EP.269/ Listener question: are flaxseeds bad for endo?
Listener question: “Is flaxseed good or bad for endo? There is so much mixed info out there about it around increasing / decreasing eostrogen. Is there a better type of flaxseed - oil, roasted seeds, ground seeds, tablets high in flax?”
Okay, I’m glad you asked this question because it comes up a lot and it’s not a straightforward answer.
Flax is a type of phytoestrogen. A phytoestrogen is a type of plant compound which chemically is similar to oestrogen but isn’t a form of oestrogen and due to the similar structures, phytoestrogens can bind to oestrogen receptors in the body.
When people hear this, they worry and think that means that it’ll increase oestrogen levels, when typically, the opposite is true. Phytoestrogens do not have the same strength as oestrogen, their oestrogenic effects are much weaker than oestrogen, so in theory, by binding to an oestrogen receptor, they are blocking real oestrogen levels, which is great if you’re someone who struggles with oestrogen dominance or high oestrogen levels.
Additionally, flax seeds are rich in fibre and are also an evidence-based tool for constipation. When it comes to keeping oestrogen in check, one of the key things we want to ensure is daily bowel movements, because our body disposes of old and excess oestrogen through bowel movements, and this process needs to happen daily. When we are not having sufficient bowel movements, our body can actually reabsorb the oestrogen and reuse it, resulting in higher oestrogen levels.
One study showed that the participants who consumed flax seeds for three cycles had longer luteal phases and a higher progesterone to oestrogen ratio in the luteal phase as well. We know that oestrogen dominance is due to oestrogen being higher than progesterone in the luteal phase, when it should be the other way round – to be clear, that doesn’t mean you automatically have oestrogen levels that are too high, you could have low oestrogen levels but even lower progesterone. We also know that low levels of progesterone or oestrogen dominance in the luteal phase can result in shorter cycles. So, for those of us who struggle with oestrogen dominance symptoms like PMS, flax seeds could be really helpful.
Finally – a nice bonus is there is research that phytoestrogens can be protective against certain types of oestrogenic cancers like breast cancer and they are one of the richest sources of polyphenols on the planet, which are types of plant chemicals that particularly beneficial to our gut microbiome and overall health.
Clinically, we see varying results. For some people, flax works really well and actually helps to improve symptom such as reduced premenstrual cramping, lighter periods, less pain, less bloating pre-period, reduced or completely eradicated breast tenderness, etc. and this is true for many - actually the majority - of my clients.
However, everyone responds differently, and we also see that some people feel worse on flax seeds, or when they eat them often or in high amounts, at least. They find they have worsening oestrogen dominance symptoms and potentially their endo symptoms worsen as a result.
Now, there are a few things to consider here. The first thing to think about is whether the flax seeds are fresh. Flax seeds contain a type of fat that can oxidise (essentially go bad) very easily when exposed to air, heat or light, and when this fat changes, it can become inflammatory. If you’re eating lots of flax from a pre-ground pack in the cupboard, chances are, it’s not going to be as good for you.
Instead, the way we use it in my training, is freshly ground, daily, with the whole seeds kept in the fridge (and then you just grind them in a coffee or spice grinder before use).
So, it could be that if you’ve reacted badly to flax, that you may have not been consuming the best quality flax and in fact, you were increasing your inflammation levels.
But, on the flip side, everybody is different and we do see that some people find flax and soy to be particularly bothersome for their oestrogen symptoms or endo. There is the chance that these people have low levels of oestrogen and so adding phytoestrogens ‘wakes’ things up a bit and can perhaps cause some discomfort, but I have no data for that – this is just a theory. We do see that some people who struggle with low oestrogen levels or anovulation (lack of ovulation) experience improvements with flax, and in fact, the study I mentioned earlier did show decreased anovulatory cycles in the group who consumed flax, but it did not show an increase in oestrogen levels. Having said that, phytoestrogens are not real oestrogen, so perhaps the flax was improving oestrogenic activity like ovulation because it was binding to oestrogen receptors, but not actually raising oestrogen levels. Considering this, if you do suffer with low oestrogen levels, you want to get to the root cause behind it, because even though flax may improvement symptoms, it may not actually be improving your oestrogen levels directly.
If you’re curious about flax seeds, my recommendation would be to just try them slowly and notice how your body responds. Use the best quality, so buy them whole and keep them in the fridge and grind them fresh (if you eat them whole, you won’t absorb them) and just observe your symptoms. One way to try them is in seed cycling, which uses a combination of sesame, pumpkin, flax and sunflower to support healthier cycles and fewer symptoms, and there was recently a really promising study showing hormonal improvements with seed cycling in those with PCOS, which affects many people with endo. With seed cycling, we do typically need to continue it for three cycles to see the positive results, and I have provided further reading and resources in the show notes.
However, if you notice worsening symptoms, you can just stop whenever you like. Due to the weaker effects of phytoestrogens, whilst I can’t guarantee this, it’s very unlikely that they’re going to actually trigger any endo growth etc. so I wouldn’t get too anxious about that, but they may just worsen symptoms if you’re one of those who don’t respond well to it.
So, the short answer is, it depends. The best way to see if flax is for you, is to try it!
Show Notes:
Flax:
https://pubmed.ncbi.nlm.nih.gov/8077314/
https://pubmed.ncbi.nlm.nih.gov/32047868/
https://pubmed.ncbi.nlm.nih.gov/15702593/
https://www.sciencedirect.com/science/article/abs/pii/S1570023202002817?via%3Dihub
https://www.researchgate.net/figure/Polyphenol-and-antioxidant-content-in-the-100-richest-foods-mg-per-100-g-or-mg-per-100_tbl1_47661728
Seed cycling:
https://helloclue.com/articles/culture/seed-cycling-i-tried-it-and-dug-into-the-research-on-whether-it-works
Nicole Jardim’s seed cycling guide
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