The Endometriosis Diet

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Please note, I am not a nutritionist or food expert, my words are all based on my experience, research and advice from healthcare professionals. I'm going to share what I've been eating and what I've been reducing or avoiding altogether here, but I'm not saying you should follow this too. Personally, I've found that reading about other's experiences and what they've learned has really helped me explore things for myself and find options that work for me, but it is not a rule for others to follow; we're all different and what works for one person may not work for another. This shouldn’t be taken as medical advice. Please consult your doctor before beginning new treatments or making lifestyle changes.

One of the first things I did after my diagnosis, was book to see a nutritionist that specialised in endometriosis, and I found this very helpful. So, if you have this option available to you, I do recommend going for it. Just make sure that you see someone who will give you appropriate information regarding food, and not just prescribe supplements.

Even though I am no longer seeing that nutritionist, I did learn a lot from her in terms of anti-inflammatory foods. The experience also kick started my journey into nutrition, it's now something I take very seriously and it has changed my health for the better; my mental health has improved, I have more energy, and the severity of my endometriosis symptoms has improved too. For me, nutrition has been key to managing my endo pain.

As mentioned before, the endometriosis diet works for me; it's helped reduce the severity of my symptoms, as well as increased my energy levels. And when I don't follow the diet for a few days, I feel that my symptoms deteriorate. However, we're all different, so listen to your body and do what's best for you.

The Diet 

The endo diet is all about avoiding foods that cause inflammation and foods that can increase oestrogen levels. Addressing inflammation and oestrogen levels is really important to reduce pain.

More research is needed, not only on endometriosis but also on how food and lifestyle choices correlates with the development or worsening of the condition. There seems to be little agreement amongst doctors that the endo diet works, but many people (including me) have found that following an anti-inflammatory & low oestrogen diet has helped reduce the severity of endometriosis symptoms.

With this in mind, it is recommended that someone with endometriosis reduce or avoid the following:

  • Gluten/Wheat ~ this triggers an inflammatory response in the body, and is often laden with pesticides, which adds synthetic hormones to the body and increases oestrogen levels. This includes bread, pasta or couscous. Wheat free pasta such as red lentil pasta may be used. But, gluten free/free from bread may still be harmful ~ however, this may be fine for you, it's important to listen to your body when exploring the endo diet, to identify what helps and what makes you feel worse
  • Soya ~ contains phytoestrogens, which are plant compounds that can mimic oestrogen. However, some studies claim it could help endometriosis. There is a lack of research on this, so I recommend educating yourself as much as possible and choosing what is best for you. Personally, I avoid soya 
  • Dairy ~ can cause inflammation, and the majority of dairy products contain growth hormones and antibiotics, which can increase oestrogen levels and cause other hormonal health issues. I use only unsweeted plant based milk ~ my favourite is unsweetened almond milk, but I have oat milk with coffee (I drink decaf coffee maybe once every fortnight, and I make sure that this is with oat milk rather than cow's milk or soya milk, for the reasons mentioned here) 
  • Red meat ~ it is suggested you avoid red meat, as many studies link red meat to inflammation and an increased risk of endometriosis. However, I have found that grass fed organic red meat is fine for me, as long as it's in moderation (I have red meat once or twice a week), it is important that the meat is organic and therefore has not been given/fed chemicals like pesticides. These pesticides act as synthetic hormones which can increse oestrogen levels 
  • Caffeine ~ can cause inflammation, and depletes vitamins and minerals. It is also an stimulant so can trigger anxiety, which is often associated with endometriosis. I have struggled to give up coffee completely, so I have decaf coffee with almond or oat milk, once a fortnight or once a month, and that's worked really well for me. Explore and find out what works for you 
  • Alcohol ~ can increase levels of oestrogen in the body, depletes the body of vitamin B, can have a negative effect on liver function. In addition to making my endo symptoms worse, I've also had a tricky relationship with alcohol, so I avoid it  
  • Trans Fats ~ new research links trans fats to inflammation and an increased risk of endometriosis. Predominantly found in fried, processed, foods 
  • Refined/ Added sugar ~ this is highly inflammatory. Choose unsweetened products, reduce use of sugar in baking, coffee, tea etc. (alternative to sugar include honey or dates ~ in moderation)
  • Processed foods ~ such as bacon, ham, sausages, canned fruits, canned vegetables, canned soups, quorn, ready meals. If you have to use a can opener to open it, then it is processed. These foods are often high in trans fats and sugar, low in essential nutrients and may cause inflammation. Processed foods can actually displace healthy nutrients from the foundation of your diet. Recommendation is to eliminate these foods from your diet, especially ones that contain long lists of chemicals in the ingredients list.

Some suggested foods and anti-inflammatory foods include:

  • Eat organically as often as possible*
  • Fruits 
  • Vegetables 
  • Wholegrains ~ like organic Quinoa, organic gluten free oats and wholegrain rice. I really enjoy black rice such as Biona Organic Black Venus rice, and Alara organic gluten free Scottish Oats Porridge
  • Avocado ~ this is good healthy fat 
  • Garlic ~ I use garlic to cook almost everything, from rice to kale. I also like to throw in some whole garlic cloves when roasting potatoes (sweet or white potatoes) 
  • Berries ~ blueberries, raspberries and blackcurrants are some of my favourites 
  • Lemons ~ I drink hot water with lemon juice (I squeeze half a lemon) every morning before breakfast, and I also like to add lemon juice to roast chicken 
  • Green leafy vegetables ~ like Kale and Spinach 
  • Wild/Organic fatty fish (high in Omega-3 fatty acids) ~ like wild salmon, sardines and mackerel 
  • White meats such as organic free range chicken is fine ~  it is important that the meat is organic and therefore has not been given/fed chemicals like pesticides. These pesticides act as synthetic hormones which can increse oestrogen levels  
  • Pulses ~ Lentils and beans are a good alternative source of protein to meat 
  • Plant based foods with Omega-3 fatty acids (and low in oestrogen) include chia seeds and walnuts. I eat chia seeds regularly, usually mixed with organic natural yoghurt for breakfast 
  • Nuts ~ unsalted nuts (not peanuts) are very useful for snacks. They are a good source of protein, minerals and essential fatty acids 
  • Herbal teas ~ like green tea, ginger tea, peppermint tea and fennel tea (peppermint and fennel teas can help with bloating, which is common with endometriosis) 
  • Turmeric ~ has strong anti-inflammatory properties 
  • Plant based butter such as cashew, hazelnut or almond butter 
  • Lots of organic vegetables ~ around 50% of what I eat every day is either vegetables and fruits; I also try to use a large variety 
  • Oils ~ I struggle to not use oil so decided to add this here for those that are like me. I usually cook with Organic Rapeseed oil, and occasionaly (maybe three times a month) use Coconut oil 
  • Moringa powder ~ I've recently started having Moringa powder with my daily smoothie (I've started with 1 teaspoon added to my banana, blackcurrants and almond milk smoothie ~ it's really good. I'm planning on gradually increasing the amount of Moringa powder to 2-4 teaspoons a day). This is something I do, and I've noticed a reduction in my endo symptoms since doing this.

*Eating organic foods as often possible can really help. Organic foods are free of GMOs, man-made fertilisers, pesticides, growth regulators and additives - these chemicals are harmful for us all, but they are particularly harmful for those with endometriosis. These chemicals add synthetic hormones to the body, which can result in excess oestrogen. Which can worsen and result in growth of endometriosis.

Helpful tip: It is a costly process to obtain organic certification, so some organic products have 'natural' or 'wild', rather than 'organic', on the label.

I try to live by this diet 100% of the time, but I manage to do it probably 70-80%(ish) of the time. It varies for me; if I'm going out a few times in a week then I find it really difficult to stay on top of it, as it's really difficult to find meals that are endo diet friendly when eating out. Be kind to you, and allow yourself to go step by step.

I also understand that people have different relationships with food, so please tread carefully and be gentle with yourself. If possible, start this process whilst working with a therapist. Remember, stress can make endometriosis worse and lead to depression and anxiety. Go step by step, slowly and tread carefully, and try not to be hard on yourself; it's difficult enough to live with this condition, we don't need to beat ourselves up for not strictly following the endo diet; it's a learning curve.


The Gut and the Immune System

One way to treat endometriosis is to calm the immune system down. Our immune system starts in the gut, and in order for the immune system to be healthy, the digestion needs to be healthy. This is because you're not going to be able to absorb nutrients unless your intestine is working, and we need those nutrients for a healthier immune system. So, it is very important to eat a diverse range of fresh, whole, foods, as above, and to consume unprocessed, unpasteurized, traditionally cultured and fermented foods, such as sauerkraut, kimchi, kambucha, and fermented vegetables of all kinds.

Consuming fermented foods can encourage more diverse gut flora to grow, and "generally speaking, a diverse gut flora is considered to be a healthy one. This is because the more species of bacteria you have, the greater number of health benefits they may be able to contribute to." (Ruairi Robertson, PhD) Some recommend around a tablespoon of fermented foods per day, some recommend more ~ this can differ for different people, so do your research and listen to your body; if you're getting tummy aches then cut back, but if you're fine with it then have some more. I try to stick to 75g per day at most, but do explore what's best for you.

Water

Yes, I'm going to nag you about drinking water! Aim for around 2-3 litres a day ~ this is what was advised by my doctor to me. Water helps maintain balance of bodily fluids; the functions of these bodily fluids includes digestion, circulation, transportation of nutrients, and maintenance of body temperature (for those of us who experience hot flushes thanks to endo ~ oh hey!).

I try to drink between 2-3 litres of water a day, and recently got into fennel tea (which helps with bloating) and berries & echinacea tea, just cause I like the taste :)  I try to not have water with food, so that I don’t dilute the digestive enzymes.


Supplements

It's important to eat a diet rich in nutrients, but it can also help to take supplements such as:

  • Vitamin B6 ~ has anti-inflammatory effects, assists liver enzymes with the removal of bad oestrogens, improves immune function, and is necessary for the formulation of progesterone and serotonin. Low levels of progesterone can lead to oestrogen dominance, and low levels of serotonin leads to depression 
  • Vitamin B12 ~ helps the blood carry oxygen, is essential for energy and nerve health, has anti-inflammatory effects, and is extremely important for mental health as it supports our cognitive functions and moods 
  • Omega-3 fatty acids ~ play a role in controlling pathological inflammatory reactions 
  • Iron ~ Menstrual blood contains high levels of iron, so losing a lot of blood (Oh hello heavy periods) can result in low iron levels. Low iron levels can lead to fatigue and even anaemia, so it's important to have regular blood tests done.

For more on my experience and on what has/is helping me, click here

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