01/24/2026
Bile salts help the body get rid of estrogen by carrying it out through the gut.
If that process gets disrupted, estrogen can be reabsorbed instead of eliminated, contributing to estrogen dominance symptoms.
Let’s walk it through step by step.
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1. Estrogen metabolism starts in the liver
Estrogen (from your ovaries, fat tissue, or external sources) circulates in the blood. When it’s time to clear it:
• The liver chemically modifies estrogen (Phase I + Phase II detox).
• One key Phase II step is conjugation — estrogen is attached to molecules (like glucuronic acid or sulfate) to make it water-soluble and inactive.
At this point, estrogen is neutralized but not yet out of the body.
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2. Bile salts are the transport system
• The liver packages this conjugated estrogen into bile.
• Bile contains bile salts, which are made from cholesterol.
• Bile is released into the small intestine to help digest fats — and carry waste hormones with it.
Think of bile salts as the garbage trucks for fat-soluble toxins and hormones.
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3. What should happen next (ideal scenario)
• Conjugated estrogen travels through the intestines.
• It stays bound.
• It exits the body via f***s.
✅ Estrogen cleared. Balance maintained.
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4. Where things can go wrong: reabsorption
Here’s the key problem area.
Certain gut bacteria produce an enzyme called β-glucuronidase.
• This enzyme can unbind (deconjugate) estrogen.
• Once unbound, estrogen becomes active again.
• Active estrogen can be reabsorbed through the intestinal wall and sent back into circulation.
This recycling loop is called enterohepatic recirculation.
So instead of leaving the body, estrogen keeps doing laps.
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5. The role of bile salts in preventing reabsorption
Healthy bile flow helps because:
• Adequate bile keeps estrogen moving forward through the gut.
• Bile salts help prevent stagnation and constipation.
• They support fat digestion, which improves overall hormone clearance.
Low bile flow (from liver congestion, gallbladder issues, very low-fat diets, or chronic stress) increases the chance estrogen will be reabsorbed.
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6. Supporting estrogen clearance (mechanisms, not advice)
Physiologically, estrogen clearance works best when you have:
• Healthy bile production and flow
• Balanced gut microbiome (less excess β-glucuronidase)
• Regular bowel movements (so estrogen doesn’t sit too long)
• Adequate dietary fiber, which binds estrogen in the gut
• Functional liver conjugation pathways
This is why digestion, liver health, and hormones are deeply connected.
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One-sentence summary
Bile salts es**rt conjugated estrogen from the liver into the gut for elimination; if bile flow or gut balance is impaired, estrogen can be deconjugated, reabsorbed, and recycled instead of cleared.