Endometriosis is a disease in which tissue resembling that which normally lines the uterus, called the endometrium, starts to grow elsewhere and form lesions. These lesions respond to hormonal cycles in the same way as endometrium in a woman’s uterus and swell and shed during each menstrual cycle. But the lesions cannot be expelled like normal endometrium. This can lead to inflammation, severe pelvic pain, and infertility in women.
We are learning more about the root cause of endometriosis each day. Several causes of endometriosis have been proposed, but no single cause has emerged as a clear trigger. It seems likely that a combination of factors may be responsible for the development of the disease. We are now discovering that endometriosis is not simply a hormonal condition, but is rather a whole body inflammatory and immune condition. It is affected by estrogen, but it is not caused by estrogen or estrogen dominance as previously thought.
The immune system
Researchers are still debating whether or not endometriosis should be classified as an autoimmune condition. Regardless of how it is classified, it is clear that immune dysfunction is at the core of the condition. The immune system in addition to protecting the body against disease and infections, works to eliminate foreign or abnormal cells in the body.
In endometriosis, the immune system fails to recognise and target endometrial tissue growing elsewhere in the body. This failure may indicate that endometriosis is an immune disease.
Endometrial lesions themselves may have some ability to evade the immune response — much as some cancers do — by tricking or confusing immune cells that would otherwise attack those cells that form the lesions.
Causes of Immune dysfunction?
- Epigenetic’s
- Genetics
- Exposure to toxins
- The presence of the bacterial toxin LPS (lipopolysaccharide) in the pelvis.
- Possible nickel allergy.
- Inflammatory foods
Bacteria
Research has found that women with endometriosis have a higher level of gram-negative bacteria in the pelvic microbiome. This bacteria produces a toxin called lipopolysaccharide which can contribute to the development of the disease. The gram-negative bacteria come from the gut in the presence of SIBO (small intestinal bacteria overgrowth) or other possibly other gut conditions which can cause intestinal permeability (leaky gut). There is often a strong link to gut health and endometriosis. The LPS from the gram negative bacteria stimulates the immune cells to release inflammatory mediators, which leads to immune dysfunction.
Bacteria is not the direct cause of endometriosis, but it can worsen the disease in combination with other factors.
Naturopathy & Endometriosis
Naturopathy is considered a whole body, multi-modality form of complementary medicine that utilises a combination of clinical therapies to treat an individual. These therapies include clinical nutrition and dietary modification, herbal medicine, nutritional supplementation and lifestyle intervention.
Because Naturopathy is founded on the principal to “treat the whole person” it can be a great adjunctive therapy to any of the above medical and surgical interventions for Endometriosis or to assist the many diverse symptoms associate with the disease. Areas Naturopathy can assist with include:
- Pain management
- Supporting immunity
- Supporting sex hormone metabolism and production
- Stress management
- Modulating immunity
Anti-inflammatory Diet: An anti-inflammatory diet is recommended for women with endometriosis. A 2013 study on selected food intake and risk of endometriosis suggested a relation between the disease and low intake of fruit and vegetables and high intake of trans fat, ham, beef and other red meat. A literature review published in 2004 on dietary risk for endometriosis showed a high intake of green leafy vegetables and fruit was associated with a lower risk. An anti inflammatory diet incorporates a wide variety of coloured fresh veg and fruits such as dark leafy’s, broccoli, cauliflower, berries, ginger, turmeric, beetroot, celery, pineapple along with coconut oil, bone broths and fresh fish. While avoiding processed foods, dairy, refined carbohydrates, refined sugars, soft drink, soy and over consumption of red meat.
Calm the immune system: This can be achieved by strictly avoiding immune-disrupting proteins like gluten, A1 casein from cow’s dairy, and possibly eggs. “Strictly avoiding” means completely avoiding for a test period of eight weeks. If you’re sensitive to gluten, as many with endometriosis are, then even a trace amount can generate a significant amount of inflammation. According to reproductive immunologist Dr Jeffrey Braverman, most women with endometriosis have the genotype associated with celiac disease.
Modulate the immune system: Consider taking one or more of the following immune-modulating natural medicines: zinc, N-acetyl cysteine (NAC), turmeric or curcumin, resveratrol, melatonin, vitamin A.
Essential fatty acids: EPA and DHA found in fish such as salmon, mackerel, sardines, and anchovies. The two primary compounds EPA and DHA are beneficial in relieving pain through their ability to decrease levels of an inflammatory chemical called prostaglandin E2. EFA’s can also be obtained through clean supplements that have had any impurities or heavy metals extracted.
Magnesium: Magnesium is a very important mineral required for over 300+ enzymatic reactions within the body. Magnesium is not only great for supporting the nervous system and aiding muscle relaxation, but one study showed that changes in magnesium status were associated with changes in testosterone and sex hormone binding globulin (SHBG). SHGB is a glycoprotein that binds to steroid hormones rendering them inactive. Lower levels of SHBG are associated with higher levels of free active hormones, such as oestrogen. In fact magnesium is one of the most common mineral deficiencies facing Australians. So, it’s not surprise that women with the condition are thought to have reduce magnesium levels.
Anti-microbial herbs: Antimicrobial herbal medicine such as berberine, which reduces levels of gram-negative bacteria and LPS toxin. Berberine has not yet been studied for endometriosis but it has been studied for adenomyosis, which is a similar disease. In one study, researchers were able to demonstrate that “berberine ameliorates the LPS-induced progression of adenomyosis.”
Herbal medicine: Herbal medicine is one such area where the use of particular classes of herbs such as analgesic, antispasmodic, immunomodulating, anxiolytic and apoptogenic herbs can assist with varying aspects. For instance, curcumin, an extract of turmeric was shown to suppress the proliferation of endometrial cells by reducing estradiol production.
Lowering environmental toxin exposure: Endocrine disrupting chemicals such as dioxins and polychlorinated biphenyls (PCB’s) have been shown to interfere with the body’s natural hormone production. There is increasing evidence that chronic exposure to these chemicals is associated with an increased prevalence and severity of endometriosis. Avoid drinking and reheating in plastics, chemical based fake tan’s and other personal care products and eating organic where possible.
Avoid nickel: Consider a low-nickel diet if you have a nickel or jewellery allergy.
Mast Cells and histamine: Reduce mast cell activation and histamine because mast cells are important players in the immune dysfunction of endometriosis. Mast cells are also highly sensitive to estrogen.
If you have endometriosis, or suspect that you may have endometriosis then please get in touch to see how a naturopathic treatment plan may help to support your overall wellbeing.