When Hormone Therapy Backfires: How Skipping Hormone Testing Can Overload the Liver

Hormone therapy can be a game-changer for women in perimenopause and menopause—but only when it’s done right. Unfortunately, I often meet women who were prescribed hormones without proper testing, and the consequences can quietly pile up inside the body. Today, I want to share a powerful case from my clinic that illustrates how hormone therapy—without looking at the full picture—can compromise one of the body’s most vital organs: the liver.

Client Story: A Healthy Lifestyle, But Something Was Off 

My client, a woman in her early 50s, came to me hoping to address stubborn belly fat, persistent afternoon fatigue, and occasional brain fog. Her case seemed paradoxical: she had a perfect BMI, solid muscle mass, and balanced body fat. She exercised regularly, followed an 80/20 whole foods lifestyle, didn’t snack at night, and prioritized sleep.

She had an IUD for 15 years and, more recently, was prescribed an estrogen patch by her doctor to ease pre-menopausal symptoms—without any hormone testing. While the patch helped her symptoms, it wasn’t the full solution.

BHRT

What the Bloodwork Revealed 

Before we met, I reviewed a comprehensive blood panel. The results raised immediate red flags:

• Extremely elevated iron and B12 levels (despite no supplements)

• Diminished liver function markers

• Slightly low calcium

• Adequate vitamin D

• Healthy glucose and cholesterol levels

  
  

All signs pointed to one culprit: liver congestion.

The Missing Link: Hormones & Liver Function 

When my client asked, “What could make my liver slow down like this?”, it hit me: Unmetabolized hormone therapy.

The liver plays a critical role in breaking down and clearing excess hormones. When external hormones (like from a patch or IUD) are added to the system without checking levels—or when the detox pathways are sluggish—the liver becomes overloaded. This can impair bile production, block nutrient absorption (especially B12, calcium, and iron), and create a ripple effect of symptoms like:

• Belly fat (even with a clean lifestyle)

• Brain fog

• Low energy and poor digestion

Functional Medicine Approach: Address the Root, Not Just the Symptoms 

Here’s what we did:

1. Back to the Doctor – I referred her to speak with her physician about reassessing the need for her IUD and hormone therapy.

2. Liver-Supportive Plan – We started incorporating bitter foods, liver-supportive herbs, and an anti-inflammatory, antioxidant-rich diet based on her food sensitivity results.

3. Lifestyle Review – While her habits were stellar, we made a few fine-tuned adjustments, especially around meal timing and optimizing digestion.

4. Next Step: Hormone Testing – My priority is to test her hormones properly—including estrogen metabolites, cortisol rhythm, DHEA, and progesterone—to build a truly balanced plan.

The Takeaway: Hormones Aren’t One-Size-Fits-All 

If you’re navigating menopause or perimenopause, don’t settle for blanket prescriptions. Your hormones are unique. Treating symptoms without testing may mask the problem—and even create new ones. In this case, it was her liver waving a red flag.

If you’ve been struggling with unexplained fatigue, belly fat, or brain fog despite doing “everything right,” your hormones—and your liver—may be telling a deeper story.

Ready to Uncover the Root Cause?

I offer comprehensive hormone testing and liver function assessments as part of my functional medicine approach. Book a free discovery call [insert link] and let’s explore your path to real balance.