Laboratory, Endocrine, & Neurotransmitter Symposium

August 28-30, 2020

Bellevue, WA

Gain additional clinical insight and treatment considerations to evaluate some of the most prevalent and challenging conditions that patients present with, including depression, anxiety, altered mental focus and stamina, sexual dysfunction, sleep disturbances, addictions and dependencies, weight management, and chronic disease. Register today!

 

Wellness Wednesday

Webinar Series

Comprehensive Hormone Health for Women

By: Laura Neville, ND

March 4th, 2020

Join our clinical staff and special guests on the first Wednesday of every month at 9:30 AM and 12:00 PM PST. This free, live webinar series will cover a variety of neuroendocrine topics that will enhance your knowledge, with clinically applicable testing and treatment considerations.

In this month's webinar, you will review the role of major hormones, gain state of the art testing and assessment strategies, and discover research and literature supporting use of natural hormone balancing therapies. Attendees will also be treated to relevant cases and clinical pearls. Sign up today!

 

IHS

New York, NY:

February 20-22, 2020

We will be in the Big Apple this month for the Integrative Healthcare Symposium. Learn about the new GI360TM profile and how our testing can help your practice.

 

CNDA

Palm Springs, CA:

February 28 - March 1, 2020

Come join us in warm and sunny Palm Springs for the CNDA conference. Chat with our booth representative, Geneva Olson, to learn what's new at both companies.

 

Belly Fat: A dangerous place for unwanted pounds | 2/4/2020

Urinary Neurotransmitter Testing: Spot vs 24 hour collections | 1/22/2020

The Role of the Gut Microbiota in the Development of Autoimmune Diseases | 12/17/2019

Glycine: Another Tool for the Hormone and Sleep Balancing Kit | 12/04/2019

Microbiota-Gut-Brain Axis: Behavior and Dementia Implications | 11/12/2019

Estrogen and Brain Function: Mental Clarity Through Menopause | 10/29/2019

Irritable Bowel Syndrome: Microbial Profiling and Fecal Microbiota Transplantation | 10/16/2019

Gut-Brain Axis: An Evolving Understanding of Depression and Anxiety | 10/01/2019

GI Microbial Profiling and Hypertension | 9/18/2019

Cannabidiol and Neurotransmitters | 9/03/2019

Russian roulette with certain gadolinium “bullets”? | 8/20/2019

Seasonal Shifts and Sleep Quality | 8/06/2019

Is Stress Affecting Your Microbiome? | 7/23/2019

Secretory IgA and Oral Health | 7/09/2019

Sensitivity and Specificity | 6/25/2019

World Health Organization Recognizes Burnout as a Legitimate Syndrome | 6/11/2019

The Green Drink Conundrum: Potential Thallium Exposure and Neurological Risks | 5/29/2019

Monitoring HPA axis when treating inflammatory conditions | 5/14/2019

Potential Systemic Toxic Effects of Cobalt from Hip Prostheses | 4/30/2019

Coffee, Estrogen and Health: What's the consensus?

 

By Laura Neville, ND | February 18, 2020

It's one of the most compelling questions in the field of health. Is coffee healthy or unhealthy? Coffee lovers delight in the multitude of studies which support its health benefits, while ex-coffee drinkers describe how great it is to live on the other side of dependency. Non-coffee drinkers often find the anxiety producing effect or the bitter taste to be unbearable.   

The majority of research alludes to health benefits, though some studies offer conflicting results, which has led to research into each biologically active compound. Coffee contains hundreds of biologically active compounds (acids, carbohydrates, lignins, minerals, nitrogenous compounds, caramelized products, lipids, and volatile compounds), which all have different human health impacts. 

In particular, coffee is known to have estrogenic activity. In fact, this was documented over 80 years ago! Although estrogen's action on the reproductive tract, mammary glands, and ovaries is well acknowledged, it should also be noted that estrogen effects other areas of the body such as the bone, nervous system, heart, and brain.  

Summary of general beneficial health findings:  

  • An inverse association between coffee consumption of 3-4 cups/day and all-cause mortality has been observed.   
  • Coffee appears to lower the risk of cardiovascular disease, congestive heart failure, hypertension, neurodegenerative disease, liver disease, inflammatory disease, and cancer.  
  • Therapeutic improvements in diabetes, metabolic syndrome, depression, obesity and asthma have been observed.  
  • Coffee consumption has been correlated with slowing the progression of sarcopenia and promoting the regeneration of injured muscle.  
  • A meta-analysis found an inverse association of coffee/caffeine with breast cancer risk in postmenopausal women.  
  • Several studies indicate that caffeine consumption reduces the relative risk of various cancers. 

Summary of beneficial health findings, specific to estrogenic activity of coffee constituents:  

  • Some of the constituents found in coffee (caffeic acid, chlorogenic acid, and vanilic acid) have estrogenic activity and have shown promising potential applications for bone protection and in the treatment of osteoporosis.  
  • Nicotinic acid shows estrogenic potential and is correlated with protection of the cardiovascular system. 
  • Caffeic acid, caffeic acid phenethyl ester (reported to act similarly to a SERM), ferulic acid (also found in black cohosh), sinapic acid, stigmasterol, and theophylline demonstrate estrogenic action and may prove beneficial in the relief of menopausal symptoms.  
  • Caffeine, gallate (octyl), serotonin, beta-sitosterol, and gamma-tocotrienol show mostly estrogenic action and seem to offer neuroprotection.  

While there are many studies that support coffee's health benefits, there are also studies to suggest negative health effects. 

Summary of deleterious general health findings:   

  • Coffee can increase the risk of anxiety, insomnia, headaches, tremors, and palpitations, especially in heavy users.   
  • There is evidence that coffee can increase blood pressure in hypertensive individuals for approximately 3 hours after consumption; however, current evidence does not support an association between longer-term coffee consumption and increased blood pressure or between habitual coffee consumption and an increased risk of CVD in those with hypertension. 
  • High coffee consumption (4+ cups daily) was associated with a small reduction the bone density of women, but that did not translate into an increased risk of fracture. 
  • Coffee has shown to increase risk of low birth weight, and preterm birth during pregnancy in a dose dependent fashion.  

Summary of deleterious health findings, specific to estrogenic activity of coffee constituents:   

  • Caffeic acid at low doses and trigonelline seem to exert unfavorable effects on bone, though it is thought that low estrogen levels are a prerequisite. 
  • Trigonelline, a natural component in green coffee beans and other unidentified compounds, was found to be mutagenic, especially after roasting.  
  • Excessive estrogen can potentially cause endocrine disruption, and reproductive dysfunction. Such effects were reported for coffee extracts, hippuric acid, humic acid, lecithin, and β-sitosterol.  
  • Acrylaminde, a substance formed during the roasting process at high temperatures in the Maillard reaction, may have carcinogenic activity.  

The health effects of coffee can be traced back to each biologically active compound such as caffeine and its constituents. Though the research specific to estrogenic activity is interesting, it is likely premature to gain any solid clinical implications from it.  

To make matters more complex, estrogenic coffee constituents may exert additional activities (other than just the estrogen activity). Consideration should also be given to the coffee species, roasting degree, brewing method, serving size, and any added substances such as milk and sugar, which may all have additional health effects. 

Coffee consumption is generally safe within usual levels of intake, with estimates indicating the largest risk reduction for various health outcomes at three to four cups each day (300-400 mg/d of caffeine), and more likely to benefit health than harm. However, some groups, including those with hypertension or anxiety, for example, may be more vulnerable to the adverse effects of caffeine. In addition, evidence suggests that it may be prudent for pregnant women to limit coffee consumption to 3 cups/d providing no more than 300 mg/d of caffeine. Women at increased risk of fracture (possibly due to low estrogen levels), may also be more vulnerable than the general population.  

Patients may seek diet and lifestyle advice following various laboratory testing findings. Practitioners can consider this article to summarize recent studies on coffee's health effects. It is important to remember that though coffee contains constituents with estrogenic activity, this will not directly result in salivary estrogen level changes. Also, remember that coffee may impact cortisol and epinephrine levels. 

 

References

Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ. 2018;360:k194. 

Cornelis MC. The Impact of Caffeine and Coffee on Human Health. Nutrients. 2019;11(2) 

Hallström H, Byberg L, Glynn A, Lemming EW, Wolk A, Michaëlsson K. Long-term coffee consumption in relation to fracture risk and bone mineral density in women. Am J Epidemiol. 2013;178(6):898-909. 

Kitts DD. Studies on the estrogenic activity of a coffee extract. J Toxicol Environ Health. 1987;20(1-2):37-49. 

Kiyama R. Estrogenic Activity of Coffee Constituents. Nutrients. 2019;11(6) 

Mesas AE, Leon-muñoz LM, Rodriguez-artalejo F, Lopez-garcia E. The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: a systematic review and meta-analysis. Am J Clin Nutr. 2011;94(4):1113-26. 

Venkata charan tej GN, Neogi K, Verma SS, Chandra gupta S, Nayak PK. Caffeine-enhanced anti-tumor immune response through decreased expression of PD1 on infiltrated cytotoxic T lymphocytes. Eur J Pharmacol. 2019;859:172538. 

Wu X., Skog K., Jägerstad M. Trigonelline, a naturally occurring constituent of green coffee beans behind the mutagenic activity of roasted coffee? Mutat. Res. 1997;391:171–177.