 1984 (+1 estrogen, lack of exercise). She’s been feeling tired all the time too, even after attempting some thyroid-specific treatments, but recently was just placed on synthetic estrogen because she is also premenopausal (+1 estrogen, because she’s taking more estrogen than she can possibly get rid of!). She’s continued to gain weight (+1 estrogen, estrogen stored in body fat). Do you think poor Debby has an estrogen dominance?!  Obviously, this is an extreme example, but think about how all those small little things can add up into a huge and overwhelming problem that affects your whole body and quality of life. It may be time for Debby to get herself some Liver Love (+1 Debby)!



  1. Newman, T. Accessed 2/2/18.
  2. Women’s International Pharmacy. The Liver’s Role in Hormone Imbalance. Accessed 2/2/18.
  3.  Ebert, E.C. The thyroid and the gut. J Clin Gastroenterol. 2010 Jul;44(6):402-6. doi: 10.1097/MCG.0b013e3181d6bc3e.
  4.  Huang, M.J, Liaw, Y.F. Clinical associations between thyroid and liver diseases. J Gastroenterol Hepatol. 1995 May-June;10(3):344-50.
  5. Dr. K News. Hormonal imbalances? Estrogen clearance is vital to healthy hormone function. Accessed 2/2/18.
  6. Dr. Jockers. Accessed 2/2/18.
  7. Kerksick, C., Willoughby, D. The Antioxidant Role of Gluthathione and N-Acetyl-Cysteine Supplements and Exercise-Induced Oxidative Stress. J. Int Soc Sports Nutr. 2005;2(2):38-44.
  8. Dr. Jockers. Thyro-Liver Protect. Accessed 2/2/18.
  9. Valenzuela, A., Aspillaga, M., Vial, S., Guerra, R. Selectivity of silymarin on the increase of the glutathione content in different tissues of the rat. Planta Med. 1989 Oct;55(5):420-2.
  10.  Adhikari, M., Arora, R. The flavonolignan-silymarin protects enzymatic, hematological, and immune system against γ-radiation-induced toxicity. Environ Toxicol. 2016 jun;31(6):641-54. doi: 10.1002/tox.22076. Epub 2014 Nov 20.

        * These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using this product.




Hi, I am Dr. Becky Campbell. I work with men and women who’ve had a health set back and are willing to do whatever it takes to reach optimal health so they can perform their best in their careers and be fully present with their family again.

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