How a Nutritionist Manages Stage 4 Endometriosis

How a nutritionist manages endometriosis  

As with many others in my industry, I developed an interest in nutrition after changing my diet helped me with a health condition. I manage fibromyalgia, pcos and stage 4 endometriosis with diet, lifestyle and supplements.

I originally turned to diet, lifestyle and supplement changes to help my chronic pain condition which I have since been symptom free from. You can read more about my experience with fibromyalgia here.

Endometriosis is a chronic hormone condition which 1 in 10 women in the UK suffer from. However due to the difficulty in diagnosing the condition it is likely that realistically far more than 1 in 10 women have endometriosis. There are 4 stages, 1 being the first stage and 4 being the most severe.

The symptoms of endometriosis vary from woman to woman, ranging from debilitating pain to anxiety, depression and fertility issues. Certainly, I see a great range of symptom type and severity in my clinical work.

Every case of endometriosis I’ve worked with is different and each case has it’s own unique set of drivers (things which contribute to a condition or symptoms) therein lies the difficulty with providing broad endometriosis support – everyone is different.

In my case, my main symptoms were a bit harder to pin point to endometriosis, partly attributed to the fact that as I’ve been interested in nutrition for years now my cycle has been well managed when it comes to severity, length and pain. However, when I first started getting a period my pain was debilitating and I’d often need to miss days from school or work. Once I started changing my diet to help with my fibromyalgia my periods became much more manageable and ‘normal’ for the most part.

I first became suspicious that I have endometriosis after a miscarriage and then difficulty to fall pregnant again. I’d started experiencing bladder pain and pain with ovulation. I was due to speak with a consultant the day after I ended up in the hospital with pain from an endometrioma (a ‘chocolate cyst’ common to endometriosis) which resulted in an emergency surgery and subsequent diagnosis of stage 4 endometriosis.

How I Manage My Endometriosis

I have another surgery planned to excise the tissue and remove adhesions across the ovary, bladder and bowel. Once I’ve had the surgery my goal will be supporting my hormones and preventing future surgeries by doing what I can to prevent new tissue growth. For now my goal has been:

Managing inflammation

Supporting hormone clearance

Understanding my hormones with testing

Supporting autoimmune/health immune response

Supporting hormonal balance and preventing further tissue growth

Supporting HPA (stress) response

The above examples are significant for me, whereas in other endometriosis cases I’ve worked with I’ve seen underactive thyroids or perhaps low stress levels but extreme levels of pain so do keep in mind that everyone is different and the following is an overview to broadly support hormonal balance.

Minimise Inflammation

The tissue created with endometriosis is very proinflammatory as well as increasing histamine release. This means that for someone with endometriosis they are starting their day with higher levels of inflammation than someone who doesn’t. This then impacts the HPA (stress response) as inflammation causes the body to release cortisol which then confuses the hormones even more – it’s a bit of a cycle!

With that in mind I aim to eat as many anti-inflammatory foods as possible and keep pr-inflammatory foods to a minimum. I aim to eat a food of every colour each day and foods like sugars and alcohol are kept to weekends or socialising.

5 Pro-Inflammatory Foods

·      Dairy

·      Alcohol

·      Gluten

·      Red Meat

·      Sugar

5 Ant-Inflammatory Foods

·      Olive Oil

·      Salmon

·      Avocado

·      Walnuts

·      Dark Berries

Managing Stress

The HPA axis refers to how we respond to stress. Cortisol and progesterone and oestrogen have such a close relationship it is almost impossible for stress to not impact the sex hormones and visa versa. While I can’t control stress triggers, I do take steps to manage how I manage stress and respond to it. I don’t get on well with meditation at all so I instead spend time gardening, pottering around the garden, reading or going for walks. I also avoid caffeinated drinks and manage my blood sugar levels.

Minimising Dairy and Managing Sugar

Dairy, in particular cow’s milk can influence hormonal balance due to the amount of estrogen and growth hormone present in cow’s breast milk. I try to be relaxed or flexible with gluten and sugars but dairy is the area I am pretty consistently strict on.

One study showed a nearly 300% increase in blood insulin levels after drinking a glass of milk with a low sugar meal. This is significant when it comes to sex hormone balance as when insulin increases, the protein which controls testosterone and estrogen is suppressed, meaning these sex hormones are left unmanaged until the blood sugar finds it’s footing again.

I manage my blood sugar by drinking 2 tablespoons of apple cider vinegar with 250ml of water before each main meal and always pairing fats/proteins with carbs and sugars.

Lastly, due to the autoimmune aspect to endometriosis I am careful to manage how often I eat sugar. With autoimmune conditions there is an imbalance between TH1 and TH2 cells, with T regulatory cells trying to control things in the centre. Sugar suppresses T regulatory cells for about 2 hours so I limit my sugar intake to once per day where possible.

Other Areas

Nothing in the body happens in isolation so I also work on supporting my hormone clearance pathways (liver, kidneys and gut health), endocrine disturbers and sleep.

Remember that everyone is different, the symptoms and drivers of my endometriosis will be different from yours but starting with minimising pro inflammatory foods, caffeine and stress are a good place to start for most people with endometriosis.