We are all told to get exercise, walk, do yoga, but most have never heard of the crucial element of doing these things while in alignment.
When in alignment, gravity works with us and we work with gravity. When everything is stacked correctly, gravity flows down through our center, blood moves freely through our pelvis, and we move through a strong core (butt and belly) which hold it up.
Here lies information to provide a key missing piece in healing endometriosis. When your body is sedentary or out of alignment it may cause light or stubborn pain, but what you can't see is how lack of circulation, cell metabolism, and wacky-alignment affects your body under the skin, as circulation, strength, and immune activity is also decreased.
How does that directly affect endo? Well, did you know that it’s been know for many years (to scientists, not to any doctor I ever visited apparently) that menstrual cramps are made much worse when blood flow is restricted in the pelvic cavity during your period? What’s more, new research shows that it's more so in pelvises lacking blood flow all of the time. Meaning if blood isn’t freely moving through your pelvic cavity on a daily basis - bringing in oxygen and immune support while filtering out the waste particles - you’re automatically setting yourself up for monthly pain, or worse.
It sounds obvious, but it's best to really understand why. Biomechanist Katy Bowman explains it well: "We require unobstructed flow of these systems to maintain optimal health. For instance, hormones are messengers carried through the blood. The blood also transports oxygen, minerals, vitamins, glucose and amino acids. When blood flow is restricted, cells don’t get fed properly and communication is impaired resulting in hormonal imbalance. Lymph is like the garbage collector and the police force of the body. Restriction in the flow of lymph allows pathological debris to accumulate, causing acidity, pain, swelling, and inflammation.” So without proper circulation, places in your body are akin to a city under siege, with no nourishment coming in, and no avenues out for waste.
Katy Bowman also made this cool cartoon for us to better understand the basics of why we need to move better.
Sedentary Living - the new norm
So, how does a pelvic blood flow become minimized? Lack of movement and/or poor alignment. Imagine the hours you spent sitting in a chair or couch (car, train, school, work, conference, computer, movies, iPhone, etc etc), directly tightening your hips, weakening your glutes, restricting the pelvic floor. Consider this, even if you “exercise” for a full hour a day, percentage wise that’s only 4% of your entire week. And if you’re stuck sedentary for the rest of the 96%, chances are that your tight and inactive muscles stay tight and inactive during your activity hours. That means your suffocating pelvis, glutes, and core remain suffocated.
Just to start the conversation, jot down the amount of hours you sit in a chair like fashion. Consider eating 3 meals, driving, work, school, TV, instagraming, hanging with friends at a coffee shop, etc. If you consider this position - chair sitting - as a plug in your pelvic blood flow, you can begin to see that if you're sitting 70% of your waking hours, that it's having a negative impact on your endo.
As women with endometriosis it becomes worse since most of the time we're told to rest, lay down, recooperate, as if all the time laying on the couch will make the mysterious chronic illness go away. The unfortunate truth is sedentary days on the couch mean sedentary bodily functions inside your body, meaning your cells aren't working well enough to battle the grit inside.
Circulation, the Lymphatic System, and Endometriosis
Circulation isn't just getting blood from your heart to your feet, it's also getting it to every muscle and organ. Moreover, it's role is to get blood to every cell in every muscle and organ. To do this - this being to distribute blood evenly to reach every cell - your body uses your arteries to carry large amounts of blood to a site, then distributes to all the cells through an intricate network of teeny tiny blood vessels and capillaries.
This is important to understand because in between all these teeny tiny capillaries is your lymphatic system, which is a vital part of the immune system. You know, like when your lymph nodes in your neck become swollen when you're fighting off sickness? Same system. And it's all woven through your body as an intricate part of your circulatory system that bring white blood cells and lymphocytes to an area in distress, and removes negative debris, proteins, and bacteria. So as you see below, when your blood is dispersed through your body it brings oxygen and nutrients to your cells but ALSO powers your lymph systems, which removes the rubbish from those cells. They're both woven together like a beautiful organic tapestry!
Here's the conundrum: your body is smart, sometimes too smart, so if you're not using a muscle it will stop expending energy to keep those bitty capillaries alive and muscle vibrant. That means your body basiclaly reabsorbs any capillaries not in use since it's wasted energy (not using this muscle? Fine, no capillaries for you). This affects endo such: if you're gluteus medius in your core is underused and sadly atrophied, you can assume the circulation to this area is null. Meaning no food in, no waste out. Are you better understanding now how if your pelvic musculature is turned off your pelvis is basically being suffocated?
Luckily it's not hard to start growing new capillaries and re-create a vibrant whole-body circulatory system. All you have to do is start activating these "dead" muscle groups through simple activation exercises, and learn to train your strengthen your aerobic base. Truly, not hard, even if you're often in pain. This is why I'm also including a page about creating a strong aerobic base. Moving your body in accordance to these principles will help slowly increase circulation to all these little muscles we've put aside.
Let's get moving!
The below links go over new ways to move. There are small movements and big movements, movements that activate muscles that haven't turned on for a long time while loosening steel-strength-tension in others. These movements add up to start pushing your body back into the shape it's supposed to be in, and letting that valuable blood supply circulate freely.
Some of the alignment posts may seem far related to your endometriosis pain, like your tight calves for example. But in the spirit of holistic healing I’ll remind you that everything is connected. Yes, even your calves, which when tight won’t stretch enough while you squat - causing your butt to de-activate and tuck under - meaning your glutes weren’t able to fire and thus - less blood flow to the pelvic region and more tension in the lower back. Catch my holistic drift? Happy findings!
We were born to move with ease, but strap on shoes at a young age, sit in a chair for a few decades and BOOM, bodies are tight, weak, and unbalanced. Learn how poor alignment can affect your endometriosis, how breaking the molds of sedentary behavior can heal, and how to begin correcting it for better all around health.
Burn Fat, Not Sugar
Do you know the difference between aerobic and anaerobic? Do you know if you're a fat-burner or a sugar-burner? Learn how these two are ultimately intertwined, and how building your aerobic base will allow you to become less stressed, injured, or ill.
Learning to move from your core will help place your body weight loads through your pelvis, bringing circulation back to the stiff and atrophied muscles that directly contribute to your pain.
As you strengthen and align, you'll begin to feel a difference in the amount of endo pain you have. Moving better is guaranteed to help heal your endometriosis, and is a factor I deeply believe to be just as important as nutrition though continually overlooked. Just like humans were never meant to eat nutrient-starved white bread products all day long, they also weren't made to move through a day using only 2-3 positions (chair sitting, standing, laying). The body is only as strong as all of it's part, and can't be truly vibrant and healthy if only your digestive system is meeting its daily quota of needs. Your body has needs too, and they truly can't be ignored.
What is the "core" and how does it relate my my uterus?
I'm going to explain just a little bit about the "core" since I refer to it at least 100,256 times, and so many people immediately think abs. Like, a 6-pack. Please recycle that 6-pack now, that is NOT a core, many people with abs of steel can look fit on the outside but have a weak core inside. Why? Because the core consists of many layers of muscles, muscles that stabilize you and help move you, and the abs you see are only the outside layer.
Truth: your core is pretty much everything but your arms and legs. It's your lower back, belly, butt, and inner thighs. What do these all have in common?
They're the exact muscles your body doesn't use if you sit in a chair (your chair holds you up, not your core). This means they're probably pretty atrophied
They all surround your uterus! If your core was a hamster ball your uterus would be the cute hamster inside. Do you think that hamster wants to be denied access to light, air, and nutrients? Neither does your uterus.
Want to see how your own core functions?? I hope so, because I have an awesome at home test for you here:)
Who is Katy Bowman and how does she relate to my uterus?
I need to introduce you to Katy Bowman because a) I refer to her in this site as often as the word "core", and b) she's rad. Katy is a Biomechanist, scientist, and educator, but a really approachable, fun, and engaging one. I guess you have to be if you're going to educate people about their pelvic floor disfunction in new and interesting ways ;) But really, she has a cult-like following because she's changed so many lives, often by just helping create a subtle shift in perspective, planting the seed that there's an alternative to the pain we're often told is here to stay.
I myself found Katy after dealing with years of wacky body mechanics that effed-up my IT band (one day I was a svelte runner, the next I was not). No one could help me, until I stumbled on Katy's site.
Thank God I did! Katy's information helped me see that my knee wasn't the problem... my whole body movement approach was the problem. By correcting my alignment I began to move better, run again, and then my endo pain started going away which led me to my total ah-hah moment: body mechanics is directly related to pelvic pain. Girls, this stuff works and it makes sense. As you become more interested I encourage you to start reading Katy's many books, check out her awesome site, follow her on instagram, and even listen to her podcast.
Here's the link to her site, bookmark it! - https://nutritiousmovement.com/
Time to Move Better
Because your core may be so weak, it's important to first activate the muscles to turn them on before you start doing a Jessica Alba style workout.
Yoga is often touted as the best form of exercise to help build core stability, but I'm here to say ... if you do yoga 3-5 times a week it won't even begin to counterbalance the lifestyle of sitting you may have. There's no way any movement practice can strengthen and heal your core if you spend the next 70% of your life sedentary, and with wacky body mechanics that degrade your core strength. That's what it's so important to re-learn movement and alignment so that you can be benefitting your core all day long.
The following information is broken down by position: sitting, standing, walking, and squatting. Each bit will give you insight into how to better hold your body so that you move through your pelvis, and gives some correctives to help you begin to shift.
Resetting your body mechanics will help you breathe with your diaphragm, which is like a free abdominal massage 23,000 times per day. This will help bring circulation back to the area you need it most: your abdominal and pelvic cavities
Sitting for elongated periods of time is really tough on the body, but it doesn't have to be as degenerative. Learn tricks to help turn your forced sitting time (work or school) into a less stressful time on your body.
Re-learning how to stand correctly may greatly improve your energy level while decreasing tension, anxiety, and pain. If you have any sort of pelvic floor issue this is even more important. When you let gravity flow through your center uninhibited you will let the chronic tension in your body struggling to hold you up (that you may not even know is there) begin to release. Doing so will allow you to move more freely, have more energy, and, of course, deal with less pelvic pain. Here you'll learn the basics of standing anew.
Walking isn't challenging, persay, you can do it without falling after all. But walking correctly might be another story. When we look at the loads placed on the body while walking, it's imperative to have a strong foundation so that, you guessed it, the main loads are falling through the pelvis and we're moving forward with strength. Ever heard "walking is like controlled falling"? Not true! Here we'll look at the basics of walking and a few exercises that will help your walk be the most efficient and beneficial it can be.
Pelvic Floor + Core Function
Both important, both connected! Learn why kegals may be making your pelvic floor connection worse, how to visualize relaxation of this hard-to-reach muscle group, and how squatting will a) turn on your glutes and b) tone your nether regions.
Let's start at the basics: human's have white and dark meat too
Before I talk about diet, I want to start at ground level on sugar and fat burning. That is, which muscles they each feed. This will help you better understand the connection between diet, movement, sugar cravings, and fat burning.
When most people think of aerobic exercise they think anything that gets the heart rate up: running, biking, spin classes, Jane Fonda. If you press the question of aerobic versus anaerobic, some people would guess it has to do with oxygen. But to what extent? Is it just when you push yourself to be completely out of breath via sprinting? Or hefting a load of laundry up 5 flights of stairs to your apartment?
Honestly, learning the difference between the two is the best thing you can do for your body and becoming a stronger, healthier person. And it’s probably not what you think.
I’m going to start by having you imagine a chicken. Chickens have both dark meat and white meat. The dark meat is more delicious since it stores the fat of the bird (the energy, if you may), and it’s also much less chewy, stringy, and “brittle”. You know what I mean, when you take a piece of cold turkey breast out of the fridge you could snap it in half. I'll explain why this is important later.
Ok, back to people. Humans also have the same two different types of muscle fiber: red and white. But instead of birds, our own muscle fibers are woven together throughout each of our muscles, so both red and white are woven into a tapestry throughout our bodies.
What’s really interesting is that each of the two muscle fibers behave incredibly different, and even require a different energy source. Here’s the break down:
Red: Known as “aerobic” muscle fiber because burns fat for energy (think a simmering stove or coal fire), a complex process which requires oxygen. They’re also known as slow-twitch muscles because of their relatively slow contraction, but they’re also the muscle fiber that gives your body a strong frame. These guys are the ones continuously holding you up in your joints, feet, and structure. They are not easily fatigued and in fact can go for days without cutting out. — think of the chicken, their dark meat is in their legs so they can walk around all day without tiring.
White: Know as “anaerobic” fibers because these fibers quickly burn (think explosion) sugar for fuel and doesn’t need oxygen. These puppies contract 3x as fast as their red counterpart which allow you to sprint fast, fight strong, or do any fight-or-flight activity … even stress. If you’re pushing yourself to your limit (even if you’re not going fast, per say), you’ll be tapping into this muscle fiber. They are easily fatigued and can really only push 30 seconds to 1 minute.— think of the chicken, their white meat is in their breast and wings since they only fly when they feel in danger.
Both systems will be working inside you all the time, although the percentage will differ. The problem arises in the question: which system do you predominantly use?
Are you a fat burner or a sugar burner?
This is the question that changed my life. I had focused so long on my healthy inputs (ie food) that I wasn’t paying much attention to my outputs (ie exercise). You can be eating really healthy and making gains, but if you’re always pushing your white muscles fibers to react you’re going to be constantly craving sugar, getting injuries, feeling tired, and even getting sick.
It’s not that white muscle (anaerobic) behavior is evil, it’s that many of us have come to rely on it as our predominant system used and the only one we feed. We are constantly revving it up by doing activities like the high intensity workouts, by pushing ourselves too fast or too far, by trying to outcompete others, or even by the simple stresses of daily life -- Yes, your body will react the same way to stress as it does by sprinting 100 yards, by tapping into the “fight or flight” response of your white muscles fibers. That means if you’re running from a lion or stressing over your job, the same system is going to be used. (learn about minimizing stress here)
As our busy lives push us to overdevelop our anaerobic system, our body responds numerous ways — the most obvious one perhaps being a constant craving for sugar as fuel for this type of energy production. And as I said before, this energy can’t be stored (you store fat, not sugar), so you will need to eat often to keep your energy up. Check in, are you starving when you wake up in the morning? Do you get shaky after a few hours of not eating? Do you always need to have food available to you for when hunger suddenly strikes? Is “hangry” (hunger + angry) a word you often use to describe yourself? Have you had bulletproof coffee and only felt sluggish after and wondered how the heck is this stuff supposed to be human rocket fuel?
These are all symptoms that your body is relying on sugar to constantly fuel you, meaning you’re anaerobic system is overdeveloped and you probably have…
Aerobic Deficiency Syndrome (ADS)
You can be a couch potato, a moderate athlete, or even a highly trained athlete and still have ADS. It’s not choosy. “ADS occurs when the aerobic system is not well developed and maintained, and the body only has the anaerobic system to depend on for energy, movement, and physical support” (Maffetone). More or less, use it or lose it.
You can develop ADS easily in our culture, but the most common culprits are
Not enough aerobic activity: not moving enough in general throughout the day, and /or not performing correct aerobic exercise (which is an easy formula! I’ll explain it later on)
Too much anaerobic activity: high intensity workouts or chronic stress.
Also can be prompted by carbohydrate intolerance and low-fat diets, i.e. you’re only fueling your anaerobic system.
Physical and mental fatigue - general lack of stamina
Chronic physical injuries - do you constantly hurt yourself when you start exercising more?
Hormonal imbalance - check
Excess storage of fat - especially in the belly
Reduced immune function - do you get colds, sinus, ear infections etc a lot?
Exercise intolerance - do you feel worse after your workouts, more fatigued or lethargic?
Poor circulation - if you’re not using half your muscle fibers, then half of your muscle isn’t getting blood
How Increasing your Aerobic Base with Help your Endometriosis
Increase your circulation which allows oxygen and nutrients in, debris and toxins out. More on that below
Aid in your chronic fatigue
Build your mitochondria - the little energy makers our cells need for vitality.
Make you a fat burning machine - that bulletproof coffee will finally acts like human rocket fuel because your body will be efficient as using fat as fuel. Similarly, you can significantly reduce the amount of carbohydrates you consume and feel incredible energy as you up your fat intake.
Turn off your sugar addiction
Heal blood sugar issues or hypoglycemia you may have developed.
Return your stamina, whether mental or physical
Help your brain function better!
If you think of aerobic activity as a necessity to live, just like vitamin C, then you can see that having a deficiency can affect you just like any other. And, like vitamin deficiencies, you can get rid of ADS with the correct inputs. It just means you need to start re-training your aerobic system to perform in place of your anaerobic to build a strong aerobic base.
How to build your Aerobic base
Don’t worry, I’m not going to suggest a nuts workout here. Quite the contrary. In order to build an aerobic base you need to do low-intensity activities that taps into your slow, fat burning system. Like? Like walking, the miracle movement that pretty much helps every endo-body out there. Of course you could also include any activity really - running, biking, swimming, kickboxing - as long as you keep the intensity low, which you can expect to be a challenge at first. Here's how you know what's too intense:
The Maffetone 180 formula
This is the formula to find your maximum aerobic heart rate. What is that? It’s the rate when your body switches from aerobic to anaerobic activity, or when you start relying on sugar instead of fat, or when you turn your fight-or-flight response on. It’s the number of beats you don’t want to let your heart go over.
Take your age and subtract it from 180.
Now modify based on the following
If you have or are recovering from a major illness or are on any regular medication, subtract an additional 10.
If you are injured, have regressed in training or competition, get more than two colds or bouts of flu per year, have allergies or asthma, or if you have been inconsistent or are just getting back into training, subtract an additional 5.
If you have been training consistently (at least four times weekly) for up to two years without any of the problems in (a) and (b), keep the number (180–age) the same.
If you have been training for more than two years without any of the problems in (a) and (b), and have made progress in competition without injury, add 5.
For example, I’m 31 and in good health now, so my number is 149 (180-31, no modifications). When I started 18 months ago at age 30, I subtracted an extra 10 for endo, allergies, poor immune function, and chronic injuries, so it used to be 140.
Once you find this magic number you have to monitor yourself while exercising to make sure you don't go above it. The best way to do that is to get a heart rate monitor. DO NOT USE the Fitbit watches, they have been shown time and time again to be inaccurate when reading your heartrate (plus I heard they can make people become obsessive compulsive ... talk about extra stress!). No, best by far is a traditional loop-around-the-chest HR monitor. You can buy either the watch kind (more expensive) or ones that sync with your iPhone and an app. (I this one and it works great). If you’re not keen on spending the money right now, you may be able to generally guess this rate by nose breathing while you move… if you feel like you need to breathe through your mouth, slowwwww down until you can comfortably nose breath again.
Depending on your level of fitness it may not be a problem to stay below this heart rate, or you might be an exercise junkie and feel so slow that you want to kill yourself. Either way, the interesting thing is thus: as you build your aerobic base you’ll be able to go further and faster without raising your HR to its limit. For me, when I started jogging at my Maffetone HR it felt nice and mellow, but I couldn’t run up hills without walking because my HR would soar. So I jogged slowly and walked up hills. As the weeks progressed, I noticed I was running miles faster and that I could slowly jog the hills without stopping. After a few months, I was cruising at a pretty fast pace for me without getting near my HR limit. I was watching my aerobic base strengthen without my usual onslaught of injuries. So if you're either dying at the slow pace or craving your fast pace again, give it time. You'll be up to speed in no time.
OF COURSE, Remember Your Warm up and Cool Down
It all starts with a warm up and cool down phase, which Dr. Maffetone calls an "aerobic bonus" but of course I want to cycle back to circulation so I call it a "circulation bonus". The more you understand circulation and it’s importance to your endo the more power you have to increase it.
Each phase should be from 10-15 minutes that you slowly raise your heart rate to your maximum aerobic threshold. So if your HR when you start is resting around 80, you want to run at 139, you’re going to start by walking, then walking fast, then maybe a very very slow jog, to a jog, until 10-15 minutes later you’re at 139. This is very different than a traditional warm up to get you immediately huffing and puffing and here’s why: you want to turn your circulation on.
How Aerobic Base Training Increases the Right Kind of Circulation
Have you seen a river basin before? They’re beautiful. And they look just like your circulatory system does when it’s well developed. Your arteries are like the huge river, and all the capillaries are the rivulets that fork off, bringing water and life without blowing out the natural landscape. If you imagine your circulatory is the same way, you want your arteries to slowly bring blood to your muscles, and then have them pool into the capillaries, feeding all your muscle fibers and bringing oxygen while taking away debris and toxins. That’s what your circulation does! So if you speed on up to your max HR you’re creating more of "garden hose at full blast" style circulation, forcing blood into your arteries like an explosion that doesn’t allow it to slow down enough to feed into the little capillaries and nourish the rest of your body.
Same for the cool down. You want to allow your blood ample time to slowly pack up and leave your muscles. Not only will this make your circulation function better, you’ll also be less sore, have more energy, and have increased aerobic performance.
Even if you only have 30 minutes, it’s better to warm up to your HR then immediately start the cool down rather than rush your body. Especially as you just start working to strengthen your aerobic base.
Lastly, if you're plodding along no where near your aerobic threshold do not force yourself to get there! Listen to your body and only do what you can. You're getting all the aerobic benefits by staying below that number, even if it's way below.
The time it takes to establish a solid aerobic base will depend on where you’re at now, but be open to giving it 3-6 months. That’s 3-6 months without going over your aerobic threshold, so be patient with yourself if you’re either starting from scratch, or used to being the fastest in the pack.
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.
Click each image for a link to where it's sold on Amazon.
Sites and Links
KATY BOWMAN'S SITE FOR EVERYTHING YOU NEED TO KNOW ABOUT LEARNING TO MOVE, CORRECTLY, AGAIN.
MOVNAT SITE FOR RELEARNING MOVEMENT, STRENGTH, AND PLAY!
Ep-i-gen-et-ics: the study of changes in organisms (people) caused by changes in gene expression rather than the genetic code itself.
Epigenetics is a seriously cool area of scientific study that’s helping humans reframe the question of why we get sick— amongst many other things of course. In simplistic terms, it’s the study of our genetic software: if genes are the computer, epigenetics program them how to behave. It’s the study of why some genes get turned on or off based on environmental factors leading to things like, well, disease. That's why epigenetics is soooo cool for us endo girls (or anyone with a chronic illness) because it shows us why we're not the unlucky winner of a genetic lottery, how our genes express themselves, and why we can't "cure" endo but we can heal it into remission.
This new information is rewriting the health conversation we’ve all heard, that women like us lost the genetic lottery when in comes to health... heck, it's the realization there's no "lottery" at all. It's the science that's showing it wasn't our genes that made us “the sick kid”, or that we got endo since it "runs in the family", it's showing us that our genes are expressing the way they are (painful, awful endometriosis) because of real life factors, not unlucky mutations.
How is that different exactly? It takes the randomness away from disease development and allows us to take back the reigns of improving our health. Take a very simple example of bad teeth. If your grandma had bad teeth, and your mom had bad teeth, it's not written in genetic stone you'll have bad teeth. It all depends on how your genes are fed. If you eat like they do, there's a high probably you will develop bad teeth, yes. But if you eat a balanced, very nutrient-rich diet, you probably won’t (and I’m not talking about more veggies, I’m talking more butter and liver). It goes for bad teeth and flat faces without cheekbones, all the way to cancer, and chronic diseases. Just as we get sick when we don’t take care of ourselves, epigenetics shows us that so too can our genes.
But epigenetics is more than food. Researchers studying epigenetics have looked at how everything we do — think, eat, breathe, stress about — affects our genes. Indeed, all of these things do affect their performance in some way. Initial studies of Holocaust survivors grandchildren are showing the immense stress faced by their grandparents two generations before have increased epigenetics markers for their own stress disorders today. Pretty trippy.
The body is resilient though, and even if many of your negative epigenetic markers were inherited and compounded by your own lifestyle, your genes can be retrained to pick up the slack! It's the reason more and more children with severe autism are being healed with intense diets, and why a person like Dr. Terry Wahls could reverse her advanced, wheel-chair-bound multiple sclerosis to now be living a healthy, vibrant life. It’s why a sickly person like me who dealt with severe endo, autoimmune, chronic illness, and joint issues is now healthier at 32 than at 16. It shows that even if you inherited a line of weak epigenetic markers, if you give of your genes an abundance of what they need/crave/are dying for, they will start expressing correctly again.
How Lifestyle Makes your Genes Sick
Epigenetics examines both toxins (stress, chemicals, etc) and nutrition to see how they program your genetic expression. You could summarize this as all your "inputs", and your body needs a lot of the good kind.
Every cell in your beautiful body has a function and a specific nutritional need. Think for a second about just how much your body does. If, for example, you eat and then walk, your body will simultaneously be digesting that food while moving the rest of the food you ate in the past 24 hours through your entire digestive system, absorbing nutrients and channeling them to their appropriate places, fending off foreign invaders, and making waste products. Simultaneously, it will be sending blood to all the muscle groups involved with your walk, will be absorbing oxygen from your breath and sending waste materials out, pumping your lymph system, all the while your brain not only views the terrain and keeps you balanced but also is thinking up all those thoughts that fill your head. There’s tons more of course, going on during this walk, but think about all the nutrients that are needed to fuel these processes alone. Lots!
If that nutrient quota isn’t met today, that’s okay, the body will survive. But if it’s not met over a lifetime (or the lifetimes before you) then your genes will start expressing themselves differently. Without enough inputs, your body will have to start prioritizing what it does to keep you alive in the now. To conserve energy, certain genes in your body will start to “turn off” (usually the reproductive tract turns off first because the body has no extras for procreation during this time of “famine”), while your body might steal vitamins or minerals from other storage units in order to function at this very moment — like stealing calcium from your bones in order to power your muscles for your walk.
This is a big reason why you might be dealing with chronic debilitating fatigue. Or lack of “spoons”. Because your body has absolutely nothing in reserves. This too, is how genes can go haywire and autoimmune diseases turned on.
Why aren’t your genes getting enough nutrients?
Many reasons, one being the enormous amount of processed foods we’ve normalized in our diets. The USDA estimates about 50% of the calories we consume are in the form of vegetable oils and sugar … this is akin to 1/2 of your calories come from cardboard. But worse. Literally worse than cardboard. The amount of sugar consumed is also pretty wild. There’s a figure that in 1700 the average bloke ate 4 lbs of sugar a year. Now the average American eats around 170 lbs per year.
Beyond that, it also comes from the demonization of fats — how we see fat as the enemy rather than a nutritional powerhouse (when it’s the right kind of fat, of course). It comes from the government powers that condemned cholesterol and encouraged margarine and veggie oils over nourishing grass-fed butter and lard. It also comes from factory farms that created sick and sad animals, eggs, and milk with no nutrient content, the enormous corporate farms that thump out veggies from soils so depleted there’s little else beyond fiber and water, and the awful relationship many women have with food, thinking the less they eat the more they’re worth.
As for toxic inputs? We’re stressed to the max, and not just those of us with high power jobs, this includes the elderly, the rich, the poor, teenagers, and even children these days. The expectations we feel we have to live up to, the never ending “to do” list, the unforgiving self, it all ads up. Stress is one of the most potent environmental toxins around, and when we have heaps of it every day it’s like living in a backed up sewer system. We compete with others in our community, we’re afraid of failure, we tell ourselves mean things about ourselves, things so mean we wouldn’t even say it to someone we hated. Not to mention the 80,000 chemicals we face every day.
No wonder our genes started expressing themselves differently!
It's not too late: How changing your lifestyle now can make your genes healthy
“You can’t cure endometriosis” This is a phrase I detest more than anything. ANYTHING. Ugh, seriously, I wish it be struck from the earth. Why? Well, ok yes, because it is technically true. Like other autoimmune diseases and their relatives, once you get your genes here “turned on”, there’s not yet a known way to turn them back off. The reason I detest it so, so very much — even though it’s true — is because it makes us sufferers think there is nothing we can do to change our trajectory. No matter what, we will be sick, tired, and chronically ill. The end.
Which is why I love epigenetics :) Epigenetics allows us to see there was a pathway to the formation of our sickness, and therefore a pathway to healing -- rather than being the random genetic lottery winner of doom. A random doomed winner would be a person near a nuclear bomb. No matter what they did in their lifetime to keep their genes healthy, their body would most likely develop severe cancer. As for chronic disease? According to epigenetics, the genes haven't been changed by a random event, and can therefore be retrained with the right inputs. Let me repeat that again: cells can be retrained. Cells respond directly to the diet and lifestyle communique we send them, and thanks to the resilience of our genes, they will respond quite nicely if they receive nice inputs. So with a series of lifestyle overhauls we an actually rebuild our genetic wealth and improve the health of every gene and cell in our body. Oh, and for our children.
Want proof? A great example of this is Terry Wahls, who is one of my personal role models. She’s a professor who reversed her progressive multiple sclerosis through diet and lifestyle (after failing miserably following the pharmaceutical path). I mean, she was in a wheel chair for heaven sakes! And now she flits around the globe helping others with autoimmune through her Walhs Protocol healing diet. She may not be able to cure M.S., but she discovered a way to heal from it.
More proof would be, well, me. My endo was life crushing, stemming from weak epigenetic inheritance, a lifetime of nutrient restriction, lots and lots of unrealized stress and self-pressure, and movement deficiency. I was told there was no cure, prescribed pain meds and surgeries as bandaids, and even just a few years ago was told I should have a hysterectomy. But with two solid years of epigenetic healing - diet, movement, and mind - I'm now vibrantly healthy. So healthy I could finally do what the doctors said I never could do on my own: conceive a child.
But, for all you nagging endo-sisters, I still admit that even though I'm healthy and can say I’ve healed my endometriosis, I still can’t say I’ve cured it. This is true of anyone you’ve heard that’s healed their auto-immune issues through targeted lifestyle changes: they’re healed but not cured. Who cares, I say?! For me it doesn’t matter what word I use if my body is back to healthy. If it walks like a duck, talks like a duck… Yes, of course it’s a shame we can’t cure our disease, but by living a new (better, funner, healthier, more creative) life, you can help ensure the other genes are happy and vibrant, meaning they’ll pick up the slack for the ones not working right.
This is why even though there’s no cure (don’t repeat that to yourself, btw), with the correct approach you can heal your body and reclaim your life. You can heal your epigenetic expression in many ways like you can heal from the flu … it just takes a little longer and lot more work since instead of one flu you have, like, a trillion cells.
Epigenetics and Diet: Your Heal Endo Diet Will Look Different Than Mine ... or Hers
If you’re reading this saying “But Katie, I tried the 'endo diet' and it did NOTHING for me!” please hear me out. Dr. Catherine Shanahan writes in her book Deep Nutrition, “By simply replenishing your body with the nourishment that facilitates optimal gene expression, it’s possible to eliminate genetic malfunction… No matter what genes you were born with, I know that eating right can help reprogram them”. So the question is, what is eating right, and how does eating right look different for me and you?
First of all, across the board we can agree that every endo girl needs to give their extremely malnourished body a big infusion of nutrients to regroup and heal. It means eating way more than we imagined, the produce should be local and organic, the animal products from happy, grass fed animals and, if you’re not digesting properly, that’s of upmost importance to fix asap so you can absorb it all. The foods you need include the epigenetic powerhouses listed below:
grass-fed meat and organs
raw grass-fed milk, kefir, cheese, or yogurt
pastured eggs, especially the yolk
large variety of veggies including - if you’re doing the Wahls Protocol at least 9 cups a day, 3 cups each - sulfur rich veggies, brightly colored veggies, and dark leafy greens.
lots and lots of ancestral, nutrient dense fats in the form of pastured butter, lard, coconut oil, avocado oil, olive oil, and cold pressed flax, hemp, pumpkin, and more.
The uniqueness of your own diet will lie in how you feel eating certain ways because of your ancestral heritage. If you’re asian you may not be able to tolerate dairy products at all, some women with European heritage, like me, will relish raw milk and have it be a key to their healing protocol. Some women will heal exceptionally well with lots of cold water fish, others with grass-fed red meat. Some women will feel best eating a high percentage of fats and low carbs, while others may really need grains in their diet. Some of you may not feel anything until you finally address the deep-set stress and anxiety that plagues your genes every second of every day. This is all unique, based on your heritage of how your ancestors best performed the past 200,000 years (that’s a long time) and why no issue of Cosmo will ever spell out which diet works best for you.
The last generation of women in your family that regularly ate like this was, depending on your age, your grandmother, great-grandmother, or great-great grandmother. In a time before vitamins, rampant antibiotics, or an ER around the corner, health was as important as gold, and these women ate what their ancestors did before them to ensure generations of healthy genetic expression. The goal of the diet wasn’t to look hot on the beach, but a diet that ensured full body and reproductive health, health of self and health of offspring. Though they were probably pretty hot too, since this diet will make your body vibrant with health ;)
Which is why I look at the old “endo diet” and wonder how it’s still in existence with all the nutritional knowledge that exists. As a diet that cuts out gluten, soy, dairy, meat, sugar, and caffeine without saying what to replace them with is a diet that can be one of the most nutritionally void on the planet. I’m not saying it definitively is, but without the correct knowledge, food prep, and nutrition understanding it can be. It certainly was for gluten-free toast and cereal me.
The longer term problem arises when a nutrient deprived body is deprived of even more nutrients, not to mention add a slew of nutrient robbing pharmaceuticals in to the picture. Many women who adopt this diet continue eating quite a bit of processed foods, including gluten free pastas, breads, and refined grains. Then there’s the highly processed and refined dairy-free products, highly refined nut milks, highly refined snack foods and “healthy” vegan shake powders, not to mention all the highly refined VEGETABLE OIL (insert scary scream of death!). This oil is like pouring free-radicals over every healthy thing you eat.
And remember, most of this stuff was invented about 40 years ago. Invented, not discovered. This is not what your great grandmother or any of your ancestors were eating for fertility and health. Read all about it HERE.
Which is why it’s just as important to heal your relationship with food as much as heal your relationship with your genes. Too often women to bring their fear of food with them during this healing journey — small portions, low fat, calorie counting, a potential desire to be vegan. Indeed the highly restrictive endo diet could potentially look like a low-fat diet from the 80’s. I wish I could beat society up for this, for what they do to us women and our relationship with food. You can’t escape it! From our mothers insulting their own “thunder thighs” in front of us from a young age to our respected women role models always following the latest fad diet, oh yah, and the media telling us our self worth is directly correlated to our dress size. Is it really any wonder we grow up to demonize food?
Indeed this was even one of my own biggest hurdles after I finished my gut healing protocol — not the endo itself but the mental gate I had to tear down as I was forcing myself to eat as many nutrient dense foods I possibly could. I looked at the Weston Price Fertility Diet and the Wahls Protocol and wondered, how the hell am I going to eat that much food?? A big breakfast, lunch, and dinner, including 9 cups of veggies, 4 cups of raw kefir, lots of eggs, organ meats, bone broth. coconut oil, fermented veggies, and 4 tablespoons grass-fed BUTTER? I was used to taking supplements, not eating TONS of real food.
It turns out that it wasn’t the fact I couldn’t eat this much, it was my mind telling myself “that’s too much food for you”. I didn’t have an eating disorder, but it’s obvious my eating was disordered from being raised in a calorie counting world that had me thinking I knew my caloric limits. But nope, my body figured it out real quick ;) My genes were ravenous and I was amazed how much nourishing food I could throw back. And as I forced myself to eat more than I was mentally comfortable with, my body came back alive. I was finally feeding my sleepy genes what they needed to turn back on and support my sick genes.
Remember, your genes need a lot of nutrients, so let's start feeding them :) Let's eat to evict our endo, and pass on a legacy of strong genetics to our children and the generations after.
I don’t know if there’s anything more contentious in the endo community than dairy, and I can’t think of a more controversial dinner party topic than raw dairy. There are so many competing trains of thought on these two issues, from vegan and paleo circles staunchly opposed to dairy in general, to the USDA recommending it full throttle. And raw dairy? Most of us only think of how dangerous it is, if at all. That’s okay, because we need to talk about both.
The truth about dairy is it’s a great option for some bodies, yet still not for every body. We’re all unique and, if you can tolerate it, the right types of dairy products can offer a perfect balance of fat, protein, and carbs, gut healing probiotics and butyrate, CLA (anti inflammatory fat), vitamin A, beta carotene, and even omega-3’s. Believe it or not, it can even help reverse chronic allergies, gut infections, and give energy to peoples with liver and gall bladder issues. But because most of us have only been introduced to the bad stuff (think Safeway refrigerated section), we often have never experienced the potentially healing factors of real, raw, grass-fed, milk products.
That’s why I ask you to at least hear me out, even if right now you think dairy is going to knock you dead with pain, if raw dairy doesn't kill you first. The types of healing dairy products I speak of aren’t the ones you see in the Got Milk ads; they’re the ones we evolved to eat. Ok, I know-- that’s not fully agreed upon, considering the often thrown around fact that hunter gatherers didn’t evolve drinking milk. Technically that’s true, but many of our recent ancestors did. How recent? Not too recent at all, really…. try 9,000 years! In the story of human evolution that may seem like a drop in the pond, but that’s still some 200 generations of peoples consuming liberal amounts of milk products - all of it raw, of course - and living healthy, fruitful lives.
9,000 years is also enough time for some of our human genes to physically evolve to consume milk products, with some 30-40% of us now being able to properly digest lactose past breastfeeding years (and that number being closer to 100% for the European/cool climate decedents). For those who didn’t develop the lactose-digesting ability (those mainly being peoples from warmer climates), it doesn’t mean your ancestors didn’t also thrive on milk products. In warmer climates where fresh milk would quickly sour, cultures instead consumed their dairy fermented. This is especially true for areas all over Africa, India, and the Middle East, whose many herding cultures relied on animals for both milk and meat.
Even in America it was widely agreed until recently that milk was purely beneficial for health! This was a time when people weren’t plagued with heart disease, obesity, auto-immune disorders, cancer, or endometriosis, and also a time when Americans consumed liberal amounts of butter, cream, and raw milk. Neither germ-phobia nor fat-phobia had yet caught on to the masses, and dairy products were revered as an enzyme and mineral rich way to get nourishment.
But the truth is, nearly all women with endo deal with severe stomach issues stemming from gut permeability, leading to a strong reaction to dairy in some way. That is potentially why you felt better going dairy free — it certainly was my case many years ago! That’s also why dairy should be approached very carefully, with full respect to where your body is in its healing process, knowing that you may or may not be able to tolerate the wide spectrum of dairy products either now or even after a gut-healing journey. Either way, I here hope to dispel a few myths about dairy, reinforce the benefits that are real, and help you see if some types of dairy can fit into your life as a healing agent. Like meat, there’s no black and white here, and you’re going to have to discover for yourself what’s good, bad, or even a exceptional partner in your healing journey.
"The concept that fat is the best of foods has been universal in all lands and climates. When Christianity spread northward beyond the Mediterranean, the Biblical phrase "to live on the fat of the land" was readily understood in Greece, Italy, and France, in Britain Sweden, and up among the Lapps. In English speech, fat food was called rich food, which was the highest praise. The fattest was best among men and gods, in most religions and in all countries" (Vilhjalmur Stefansson)
Ancestral fats have been the basis of human health for millions of years, a source of nutrients and energy that was revered and worshiped across cultures, literature, and religions. Our ancestors knew the value of these foods: healthy fats that acted as a delivery sources of fat-soluble vitamins to fill you up with nutrients, offer slow burning energy to regulate your blood sugar, grow healthy children, and offer the foundational building block to each cell in your body. Now they're known to help heal your endo.
So what are ancestral fats? Easy, it’s the fats and oils peoples have relied on for millennia. They include items like butter, ghee, lard, tallow, extra virgin olive oil, coconut oil, palm oil, nuts and seeds and their cold-pressed oils. Food sources include egg yolks, cream, the fatty cuts of meat, drippings from roasts, oily fish and fish eggs. Do any of these give you the heeby jeeby’s? Hopefully they won’t by the end of this :)
Modern, industrial oils, on the other hand, are incredibly damaging to your body. They include the obvious trans-fats, but also the lesser realized refined vegetable oils like canola, soy, corn, grape seed, safflower, sunflower, or plain old vegetable oil. If you’ve heard these are good for you, that's intentional on behalf of these companies: their marketing arm is incredible, with a lobbying force to be reckoned with! Unfortunately like many other industries with huge marketing campaigns (processed grains, processed milk, vegetable oil), these guys should be in your trash by the end of this post.
The truth is: fat is absolutely necessary to the diet, as long as it's the right kind of fat. Your body was made to run on fat as your majority fuel, and doing so will immediately help bring your cortisol levels down. Moreover, your body has trillions of cells, and they’re all coated in something called a lipid-protein bilayer. It’s a fatty coating with some protein mixed in, and your cells depend it being made from really high quality fats in order for your cells to function properly. If there’s a fat shortage in your diet, or a poor-quality fat source, your cells will directly suffer (imagine legos being made of powdery chalk). Not to mention your skin, your energy, your brain function, and your overall quality of life.
So hang with me while we talk about fat! I’ll take you through the good, the bad, the ugly, and the truly healing. I want to help you understand that fat on your lips is not fat on your hips — it can actually be the opposite with the right approach, that saturated fats are not going to cause heart disease, that cholesterol will not clog your arteries, and that despite all those government recommendations you’ve heard for 5 decades, science is now way ahead of the US Government's food recommendations and is in agreement with what our ancestors knew all along: eat the fat.
Eggs aren’t detested in the endo community like meat and dairy are, but there’s still a good amount of misinformation out there to make us wonder about their impact on our pain and health. That’s because some books — like Recipes and Diet Advice for Endometriosis by Carolyn Levett — recommend using egg replacers in the place of eggs, saying eggs cause inflammation, while the vegan documentary What the Health comes along and tells us eating one egg a day is akin to smoking 5 cigarettes.
Hold on a second, is this all true?
The answer is a resounding no: not eggs from healthy, pastured chickens. You know, the real bug eating, sun bathing, grass scratching kind of chickens. These eggs are some of the most nutrient dense of any food in the world, especially the yolks which house an assortment of nutrients so many of us endo girls are utterly deficient of: omega 3’s, choline, B vitamins, vitamin A, E, D, K, calcium, iron, phosphorus, folate, and pantothenic acid. It’s like a delicious multi-vitamin in a shell that your body can actually absorb. These eggs are listed as a top healing food on this site for a reason!
And sorry, it’s still not true that eating any egg is akin to smoking 5 cigarettes. Who comes up with this stuff?? The truth is, just like all the other items I recommend, egg consumption and health isn’t black and white, and some eggs can lead to inflammation, and some eggs do have contamination. It just depends on the source of your egg, as well as your body.
Still, eggs can potentially cause inflammation or reactions for a few real reasons. One is if they’re from factory farmed birds fed an atrocious diet that sets their omega 6:3 balance askew, leading to inflammation in your body. They also won’t offer the nutritional benefits of their outdoor sisters who eat bugs, greens, and sunbathe, so what you get instead is a nutritionally void egg that upsets your omega balance and can indeed lead to more pain.
The other reason why eggs might do your body harm is because you have gut permeability, and have thus developed an allergy or sensitivity to them. Being uber sensitive to eggs can also (potentially) be a sign of liver and gallbladder malfunction. That means no eggs for you until you heal and seal your precious gut, and then hopefully you’ll be able to incorporate this nutrient dense food back into your life. Indeed eggs yolks themselves are one of the most tolerable foods to eat, since they're one of the very first foods allowed during the re-introductory phase of gut healing.
Overall, eggs are one of the most nutritious foods you can eat when they're sourced well from pastured chickens, and can fill up your nutrient stores in ways you never imagined! So if you were previously scared, fear no more. I’ll go through the good eggs, the bad eggs, and how to know if you can tolerate them at all.
“Fermentation is the transformation of food by various bacteria, fungi, and the enzymes they produce. People harness this transformative power in order to produce alcohol, to preserve food, and to make it more digestible, less toxic, and/or more delicious. By some estimates, more than 1/3 of all food eaten by human beings worldwide is fermented … Fermentation has played an instrumental role in human cultural evolution.” - Sandor Katz, The Art of Fermentation
Take a step back from your modern life and lets move back in time. Not far, just 200 years - when canned foods were invented and before refrigerators became the norm. Canning was invented in 1810 and allowed the folks abandoning their farms for cities during the industrial revolution to quickly eat “fresh” food after long shifts, packed in salt and/or vinegar to preserve. Enter the personal refrigerator in 1913, and our food system was revolutionized so much that it changed our entire food culture! Refrigeration now allows us to move produce on a mass scale from, say, Chile to Hawaii, and then allow us to store this globally grown food for long periods at home before finally consuming it. These two modern technologies together, combined with germaphobia and a fast-food nation, have more or less destroyed our human culture of fermentation.
200 years may sound like a long time, but it’s only 1/10,000 of our human existence. A drop in the pond. So what did we do before these modern conveniences? How did we prepare and store fresh foods? We fermented them. Meat was stuffed into sausage casings and cured (i.e. fermented) and smoked to keep without rot. Milk was clabbered, turned into kefir or yogurt, strained into sour cream, or made into cheese for long journeys. Vegetables were made into all sorts of things, from krauts to kimchees to pickles. These could provide ample vitamin C all winter winter long.
And, of course, we always fermented our grains, beans, and nuts. This an important technique, since the fermentation of these foods pre-digests the phytic acid inherent in all seeds as well as many starches. It additionally eats the excess startches which, when eaten in abundance, mess up our gut bacteria and turn into sugars. With modern grain growing and milling, rare is a store bought bread that is actually fermented. And who at home grew up soaking and sprouting their rice, quinoa, beans, or oatmeal overnight before throwing it in a pot? These methods are old fashioned, yet ingrained in every culture across the globe for a reason: health and prosperity.
Nowadays in America, nearly all our fermented food traditions are dead. Literally. They’re processed and “pickled”, and dead on the shelf. Think of everything we used to eat that was alive and fermented: cheese, bread, wine, beer, soy, sparkling beverages, salsa, grains, ketchup, mustard, pickles, olives, vinegar, etc. All of these were properly fermented not too long ago, meaning they were still a living food. This is why you’re always recommended a probiotic by your doc, because today we don’t eat many - if any - probiotic rich foods, although we know that gut health is invaluable.
What about yogurt (or another living, fermented food here you eat, like kombucha). Well yes, this is a food that has beneficial bacteria in it, but it’s one strain of many. If you imagine your gut, it should contain around 3 entire pounds of bacteria alone, beneficial little microbes that make your body function optimally. It’s where your immune system is housed, where your toxins are filtered, where your nutrients are absorbed. You want this ecosystem to be like the Amazon rainforest: fantastically diverse. Eating yogurt or kombucha or taking a probiotic pill is akin to mowing the amazon and planting a mahogany forest yet still expecting it to still maintain the same abundance of life… Enter endo belly. And chronic disease too.
Time to Heal the Amazon: Your Gut
So how do we heal thy gut and begin to re-plant the Amazon?? You have to eat fermented foods every single day. And a variety of them. Luckily for the time-starved, more and more awesome companies are selling actually fermented products in the grocery store refrigerated sections, and lucky for the foodies, making ferments at home is freaking easy and really cheap.
For most people, fermentation is really intimidating at first. We’re all really scared of doing it wrong and dying from bad bacteria! I was … I think it took me about a year building up courage to finally try fermenting my first batch of cabbage. But the truth is, fermentation is really easy, like really-really easy. Often the first few times will take longer as you figure it out, but then it becomes second nature. That’s why I recommend for everyone to just start with one thing, one ferment to wrap your head around and get the hang of it. After you master one, your confidence will build and you can try another. For me, I usually stick with three ferments that I make consistently (mine are kefir, lacto-fermented vegetables, and beet kvass), then add in extras when I feel like it (like ketchup, kombucha, soda, mead, or whatever else). Oh, and always soak your grains.
And if it’s bad, you’ll know! It’s not like your delicious homemade sauerkraut is secretly hiding bad bacteria, it’s more like you open your sauerkraut lid to see black or rainbow colored mold combined with a nasty, horrible smell. You know the difference, the difference between a rotten food and one that smells kind of sour like vinegar. Listen to your primal instincts and you’ll be okay :)
So get ready to delve into the beauty of ferments! Learning how to properly prepare grains will greatly improve your health, especially if you eat grains on the regular. Adding fermented veggies to your meals, making your own fermented condiments, and drinking new fermented beverages will start to repopulate your gut the way you imagined that super-expensive-little-bitty-probiotic-pill was supposed to do. And if you take my advice and make this a hobby, you’ll find yourself more connected to your food sources and health than ever before. These are the big guns of nutrition, and they’re here to save your gut, your health, and your life.
“It occurred to me, that I should get my long list of nutrients from food [rather than supplements]. That if I did that, I would probably get hundreds and maybe thousands of other compounds that science had yet to name, that would be helpful to my brain and my mitochondria.”- Dr. Terry Wahls
Finally, something all endo girls from all walks of life can agree on: eat your veggies! The question is, what does eating veggies look like if you want to heal from endometriosis? For those of us who grew up counting baked beans and white potatoes as our veggies, it's harder to understand just what to eat to impact our health. Lucky for us, there's a formula.
To answer this question we look to Dr. Terry Wahls, creator of the Wahls Protocol and self-healer of the Multiple Sclerosis that had left her wheelchair bound. She’s a scientist, so Dr. Wahls ended up using her medical background to understand that we can’t even begin to unlock the secrets of nutrient content from real, whole foods, so we might as well heal with the real thing rather than supplements. Her mitochondria healing diet is known to heal everything from autoimmune to leaky gut to chronic fatigue to, well, endometriosis. And a big big big part of it is a large serving of vegetables every-damn day.
What are mitochondria and how do they become sick?
Mitochondria are the tiny factories within each cell that turns the food and air we intake into energy. They’re so big they take up about 40% of your cellular space! Now imagine just how many mitochondria we have in our bodies: trillions. So keeping these guys healthy and functioning directly translates to us being healthy and functioning. Simple enough.
The mitochondria stay healthy the same way you do: nutrition and exercise. The more micronutrients you feed these buggers, the happier they’ll be. And, the more you exercise — i.e. the more you use your muscles and bring blood, nutrients, and oxygen to them — the more mitochondria you’ll grow. That’s right, you can increase the amount of mitochondria you actually have in your body! This is the reason why you end up having more energy throughout the day the more fit you are, because you’ve built up a larger supply of mitochondria.
One of the main things that erode our lovely mitochondria is the fact we eat a surplus of poor-quality foods, and a deficit of the good kind. Empty calories like improperly prepared grains, bread, processed foods, refined flours, sugar, trans-fats, and vegetable oils, all build up in our system and burn out our energy factories. End result? Body falls apart. Sound familiar? What the mitochondria need besides quality movement is micronutrients, think vitamins and minerals. Lots of them, and a variety of them.
How to take care of your mitochondria:
Feed them! Through years of personal study, Dr. Wahls identified 31 micro-nutrients that your mitochondria need to function. She then learned which foods provide those nutrients and came up with her “9 Cups Daily” protocol (her full protocol also includes ancestral fats, bone broths, and organ meats, fyi) which supply essential nutrients we can't get elsewhere. Per day, your allotment would look like this:
3 cups of leafy green vegetables, such as kale, collards, chard, spinach or lettuce, which provide vitamins A, B, C and K. That's about one heaping plateful, much less if steamed or blended in smoothies. Why? For the tons of minerals and micronutrients condensed in these buggers.
3 cups of sulfur-rich vegetables, such as cabbage, broccoli, cauliflower, onions, garlic, mushrooms and asparagus, because they support the removal of toxins from the body. Why? For their sulfur rich compounds, which directly support our livers' ability to detox. If you're avoiding goitrogens for a thyroid issue, you should be okay as long as you make sure to eat these types of veggies cooked, never raw.
3 cups of colorful vegetables and fruits (ideally three different colors each day), because they’re full of antioxidants. They have to be colored all the way through, so apples and bananas don’t count as colored, but berries, citrus, beets, red cabbage, peppers, and carrots do. If choosing fruit then no more than 1 pc per day. Why? For their antioxidants, which attack the free radicals that cause inflammation in your body. Plus the micronutrients of course :)
Oh my, that’s a lot of vegetables...
It's true that 9 cups may seem like a lot, especially if you’re a little lady! Dr. Wahls recommends 9 cups/day for a tall woman, but agrees a petite woman might be able to make due with 6 cups/day. If 9 seems like an unreachable goal, simply start with 6, 2 cups of each. However, if it's the fact the 9 cups seems like a lot because you're filling up on other, less nutrient-dense fare (gluten free toast, pasta, and rice) it's time to start substituting by cutting out the crap ;)
The veggies will then end up taking the place of processed foods since you might otherwise eat, since in order to meet your veggie-allotment you won’t be able to fill up so easily on processed foods. That might mean cutting out your avocado toast for breakfast and replacing it with a veggie-egg scramble with avo on top. Or removing the cup of quinoa at lunch for a heaping serving of sauteed veggies. Taking the gluten free noodles for dinner and replacing them with steamed broccoli or cauliflower, with lots of sauce and butter on top. It's taking the fillers out of your meals, and replacing them with 3 cups of 3 varieties of veggies.
If this is still too much, smoothies can easily be your friend, as long as you stay away from sweet smoothies and stick to nutrient-packed options that include fats, lots of greens, and a few berries. And remember to always eat your veggies with ancestral fats for best absorption of nutrients.
Looking for inspo? Grab The Wahls Protocol Cooking For Life Cookbook!
What about fruit?
Fruit is neat: it has anti-oxidents, minerals, vitamins, fiber, and water. Everything that veggies do except that it also has sugar. Lots of it. At the turn of the century average fructose consumption (fruit sugar) was about 15/g/day. That's akin to 1 piece of fruit per day. Now, with globalization, we can get fruit all the time, even in the dead of winter! And for many girls who are addicted to sugar yet trying to eat healthy, fruit seems like a great option at first. Sorry to say, too much sugar is still too much sugar.
Are you addicted to sugar? Imagine going an entire day or two without it ... and I mean all of it: ketchup, honey, refined flour products like pastas and breads, sweet drinks, fruit, alcohol. If you just freaked out, you're addicted ;)
That's why I recommend limiting fruits to no more than 1 pc/day, but getting all the same benefits of anti-oxidents, minerals, vitamins, fiber, and water (without the sugar) from veggies! This piece of advice seems to make some people angry (those who have been told their whole lives to eat a lot of fruit). If you feel angry about this right now, it's okay :) Take a deep breath, and just let yourself mull this one over for a while. Just try to remember: a fruit is similar to a vegetable, but with sugar in it.
The importance of local and organic: more nutrients, more probiotics
I am a HUGE proponent of farmers markets and buying local. Not only is this a much more affordable option for organic foods, but it also gets you in touch with your local food system - supporting farmers instead of corporations - plus it also allows you to buy veggies that are often more nutrient dense. That's because most small-scale, organic farms tend the soil like it should be cared for, with an emphasis on plant health and vibrancy, rather than enormous mono-cropped fields of organic broccoli from China that care only for profit.
Buying local will also force you to switch up your diet so you don't get stuck eating the same 10 foods all year long, plus it will allow you to add much more soil based probiotics (SBOs) into your diet. Yup, that's right, dirty farm-fresh plants will benefit your gut health. According to The Candida Diet website: “Soil-based organisms are ‘endospore-forming’ bacteria, which are naturally hardier and better able to withstand the challenging environment of the stomach. These means that soil-based probiotics differ from regular probiotics in two important ways:
They are much more likely to make it to the small intestine intact.
This means that a soil-based probiotic supplement needs to contain much fewer colony forming units (CFUs) than a lactic acid-based supplement. It also eliminates the need for special coatings or manufacturing techniques that are used to deliver lactic acid-based bacteria.
They colonize the gut more effectively.
This enables us to reduce our dosage to ‘maintenance’ levels much sooner, without worrying that the health benefits of the probiotics will disappear. (source: The Candida Diet)
Still, if you must buy produce at the local market, the Dirty Dozen and Clean Fifteen list is helpful for anyone on a budget! It helps us understand which conventional produce is the most toxic, and what we can let slide if we're budgeting. It's important because some of the produce on the shelves has been sprayed innumerable times, with some of the most toxic components on the planet!
Truth be told, creating delicious recipes and taking freaking amazing pictures is a career in itself, and I so respect the women doing this from all over the world. Here are some of my favorite corners of the world, super-Heal-Endo-approved meals, ideas, recipes, and inspo! Go check out these pages and have fun making food :)
Want Meal Plans, not just recipes?
Realplans.com is the best meal planning software I know! That’s because they partner with key bloggers, nutritional therapists, and experts to tailor your plan to your own specific dietary needs. You can even import your favorite recipes from home so that your shopping lists are always accurate.
Endometriosis as a disease is vastly complex. Although most people often refer to it as a gynecological or hormonal issue, it’s really not. Endometriosis is a systemic issue much bigger than your pelvic cavity, and so much more than a “woman’s condition” - and needs to be addressed as such.
In it’s entirety, we know through research that endometriosis is an inflammatory + immunological issue, a hormonal issue, a malnutrition issue, a gut-associated issue, and perhaps an epigenetic/genetic issue. Endo is all these things, not just one, and probably a lot more we’ll find as research continues.
What endo is not is a single-faceted issue, and by knowing more about your disease, where it comes from, and how it’s affecting your own body, you’ll be able to chose the best course of action for you. Even more, knowing all the facets that contribute to endo shows us that we can successfully support the body in many holistic ways to reduce the severity of our disease - which is awesome AF. Read on to discover the many faces of endo!
The Hormonal Component
Much of the hormonal implication of endo is directly linked to to the endo lesions themselves, whose growth is fueled by estradiol (a type of estrogen). This makes sense in the same way that your uterine lining grows via estrogen during your monthly cycle, this specific endometrium lining is just misplaced where it shouldn’t be.
The issue, however, is that this may not be a normally functioning endometrium lining. In a healthy woman without endo, the endometrium responds to both estrogen and progesterone throughout the cycle. They balance each other out, working together to grow and shed the lining every month. In the endo-woman, research is uncovering that the endometrium itself may be aberrant - meaning problematic and misbehaving - even when correctly placed in the womb. The big issue here is progesterone resistance, specifically problem with this tissue’s progesterone receptors, so even if you have enough progesterone circulating there’s a possibility your uterine lining isn’t using it .
This is important for a few reasons. One, progesterone is anti-inflammatory hormone, and in a normal cycle it helps break apart the endometrium tissue in the normal course of the month. In a woman with endo, this break down may not happen as usual, and instead the estrogen will dominate the tissue and spur its continual growth without the necessary break down. The other issue this may fuel is endo-related unexplained infertility - these are women with endo who have open tubes and ovulating ovaries, but they still can’t get pregnant. This may be related to this malfunctioning endometrium, or it may also be related to the inflammatory environment of the pelvis (which can create progesterone resistance on its own) and something research will have to help uncover further.
To add insult to injury, many of the toxins in our world today are known endocrine disruptors, specifically estrogen-like compounds called xenoestrogen. As we slather on conventional beauty products or eat off of plastics, we’re introducing such ingredients as PCBs, BPA, parabens, and phthalates to our system which may then continue to fuel more endo growth.
The Epigenetic Component
If you’re wondering why your endometrium is misbehaving in the first place, research is starting to uncover that epigenetic modifications may be at play. One gene being affected is important within the endometrium cells themselves. Homeobox A10, aka HOXA10, is a gene involved in normal uterine function, and has been noticed to fail to do its job after ovulation in women with endo due to a methylation issue . This may be one of the reasons for the progesterone resistance of the uterine lining. How this came to be may have been seeded before you were even born, in this case through dioxin exposure in the womb. Researchers exposing pregnant mice to dioxins observed that the offspring had the same epigenetic progesterone resistance issue.
Before you get mad at mom, know that dioxins are really really abundant in our food supply so it’s not like she was bathing in irradiated beauty cream or anything. We can only blame our generations above us for dumping these toxins onto our planet (toxins that never break down smaller or go away), and do our part to stop the pollution from continuing in order to protect our daughters and all future generations. But I digress.
Back to endo, what this uncovers is that your aberrant endometrium may have been laid down pre-birth. It may mean that its progesterone resistance and its odd genetic behavior may also be the reason that way-word tissue could set up shop where it shouldn’t be in the first place, and why it continues to fuel its own growth without being able to properly break apart and be cleaned up.
The Immune Component
There’s a little known fact in this community that endometriosis is an autoimmune-related disease, and that the immune system of a woman with endo is improperly functioning. This is very very very important to understand.
When we think of immunity we often think of sick, or not. You might even be saying “Katie, my immune system is great, I never get sick!”. Hear me out. Your immune system is in charge of a LOT, with being sick just a fragment of how your body deals with pathogens. The other thing an immune system is responsible for is inflammation. When there’s an acute injury, inflammation comes to the rescue with blood, lymph, white blood cells, and nutrients. Even more, the immune system is also responsible for turning the inflammation off once the job is done. The problem arises when this inflammatory response get’s stuck on and can’t turn back off. Hello Endometriosis.
The other thing your immune system should do is clean up misplaced endometrium lining. If we look at the theory of retrograde menstruation, it’s estimated to occur in up to 90% of healthy women, yet only 10% of women have endometriosis. The immune dysfunction may be the missing piece to this puzzle since it’s well understood that the immune system is acting peculiar in the pelvic cavity. There’s an issue with both the innate immune system and the adaptive immune system - neither are working right - and in fact this misbehaving immune response is part responsible for creating even more inflammation while inducing less down-regulating of inflammatory activities.
In addition, it has been noted there are often auto-antibodies floating around in the endo-body - these are the antibodies your body would produce if you have an autoimmune disorder. They’re attack-cells that attack, well, your own cells. However, in the case of endometriosis there isn’t just one that we could test for (say, an auto-antibody that attacks your endometrium lining) and we instead see a changing variety depending on each woman. This may be because endo has associated auto-immune disorders, or because there’s something more complex we have yet to figure out. Just know, there is a definite auto-immune component with endo, an important thing to remember when we look at how holistic healing comes into play.
The Gut Component
One thing virtually all autoimmune disorders have in common is increased gut -permeability (aka leaky gut) and/or dysbiosis. In fact, it’s widely agreed upon in science to be a pre-requisite for developing autoimmune disorders - and remember endometriosis is an autoimmune-related disease. Leaky gut is when your intestinal lining has degraded so much that the insides of your intestines (aka poop-to-be) are now leaking into the insides of your body. A gross analogy? An I.V. of fecal water. You can imagine this will have an impact on your system.
And this is especially bad for the immune system, obviously, since it now mounts an immune response to foods you’re eating that are leaking directly into your bloodstream, like tomato sauce being poured into an open wound, for example. Tomatoes were never supposed to be in your blood stream, so if you eat tomatoes everyday your immune system may go so haywire from attacking tomato juice 24/7 that it starts attacking your own body (this is the autoimmune component I just discussed, when you make auto-antibodies to attack yourself). This is a big reason for chronic inflammation and an immune system on the fritz.
The other issue connecting endo + the gut is related to gut bacteria. Pathogenic species in the gut release something called endotoxins, or LPS, which is a highly toxic compound. If it stays in your intestines, that’s great, if it leaks out into your body, it’s not great, and it may even be directly implicated in the development of endometriosis.
Studies are now showing that LPS alone is both a promotor and aggravator of endometriosis. Not only has it been shown to directly stimulate endo lesions, but it’s also been suggested it’s working hand in hand with estrogen to grow lesions and inflammation in the pelvic cavity. Even more, LPS was found to be 4-6x higher in the menstrual blood of women with endo, and some varieties even colonized within the endo lesions.
And as far as the endo-warrior gut, studies have shown us to have significantly altered gut microbiomes, specifically less gram positive bacteria and more gram negative varieties (gram negative varieties produce the LPS I mentioned). Some scientists are now hypothesizing the “gut microbiota may be involved crucially in the onset and progression of endometriosis.” This is great because it’s opening brand new doors of research that may be key in unlocking new treatment options for this multi-faceted disease, as one 2019 study posits “whether dysbiosis leads to endometriosis or endometriosis leads to dysbiosis.”
This is a very important takeaway, knowing that your “endo-belly” may be fueling the endo, rather than the other way around.
The Malnutrition and Stress Component
One thing all chronic disease has in common is a level of malnutrition, and Studies show nutrient deficiency may even directly contribute to the development of endometriosis in the first place. There are also studies showing us endo-gals are either in extra need (or very deficient in) vitamin E [1,2], vitamin C [3,4], zinc , omega3’s , vitamin D , vitamin A, and selenium . This may be because we’re a) not eating enough nutrients, or b) because we require more nutrients than our endo-free sister to fight the inflammation in our bodies. I would hypothesize it’s a combination of both, since 90% of Americans are deficient in at least a handful of vitamins and minerals, and on top of that our endo-needs are higher.
Here’s a teeny-tiny example why you should care: zinc, omega-3’s, antioxidants, D, and A are all absolutely necessary for immune activities - meaning they’re needed to turn off inflammation (yes please!). If you’re severely deficient in these nutrients (which science says you probably are) then you literally won’t be able to do this, and the inflammatory response continues. It’s that simple. In fact, the immune system is one of the biggest users of nutrients in our whole body! So if your immune system is acting out - as you know yours is - you may want to consider her like a toddler who’s hungry and throwing an angry tantrum. Please feed her :)
Stress itself is a huge player. Not only is it linked to increased gut permeability, depression, anxiety, and disease prevalence, it's also now known to increase the amount and severity of endometriosis. In a 2012 study, scientists made rats with endometriosis perform a stressful swim test 10 days in a row (omg, poor rats) to measure the bodily effects. The stress not only increased the amount of inflammation involved with the endo and surrounding tissues, it also increased the amount of endometriosis lesions!
Putting it all together
If you’re now thoroughly overwhelmed (sorry!), here’s the summary:
Your predisposition for endo may have been laid down pre-birth when dioxins ravaged your progesterone receptors amongst other things, creating a misbehaving endometrium. This endometrium was then able to get out of your uterus (either retrograde menstruation or in-utero), where it wasn’t able to be properly cleaned up. This may be because the endometrium itself is abnormally behaving, or because your immune system couldn’t clean it up properly. Maybe both. In addition, the inflammatory environment may further create progesterone resistance, so it may be a chicken or the egg issue.
And now, because of your endo-belly, you have LPS flowing into your pelvic cavity, potentially working in this inflammatory environment to create even more chaos and inflammation - sparking more growths, more lesions, more pain. Where did it come from? We could hypothesize the leaky gut issue combined with the dysbiosis issue, allowing for lots of toxic substances that should be in your poop to creep on over to your pelvis and inflict pain instead. And with the leaky gut comes the autoimmune component, since leaky gut is virtually a prerequisite for the development of any autoimmune disorder. Now your immune system itself is acting abnormally, and it can’t turn off the inflammation. This is also why you may develop an additional autoimmune or two.
Insert malnutrition and your body doesn’t have either the nutrients needed to fight the inflammation (like vitamin C, E or zinc), nor does it have enough nutrients to regulate the immune system (like A, D, zinc, or selenium) to turn that chronic inflammation off. Insert stress and we’re adding a gale force wind to the wild-fire.
All these things together paint the picture of endo - the big take away being that endo is incredibly multi-faceted. This is why no single treatment will work for everyone, why some people have more pain than others, why some deal with infertility and some don’t, and why your endo journey to health will be 100% unique. Ah, the many facets of endo :)
Does this help paint a bigger picture? How we should start looking at endo less as a gyno issue and more of a full-body-gone-bizerk issue? It’s important to see it this way because there’s actually a lot we can do to bring a system like this back into balance!
Why You Should be Excited Rather Than Overwhelmed
I may have just painted you a complex picture of a disease that is now, you realize, a full body issue. So before you crumble thinking it’s even worse than you previously imagined, let me tell you this should instead give you hope! Yes, hope, because knowing endo is all of these things offers us new way of approaching this disease to heal.
This is how nutrition + lifestyle can help
Nutrition and lifestyle (a la Heal Endo) are going to be the foundation from which you heal the systemic issues. These facets alone can help regulate the immune system! Yup, they can actually help correct course to calm down the self-attack soothe the inflammation. This is also how you can heal and seal the gut, balance hormones, reverse IBS and gastro symptoms, stop stress, and reverse malnutrition. There is no pill available that will do this, it’s 99% up to your food and lifestyle choices. Pretty cool huh?
Want to see an inspiring study? 15 folk with active IBD (autoimmune/related diseases, also “incurable”) were put on the Paleo AutoImmune Protocol diet + lifestyle. After six weeks 11 participants (73%) achieved full clinical remission, and they maintained remission throughout the maintenance phase of the study as well. This goes to show just how much what you do + eat can reverse the “incurable” in many sufferers.
Movement helps too - immensely. it brings blood flow and lymph to the place you need it, your pelvic cavity. If you want to bring in fresh troops of nutrients + immunity, while relieving the fallen soldier of inflammation and toxins, you must bring blood flow to that pelvic cavity, and why movement and alignment are huge parts of the Heal Endo approach.
Complementary methods not on this site have also helps many a fallen endo-warrior, and are an important aid to consider for stubborn endo. Chinese medicine, acupuncture, herbalists, meditation, they’re all know to help certain women with certain issues. If you’ve tried one and it didn’t help, try another. They’re all different, and you may find exactly what your body is craving after a few tries.
How medical practitioners can help
Surgery is the foundation from which you heal from endo-body-specific issues, such as removing endo lesions + scar tissue, or dislodging organs from one another. This may be a crucial step on many endo-journeys as a well-done surgery may be the difference between complete remission and partial symptom management. If you’re here on this site because you’re trying your best to avoid surgery, please know that at the end of the day there is NO SHAME in having to opt for a surgery. This is where modern medicine can really help us endo girls!
Additionally, if your tubes are blocked, damaged, or there is significant scarring, IVF may offer hope to women wishing for a child. Truly, modern medicine may be a big part of your fertility option if you have “mechanical issues” like this, quite literally preventing pregnancy from happening.
Remember, healing from endo is holistic. Whole = using all the tools in your kit to bring your body back into balance. Endo is many things, and sometimes needs many experts, many healing hands, and many healing modalities for you to feel your best. By always knowing everything you can both about your disease, and about how the disease is affecting you personally, you’re already on the correct path. Never give up your hope in finding a life you can be happy living!
We need to talk remission. Need to with a passion. This is because there is so much information and misinformation out there, and this little conversation may make an entire world of difference to someone. So please allow me to elaborate on this somewhat nebulous topic.
R is for remission
A few weeks ago I saw an angry post by an endo-sufferer who had spoken with another woman who said she "used to have endometriosis but it cleared up”. The woman posting was so angry how this was part of the problem that perpetuates the myth you can cure endo, because there IS NO CURE. The anger was real, and it helped me understand the extent the tagline “There is no cure” may be destroying women’s hopes for a better life.
Because here is the truth: endometriosis can’t be cured, but she and her associated symptoms may be able to be put into full or partial remission. Depending on the woman, the process may include a properly done surgery, lots of lifestyle tweaks, a dietary overhaul, addressing the dysbiosis/digestive insufficiency issue (i.e. endo-belly) and maybe a lot more. It may take a year, or many years, but it’s very possible to address many if not most (or all) your worst endo symptoms with the correct approach and a supportive team.
What is full remission?
Clinical remission of endometriosis would mean the end of your endo-specific associated symptoms. If you’ve heard of women undergoing specialist excision surgeries and achieving remission, this is a perfect example. It means even though you have endometriosis, the symptoms of the disease have gone. Other examples may be older women you’ve talked to who said “they used to have endo but it disappeared after kids”, or even a friend who went gluten free and that alone remised her endo. Something along that line. Even though some examples like this may really annoy you, it’s true that some women can find spontaneous remission or even remission with barely any effort.
Then there are those with complex cases that may require a lifestyle overhaul, like me. And it’s important to note that while surgery may rid you of the very specific endometriosis induced symptoms, I have worked with quite a number of women at this point who have done the excision surgery and totally reclaimed their lives from the endo pain and misery, but are still left with many associated symptoms such as fatigue, severe bloating, gastro issues, or unexplained infertility. In these cases, complete remission would mean dealing with all of these issues as well through diet + lifestyle so they also melt away.
Thus, complete remission from endo means you have been diagnosed with endo, but your new life is no longer affected at all by the disease or her many associated symptoms. You are free.
What is partial remission?
This is basically the same thing as symptom management. It means you’ve cleared up a lot of the symptoms, but you haven’t achieved full remission. This may be because you still have work to do (like maybe getting rid of SIBO, reversing malnutrition, or getting a surgery), or it may be because of issues that are irreversible such as organ damage, scar tissue, a botched previous surgery, or other issues that are here to stay. You may also have associated diseases such as other autoimmune damaged tissues, organs, or specific mechanical issues that mean you may will find that 100% remission we all deserve.
But that’s no reason why a woman in this boat wouldn’t aim for partial remission, as in reducing the constant spread of more endo, treating their digestive woes once and for all, regaining their energy, and more, all to find a place of balance where the endo, the pain, the fatigue, the belly, are no longer ruining their lives. Aim for that happy spot of nourishment, love, laughter, and living, even if it’s not as totally perfect as you dreamed.
Remission can come and go
Here’s the thing, if there was a cure for endo you wouldn’t have to change anything in your life but your endo would be gone. Gluten? yes please! Stress? Absolutely! Forfeit sleep for binging on Netflix or tequila? Duh!
Remission, on the other hand, means you’ll have to create a new life that balances your body enough to keep the symptoms where they should stay - on an old dusty shelf. That’s also why healing from endo is no crash diet, it’s a complete re-creating of your life, and why it’s important to make that lifestyle sustainable rather than miserable.
As a real life example, I myself am currently in full clinical remission of endometriosis. I was lucky to have an early diagnosis that preserved my organ function and health, and may be why full remission was possible for me, even without a specialist excision surgery. To stay in remission I know I have to prioritize sleep, happiness, food, laughter, being outdoors, being active, and reducing stress as much as humanly possible (which is why I’m always off social media ;). I eat liver. I binge on veggies. I love the sun + beach. I walk barefoot 3 miles every day. I am vigilant about remaining present with my son. I have no doubt that if I went back to may old lifestyle of frantic living, gluten-free goodies, copious wine consumption, and over-exercising, the endo would creep its way right back. This is the reality of remission.
And still, there’s no “for absolute sure” the endo won’t come creeping back. Who knows, right?? But for now, I’ve found a great happy spot of health and wellness, and I aim to make this my new normal. I now love life, and that’s the point.
Why it’s important to allow for the conversation of remission
Remission is a loaded word in many ways and sometimes I wonder why I use it. It has the possibility of getting some women’s hopes up who may not be able to achieve full remission, and they may feel like all is lost. If this is you, please know you’re still on the perfect path for you, no matter what! Digging in to as many associated symptoms as you can will help make life bearable, even if there are issues you’ll have to learn to live with otherwise.
So why I chose to continue to use this word is thus:
It allows all endo-suffers to understand remission may be possible, that it’s a goal to shoot for, even if full remission isn’t a reality.
It reminds doctors of the pressing need for early interventions or diagnosis to preserve fertility, organ function, and more.
It opens the door for our endo community to engage in a dialogue with women who've achieved full or partial remission (also called successfully managing symptoms) in order to learn from them! We’re all in this together, and by spreading personal stories of hope, healing, and positive movement, we may really impact another woman somewhere in the world who can benefit from what you’ve learned. I’m hoping science comes to our rescue as well, to really investigate what remission looks like when achieved (like, do we still have lesions but they just don’t bother us anymore? Or all they all gone??)
So the next time someone says to you “I used to have endo”, I beseech you to approach them with the mind of a scientist and sister! Ask them how, what happened at that time, was it spontaneous remission or did she discover an issue and address it (like chronic stress?). Even if she doesn’t hold the golden ticket to your own endo, you’ll be one step closer to finding your own path to wellness.
As a Nutritional Therapist, I understand that you can't cure endometriosis, but believe with the correct approach you can heal the body in amazing ways. That's why I offer this site as a free resource to any endo-warrior to learn more about their bodies, this mysterious illness, and how to start mending. I offer my own services as well, which you can learn more about here, but this site is truly about community and offering as much information as possible for women to find their own paths.
Half of the women here may be looking for a natural way to manage their endo, while many the others may not yet understand how something so vague as “diet and lifestyle” can impact a “cure-less condition" but are open to new approaches. To everyone on this spectrum, and anywhere in between, this info is for you.
Endometriosis is a very complex issue. Although it demands our attention turn towards the pelvis, it also includes issues far beyond the pelvis: hormone imbalance, immune dysfunction, systemic inflammation and digestive issues. Not only that, but every woman with endo will be experiencing different symptoms to different degrees. We're all so different in how we express this disease!
The shovel we used to dig this ugly 'ol pit probably included a lot of stress, endocrine disrupting chemicals, poor food choices, and more. In fact, when it comes to chronic illness, it's thought that only 1/3 of the recipe for disaster is your genes (so if you're genetically more susceptible), while the other 2/3 comes from diet and lifestyle. So even though you were predisposed, diet and lifestyle were probably your tipping point into endo and beyond.
This here is the reason diet and lifestyle can help swing the endo-pendulum back into the "oh my goodness I'm starting to feel better" category. Because through diet and lifestyle alone can you really balance hormones, dissolve stress, improve sleep, and reverse malnutrition. There is no drug available that will do these things. I liken it to a dog missing his backless that sprints in a wheelchair. He may have a big issue (like, missing his backlegs), but by supporting the areas on his body where we can, he can now run again. Diet and lifestyle, my friends, is that wheelchair.
Holistic healing also means incorporating medical support when needed. So many women with endometriosis have associated autoimmune conditions. Some of these, like Hashimotos thyroiditis, means your body may be attacking (and thus destroying) a gland or organ in your body. This may mean you need medication for the rest of your life because your thyroid gland is so damaged.
Healing gut infections also takes a knowledgable practitioner who will know what to test for and how to apply the information. Do you have SIBO? Giardia? An E coli overgrowth or a bacterial imbalance? These need to be addressed in order for that systemic inflammation to come down, and only a professional will be able to prescribe the necessary herbals or remedies needed.
"But my doctor doesn't know sh*t" - said many of you
If you have an amazing GP, make sure to give them a high five!! Truth be told, there is a 17 year gap between what research knows and how medicine applies it, though, so many of you may have realized your well meaning doc may not be as well versed in your condition as you wish. This is not ideal, to say the least, but not worth throwing all medical approaches to the side because of 1 (or 10) bad apple.
In my humble opinion, the best way to re-approach the medical aspect of endo is through working with a functional medicine doctor. This is different than the doctor at your local hospital, as she will be a licensed doc with advanced training to uncover the root of problems rather than address symptoms. EXAMPLE: you have chronic acid reflux so your regular doc prescribes antacids which address the symptoms, but without focusing on the cause. A functional approach would be to test for h. pylori (a common parasite that causes gastritis), look for stomach acid deficiency, and run a stool test to look for other GI infections. By uncovering the root cause of an issue you can address is, rather than giving a band aid.
And it's important to note, endometriosis excision specialists aren't Functional Medicine doctors unless they clearly state such. Although these surgeons may be insanely skilled in removing the endo, they may not know as much about your related thyoid, endo-belly, other autoimmune conditions, chronic fatigue, skin problems, or joint pain.
This is why it's so important to invite all the healing methods you need to feel your best!
Holistic = Whole-istic. And addressing your own endo may really mean having a team of dedicated professionals that include a nutritional therapist, a functional medicine doc, and a specialist surgeon. It may also include other holistic aids like chiropractic, acupuncture, meditation, alignment specialists, pelvic floor physois, and more.
So anyone who's obsessed with the 100% au-natural approach, be kind to yourself and allow for modern medicine when it's needed. You may really need a surgery or medication, and that's okay.
And for you ladies who have only gone the medical route and still feel lousy, know there is so much that diet and lifestyle can contribute to your whole-body healing process! It's okay to eat well and see positive benefits, it's okay to look into natural care without a stigma of it being woo-woo, and it's okay to feel better without feeling like you have to get a prescription.
The Heal Endo Approach
Since endometriosis is a full-body disease, it must be approached by a full body plan of treatment, which is layed out in the site through 4 pillars.
A nutrient dense life
A movement rich life
A toxin free life
A connected life
"Life" is at the end of each pillar because these won't work as little additions for a life that is led otherwise, just as you can't add turmeric to a sugar laden diet and expect your pain to dissipate, nor can you add a little yoga to your week and expect your endo lesions to minimize.
So many women with endo have deep nutritional deficiencies requiring a multitude of nutrients to heal. Just as important is their biomechanics, bodies with restricted blood flow to the pelvis from poor alignment, sitting habits, and years of positive heeled shoes. All of this is sewn together with chronic stress, something that without addressing can forever keep a women in the vicious endo-flair cycle. The more you learn about the entirety of this disease the more you'll see it's not solely confined to your pelvic cavity, and how treating your whole body you may finally find solutions!
Each one of these pillars is a lifestyle approach to be incorporated throughout your everyday. It's re-learning how to move in it's entirety so that when you do a little yoga, you don't unravel its benefits by sitting in a chair all day. It's learning about nutrient dense foods so that when you eat turmeric it fights inflammation caused by the endo, rather than by the processed foods you were eating. It's removing the endocrine disruptors from your beauty routine and home so that you don't fight the endo through diet and then add it back in through your perfume. And it's doing all of this while re-connecting to yourself, others, and the world at large. It's a new life, and a good life.
Treating disease this way isn't necessarily easy ... not like in the pill form of easy anyways. It takes persistence, dedication, enthusiasm, a will to thrive, and definitely a sense of humor. Why? Because it's an entire lifestyle swap that may (depending on your current life) flip your current mode of operation on its head. But hey, from new foods and bath products, to less stress, more fun, and slowing wayyyyyy down, I'm here to say it's actually pretty cool ;)
I did an instagram post the other day after I was tagged by a well meaning woman suggesting to another that by following my advice she’d never have to have a surgery. I said how this was incredible hope, but not 100% realistic because, while diet + lifestyle changes are imperative for full-body healing, they’re not a stand-in for surgery if you really need one.
This resonated with a lot of women, and I received a flood of questions, comments, and insight into this form of medical intervention since most of my Heal Endo tribe is really about holistic healing, and most of us want to avoid the dreaded surgery as much as possible. So I thought I’d do a wee little blog post to shine light on some of the information and misinformation out there.
Here’s the thing: some women are hell-bent on getting better without surgery, while others lump all their eggs into one basket - so to speak - that surgery will fix everything. Truth is, it’s all so complex (isn’t is always with endo?? ANNOYING). Overall surgery is awesome when done correctly but can expensive for the good ones, scary for the bad ones, doesn’t come without certain costs, and no one wants to go under the knife unless necessary. I have had clients that got better symptomatically from dietary changes alone, and those who felt loads better but still needed a surgery to remove the scar tissue literally searing their organs together.
Why the big divide in symptom changes with diet/lifestyle changes? Lots of reasons. Let’s chat surgery!.
1) Why does someone with endo need surgery in the first place?
Here’s the a simple #endoschool recap. Endometriosis is super-duper complex and very unique in how it operates in the body. Although it’s an auto-immune related disorder (autoimmune disorders attack a tissue, cell, or organ in your body), instead of tissue being attacked, tissue is instead being grown. Your endometrium tissue, obviously, growing where it shouldn’t. This is weird and, even more, this incorrectly placed tissue causes more issues as it grows - such as scar tissue and adhesions - and also often correlates with big, painful cysts. This means now you have a bunch of stuff growing in your pelvis that shouldn’t be there.
This environment can also fuel itself to become quite sickly. Endo lesions aren’t like a normal endometrium tissue and they’re progesterone resistant, meaning the whole pelvis can become overly estrogenic, fueling more endo growths, inflammation, and scarring. Endo is also stimulated by LPS bacteria (from bad gut bacteria migrating into your pelvis), so it can also become colonized by inflammatory yuckies like e.coli. Now in this realm of pathogenic bacteria, free flowing blood, and too much estrogen fueling the fire, scar tissue and adhesions can stick your organs together.
This is the basic reason why someone may need surgery: rampant endometriosis tissue growth, scar tissue, adhesion, and cysts.
2) There are studies showing that diet and lifestyle aids can help endometriosis lesions to minimize or disappear, though. So, if I did this would I not need surgery?
Totally depends! There are so many levels of endometriosis, from very minimal amounts of lesions to an entirely frozen pelvis. So while some studies show some bodies able to reverse lesions through targeted lifestyle approaches, there’s still the issue of scar tissue, adhesions, and sometimes enormous or painful cysts which aren’t so easy to dissolve.
Truthfully, some women I work with have been able to reclaim their lives through diet and lifestyle alone. And I mean totally. No pain, no fatigue, no bloating, they got pregnant. Other women I’ve worked with felt certain symptoms abate, felt better in one way, but still had pain or an issue to resolve - and in this case I’ve recommended surgery as a next step with total symptom management (i.e. remission) always as the goal.
One perfect example of how we may need surgery after all is said and done is Angie Alt, one of the leading members of the Paleo Autoimmune Protocol community, who has endo amongst other autoimmune issues. I mean, who understands the importance of diet lifestyle more than this woman?? Unfortunately, she writes in her blog that after so long of being, like, uber healthy, working to reverse deficiencies, heal the gut, etc, she still had to have another surgery because the endo creeped back. Bummmmmer.
As for me? I had 2 poorly done surgeries and felt like I was signing up to be on the “surgery treadmill” when I had another horrible STAB of endo-growing-back-pain just 10 months after my second surgery. For me, that’s when I finally did a huge (and I mean huge) diet and lifestyle 180 that threw my body into full remission for 4 years now. What did I do? Everything on this site. And more.
3) Endo and you, endo and me, we are different as can be
It’s so important to remember your journey is going to be TOTALLY different than all your endo-sisters, and to get to a point of full or partial remission your journey is going to be your own. You may need a surgery or two.
That’s because endo affects women differently, and I do believe there is such a thing as more aggressive endo (although it may stem from lifestyle more than the endo itself). You also inherited a set of genetic characteristics from your parents that may make your body more susceptible to certain health issues, meaning you may have associated autoimmune disease, mental health issues, or physical barriers on top of your endo.
That being said, it’s soooo important to know that you’re not a failure if you need surgery or other medical help while Susie just needed to stop eating gluten to feel totally fine.
4) But surgery may still only be one part of the solution
Important message: a well-done surgery may throw you into full remission, or it may not. There’s been a huge push these past few years of well-meaning folk repeating “One Surgery One Time”, meaning one expertly done surgery to remove all the endo and give you a state of full remission - and yet this isn’t totally true for every woman.
In my clientele, I’ve had a handful of women so far who had an advanced, expertly done endo surgery and still needed my services for alllllll the associated issues they thought the surgery would fix. They can’t digest properly, they’re fatigued out of this world (spoonies), they may still oddly have pelvic pain. These are associated issues of endo, and ones that surgery can’t just pick out of your body and toss in the trash (that would be too easy, hah! oh wait, you’re not laughing - yah endo is a bully).
There’s also the social justice issue of “One Surgery One Time”, since many women will not be able to afford such a surgery, nor even qualify for a loan to afford the surgery. Since there are only a certain amount of expert surgeons in the world most of us will find ourselves forking over personal funds for these experts. Even if you have insurance, a skilled surgeon may still leave a hefty co-pay in your mail, something not every woman can fathom when just making rent (with a chronic disease) is hard enough. I know when I was looking into specialty surgery years ago I threw in the towel as $40k was beyond my comprehension at the time.
5) What’s a girl to do in the face of all of this?
Learn!!! Learn about endometriosis in its totality (Like, READ THIS PAGE), then learn about how it’s affecting your own body. First, follow your symptoms and unique diagnosis, get opinions and second opinions, aim to avoid surgery at all costs, and then get surgery if you need one.
In the meantime, do everything you can to heal your body and associated symptoms in hopes of avoiding a surgery or preventing yourself from needing another one. Remember that endometriosis is affected in severity by:
Immune regulation issues - work to recalibrate your immune system so it functions normally. Consider the PaleoAIP diet.
Malnutrition - so aim to eat to reverse chronic disease by doubling your nutrient intake rather than worrying about whipping your thighs into shape.
Gut-Issues - we now know that bad bacteria in the gut shed something called LPS, it leaks out of the gut, and falls into your pelvis, stimulating more inflammation and more growths of endo. This means you need to absolutely heal and seal your gut to help your endo severity. Each woman may have her own unique set of gut issues and infections, but 2 places to consider starting are with a lowFODMAP diet (if you have IBS) or a PaleoAIP diet if you don’t have IBS. Both should be considered short-term, therapeutic diets, not long-term lifestyles.
Movement - sometimes I wonder if the recurrence rate of endo in super healthy people has to do with incorrect movement and breathing patterns, or stagnant flow of blood to the pelvis. Indeed we need to eat nutrients and then GET THEM TO THE PELVIS, which only happens with correctly blood flow. A recently published study “suggested that pelvic floor spasm may be a major contributor to endometriosis-associated pelvic pain”, so take your core + pelvic floor function seriously ladies.
No matter now much you want to avoid it, surgery may be a huge part of your endo puzzle. One that demands respect. One that is never a failure when needed. One that even a woman currently in remission and doing everything under the sun to heal may need in the future, because endo is one-heck-of-a-disease. But also one that may not be the perfect solution depending on your disease severity and symptoms, and one that should be approached with caution to avoid the risks and costs that inherently come with surgery. Do your research, talk to other women, find a surgeon you believe in and who believes in you. Healing from endo is holistic, meaning using all the tools in your kit, and sometimes your holistic road will also need some professional surgical help. That being said, surgery is also no replacement for dietary and lifestyle shifts :) This is why healing must be balanced. So is life.