EP.292/ My number one endo management strategy
Okay so today I am taking my IG Live series to the podcast, because for the life of me, I cannot get my IG Lives to not have that strange ticking/buzzing sound in the background! So, I thought it would be better to answer the questions I’ve had submitted here.
Today I am answering “What is the number one thing to manage endometriosis?”
Now, before I dive in – a huge disclaimer: It’s not often just one thing. Endo is a multifaceted disease and there can be various root causes behind your pain and symptoms, from pelvic floor problems, to gut dysbiosis, to high levels of inflammation.
So, it normally takes a layer of approaches, tailored to the individual, to see success.
However, having said that, I do think there’s one aspect that pretty much everyone would benefit from.
So, if I had to pick one, my number one endo strategy has to be nutrition, and when I say nutrition, I mean a dietary approach which is both anti-inflammatory and blood sugar balancing.
Whilst every person with endo has different needs and different root causes to be addressed, as a general rule of thumb, nutrition can really help everyone (the caveat here of course if someone has a history of an eating disorder).
Now, remember, what is anti-inflammatory for one person may vary to the next, as one may have certain intolerances that the next person doesn’t, so it always has to be individualised. But generally, eating a more nutrient dense, blood sugar balancing diet, is a great tool for calming endo.
Here's why:
Fights oxidation and inflammation
People with endo have higher levels of oxidative stress and inflammatory markers, and lower levels of antioxidants. Oxidation is a process that triggers inflammation and contributes to the development of endo, and antioxidants help to stop that oxidation process from happening. Research has shown that when people with endo ate a diet rich in antioxidants, inflammatory markers reduced, and antioxidant levels improved.
Helps lower inflammatory prostaglandins that feed endo growth
Inflammatory prostaglandins are the drivers of endo pain. They are normal parts of our immune system which can cause pain, swelling and heat, and they rise during ovulation and menstruation to trigger the shedding of the uterine lining and the eruption of the egg out of the follicle in our ovary. However, in people with endo, heavy menstrual bleeding, and dysmenorrhea (painful periods) they are too high.
These inflammatory prostaglandins are made from omega 6 fatty acids, whereas as omega 3 fatty acids help to make our anti-inflammatory prostaglandins. We need both in balance to have a healthy inflammatory response which doesn’t cause us excessive inflammation and pain.
Anti-inflammatory diets place particular emphasis on a balanced intake of (healthy sources of) omega 6 and omega 3, which can lower the inflammatory prostaglandins to normal levels and raise the anti-inflammatory ones to help counteract pain.
In fact, adoption of an anti-inflammatory diet following surgery was found to be just as effective as hormonal treatments for both pain and quality of life with endo.
Oestrogen balance
When you’re eating an anti-inflammatory diet, it focuses on a lot of foods that help to feed the liver what it needs to function properly, such as antioxidants, and foods that help to metabolise oestrogen (think of this as detoxifying), like cruciferous vegetables.
Additionally, the fibre, polyphenols, probiotics, and prebiotics that are included in an anti-inflammatory diet support a healthy microbiome and daily bowel movements. For oestrogen to be balanced, we need to remove it daily when we go to the toilet.
To add to that, when the microbiome is imbalanced, it can lead to an excess of an enzyme in our gut called beta-glucuronidase, which recirculates oestrogen that should be queued up and ready to leave through bowel movements, back into our blood stream.
Both scenarios can lead to an excess of oestrogen and as oestrogen is another contributor to endometriosis activity, we want to try and keep oestrogen at healthy levels.
Reduces LPS exposure and leaky gut
The foods I listed earlier that help to support a happy gut, can also in turn calm intestinal inflammation, which means that our gut lining can be healthy and sealed properly, preventing lipopolysaccharides from leaking through into our pelvic cavity, contributing to endo growth and inflammation.
So, let me back up a bit. Think about your intestinal lining as the skin of a sausage, and the meat inside is what’s inside your gut. If we pricked holes in that skin before the meat was in it, and then we tried to fill that sausage skin with sausage meat, that meat would start seeping out.
Our intestinal lining is exactly the same. It is super thin, and can start to form gaps when damaged from inflammation, food intolerances, infections, etc. When these gaps form, it allows bacteria, toxins known as lipopolysaccharides and food particles to enter the blood stream on the other side. This triggers an immune reaction, which when repeated every time we eat, can lead to full body inflammation and local inflammation in the pelvic area and abdominal area (queue endo pain).
But one of the key issues with leaky gut is that it allows for lipopolysaccharides to escape into the pelvic cavity. LPS are types of toxins released from gram negative bacteria. We all have some gram-negative bacteria in our gut, but people with endo may have more due to the microbiome dysbiosis we have (based on what we know from the research so far). LPS are now being shown as one of the key contributors to endo development and progression, whilst leaky gut is one of the key causes of LPS translocation, meaning movement from the gut to other parts of the body.
So, we really want to keep the gut microbiome happy and balanced, and that intestinal lining healthy.
Now, a caveat here. People with certain gut problems, like SIBO or bad dysbiosis, may not be able to eat all that lovely fibre and prebiotics at first, because they can actually worsen symptoms, leading to more inflammation. So, for these people, an ant-inflammatory diet for them, will look a little bit different at first, whilst their guts heal. That’s why it’s important to work with a practitioner, or take a group course or at the least, follow a book written by a specialist in these areas.
Boosts progesterone production
An anti-inflammatory diet is also full of healthy fats, proteins and nutrients that are essential for supporting healthy ovulation and progesterone production. Normal levels of progesterone are really important to help counteract the effects of oestrogen on endo. Oestrogen is a proliferative hormone, meaning it helps cells to divide and multiply – a bit of a problem for endo. Progesterone puts a dampener on oestrogen and gets it to slow the hell down.
Now, some of our endo cells are resistant to progesterone, which allows them to keep growing away, but more recent research shows that not all of them are! So, keeping progesterone levels healthy can help to keep endo activity, at least somewhat at bay.
Additionally, if progesterone is too low, then that can set the stage for oestrogen dominance, which can really worsen endo symptoms and also lead to other unpleasant symptoms like PMS, painful breasts, and mood swings.
Okay so let’s talk about the blood sugar balancing aspect of nutrition.
Fatigue
One of the first benefits is that it helps to fight chronic fatigue. When we experience blood sugar swings throughout the day, it can result in huge energy dips, especially after meals or mid-morning and mid-afternoon, but over time, it can create continuous low levels of energy due to something called insulin resistance. Insulin resistant occurs when we’ve experienced too many blood sugar spikes and our cells have become resistant and will no longer take in glucose from food, meaning we’re starved of energy, despite having high blood sugar levels.
Cortisol
Balancing your blood sugar also helps to regulate your cortisol levels. Cortisol is not just our stress hormone, but it’s also our waking hormone. It rises in the morning, peaks about an hour after waking and then gradually drops until, by the evening, it’s low, so that melatonin can rise, and we can sleep.
However, people with endo have been shown to have HPA axis dysregulation, specifically, low cortisol levels. The HPA axis is a system that regulates your stress response and your sleep wake cycle and when this is struggling, we can end up with cortisol problems.
One of the ways to start building healthy cortisol levels is to regulate your stress response, because the more taxed the HPA axis system is, the harder it will be for you to have normal waking cortisol levels. Blood sugar highs and lows stress the body and will further contribute to HPA axis dysregulation, so balancing blood sugar levels is a key approach for recovering from this.
Additionally, when your body is stressed from problems like insulin resistance or continual blood sugar swings, it can actually cause hormonal problems like low progesterone, oestrogen excess and elevated testosterone and we’ve already explored what these imbalances can do.
Oxidation
Regulating blood sugar can also significantly improve levels of oxidation in the body. Blood sugar spikes create something called Advanced End Glycation Molecules. These molecules trigger the oxidation process, which as we know, contributes to endo development.
Prostaglandins
However, oxidation can also trigger an inflammatory cascade that leads to higher levels of prostaglandins. This inflammatory process can happen relatively quickly with a blood sugar spike, which can result in an increase in pain, so balancing blood sugar can really help towards controlling pain levels.
So, that brings me to an end on why I would pick anti-inflammatory, blood sugar balancing nutrition for as my number one strategy for endo.
As you can see, the simple act of eating well can cover an entire range of root causes that can influence endo, and whilst I do focus on all of these components further and individually in my protocols (so for example, I work specifically on gut health, HPA axis, the liver, etc), really, the foundation of working on all of these, is nutrition.
I hope this has been helpful!
Remember, if you want to learn my exact protocol for endo healing, I’m holding my signature free masterclass, Creating a Roadmap for Endo Healing next week on Tuesday 2nd and Thursday 4th. Don’t worry if you can’t attend live, just sign up and I’ll send you the recording!
To sign up, head to the link in my show notes on your phone or go to www.theendobellycoach.com/free-endo-healing-workshop-2024
See you next week!
Show notes
Diet
https://pubmed.ncbi.nlm.nih.gov/23419794/
https://academic.oup.com/endo/article/149/3/1190/2455150
https://pubmed.ncbi.nlm.nih.gov/15051604/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693127/
https://pubmed.ncbi.nlm.nih.gov/17434511/
Prostaglandins
https://pubmed.ncbi.nlm.nih.gov/22003899/
https://www.yourhormones.info/hormones/prostaglandins/
https://pubmed.ncbi.nlm.nih.gov/3488529/
https://pubmed.ncbi.nlm.nih.gov/12009336/
https://pubmed.ncbi.nlm.nih.gov/6790261/
Oxidation/advanced end glycation molecules
https://pubmed.ncbi.nlm.nih.gov/7918300/
https://jamanetwork.com/journals/jama/article-abstract/202670
https://pubmed.ncbi.nlm.nih.gov/20497781/
https://pubmed.ncbi.nlm.nih.gov/19088375/
https://pubmed.ncbi.nlm.nih.gov/20537326/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333061/
https://pubmed.ncbi.nlm.nih.gov/18508964/
https://pubmed.ncbi.nlm.nih.gov/12379575/
https://www.ncbi.nlm.nih.gov/books/NBK493173/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783643/
LPS
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902457/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033038/
If you’re feeling overwhelmed by your symptoms, all the info on endo or you’re just stuck not knowing where to start, and you want clear, actionable and effective steps to guide your endo journey, I invite you to my free signature masterclass...
Creating a Roadmap for Endo Healing Masterclass
(It's back and it’s new and improved!)
In this two-hour masterclass I’m going to…
· Show you how to overcome the endo overwhelm
· Help you identify your core endo challenges
· Teach you my 8 key pillars of healing that I go through with all my clients
· Empower you to set 1-3 goals and next steps so you can get started and take action after the masterclass.
This masterclass is all about sorting through the confusion so you can begin managing endometriosis with confidence and clarity.
I’m holding the masterclass on two dates next week:
Tuesday 2nd April, 6pm BST
Thursday 4th April, 7pm BST
Don’t worry if you can’t make it live, as long as you sign up to the masterclass, you’ll receive the recording.
To sign up, just head to my show notes (and click here!) or go to wwww.theendobellycoach.com/free-endo-healing-workshop-2024
Need more help or want to learn how to work with me?
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From Mon 4th March 2024, you’ll receive a weekly email with education on one specific strategy which can help reduce the frequency and/or severity of your flare ups, whether they’re random or come like clockwork every period.
Don’t worry if you see this email after we get started, as long as you sign up in March, I’ll catch you up on any emails you missed.
Sign up here.
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Ways to work with me:
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Can you help me save Jelly the kitten? We are currently travelling, working remotely, and within 24 hours of arriving in Montenegro, we met Jelly. He was extremely thin, with a distended stomach and a little lollypop head and bulging eyes. We took him to the vets where he was put on an IV drip for dehydration, and treated with antibiotics and anti-inflammatories for a bacterial infection that has spread into his bloodstream from his intestines. His intestines are damaged due to excessive worms, which has caused him to become malnourished.
The vets have given us a very stark picture of the reality. If Jelly goes back on the streets, his condition will deteriorate and he will suffer until he eventually passes away. We have been told to find him a home where he can continue getting care or put him to sleep.
We have found him a foster home and a forever home in the UK, but the total cost is over £1200. We have already spent hundreds on vet visits getting him to this point, and need your help, if you can.
If you are able to and want to support, you can donate and read Jelly’s full story on our Go Fund Me page. I truly cannot express how much your support means to me, thank you from the bottom of my heart.
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Produced by Chris Robson