Some research has shown DIM may affect blood sugar levels. seaseme and suflower seeds? Brenda Wesa, Calgary. This explains why many women either feel their symptoms of ED lift for a few weeks, and then start feeling worse. Endometriosis, defined as the presence of endometrial glands and stroma outside of the uterine cavity, develops mostly in women of reproductive age and regresses after menopause or ovariectomy, suggesting that the growth is estrogen-dependent. In fact, a lot of women struggle with this issue and dont even realize that it is something to be aware of. Please feel free to reach out to [emailprotected] for additional support. Plus, I3C, in the process of helping the 2:16 estrogen metabolism, also increases the 4 hydroxy estrone which has been linked to breast, ovarian, and uterine cancers. Broccoli sprouts and sulforaphane content. The Elimination Diet is the best diet to start with according to Magdalena. They work on a strict regime requiring all hormones to be at certain levels in order to function properly. Healthy regards, HB team, [] Best Supplements for Estrogen Dominance HormonesBalance.com [], We have not had any reports on DIM causing dry skin. Hawaiian Spirulina - rich in beta carotene, vitamin B12, and a variety of minerals and esential amino acids, this species of spirulina has anti tumor properties, and . Please feel free to reach out to [emailprotected] for further support. Urine and saliva hormone labs can give us a complete overview of how well your hormones are functioning. ), and metabolite imbalance (glucose, lipid etc. The symptoms range from lumpy and fibrocystic breasts to thyroid nodules, hot flashes, fibroids, uterine polyps, painful, heavy or irregular periods to infertility and miscarriages, from mood swings to insomnia, weight gain to fatigue. My daughter is 25 and suffers from acne and very painful periods. ~ HB Support. Although hormone levels might be within the normal range, estrogen dominance occurs when the level of estrogen is relatively high compared to the level of progesterone and/or testosterone. It can be very hard to completely avoid estrogen excess, because we are surrounded by endocrine . Supplements such as vitamin D, calcium, and turmeric may also be beneficial. There are two cases where estrogen dominance shows up: Estrogen levels are normal, but progesterone is low. Catt Sadler: Using Radical Pain To Heal, Gender Pay Disparity, Career Changes & Personal Pivots, What Is Liposomal Vitamin C? At 65 should I stop using the progesterone completely? Side effects and downsides Although spirulina. If you need more ideas, read, Olsson, Erik M et al. Its the estrogen metabolites (I call them the dirty estrogens) that cause it not too much overall estrogen. Im unsure of which part of the article youre referring to? This product is not intended to diagnose, treat, cure or prevent any disease. The role of diidolylmethane aka DIM can reduce the antagonistic estrogen responsible for cancer growth you may be interested in checkout out this study: https://www.ncbi.nlm.nih.gov/pubmed/15623462, Hope this helps! Lots of the info above has the source linked for further reading, just click the highlighted word. 2. Sulforaphane supplements are not made equal (what to look for). Not to mention that crucifers help to detox the liver which is fundamental to thyroid health as well as estrogen metabolism. Both women and men produce many different forms of estrogen. This condition is often misunderstood because it can occur both men and women, who can have either low, normal, or excessive estrogen levels. If you are experiencing any of these symptoms, the best way to know for certain is through lab testing. How will I find similar products to the ones you recommend? I have been on DIM for several months & felt decent, better periods also. Estrogen dominance is all too common for women these days. I spent the next 3 days feeling like I have the flu (die-off?) B vitamins act as fuel for methylation and help boost your bodys ability to detox and break down estrogen. Had breast ca. We are hoping you have found some answers for your daughter. Healthy Regards, I have Invasive Lobular carcinoma driven by estrogen. Estrogen dominance is a type of hormonal imbalance in which the body produces too much estrogen. As mentioned earlier, the market has established DIM as an estrogen buster. DIM can be wonderful as it helps metabolize estrogen, especially dirty estrogens, which are the problematic metabolites that can cause so many of the Estrogen Dominance symptoms. It is widely found in the liver and spleen. - HormonesBalance.com, Digestive Enzymes Are Key to Hormone Balance - HormonesBalance.com, https://wellena.com/products/brocco-power-sulforaphane, https://hormonesbalance.com/?s=astragalus, How Estrogen Dominance Affects Mast Cell Activation Syndrome & Histamine Intolerance, https://hormonesbalance.com/articles/best-supplements-for-estrogen-dominance/, https://hormonesbalance.com/articles/topical-progesterone-when-why-and-how-part-1/, B Vitamins for Your Hormones + Deficiency Checklist, estrogenic cancers such as breast, ovarian, uterine, cellulite and stubborn fat on the butt and thighs, weight gain, especially around the butt and hips. Excess body weight Since fat secretes estrogen, if you have a higher amount of body fat, you are more likely to also have high estrogen levels. Hi Nikki, thank you for sharing with us what you have been experiencing and have experienced. HB Team. I recommend using DIM and not I3C for two reasons. Supplements dont work. Yes, it is designed to help but to work, one should be taking the whole see rotation as she recommends for it to be most effective ~Deanna HB Team. Hey Kris, you need to do a complete thryoid and hormonal workup. Digestive health: A recent study determined sulforaphane supplementation decreased the overgrowth of pathogenic bacteria in the stool including h.pylori, and improved daily bowel habits of the study participants. Sulforaphane impacts the liver and these medications may act too fast or have side effects. Sulfa-based drugs, also known as sulfonamides, do not occur naturally and are used as antibiotics. Just wanted to know, if DIM can u make you bloated when u start taking it? Do you possibly know why? More than 70% of women experience Estrogen Dominance. I have noticed that when I take the supplements, I start spotting around my ovulation and it doesnt stop unless I stop taking the pills. Certain herbal medicines like milk thistle have been used for years to help support optimal liver function by working to restore liver cells that have been damaged from increased toxin exposure. 11 Signs of Estrogen Dominance. I am very confused if I should take your estrogen kit or not. The body makes three main estrogens: Estrone (E1) Estradiol (E2) Estriol (E3) Estrone (E1) is the main type of estrogen present in the body after menopause, made primarily in adipose tissue. Overproduction and poor breakdown can be caused by: Since fat secretes estrogen, if you have a higher amount of body fat, you are more likely to also have high estrogen levels. Id be very interested in knowing where Im at with my levels. If one is too dominant, the other needs to step up. Most women with ED do not suffer because of too much estrogen but because they are not breaking down and evacuating these estrogens well enough. In order to keep estrogen-balancing progesterone levels in check, we want to lower the bodys stress hormone cortisol, as much as possible. I did experience a time in which I was able to achieve a balance between Estradiol and Estrone and when I did I dropped 30lbs in 3 months, it was so fast my hair began to fall out. Foods rich in vitamin A help decrease the amount of this potent hormone in your system. I have of course schedule an appointment with my gynecologist but that is in a month. The below chart demonstrates this finding. The dosage range of 200mg/kg C-phycocyanin (1g/kg spirulina) converted to human equivalent doses from rats is approximately: 11.0g for a 150lb person 14.5g for a 200lb person 18.2g for a 250lb person Thank you for your question. Instead of conventional cleaners, perfumes, candles, air fresheners, and beauty products try swapping them out for essential oils and plant-based, non-toxic household cleaners and personal care products. Ive just bought vitamin C 1000 It is also believed to be an excellent source of energy and eye vitamin. Information is shared for educational purposes only. Buying Tip: When getting DIM, be sure it comes in oil form it is the highest bioavailable form that is most likely to make a difference in your health. Estrogen dominance is a type of hormone imbalance where you have too much estrogen in relation to progesterone. These labs look at sex hormones like estrogen, progesterone, and testosterone as well as cortisol levels and your HPA-axis function. Since hormonal birth control prevents ovulation, that is often another contributor. Talk to your healthcare provider and make sure blood glucose levels are being monitored if you start taking DIM. A standard daily dose of spirulina is 1-3 grams (g), but doses of up to 10 g per day have been used effectively ( 1 ). Hi Chelsea. DIM balances the hormones by breaking down estrogen and removing it from the body. Chronic stress can lead to high cortisol which actively depletes your bodys estrogen balancing hormone, progesterone. Im wondering if taking DIM would be a good idea to get rid of potential bad estrogen and would enable me to still stay on the bioidentical hormone replacement? They work best when taken together along with an anti-inflammatory diet. Then I learned I am sulfur intolerant & stopped the DIM & switched to calcium d glucarate. (Its not the kind of calcium you take for your bones. If you're dealing with a hormone imbalance like estrogen dominance, backing off on marijuana consumption is most certainly good practice! When thyroid hormones are attached to TBG, they remain inactive. Thryoid tests must include TSH, Free T4, Free T3, Reverse T3 and thyroid antibodies. High estrogen levels can cause symptoms such as irregular or heavy periods, weight gain, fatigue, and fibroids in females. Sometimes, however, the body produces too much estrogen or too little progesterone causing the ratio between sex steroid hormones to change. This delicate dance between your brain and hormone system, includes your brain-adrenal (HPA) axis, brain-thyroid (HPT), and brain-gonadal axis (HPG). To make it a little more graphic, imagine a toilet with a toilet bowl and a drain to carry the waste out. I recommend taking this quiz to find out for yourself here. It's a non-GMO, hormone-free whey isolate that comes from grass-fed cows. We have not heard of anyone having problems with their service. Many people with immune problems have genetic methylation impairments, such as MTHFR gene mutations, which makes it difficult to detox on your own. If you are estrogen dominant, that means your are ALSO relatively low in progesterone! Thanks, Hi Rebecca, I have been researching Dim. As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. Reduce estrogen as much as possible using the tips above. The truth is Estrogen Dominance symptoms occur to 75% of women, but a whopping 90% of them dont even realize they have it. Some of my favorite adaptogens for estrogen dominance include ashwagandha, licorice root, shilajit, and schisandra. I used atural progesterone to get through menopause symptoms and for bone health. Spirulina and chlorella (the best kinds of algae) are both known for their effects on detoxifying the liver, and when your liver is clean then it flushes out estrogen with a much better rate. More than 70% of women experience Estrogen Dominance. Breast cancer, benign breast disease, and pre-cancerous conditions. There is literally ZERO data out there for someone like me. Urine and saliva hormone labs can give us a complete overview of how well your hormones are functioning. Can you comment on any solutions for progesterone resistance? It is an estrogen type cancer that does not show up in mammograms. Estrogen Dominance: Common Signs and Symptoms. The best approach that will generate the fastest and most profound changes is when you combine diet changes with supplements. Occasionally, estrogen dominance can be due to low progesterone production, which likely means you aren't ovulating. Clear margins on tumor and nodes . 420 views 11 months ago #hormonalweightgain #womenshormones #estrogendominance Women's Hormones | Estrogen Dominance & Hormonal Weight Gain | Dr. J9 Live In this video, Dr. Janine talks about. Is this normal? Fatigue. I am now 46 years old but at 26 years old I lost my uterus, ovaries, cervix, and tubes due to endometriosis. For this reason, people with diabetes or hypoglycemia and those taking drugs, herbs, or supplements that affect blood sugar should be cautious when supplementing with DIM. Im a big fan of getting sulforaphane from broccoli sprouts, but if you dont have the time or access, a supplement is a good option. In males, they can cause breast tissue growth, erectile . When it's over-stimulated, you may suffer fluid retention, constant anxiety, tummy troubles, weight gain and lowered immunity. If you have more questions, please contact [emailprotected] Just as with estrogen deficiency, estrogen dominance also has its unique list of causes, risk factors, signs and symptoms. Im still a big fan of growing and consuming broccoli sprouts on a regular basis. My bowels are also sluggish and I feel a bit constipated. 2. Your diet can play a role in estrogen dominance. Many cheaply-made supplement manufacturers dont use this formulation approach leaving the product efficacy to chance. I advise going to a functional medical practitioner instead of using a traditional gyno, endocrinologist, or primary for these concerns. Each supplement works on a different area. I am happy to hear that you have benefited from this article! Why cant I get there again???? To get 100mg of DIM (I typically see best results with 200mg/day), one would need to eat 6 pounds of these crucifers which isnt doable for most people. More water retention, bloating, breast tenderness, weight gain. I am curious if what I believe is true can I woman not have enough estrogen naturally? As described above, "estrogen dominance" involves a discrepancy between estrogen and progesterone. The only thing you want to lower is xynoestrogens (synthetic or external estrogens) found in commercial skin care products, perfumes, and cleaning products. It can also lead to autoimmune conditions, like Hashimoto's. HI I really appreciate all the good information here. The info I have read does say not recommend if you have a estrogen breast cancer risk. A third sulfur-containing compound, known as sulfites, is a form of preservative that can cause allergic reactions in some individuals. If you suspect that you are struggling with estrogen dominance, schedule a consultation to learn more about how you can alleviate your symptoms naturally with functional medicine. Reason #2: The way your body is breaking down estrogens to the various estrogenic metabolites, is not favorable to you. The DIM was making me feel sick so I decide to pair it with the calcium D-glucarate. We recommend taking these three supplements with food. ESTROGEN DOMINANCE IN MEN & WOMEN It's common knowledge amongst medical professionals that . It kick-starts a cascade of stress hormones including adrenaline and cortisol. Also is the elimination diet the best diet to start with or do you recommend something else, Hi Angie, I had a round of IVF where they put me on down regulation meaning they eradicated all my natural hormones and gave me just the right amount, its no coincidence that following that I became pregnant 3 times in 4 months. Please help me! There's a fine balance between the two as progesterone is generally a calming agent against estrogen's pro-growth effects. We wish you the best on your healing journey! I3C and DIM have been studied for their health-promoting benefits when used as supplements. Are these symptomatic of ED, and if so, which supplements would be most helpful? It inhibits beta-glucuronidase, which is an enzyme that reduces the livers detox ability, allowing toxins and dirty estrogens to re-enter the blood. Yes, that is a sign of estrogen dominance. This happens as the result of the foods we eat, the products we use, stress, poor sleep, and other environmental factors. First, let's talk about the symptoms of estrogen dominance. Can I take any of the supplements with the Maca from femminessence? You can start off one at a time and see which works best for your body. Some may have found it makes estrogen symptoms even worse. I would very much appreciate your input and of course will run it by my doctor (who may not know about DIM). ~HB Support. Provides antioxidant properties. How Much Sleep Do I Need?Centers for Disease Control and Prevention, 2 March 2017, www.cdc.gov/sleep/about_sleep/how_much_sleep.html. Liver detoxification: Sulforaphane is directly involved in supporting liver detoxification, which is important not only for liver function but for the rest of the body as well. Misconception #3: Even though I clearly have Estrogen Dominance, I should not eat cruciferous vegetables because I have hypothyroidism. Commonly known ingredient as MSG used in many of our every day items, including bottled water which is why I have to be extremely careful. Hi Katie, this can happen when you start to open up the liver detox pathways and you start experiencing a sudden increased ability to detox. Certain medications like birth control pills and hormone therapy can boost estrogen levels to an unhealthy level. Thanks so much for such an informative article! We live with hot flashes. Breast sensitivity. Both breast just removed. The Difference Between DIM and Sulforaphane (the clogged toilet analogy). It also affects your kidney function, metabolism, digestion and mood. The primary plant indole found in cruciferous vegetables is known as Indole 3 Carbinol (I3C), which converts to DIM in the body. Is that also true for birth control pill? It turns out that estrogen withdrawal leads to hot flashes and night sweats. with high chlorophyll. Then it comes its full of clots last a day and goes. So in effect, estrogen is dominant in relationship to progesterone. Key Concepts for COMT and Estrogen. Several studies have demonstrated that milk fermented with L. helveticus decreases the growth rate of mammary tumors in experimental rats (including HER2+ tumors) and that this involves reduced production . Hi Julie, If you know you are sensitive you will want to avoid them. Due to a poor liver function, inappropriate diet, nutritional deficiencies, gut issues, chronic constipation, and use of conventional skincare and cleaning products, your body is receiving and/or creating too much of the antagonistic or dirty estrogen metabolites that cause harm. You mentioned taking CDG and other medications 4 hours apart to avoid decreasing their effectiveness. Many women with low thyroid function suffer from high LDL cholesterol. We do not aim to diagnose, treat, cure or prevent any illness or disease. Can CBD help with estrogen dominance This is a common question and usually speaks to estrogen's relationship with progesterone. It does sound challenging. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue., vol. Sulforaphane works on the 16-OH pathway as well as the Phase 1 pathway, and does not lower estrogen. So many women have experienced the pain and frustration that comes when they feel their symptoms and complaints are dismissed or minimized. https://hormonebalancenutritionals.com/collections/single-products/products/estro-support, https://hormonebalancenutritionals.com/collections/single-products/products/calcium-d-glucarate, https://hormonebalancenutritionals.com/collections/single-products/products/brocco-power, https://hormonebalancenutritionals.com/collections/frontpage/products/fibroid-kit, https://hormonebalancenutritionals.com/collections/frontpage/products/estrometabolizer-kit, https://www.ncbi.nlm.nih.gov/pubmed/15623462, https://hormonesbalance.com/articles/adrenals-articles/how-to-trust-a-brand-of-supplements/, What Are Fibroids? Since estrogen dominance occurs because there is a dysfunction with how your body is designed to normally operate, we need to determine how to get back to baseline. We can only imagine the stress going through all of this caused for you. However, more severe symptoms become noticeable when hormones are out of wack. Vitex: Vitex is one of the most powerful herbs for women's fertility and menstrual health. Eating two pounds of cruciferous vegetables like raw cabbage or broccoli can ultimately supply, via I3C conversion into DIM, about 20-30 mg of DIM. Also, take stock of your workload and personal relationships and set up healthy boundaries where needed. If you need more ideas, read my article on ways to improve your sleep hygiene. Spirulina in Menopause This is an excellent superfood to aid in the control of weight during menopause. Do you plan on keeping the IUD in place? The benefits of progesterone. So, I take the DIM, the Brocco Powder, and Calcium D together or do I spread them out during the day? These are the ingredients in Myomin according to the label: Myomin is a herbal complex containing astragalus membranaceous, white curcumin, aralia, cyperus rotundus and smilax grablar According to Dr. Ray Peat, PhD., estrogen dominance is a leading contributor to many women specific cancers, "Benign breast disease, breast cancer . Named one of the top 50 functional and integrative doctors in the nation, Dr.WillCole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Astragalus: https://hormonesbalance.com/?s=astragalus If you need cannabis for a health-related concern, opt for edibles. So when is it right to just rely on food or when to take the supplements? Broccoli, whether in powder or sprouts, is poison for some people. This can lead to a variety of symptoms and chronic health problems. Im 49 in March on antidepressants. While working with our manufacturer on formulating the sulforaphane supplement, I learned that, unfortunately, the sulforaphane content in supermarket-purchased broccoli sprouts can vary significantly from low to high. Also, it is recommended to start with the Fibroid Kit https://hormonebalancenutritionals.com/collections/frontpage/products/fibroid-kit first and if more support is needed, then follow with the Estrometabolizer Kit https://hormonebalancenutritionals.com/collections/frontpage/products/estrometabolizer-kit. In fact, studies have shown that a lack of sleep can lead to chronically elevated cortisol which doesnt do your progesterone or estrogen levels any favors. Eat More Cruciferous Vegetables. We live in a toxic world. This is all very interesting, Im 46 and do have some of the symptoms listed..how would I know for sure? Exactly How This Superstar Supplement Can Benefit Your Health, Your Definitive Functional Medicine Guide To Autoimmune Disease: Symptoms, Causes, Supplements + More. The dirty estrogen needs to be released for our good estrogen to naturally boost. To get your copy of Overcoming Estrogen Dominance, go here. is estrogen dominance, particularly among women. These are the recommendations for resolving estrogen dominance; DIM https://hormonebalancenutritionals.com/collections/single-products/products/estro-support, Calcium D Glucarate https://hormonebalancenutritionals.com/collections/single-products/products/calcium-d-glucarate and Brocco Power https://hormonebalancenutritionals.com/collections/single-products/products/brocco-power. Kind regards, I have become quite bloated and emotional since I started it about a week ago. Healthy regards, At 39 years old I began to gain weight no matter what I did so after much research I found a clinic that FINALLY checked ALL my hormones and I found out I had NO detectable progesterone or testosterone in my body, my estradiol was low and my Estrone was about 6 times higher than my estradiol levels which explained my weight gain, acne and all my other symptoms. Sulforaphane aids hormone balance in several ways. Will it stop? Both chronic and acute stress can cause hormonal imbalance and thus estrogen dominance issues. (1), Ideally, everyone should be getting between 7-8 hours of sleep a night as. Women hear that too much estrogen causes breast disease, and too little causes everything from hot flashes to hair loss in menopause.We also hear from many women with concerns about "estrogen dominance" a state of high estrogen levels blamed for a wide range of distressing symptoms as well as fibroids . You need all these communication systems working in perfect harmony for a healthy mood, metabolism, energy, immune system, and sex drive, due to its ability to, and in turn, help balance progestrerone and estrogen levels. It would be best to speak to your doctor or practitioner about what would work best under those circumstances. I started HRT (estrogen) 7 years ago because my fare up revolved directly around my period. I just got the results from a genetic test that showed my estrogen metabolizing pathways in the liver are pretty much busted. I have completed a Dutch test and I have very high levels of estrogens going through the 16-OH pathway but I also have low estrogen and androgens and I read that DIM can reduce estrogen so it is not advised to take if you already have low estrogen, Can you recommended another Phase 1 detoxification supplement that doesnt reduce estrogen? The immune system: Furthermore, this study shows calcium d-glucarate decreases inflammation by activating the immune system and increasing the activity of the anti-inflammatory cytokines. HB Team. However, if your liver isnt functioning properly, it wont be able to break down estrogen causing it to accumulate in your body. . I suffer from ED but am not peri-menopausal. The way to solve this is to combine DIM with Phase II liver detoxifiers sulforaphane and calcium d-glucarate. Top-quality sulforaphane is derived from raw material containing high levels of glucoraphanin (the raw material) as well as added myrosinase. Overwhelmed with where to start? More on these, below. Even small amounts of broccoli make me very sick. Biochemically, the higher your level of estrogen is, the more readily you absorb alcohol, but the slower you break it down. ~Deanna HB Team. I am on Progesterone / testosterone cream and estrase cream as well for menopause issues. My OBGYN stays very on top of my testing for breast, and ovarian cancers and I am good. However, if you are dealing with a persistent type of Estrogen Dominance or serious conditions such as a large fibroid, breast, or thyroid cancer, I recommend considering supplementing with a high-quality sulforaphane supplement. First off, there is not a single study that shows that cruciferous vegetables inhibit thyroid function. A single tablespoon (tbsp. Im very curious as I am on bioidentical HRT and would like to take DIM. DIM helps support a more optimal balance of these two estrogen metabolites, thereby providing a protective effect on the body. If estrogen levels are too high and progesterone levels are too low, this means the balance gets out of control and can lead to symptoms including ovarian . ~Deanna HB Team. A study showed that vitamin C was able to reduce heavy bleeding in 87% of women who participated. Hey, I just started DIM Im taking the Zhou product which is 250mg per tablet and I have been taking 1 a day for just over a week. Estrogen dominance can start early in a woman's menstrual history. Fibrocystic breasts and Gynecomastia in men (2) Insomnia. It was miraculous! ), the increment in inflammatory agents in day-to-day life are enhancing the estrogen (or estrogen mimic) level, fueling 'estrogen dominance'. The infamous "beer belly" is really just an "estrogen belly.". yet I need to take estrogen because the lining of my uterus is loss an according to the Dr. can come out. 3. The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. ESTROGEN-FREE PROTEIN POWDER (WHEY ALTERNATIVES) I was sweating profusely and felt hungover the next morning. Hi Taylor, what if the hysterectomy is a result of first stage uterine cancer? Many thanks. Smaller dose with something else to help with reactions? Vitamin A-rich foods include carrots, sweet potatoes, spinach, and mangoes. There's no set number that indicates estrogen dominance. Even if you dont go full keto, try incorporating more wild-caught salmon, avocados, hemp seeds, and coconut oil into your diet. While both may help support healthy estrogen metabolism, DIM may be a better option as it does not produce the unwanted side effects of I3C (including possible nausea and equilibrium issues). It does seem like you may want to consider looking into Magdalenas Cooking for Hormone Balance program. It all depends on your health and on which links are broken or not working optimally in your body to detox you from the dirty estrogen metabolites. COLE NATURAL HEALTH CENTERS, 111 Whitehead Lane I have read that liver detoxificating supplements such as milk thistle and calcium d glucarate can lower the effectiveness of birth control pill since both are filtered by the liver.