Tame Your Blood Sugar, Calm Your Endo

Do you have blood sugar regulation issues?

If you have hypoglycemia, relate to the word “hangry” (hungry+angry), have huge ups and downs with your energy throughout the day. If you are hungry ALL the time, rely on a steady stream of snacks, get shaky or lightheaded when you don’t eat. If you wake up in the middle of the night wide-awake OR can’t go for more than a few hours without being hungry, it can be assumed you have some blood sugar regulation issues. The more symptoms or the more severity, the more you can see the significance blood sugar plays a roll in your life... for the worse.

 This is the "blood sugar out of control" emoji. Can you relate?

This is the "blood sugar out of control" emoji. Can you relate?

Also, if you follow a low fat diet or even find yourself under-eating or slashing calories and still gaining weight or maintaining, you can also assume you’re in this club due to something called insulin resistance. Insulin resistance is directly related to poor blood sugar handling and if unchecked will lead to PCOS, pre-diabetes, and eventually diabetes. In these cases you most definitely can assume you’re in this category.

If you've woken up in the morning for a fasting blood test (where you don't eat beforehand) so they can test your glucose levels, which ended up "fine", you may think you're in the clear. Here's the thing, that test will often will only catch blood sugar issues once they become incredibly severe, like how cancer is often only diagnose after it's metastasized all over. If you want to stop the issue before it gets to that stage, read on :)

 

What the heck is blood sugar regulation? I promise not to bore you

Have you ever cut yourself and noticed the blood was sticky? Congratulations, you've meet your blood sugar. Sugar in its simplest form is called "glucose", and your body needs glucose to function. Your blood acts like a glucose ATM, allowing any part of your body that needs energy at anytime to have access.

Blood sugar regulation, then, is how your body responds to surges in sugars (glucose) that you consume so that the glucose in your blood remains at a very precise level.  All carbohydrates break down into glucose, so this could also be said it’s how your body keeps the level of blood sugar stable.

Your body wants to have a very steady amount of glucose in the blood at any given moment, 80-100 mg/dL to be exact. If it goes to high your blood is way to sticky and will cause big time problems (#diabetes), if it goes way too low you can faint or pass out (#hypoglycemia). So to maintain this amount without enormous fluctuations, your body must be constantly doing an eloquent dance to always be fueling cells without huge surges or crashes. To do this is relies mainly on the pancreas, adrenals, and liver. 

 This is why your blood sugar needs to remain so constant: So your body has access to glucose energy but it doesn't clog up the roadways. That's why this regulation "dance" is so important.

This is why your blood sugar needs to remain so constant: So your body has access to glucose energy but it doesn't clog up the roadways. That's why this regulation "dance" is so important.

Let’s introduce the players

Do you know what your pancreas does? Do you know how it affects your adrenals, or your liver? No? Cool, let's get down to business and learn some cool stuff then! Here we'll look at the three main organs that work all day long to keep your blood sugar stable. Or, they try to :)

Pancreas:

This incredible organ is part of both the digestive system, and endocrine/exocrine system, meaning it makes hormones amongst other things. In the case of blood sugar regulation, the pancreas makes insulin after glucose consumption, and also makes glucagon when the body is in need of glucose (when someone hasn't eaten glucose in a while). It's the head messenger in this system.

Adrenals:

The adrenals make over 200 different hormones, including the well know sex-hormones estrogen, progesterone, and testosterone. Additionally, they make cortisol which is triggered by the pancreas when there’s not enough glucose in the blood. Cortisol alerts the liver there’s not enough, which then releases the tiny stores it has before breaking down muscle to turn into glucose.

If the stores run out (you can only store a tiny amount of glucose in the body), your adrenals bring out the big guns and pump adrenaline into the system. Adrenaline forces the last reserves of glucose into your muscles in a fight-or-flight response. This used to only happen during majorly stressful events, like a tribe attacking your village, but now can happen over dessert.

Liver:

The liver stores extra glycogen for emergencies, but only a small amount (the average person only has 1,500-2,000 calories worth of glucose stores). When that storage gets low the liver then makes glucose from amino acids in the blood, and by breaking down more muscle to free up even more amino acids when necessary.

 

Look at the Cool Graphs I Made

Want to see a visual of the delicate dance your body does to maintain levels at a very precise 80-100 ml/dL? Good, because I made some graphs to show you :)

See, when properly functioning that purple line is your energy, smooth and constant throughout the day. Your organs aren't overworked, your stress levels aren't rising, all is well.

Now see that red line? That's your energy levels when your body isn't functioning properly. All organs here are on Red Alert, working overtime to try to get the blood sugar back in that healthy range. This alone, without any stressful job or home life, can make your body very very stressed.


Poor Blood Sugar Regulation Severely Affects Endometriosis

Blood sugar regulation is quite the process, but I hope you better understand the basic process now. To summarize, when your body is overwhelmed processing too many carbohydrate rich foods (which is the first time in history this has happened) it wears out the pancreas, the adrenals, and the liver. This in turn affects your endo, and it can affect it a lot.

The pancreas and endo belly

You know digestive enzymes you buy at the store? Your pancreas should be making these in abundance, for free. When it’s overworked it can strongly minimize it’s capacity to help digest. Most if not all women with endo have severely impacted digestion that requires lots of pancreatic support.

Additional food for thought, carbohydrates are only broken down in 2 places. A) your mouth through chewing and saliva enzymes, and then b) in your small intestine with pancreatic enzymes. Because most of our carbohydrate rich foods today aren't very chewy - imagine leaves, roots, and shoots - we basically swallow completely whole carbohydrates without breaking them down first (think, did you really chew that oatmeal this morning?). This puts another enormous burden on your pancreas and when you can't digest carbohydrates correctly do you know what they do? Ferment. Literally. Insert endo belly here.

The adrenals

 The viscous adrenal cycle

The viscous adrenal cycle

The adrenal glands are vital for hormone control. When they're off, so are your hormones. Many women with endo suffer from too low of progesterone, often seen through spotting during the luteal phase and severe PMS. Moreover, healthy adrenals mean healthy stress levels, so if you’re burning out your adrenal function with excess carbohydrate consumption your body will be overall more stressed… potentially even stuck in a stress-based mode that it can’t turn off. This is serious, and will not only make your endo hurt more, but will enable it to spread more rapidly.

The liver

Think you're tired? Imagine your liver. Your liver is responsible for over 500 functions essential to the body, but its main job (like all your organs) is to keep you alive in the moment. That means if it’s getting a fight-or-flight response from your adrenals it’s thinking there’s some serious sh*t going down — maybe you’re being chased by bandits or something — so it drops everything to bring the glucose levels back up from the hypoglycemic state. In dropping its other responsibilities it won’t be detoxing or removing those excess estrogens from your system. Did you know in Chinese medicine there’s no word for endometriosis, but instead seen as weakness in the liver?

Deep Deep Fatigue:

The processing of carbohydrates in this excess can severely deplete your body of vital nutrients. Being in a stressed state burns through your vitamin and mineral stores like a wildfire, so if you’re not only burning stores but then ingesting more nutrient-less carbohydrates at the end, you will continuously be depleting your body of what it needs to survive. It can be summed up as Stuffed yet Starved, and will lead to total exhaustion.

Additionally, to bring it back to "spoons", how many of us only have so many "spoons" to give. Your body was only wired to deal with so many stressors, and like how many internet tabs you have open affecting your computer, when you have too many stressors your body starts slowing down with overburdens. The adrenals are a big part of this, they're frazzled at this point, not to mention the enormous body burden of being undernourished. Deep fatigue sets in.

Infertility:

 "Ninja Assassins?! Now's not the time for pregnancy!" - Body

"Ninja Assassins?! Now's not the time for pregnancy!" - Body

You’ve heard stress affects fertility, so what if unknowingly to you your body was fighting a ninja assassin all day? The processes within the body may be complex, but its thought process is very simple: when our signals say "stress!", we stress. The body doesn’t differentiate whether the stress is a ninja assassin or an ice cream sundae or a huge cold pressed carrot-orange juice. As the blood sugar rollercoaster ensues, your body reacts the same to all three, and it gets s-t-r-e-s-s-e-d. There are remarkable stories of recovery from plaguing infertility, even the IVF resistant ones, by simply controlling blood sugar and increasing healthy fats. This is especially important if you have PCOS (the only way to really manage it is through diet changes like the ones here), but truly just as important for endo.

OK ok, I have the symptoms, but I don’t eat much sugar at all! I mean, do I?

Let’s go back to the basics: all carbohydrates are broken down into glucose. The ones with fiber will break down much slower, yes, but overall if you’re diet is exceedingly high in carbohydrates, blood sugar issues will still arise. That’s why if your diet is based on grains or starchy carbs, if you’re a vegetarian, vegan, or on a low fat diet you can have severe blood sugar regulation issues, even if you’re eating “healthy”. 

 Gluten free pasta, breads, baked goods, sweets, honey, rice, grains, or fruit make up the bulk of your diet? These all quickly turn into a wave of glucose. If your body is strong and this wasn't a daily occurance it wouldn't be a problem, but when this is breakfast, lunch, and dinner for 2 decades you can understand why your body is reacting.

Gluten free pasta, breads, baked goods, sweets, honey, rice, grains, or fruit make up the bulk of your diet? These all quickly turn into a wave of glucose. If your body is strong and this wasn't a daily occurance it wouldn't be a problem, but when this is breakfast, lunch, and dinner for 2 decades you can understand why your body is reacting.

And if we go back and dissect our childhood history, many of us endo girls ate wayyyy too many carb as children and young adults, then had a “health revival” with endo and became vegan or vegetarian. That seems to be the story for about 90% of women I’ve met with endo, certainly me. That means our blood sugar has been out of control for decades, and many of us may never even enabled the fat burning side of our biology kick in.

If you’re still in question, go back to the beginning: do you have symptoms? Hangry, hypoglycemic, always needs snacks, shaky when hungry, big energy surges and crashes, PCOS, insulin resistance, incredibly reliant on caffeine. These are the signs that your blood sugar regulation is out of whack and your body needs to be nurtured and retrained.

 

Why this can make you gain weight… even if you’re eating 1200 calories a day

 The obesity epidemic in America started nearly the exact year that low-fat guidelines were put in place!

The obesity epidemic in America started nearly the exact year that low-fat guidelines were put in place!

Remember, the pancreas makes insulin, and this insulin shuttles the glucose to cells. But, the cells can only use so much glucose. When they’re “full”, so to speak, but the glucose keeps arriving at the door like an annoying salesman, the cells mark the insulin as spam and starts to make the receptors resistant. So the insulin, being turned away from cells, stores it instead. How? By turning it in to fat. Yes, fat is the stored form of glucose.

When functioning optimally, your body can then turn the fat back into energy when it needs … if it remembers how. This is what’s referred to as “fat burning”. But, because so often we’re eating carbohydrates in excess at every meal and throughout the day, the body forgets how to make this conversion. Why should it, if it has excess glucose around all the time?? This, then, is referred to being a “sugar burner” — when your body has forgotten how to burn fat for fuel and demands constant glucose to run. Hence, the constant need to eat carbohydrates (It’s not in your head, your body is literally demanding it of you).

You need this fat conversion system to be primed and ready because, as I mentioned before, you body cannot store much glucose at all. Remember, only 1,500-2000 calories worth. Instead it stores fat, the main source of energy the human body is meant to run on. That means every time you eat an excess of carbs for your energy needs, the cells only use so much, and then all the rest of it is stored as fat. This is why you can be eating a maintenance diet or even a starvation diet and still GAIN weight. Yes folks, it’s totally possible. And the more insulin resistant you are the worse it become.

How to get off the blood sugar rollercoaster

Now that you know how debilitating this stressful rollercoaster can be, it’s time to jump off. A nice thing about controlling a blood sugar system out-of-whack is that it doesn’t often need supplements to heal like the digestive system. It will most often respond incredibly to diet alone. The hard thing is, though, that you have to change your diet. And if you’re addicted to sugar, this won’t be very fun.

At first! Not fun at first! But then I promise you’ll feel better. And remember, this from the girl who gagged at the idea of eating eggs without sweet ketchup. Honestly, the cravings for sugar disappear. Instead, you end up eating a lot of delicious, rich, satiating foods.

The main gist? Remove all sugar and processed foods from your diet (even “healthy” processed foods like gluten free pastas, breads, and baked goods), increase protein and fat.

Recipe Makeover #1:

Blood Sugar Spiker: Fat-free yoghurt with bananas and gluten free granola. 

Better choice: Full fat yogurt with a tbsp cold pressed flax oil mixed in. Blueberries, chia, and pumpkin seeds on top.

Recipe Makeover #2:

Blood Sugar Spiker: Gluten free pasta with vegetable and tomato sauce on top.

Better choice: Steamed squash, drizzled with a 1-2 tablespoons of butter or olive oil, topped with sauce of choice (make sure no sugar added)

BUT don't be afraid of carbs :)

This is by no means trying to make you scared of carbohydrates, we need them! This is more about balance. It’s just getting down the to basics of how many and in what combinations. Increasing protein intake is often a big shift many endo-ladies (who became scared of meat and dairy) can make that will help pretty quickly, Making sure when you eat carbs that you do so with fat will aid your assimilation. Fat slows blood sugar spikes, which is why eating carbs with a fat (think apple and peanut butter, strawberries with cream) will keep your levels more stable. A low fat diet based on grains, fruits, low fat products, starchy carbs, juices, and fat free smoothies will eventually overload the system just like candy.

Women especially need carbohydrates for hormone regulation, so if you're of childbearing age then a longterm ketogenic diet most likely isn't going to help your endo-hormone balance. But the goal is to re-boot your fat burning capabilities so that your organs can relax, your liver can focus, your food can digest, and your body can reclaim its fertility :)

 Click this image to check out a neat article on healthy carb choices from Balancedbites.com

Click this image to check out a neat article on healthy carb choices from Balancedbites.com


 

 

 

 

Endo Enemy #1: Refined Vegetable Oil

I’ve been getting numerous questions about fats since I so widely recommend a more high fat diet, but I realize I need to address the basics before anything else. I wanted to start with how eating fat doesn’t make you fat, or why you shouldn’t be afraid of fat, but first things first. I need to explain which fats literally will make your endo, and overall health worse.

 In this modern day war, traditional fats = good , vegetable oils = evil

In this modern day war, traditional fats = good , vegetable oils = evil

Everyone hates Hitler, but not everyone hated him at first. He was a true politician, coming in a time of societal heartache, passing blame on the innocent, and maintaining an aura of glamour. I’m not going to say vegetable oils are just like him but, hey, kind of close. They came to power during a fear of heart attacks, saturated fat was innocent though widely blamed, they fit a glamorous profile of being associated with vegetables and therefore healthy. See where I’m going here? Yah, I’m about to tell you they’re akin to mass atrocities and a war of good versus evil, with refined veggie oils the latter.

What are refined vegetable oils? Technically they’re actually refined vegetable seed oils, and include safflower, sunflower, soy, canola, corn, and grape seed oils that aren’t cold pressed. If you're like most people you probably have a container or two in your pantry you use on the regular... although by the end of this post they'll hopefully be in your trash (or biodiesel car?). These oils are pushed on the public as “healthy”, which we are finding out they surely are not. Why are they bad? Because, like other seed oils, they’re high in polyunsaturated fats, aka PUFAs. I know I know, polyunsaturated fats are what we’re told in the endo community to eat more of — they include the essential fatty acids omega 3 and 6, which we all know will fight our inflammation. Polyunsaturated oils aren't bad, remember that, the issue is how these PUFAs are manufactured, in a process that renders them extremely toxic

Note: in case you don't want to read much more, avoid safflower, sunflower, soy, canola, corn, and grape seed oils, and remember to read labels since they're in so many processed foods.

Polyunsaturated Oils: the good and bad

Omega 3 and 6 are indeed awesome and necessary to build anti-inflammatory prostaglandins. Every day you should aim to get some really high quality omega 3/6's into your diet for this and many other reasons. Good-for-you doesn't mean heat or shelf stable, though, and these oils are extremely sensitive to oxidation under heat or light. Think about when you get quality flax or hemp oil at the store, they’re in the refrigerated section, and in dark bottles. And as anyone who uses with such oils knows, one never cooks with them! They’re for dressing salads or pouring on food after cooking. Again, it’s because PUFAs are so easily damaged by oxidation. Oxidation = free radicals. Free radicals = endo growth, pain, and progression. And cancer, don’t forget cancer.

 Flax seeds are full of healthy PUFAs, which is why they're cold pressed and kept refrigerated when turned into oil.

Flax seeds are full of healthy PUFAs, which is why they're cold pressed and kept refrigerated when turned into oil.

Looking at how we treat high quality PUFAs (cold pressed, refrigerated, dark bottles) should be your first indication something is totally wrong with the way we treat vegetable oils, which are also PUFAs. When you go to the grocery store do you ever wonder why they’re in a row of big, clear, unrefrigerated bottles? This is the first clue, and yet, they don’t smell rancid at all! Here’s why.

Most of the vegetable oils I listed above are really big ag waste products. They didn’t know what to do with the seeds until they realized they could squeeze oil out of them … but in order to make them so cheap they had to invent a large industrial process to do so. First the oil needs to get extracted out of the seed, which manufacturers use high heat and a toxic gas called “hexane” to get out every drop. You know what heat does to PUFA’s, oxidizes the crap out of them, so now we have a big vat of rancid oil. To make it palatable these manufacturers take 20 or so extra steps to bleach and deodorize the oil, which is why none of these oils have a very unique or strong flavor like other quality oils. Now not only is this oil completely toxic, but it’s a great and cheap preservative for just about every processed food on the store shelves. 

 Don't be fooled, these oils are harboring just as many free radicals as their non-organic counterparts since it's produced the same way.

Don't be fooled, these oils are harboring just as many free radicals as their non-organic counterparts since it's produced the same way.

If you think I’m making up this up, go look for yourself. This is 100% true.

And if you think organic expeller pressed oil is different, I’m sad to say it ain’t so. The process is very similar, minus the hexane, but still involves high heat and then a series of processes to make the rancid oil taste normal again. That means the oil in the bottle is already oxidized before you bring it home, where you may be exposing it to heat all over again.

How Refined Veggie Oils Wreak Havoc in your Body

Back to what I wrote before, oxidized PUFAs = free radicals, and these are the buggers that really cause internal damage. Free radicals are high energy electrons that don’t have a “pair”, so they zoom around from tissue to to cell to tissue looking for another electron to pair with. The intensity is high — think a crazy man on meth with a baseball bat — and one free radical can cause quite a bit of damage, not to mention they multiply within you! Yup, that’s right, if you consume just a little bit of free-radical soup (aka refined vegetable oil) they will multiply inside you by mutilating other previously-normal PUFAs with that baseball bat. This is referred to by chemists as a free radical cascade.

 A yummy free radical cascade on show

A yummy free radical cascade on show

Want to see how a free radical cascade works? Fry something in vegetable oil in your frying pan. Better yet, go get something that's been deep fried. When you do you’ll notice that familiar and delicious crispyness that quickly happens, and much quicker than frying in traditional oils like butter or lard. I’m here imagining McDonalds hash browns that a perfectly crispy brown without being burnt (I used to love those as a kid). That, my friends, is actually a free radical cascade that “fuses” molecules together making them stiff and inflexible rather than a heart healthy fry. And it’s the exact same thing it does inside the body, causing system wide stiffness, inflammation, pain, and, well, heart attacks.

That same free radical cascade that makes your potatoes crispy works equally well on the food you’re cooking as it does frying the inside of your body. They actually blast the amount of vitamins and antioxidants down to lesser amounts than foods cooked in traditional oils. So as you cook with these oils you free-radicalize the nutrients you were hoping to eat, and then you ingest the nutrient-poor food plus the free radicals. Are you starting to hate these oils as much as Hitler yet?

free-radical-illnesses1.gif

It’s also important to remember that every cell in our body has a lipid membrane, meaning it’s encased in fat. Every cell. That means your entire cellular body (ie you) is going to be made up of the fats you eat. If you eat rancid vegetable oils your cell walls will be weak, the communication poor, the function less than optimal, and free radicals abound.

So what do I cook with?

This is easier than you think. Just remember, quality over quantity, and hard as it is sometimes to pay the price tag. Look for extra virgin, cold pressed, organic, and sustainably produced items. These are the oils that should make up your ancestral diet and the basis of your high fat meals.

High Heat Cooking: 

Saturated fats such as ghee, lard, butter, coconut oil, palm oil. Animal fats should be pastured and tropical oils should be sustainably produced (since there’s a lot of rainforest destruction right now to make room for the global demand). Kerrygold is pastured Irish butter sold at Costco, which is an affordable option for good butter.

Med/Low Heat Cooking: 

Monounsaturated oils such as extra virgin olive oil. Try to avoid expeller pressed.

No Cooking

Polyunsaturated oils like cold pressed flax, hemp, walnut, sesame, pumpkin, almond, or other seeds or nuts from food sources. Even sunflower. Must be cold pressed and in dark bottles, no expeller pressed. 

 Traditional fats have been tested for safety over 200,000 years of healthy human reproduction

Traditional fats have been tested for safety over 200,000 years of healthy human reproduction

Supplements - remain vigilant

Just as important as the oils you eat are the oils you supplement with. For many years I was taking a cheap fish oil supplement because I didn’t want to buy the expensive kind. What I didn’t understand was that it was better I didn’t take these fish oils at all. Highly processed and refined, the fish oil I was buying was a rancid PUFA, and instead of omega 3 benefits I was getting free radicals. In a pill. And paying for it.

It’s of course important to get quality omega 6 and 3 oils, especially for people with chronic pain. Without them, you won’t be able to create anti inflammatory prostaglandins your body needs to cool the fire. The thing (there’s always a thing) with eating omega oils is that your body must convert the oil from an omega into a usable form through processing in the liver. Omega 6 is turned into GLA, and Omega 3 is turned into ALA. When one’s liver is not functioning optimally — ahem, most endo ladies — this process is inefficient at best. That means it can help to supplement directly with GLA and ALA while you get your body back to optimal functioning, otherwise you can eat all the omega’s you want but no anti-inflammatory response will happen without the conversion in your liver.

The best supplemental omega 6’s that are already in GLA form include borage oil or evening primrose. Make sure you find oils that are cold pressed and in dark bottles

The only omega 3 supplement available that is already converted into ALA is fish oil (sorry vegans). This is a highly contaminated market though, with heavy metals, rancidity, pollution, and overfishing, so be very careful what you buy and ingest. The only brand I recommend is Rositas Extra Virgin Raw Cod Liver oil, which has been third party tested numerous times and is from a sustainable fishery. That’s not saying there aren’t others, but it’s the one I use and recommend after about a 1000 hours of research.

If you can’t afford the quality supplements, simply don’t buy them. If you stick with avoiding refined vegetable seed oils you’ll be laying a solid foundation already.

Want to Learn More

There's lots of great research available online and in books. You can check out the following links for other blogs:

Wellness Mama - The Post is AMAZINGLY in depth

TheTruthAboutCancer.com - great article on how these oils cause cancer

Healthy Home Economist

Dr. Axe

If you're looking for a GREAT read my personal favorite is Deep Nutrition, by Catherine Shanahan. She does an in depth look at how these oils not only affect your health, but also the health of your offspring!

5 Digestive Reasons You May Have Endo-Belly

THIS POST HAS BEEN UPDATED FOR THE BETTER! CLICK HERE TO GO TO THE NEW PAGE




Endo belly {noun}: the painfully distended and embarrassingly large bloated belly that accompanies endometriosis.

Okay, maybe that's not the official definition (is there one?), but if you have endo you’ll relate. Some women get it more often than others, some get it larger than others, but most endo-sisters will agree that appearing 6 months pregnant is a reality that accompanies them throughout their endo-lives, and no one gives us much help as to WHY?? I mean seriously, why did I look 6 months pregnant on the reg????

Perhaps because endometriosis is so often touted as a “hormonal” problem, many people lump it together with the PMS bloat that happens to many women at some time during their cycle, and just assume ours is bigger and bolder since everything involved with our hormones is bigger and bolder. Rarely will a gynecologist emphasize the crucial role that digestive health has in contributing to this horrible symptom, forcing us women to accept limited treatment options when something is seriously wrong. I know I personally assumed for a long time that it was something related the hormone rollercoaster that has no end....

So, what happens if we start extricating "endo belly" from endometriosis and start treating it as a separate symptom on its own, one that is actually contributing to our chronic sickness, colds, flus, and sinus infections all on its own? One that is creating our allergies and is the reason behind our chronic fatigue? What if, by turning our attention for a moment away from the endo and instead focus diligently on our “endo bellies” we could make large gains towards healing?

Endo Belly and AutoImmune

What all auto-immune diseases have in common is a severely impacted digestive system (and remember, endo is auto-immune related). Moreover, what nearly all endometriosis patients have in common is digestive distress of some sort, which is another reason endo is often overlooked during diagnosis which instead says something like IBS. Even more, since changing of diets is the most touted way to help relieve endo symptoms, we can understand that, overall, there’s a gut-endo connection.

Plus, one of the most obvious signs of a digestive system in distress is: severe abdominal bloating.

Here’s a question for you: did you actually have “endo belly” long before your diagnosis? Ok, I know diagnosis can take a ridiculously long time, so how about: did you find yourself with obnoxious abdominal bloating before your onslaught of other endo symptoms? I ask this just to check in with your own story and see if your endo belly was caused by endo, or perhaps helped cause the endo…

For me I was diagnosed very young with my first autoimmune disorder: ITP. This is where your body attacks your platelets (the little guys that coagulate your blood when you’re cut) so I could potentially bleed to death if I was hit too hard. That’s another story on its own, but looking back at pictures I had "endo belly" all the way back then, long before I even had my period. I looked like little miss sunshine, glasses and all!

 Me next to all my friends, took the glasses off for this pic ;)

Me next to all my friends, took the glasses off for this pic ;)

I only was able to put the story together as I started to heal my gut and saw my endo-belly deflating. I wasn’t treating the endo, rather I was treating my entire digestive tract, and as my enormous endo bloat faded, so too were many of my endo-related symptoms. The digestive distress was, unknowingly to me, directly impacting the severity of the endometriosis. 

Ok ok ok, enough about me, this is about all of us! Which is why I want to introduce 5 reasons you might have endo belly, and a few solutions (including baby steps). To get in touch with your digestive system I’m going to go through each step of the process, and explain why, if it’s not working properly, you might have endo belly.

** The below issues are VERY simplified. If any of you endo ladies want me to go deeper into each one, please send me a note :)

Endo Belly Reason #1: You’re running from lions

Potential symptoms: overall digestive distress, can lead to any/all digestive issues

You probably wanted me to start with something else, but don’t skip ahead! This is where digestion starts, as you get excited about food your body turns on your digestive juices. If you’re on the run, doing a thousand things while eating or stressed out, your body won’t produce these juices. Why? It’s that simple fight or flight mechanism … if you’re body is worried about survival, it’s putting its energy where it counts: towards surviving in the moment. It doesn’t care about slowing down to produce digestive juices! Plain and simple it would rather you make it through the day alive.

Solution: Take time to eat, to appreciate and respect your food and where it came from, to smell it and salivate, and be mellow while you eat. B R E A T H E. If you can eat with a friend or family that’s best. Take time to talk and enjoy each other. Eating alone and get bored? Read something that relaxes you, or listen to a positive podcast or book on tape. Seriously, you could even buy a cute picture book of puppies and kittens (or whatever cuteness overload gets you) and stick it on your dining table to remind you to slow down and put your body in a parasympathetic - opposite of stress - state.

Another reminder if you’re afraid of gaining weight or deal with body image doubts, try to work on changing the way you see food, moving it from the enemy to the savior. The power of the mind is strong, and if you’re subconsciously cursing food, or afraid of it, or have an unhealthy relationship around it, your body will follow in your thought-shadow. Send your food L-O-V-E :)

Reason #2: You don’t chew enough

Potential symptoms: overall digestive distress, can lead to any/all digestive issues

I’m sure you’ve heard a thousand times how we need to chew our food. You might want to yell at me “DUH! I get it!”. Slowwww down here though because I have a very important question: do you really chew? Before you answer, go grab something actually chewy. Could be an firm apple, a steak, or kale salad, whatever you like best. Now chew this food, each bite, until it’s pulp. This will probably take about 30 or so chews, no joke. Now  swallow. Ok that was one bite. If you haven’t been chewing, you may have just realized chewing an apple fully, bite for bite, takes quite a long time, and your jaw will literally be sore after this one little meal. One meal! That means your jaw, my sister, is atrophied from not chewing.

Why is chewing important? You mean, Why is it perhaps the most important and absolutely free thing you can do? Good question :) Because it sets your entire digestive system up for success, and if your digestive system is already incredibly distressed, which it is, than this is the most beneficial thing you can before anything else. And it's free!

Chewing does three things, the most obvious #1: masticating your food to bits. If you think your stomach will take care of the rest that’s NOT TRUE because of #2: salivary amylase. This enzyme is produced in your saliva and is the first (and only) thing that breaks down starches until they reach your small intestine — so if they haven’t been broken down through saliva first, the army of tiny enzymes down south doesn’t stand a chance against these enormous bits. Neither do fats and proteins because of #3: chewing signals your stomach to release HCL (hydrochloric acid). This is why it’s wrong to think your stomach will do the rest of the work your teeth don’t, because if you’re not chewing + salivating + slowly swallowing, your body doesn’t see a need to produce enough HCL.

Solution: Take a clue from step 1, and  allow yourself a nice, relaxing environment in which to eat. Bad habits are hard to break though, so while you're chil-axing with your food, remember to either put down your fork in between bites (and not add more food into your mouth until you’ve swallowed fully), or eat with chopsticks. Ask your friends and family to remind you or make it a goal to support each other so everyone benefits from the magic of chewing. As you get better at chewing your jaw will also get stronger, making it easier to dismantle chewy object.

Reason 3: Not enough stomach acid (HCL)

Potential Symptoms: endo belly appears within an hour of eating, feeling uncomfortably full after eating, acid reflux, GERD, H. Pylori, chronic nausea, food feels “stuck” in stomach.

Your stomach depends on the above two protocols to perform optimally, so if you are stressed, distracted, rushing, and not chewing, your stomach will get hit hard. 

A stomach in distress can have many symptoms, including acid reflux, GERD, a “way too full” feeling after eating, ulcers, or an H. Pylori overgrowth. All of these symptoms are most of the time linked to too low HCL levels, rather than too much acid as we hear about, and why all naturopaths have their clients introduce HCL pills to their meals rather than ant-acids. Here’s why:

When you fill your stomach up with everything you chewed it’s like a fat, protein, and starch smoothie. If you have plenty of stomach acid these foods will start breaking down quickly and be moved forward into the small intestine. If it’s not acidic enough, the food will do what food does in a moist, warm, alkaline environment: rot. Imagine if you blended up you meal and stuck it in a jar, on a shelf, in humid 98 degree weather. You’d quickly watch those fats go rancid, the proteins putrefy, the starches ferment, and the entire jar contents would expand and expand. If you sealed the jar tight it would explode (I'm not kidding, I've had this happen to one of my ferments!) 

This is what happens in your stomach when there’s not enough HCL, it becomes a warm, moist cave. As the expanding food mass rises, it hits your esophagus and burns it - which is why taking an antacid helps. The antacid neutralizes the acid right there at your esophagus where the rising food mass hit as it grew so large. That’s why the antacid is often a band-aid for a much larger problem of not enough HCL in the first place.

Solution: If your endo belly appears within an hour of eating, you could well pinpoint your stomach as one of the main issues in your digestive chain. Same with being overfull or having chronic nausea - a big endo symptom. As you’ll start to see, the solution often lies in treating the issues north of the problem, so in this case focusing on creating a non-stressful environment while eating as well as Chewing. Chewing. Chewing. This will help remind your body to make HCL :)

However, if you’re quite nutritionally depleted (like most of us with endo) even the simple act of making HCL can be very difficult to do. That’s because it takes a lot of nutrients to make HCL, and vise versa it takes lots of HCL to absorb these nutrients (for example you need zinc to make HCL, but you need HCL to absorb zinc). So if your stomach has been working overtime for a long time, you might have lost your HCL ingredient reserves.

In this case, you might consider supplementing with HCL Pepsin pills. This sounds scary (omg taking stomach acid pills??!!) but for many of us can get to the crux of the issue while our body builds back up enough reserves to make stomach acid. If this is the case for you, once you start introducing HCL into your system, your body will your body will finally be able to correctly start the process of digestion.

I’ll remind everyone it’s always best to do this under the supervision of a nutritional practitioner who can help guide you through the process. If you want to read about the HCL Challenge here’s a link to Wellness Mama where she describes it at the bottom. In my personal journey this what an enormous key in finally allowing my body to properly digest and absorb nutrients.

Another thing to consider are your meds. A lot of pain medications can seriously impact your stomach lining and gut mucosa. Only you and your doctor know which meds you need and which ones you can minimize or stop taking, but it’s worth thinking about if you’re serious about starting to heal your gut.

**Food for thought (no pun intended), HCL breaks down proteins, so if you don’t produce enough HCL you can’t effectively break down tryptophan, an important amino acid necessary to make serotonin. If you don’t have any, you literally won’t be able to make serotonin, and you will have issues feeling, well, good. See how it’s all connected?

Reason 4: Small intestine dysfunction

Potential symptoms: Endo belly flairs 2-4 hours after eating, allergies, chronic sickness, malnutrition, have other autoimmune disorders

Now if you're stuck in hyper-drive, haven’t chewed, and don’t have enough HCL, not only will you be utterly uncomfortable, but food from your stomach will pass into your small intestine only partially broken down. Not to mention any pathogens will still be alive and well as they hit your sensitive intestinal tract. 

The middle and lower part of the small intestine is where the bulk of absorption happens. Here the villi and microvilli act like grasses, sweeping up the now itty-bitty nutrients. If your food is half digested, the villi won’t stand a chance at nutrient catching. Imagine having a butterfly net in a field of monarchs. Now imagine having a butterfly net in a field of tetradactyls (yes I had to spell check that one). If your villi aren’t getting nutrients it doesn’t matter how much organic, healthy food you eat, you won’t absorb it. You know what this also means? Yup, chronic, debilitating fatigue.

 On left, villi is short, damaged, and fragile. Nutrients pass on by.

Moreover, now your villi are going to be barely surviving in this unhealthy toxic environment of all those gross, unbroken down food particles and pathogens. I don't want to talk too much about other issues here since there's simply not enough space, but stress, drugs, excess alcohol and sugar, and antibiotics are also big time compounding factors. All this stress leads to issues like gut permeability, or leaky gut.

click image to make bigger - this is your gut when leaky

Leaky gut occurs as the villi environment breakdown, teeny tiny gaps in the intestinal lining are created from which proteins leak out. Because your body is programmed to attack proteins (like viruses and bacteria) they stage an immune response here in your gut against things like … gluten, or casein. Eventually maybe your gut is so deteriorated your body goes into an immune response with nearly everything you eat: eggplant, tomatoes, eggs, grains, etc, and you fall into a cycle of chronic sickness.

Solution: If your endo belly really flares 2-4 hours after eating, or you struggle with allergies, skin issues, or chronic fatigue, you’re probably going to want to spend a good long time healing your sensitive, inflamed, and damaged small intestine.

First steps? Start at the top: Relax while you eat, chew-chew-chew, breathe, and make sure you have enough HCL and Pepsin. This will start to ensure food passing through your system from here on out is more properly digested.

Next, you’re going to have to really delve in to your diet. The diet most associated with healing leaky gut is called the GAPS diet, and is used to heal autoimmune issues as well as issues like autism. Again, it’s really important to work with a naturopathic diet specialist if you want to really see a thorough impact in this area. Every person is unique, so if you try the same elimination diet as your friend Betty, you might not get the same positive results and feel like giving up. When you work with a specialist (I highly recommend working with a Nutritional Therapist, find one here) you’ll be able to start your healing journey with a map, sword, and steed. Without one you may start your journey with some tattered boots and a bucket full of hope … needless to say it could take years. 

Not to say it can’t be done though, you just have to be vigilant :) For more info you can check out my Heal The Gut link all about intestinal permeability and how to approach it. Healing the small intestine means eliminating all inflammatories while the gut heals, including all sugar and starches to kill off pathogens, and calm that inflammation. Depending on your situation (if you deal with candida or SIBO) you may have to do extra re-building and eliminating protocol. Bone broth here will be your best friend (or collagen or gelatin powder) as L-glutamine helps seal and rebuild the intestinal wall.

Reason #5: Large Intestine Dysfunction

Potential Symptoms: foul gas, white coated tongue, diarrhea or constipation, Crones, IBS, Colitis, parasites, dysbiosis

Your large intestine is quite different from your small. It’s where the “leftovers” of water, fiber, and waste move through a larger tube filled with gut-friendly bacteria (over 3 pounds in a healthy person!!) where there leftovers are sucked dry of water and any last-standing nutrients before they exit your body as waste. 

There’s not much blood supply to the large intestine. Instead it relies on its enormous colonies of beneficial bacteria to nourish it. Indeed the bacteria thrive under the right conditions and even create nutrients - including vitamin K, B1, B2, B12, and butyric acid (which is needed to heal and strengthen the intestinal lining)

When there’s dysfunction, though, the large intestine often bears the brunt of everything going on above it. When there’s mal-digested foods arriving from the small intestine, the ileocecal valve (where the two meet, you’d find this halfway between your belly button and right hip bone) can get clogged or even stuck open, allowing “sewage” more-or-less to seep back up into the small intestine where it’s not supposed to be. My celiac friend told me she calls this spot her “gluten spot”, since it always hurt when she accidentally ate gluten, which is a sure sign the valve is inflamed and unhappy.

As these toxic food particles make their way through the large intestines — it’s been maybe 20 hours of warm incubation now, so imagine teeny tiny particles of rancid fats, putrefying proteins, fermenting sugars, and living pathogens — the system is, needless to say, unhappy. And if it’s bombarded like this for years and years, the unhappy ecosystem goes completely haywire. Out go the good bacteria, who can’t thrive in that environment, and in come the guys who can: parasites, dysbiosis, and lots of inflammation. This is where you’d experience anything from chronically bad gas to life altering problems of crones, colitis, or IBS.

A quick note on constipation -- which many endo girls have -- this may not be a symptom of too little fiber. Yes of course it can be that too, but if you've added fiber and still deal with this issue hear ye' hear ye': constipation can just as easily be a symptom of malnutrition. It happens when your body is dry of nutrients and doing everything in its power to absorb them, so if you're small intestine is dysfunctioning and you're not getting what you need, your large intestine is going to try to make up for it by absorbing as much as it can. Since this isn't the main function of the colon, you're going to find yourself chronically clogged (or also going between constipation and diarrhea) and your body strains to get something out of your meals.

Solution: You should be able to repeat this by now :) Start at the top! Relax while you eat, chew-chew-chew, breathe, and make sure you have plenty HCL and Pepsin in your stomach. This will start to ensure food passing through your system from here on out is more properly digested.

I also sense big diet changes in your future, although what they are will depend on your unique circumstance. To address issues like SIBO, crones, colitis, or IBS, I can’t say enough how working with a skilled provider would benefit you. Many of these large intestinal issues are very, very deep, and some people find themselves managing them for years, even decades, without improvement. By addressing diet, adding specially targeted supplements, and taking a Sherlock style approach to discovering which foods trigger you and which pathogens have their hold, you will slowly be able to calm the inflammation, heal the gut, and eventually resume a normal, healthy life without digestive fear.

Lastly, it’s a really good practice to start abdominal massage. Your large intestine skirts your abdomen, and massaging it with little circles as you pass over your abdomen from right hip up to rib cage, across, and back down to left hip will help you colon start functioning better. If you have pain at your ileocecal valve a daily massage will help slowly ease the discomfort.

Endo Belly Popped

I hope this lay-mans description of the digestive tract has helped you better understand what’s going on inside your body and a few of the reasons you may experience such extreme endo belly. Yes you may experience bloating because of hormones, but daily endo-belly distress is most often the symptom of digestive dysfunction rather than a side effect of hormone imbalance.

This might also drive home for some of you the reasons behind your chronic allergies, chronic fatigue, chronic sicknesses, why you have a nice collection of auto-immune diseases, or even why your extreme endo diet didn’t work for you. If your digestive tract is in terrible shape it doesn’t really matter how many nutrients you put inside if they can’t be properly absorbed.

It's also a good reminder why the common endo suggestion of making sure you have a high fiber diet won't do any healing ... the deterioration of our guts is wayyyyy beyond a simple fiber solution.

Healing the gut is really a fascinating process though. I'm sure you'll first be amazed at how much better you feel by simply CHEWING your food, and maybe adding a few HCL pills at each meal. This alone might take your endo belly down a few big belt notches. As for diet, unlike a strict “endo diet” of limiting everything you eat for, like, ever, your strict gut-healing diet will eventually end. As you heal your intestinal lining with a diet like the GAPS diet, you will be able to add back in foods you once would have fallen over in pain as you ate, and foods you probably really miss.

Depending on the level of destruction within (you might be able to guess by the severity of chronic fatigue, digestive issues, and amount of autoimmune disorders you have) the diet could, potentially, take a year or so for you to really recover. For others, a 1-2 month strict protocol might be all you need to start immediately feeling better. Try not to think about the time, though, focus on where you are now in your healing journey. The time will pass no matter what, so always better to feel better as it passes than feel worse. Be patient and lean in to it, remembering to always chew of course :)

Hey, no one said healing was easy, but that’s why they call us endo-warriors.

 Endo warrior, off to kill pathogens in her gut

Endo warrior, off to kill pathogens in her gut

The joys are in what you find as you heal the gut! You wouldn’t even believe that your sugar cravings will disappear (this from a girl who, 5 years ago, screamed at the thought of not having ketchup on her eggs) and you will find yourself with energy without an all-day stimulant stream. Dealing with chronic fatigue is one of the worst things I personally experienced with endo (aside from the pain), and healing my gut allowed me to reclaim my life. You will find your skin returns to normal, your nails and hair begin to regrow, and your moods lifted. Oh yah, and you’ll fix your endo belly too :)))

DISCLAIMER:  I am not a dietitian, doctor, or medical professional, this site is solely for guidance and information to give people more information to make an informed decision about their own bodies best treatment plan. It’s a source of information that helped me put my own endometriosis in remission, and information I wanted to share for anyone else it might help on their journey.