Endo is many things

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 [1].

your endo lesions are fueled by estrogen, and while they should use progesterone to properly break down, they seem to be progesterone resistant. This leads to unchecked growth.

your endo lesions are fueled by estrogen, and while they should use progesterone to properly break down, they seem to be progesterone resistant. This leads to unchecked growth.

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 [2]. 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.

is the uterine lining itself dysfunctional? looks like it.

is the uterine lining itself dysfunctional? looks like it.

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.

[There is more evidence of endo as having an epigenetic component, but it’s too much science for this short intro. If you’re interested make sure to read the correlating studies - 3, 4, 5]


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.

endobelly-endometriosis-diet

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 [5], omega3’s [6], vitamin D [7], vitamin A[8], and selenium [9]. 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.

endobelly-endometriosis-diet

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

my home on kauai, where i live close to nature, close to family, laugh with friends, and eat a heck of a lot of local food. See? Healing from endo doesn’t have to be a life of DEPRIVATION.

my home on kauai, where i live close to nature, close to family, laugh with friends, and eat a heck of a lot of local food. See? Healing from endo doesn’t have to be a life of DEPRIVATION.

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!

holistic healng means creating a diverse team to help you achieve all the results you need to build your best life

holistic healng means creating a diverse team to help you achieve all the results you need to build your best life

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!

Remission + Endo

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.

Remission: Disappearance of the signs and symptoms of disease. A remission can be temporary or permanent.

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.

my new life has to include copious amounts of 'cruise time’. ummmm, no complaints here :)

my new life has to include copious amounts of 'cruise time’. ummmm, no complaints here :)

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:

  1. 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.

  2. It reminds doctors of the pressing need for early interventions or diagnosis to preserve fertility, organ function, and more.

  3. 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.










Endometriosis - a whole-body approach to healing

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 ;)



The Heal Endo Approach to Surgery

Endometriosis_surgery_diet.jpg

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?

colors, ANTIOXIDANTS, minerals, fat soluble vitamins, omega-3s? YES please. Replacement for surgery? well, that depends on your body, your disease level, and so much more.

colors, ANTIOXIDANTS, minerals, fat soluble vitamins, omega-3s? YES please. Replacement for surgery? well, that depends on your body, your disease level, and so much more.

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. 

That’s why…

3) Endo and you, endo and me, we are different as can be

my endo jouney will be different than yours will be different than hers. Love and support each other, but know your journey is your own!

my endo jouney will be different than yours will be different than hers. Love and support each other, but know your journey is your own!

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. 

It sounds corny, but get a self-titled PHD in endo. Read pubmed, listen to stories, understand your symptoms and ask “is this endo, or is this digestive distress” or “is this stress related”. etc

It sounds corny, but get a self-titled PHD in endo. Read pubmed, listen to stories, understand your symptoms and ask “is this endo, or is this digestive distress” or “is this stress related”. etc

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.

Surgical Takeaway

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.




xxxx

Katie