Healing Your Endometriosis, Naturally

Healing Your Endometriosis, naturally. The herbs, supplements, nutritional and lifestyle changes for endometriosis. Listen to my podcast episode on this here!

Endometriosis awareness month is March, 2022. In honor of all my endo warriors, I wanted to dedicate extensive analysis on the latest research we have gathered on this disease. one that so many suffer from silently. 

Endometriosis is an inflammatory disease, mostly due to immune dysfunction and is affected, not caused, by hormones. With endometriosis, a tissue that is similar to endometrial tissue grows outside the uterus and can cause pain and other symptoms. These endometriosis lesions are laid down before birth or come to be via retrograde menstruation. Endometriosis can be improved by surgery, especially excision surgery, which attempts to cut out and remove some or all of the lesions. Although this can provide relief, this doesn’t necessarily fix the root cause. Endometriosis typically progresses and worsens over time as the chronic inflammation leads to accumulation of scar tissue, causing adhesions (connection the of scar tissue/lesions)  that can cause organs, like the intestines and bladder, to become fixed in place, leading to frequent pain with bowel movements and urination, and painful sex.

Common Symptoms of Endometriosis:

• Intense cramping during menses. Often chronic between bleeds too.
• Constipation
• Bloating
• Pain during sex
• Urinary problems
• Low back ache
• Abnormal vaginal bleeding
• Chronic fatigue

Often people get confused between PCOS, a metabolic hormone condition, and endometriosis. Here is a simple breakdown of the main symptoms of each condition as stated by Lara Briden.

You know me, I am a big advocate for the natural route. However, so many of us are suffering silently with endometriosis, and when it goes too long untreated (It can take 9+ years to get a proper diagnosis), conventional intervention may be needed for temporary relief. Luckily, you can use both conventional practices and natural remedies simultaneously. But, hopefully I am getting to you before pharmaceuticals are needed. 

The Root Causes of Endometriosis:

1. Hormones 

• Estrogen strongly stimulates endometriosis lesions and is even made by endometriosis lesions. This is why switching off estrogen has been the standard conventional medical treatment, but unfortunately, this method has downsides because estrogen is important for our overall health.
• Endometriosis lesions are resistant to progesterone, which is negative because progesterone has the ability to slow down the growth of lesions.
• Both estrogen and progesterone affect the immune system. Estrogen generally promotes inflammation while progesterone generally reduces inflammation, especially the inflammation found in autoimmune.
• Endometriosis is linked to low androgen exposure in utero. This is most likely  due to environmental toxins causing epigenetic changes to hormone production, hormone-sensitive tissue, and the immune system

1. The nervous system

• Endometriosis lesions are heavily innervated, way more so than normal endometrial tissue. There’s also a complex interaction between the nervous system and the immune system called neurogenic inflammation.

1. High iron levels

• There are research findings about high iron, probably from damaged cells, and hypoxia or low oxygen at the site of the lesions.

1. Toxins

• Environmental toxins can cause other epigenetic changes, some of which may be transgenerational. This means your endometriosis today could be the result of an environmental toxin, such as a dioxin, that your grandmother was exposed to.
• Epigenetics: branch of biology that is the study of changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself.

1. Autoimmune

• There are tons of research findings about genetics, including the presence of specific genes that increase the risk for autoimmune issues and endometriosis. This raises the controversial question of whether endometriosis itself is an autoimmune disease. However, I believe that there is no need to put a definitive label on it, but focus on treating the disease. 

1. The microbiome:

• I will FOREVER preach the importance of the health of our gut, our first brain.  There are countless research findings about the role of the gut microbiome and all the different ways our resident bacteria affects our hormones, immune function, and endometriosis.

Lara Briden’s road map to endometriosis:

1. There’s a background vulnerability to the disease, which is partly genetic and partly epigenetic.
2. Next, there’s the presence of the lesions or endometrial-like tissue which, could be laid down before birth and/or deposited via retrograde menstruation.
3. Next, there’s the normal level of estrogen that kicks in with puberty. Estrogen stimulates endometrial tissue and can be highly inflammatory, especially in the presence of a bacterial toxin called LPS.
4. Which brings us to the microbiome and the “bacterial contamination theory” of endometriosis, which states that the presence of a bacterial toxin called lipopolysaccharide or LPS in the pelvis could be an initiating factor in the immune dysfunction of endometriosis. Specifically, LPS upsets macrophages, which then interact with all the other parts of the immune system and are big players in endometriosis. To the point that one paper calls endometriosis “a disease of the macrophage.” There is a strong link between endo and gut issues. 
5. Inflammation dysregulation 

Treatments for Endometriosis

The right surgery, done well, can be effective. Unfortunately, this is more often than not, the case. Medication‘s can be effective at relieving pain in reducing the growth of endometrial implant. But it’s not guaranteed and risks and side effects are real. High rates of recurrence since neither of these options get to the root cause of endometriosis. I support all choices and want all choices to be known. Most of us want to take a more natural approach first.

Various small-to-medium size studies showing the following herbs and supplements to improve endometriosis pain, growth, etc. and in some cases even regression or repression of endometrial lesions and endo-related cysts. I highly recommend working 1-1 with a trusted practitioner to monitor your body’s acceptance of these supplements and symptom improvement.

1. Melatonin

• This is a powerful antioxidant, anti-inflammatory, immuno-regulatory, and pain-regulatory. It is also a natural detoxifier and helps to break down harmful xeno and endotoxins (estrogens). 
• Suggested use: Start with 1-3 mg before bed and increase slowly to 10 mg/day. Discontinue 8 weeks before trying to conceive, as higher doses may halt ovulation for a short time.
• Results: Better sleep, less pain, shrinkage of endometrial tissue. 

2. NAC

• This amino acid increases glutathione which is one of the most important natural detoxifiers produced within our bodies and, therefore, supports liver phase 1 to 2 detoxification.
• Suggested use: 600 mg/day for 3 months for full benefits.

3. Pycnogenol

• This is an extract of pine bark. In a study of patients taking it for four months, we saw a 33% reduction in pain, including severe pain. While the pain reduction was not as strong as hormonal treatment, it actually persisted without relapse, unlike the medication group. Further, 5 women in the pycnogenol group became pregnant. 
• Suggested use: 30 mg twice per day for a year.

4. B6 

• B vitamins are needed for the breakdown of excess estrogen. B6 is needed for the production of glutathione.

5. Omega-3

• Omega 3 fatty acids help to reduce inflammation and reduce pain. A study showed that just three months of supplementation reduced pain so much that women did not need to use a painkiller. 
• Suggested use: Fish or algae with the proper EPA to DHA ratio. 2-3 g daily.

6. Curcumin

• This is the active ingredient in turmeric and has anti-endometriotic effects (reducing lesions), due to it’s antioxidant and anti-inflammatory effects. It also increases glutathione and regulates the immune system. 
• Suggested use: 500 mg 2x/day. Avoid if you have gallstones. Make sure it’s bio-available.

7. Ginger

• Hence why gals love Soothe, my herbal remedy for PMS, period pain, and hormone imbalances. 
• Suggested use: 500 mg 2-4 times/day has been shown to reduce pain equal to the effects of ibuprofen.

8. CBD 

• There have been impressive studies done proving cannabinoids not just to reduce endometriosis pain symptoms, but for them to actually have a therapeutic role in resetting the immunologic dysfunction that's happening in endometriosis-like tissue. But this is nothing new as women have been using this medicinal plant for centuries. 

8. More crucial nutrients:

• Zinc, Vitamin A, immune-loving nutrients, vitamin D, selenium, iodine (which has anti-estrogen effects), and resveratrol. 

8. To reduce LPS toxin, antimicrobial supplements can also be helpful, especially berberine, certain probiotics, and other supplements that work for SIBO.

Lifestyle/Nutritional Changes:

• Adopt an anti-inflammatory way of eating and nourishing yourself and learn how to eat for your hormone health here. 
• Reduce or cut out caffeine. 
• No gluten (autoimmune driver) or normal dairy (A1 casein). Watch out for eggs (1 in 3 women will be impacted by this). 
• Keep blood sugar steady. 
• Mindful movement.
• Reduce toxins and support detoxification.
• Wait 3-6 months for symptom improvement. I recommend 6 months for any herbal protocol before deciding if it does or doesn’t work for you.

FAQ:

Is it hereditary? Some studies suggest yes. Most of which are just surveys. Is it a given? No this is unfortunately the case for a lot of our reproductive and gynecologic health. A number of studies have demonstrated the familial clustering of endometriosis and that first-degree relatives of affected women are 5 to 7 times more likely to have surgically confirmed disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346178/

Resources:

1. Porpora, Maria Grazia et al. “A promise in the treatment of endometriosis: an observational cohort study on ovarian endometrioma reduction by N-acetylcysteine.” Evidence-based complementary and alternative medicine : eCAM vol. 2013 (2013): 240702. doi:10.1155/2013/240702
2. Schwertner A, Conceição Dos Santos CC, Costa GD, Deitos A, de Souza A, de Souza IC, Torres IL, da Cunha Filho JS, Caumo W. Efficacy of melatonin in the treatment of endometriosis: a phase II, randomized, double-blind, placebo-controlled trial. Pain. 2013 Jun;154(6):874-81. doi: 10.1016/j.pain.2013.02.025. Epub 2013 Mar 5. PMID: 23602498.
3. Kohama T, Herai K, Inoue M. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetate. J Reprod Med. 2007 Aug;52(8):703-8. PMID: 17879831.
4. Kohama T, Herai K, Inoue M. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetate. J Reprod Med. 2007 Aug;52(8):703-8. PMID: 17879831.
5. Kohama T, Herai K, Inoue M. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetate. J Reprod Med. 2007 Aug;52(8):703-8. PMID: 17879831.
6. Vallée A, Lecarpentier Y. Curcumin and Endometriosis. Int J Mol Sci. 2020;21(7):2440. Published 2020 Mar 31. doi:10.3390/ijms21072440
7. https://clinicaltrials.gov/ct2/show/NCT04527003 Reddi, Kiran Kumar et al. “Berberine, A Phytoalkaloid, Inhibits Inflammatory Response Induced by LPS through NF-Kappaβ Pathway: Possible Involvement of the IKKα.” Molecules (Basel, Switzerland) vol. 26,16 4733. 5 Aug. 2021, doi:10.3390/molecules26164733