Endometriosis Diet That Stopped 20 Years of Pain | Khush Sra

26:56So we can use botanicals, but we can also use an elemental diet now. So it really is individual on what's available to you, where are you at with your lifestyle? And, you know, how exhausted are you? Because sometimes it's like, you're so exhausted. I mean, I would say the SIBO individuals, I have like so much empathy for them. They've just really exhausted so much trial and error with diet. Um, and, and what I say is like, start small, start with some supplements, you know, take the pressure off from a nervous system perspective, focus on hydration as well. And honestly, a lot of sleep. So I look at sleep and sometimes fasting tools to help those individuals before I'd go to nutrition.

27:37Yeah. And, you know, for anyone listening, the other thing I would add to that is that if you have SIBO and you've taken rifaximin round after round, you know, endometriosis, when I refer people to surgeons, I will say, I have a high level of clinical suspicion that something is going on with the digestive tract as it relates to their endo. So if you're going to, you know, if we're going to go with imaging, doing a gel MRI, that's a great way to take a look. We can do a abdominal ultrasound. We can't always see everything and it's not definitive, but I think it's better to have the imaging and to know what you're going in on than to go in blind.

28:18But I let the surgeon know this because often what I'll see with SIBO when it's like time and time again, and it's not getting better, they find lesions on the intestines and they might not have looked there had somebody not cued them in. So if you are someone who's experiencing that, that's worth letting your surgeon know that like, I would like you to check what is going on with my digestive tract. Because sometimes, you know, we look at the motility, there's the migrating motor complex, which is, I like to call it the street sweeper of the gut. And it's the nervous system that's going to move everything through.

28:54If you have endo, you have inflammation and that inflammation can be causing nervous system dysregulation. I mean, that's why we see anxiety. That's why we see insomnia, but it's also why we can see motility issues. We can see nerve pain. It's like, why do I have this nerve pain? This doesn't even make sense. And so I think that's a really important thing for women to cue into. You brought up histamine. Histamine is connected to endometriosis. Can you tell us about that connection and what women should know about endometriosis and histamine and food? Yeah. We're seeing this more and more. Maybe it's awareness and education.

29:33And women are like, yes, yes. Like you said, just listen to them. They know this. They just didn't know to connect the dot between histamine and or their allergies. and they're like, oh yeah, but I don't have painful periods, but I have painful ovulation. And we see that a lot. We see histamine rise because we need it at ovulation. So, you know, histamine is important for us and, you know, it rises and it, you know, cycles with our cycle as well. So we see individuals where there's a lot of pain at ovulation and histamine, we know, rises with estrogen. So there is a connection with histamine and estrogen.

30:07And a lot of the individuals are like, yeah, I have to avoid all histamine foods, but that's not necessarily a long-term solution. It definitely can give you immediate relief, avoiding some of those, you know, like pre-probiotic foods, you know, fermented foods they avoid, we avoid any leftovers. And that gives them like, oh yeah, I do feel better. I do feel like I'm not reacting as much. Great. But how are we able to then support clearance of estrogen and clearance of histamine? So it's not necessarily an overload perspective that I take, but also a clearance perspective. And it goes back to the gut.

30:43Is that that whole, you know, digestive detox clearance pathway. If our drainage pathways of our immune system, of our digestive and detox pathway, the liver, that gallbladder, we see a lot of liver and gallbladder supports coming in here. And by doing that, whether it's things like milk thistle, NAC, resveratrol, like helping that liver, methylation tools, but also helping the bile and things like Tudka or even bitters like arugula, dandelion, getting the bile flow. Those supports, along with everything else we talked about, about sweeping the full gut, has definitely seen over like two to three months, a lower reaction in the histamine response through ovulation and through the cycle.

31:29We also see individuals who get like that flu right before their period, that flu feeling. So this is all immune system, histamine, estrogen, balancing and talking to each other and clearing through those pathways. Mm-hmm. Endometriosis doesn't always show up the way people expect it to. And too many women are left managing symptoms without a full evaluation of what is actually happening. Endoglobal specializes in complex endometriosis care, including advanced imaging review, multidisciplinary evaluation, and excision-focused surgical planning. You deserve a team trained to recognize the full scope of this disease.

32:12To learn more or schedule a consultation, visit drbrighton.com slash endoglobal. That's d-r-b-r-i-g-h-t-e-n.com slash e-n-d-o-g-l-o-b-a-l. Yeah, and for people listening, so when histamine goes up, it can cause the mast cells to release, excuse me, when estrogen goes up, it can cause the mast cells to release histamine. and then the histamine can perpetuate the estrogen cycle. And so that's why you're talking specifically about how do we eliminate the estrogen? And this is not, women always, you know, I feel like if you're in your 20s, you're like, estrogen is the worst. And if you're only in your late 40s, you're like, no, I don't want to do anything to eliminate estrogen.

32:58And it's like, well, we're talking about the estrogen you no longer need. This is the estrogen that your body's like, we did it, we're done with it, let's get it moved out. So you brought up some supplements, What are some of your favorite supplements to use in this situation to help with clearing out estrogen, especially when somebody can't tolerate cruciferous vegetables, which we know are like gold star winners of helping with estrogen? Yeah. And you brought a key point there. It's important to know that, especially as you hit the 40s and perimenopause. Like, you know, I'm in that phase right now where you're like, you want to keep all the estrogen you can.

33:38but it's the right estrogen that you want, right? Like, and it's a good estrogen. And so it's, you know, clearing out, you know, xenoestrogens and like endocrine disrupting type of estrogens is still, you know, very important, especially important as we get hit perimenopause. So I would say instead of like going to DIM, like I know DIM is great, but I always say get your data. Like get your data before, and that's why nutrition you can explore. But once you're talking, getting into the world of supplements, I love to get the data, whether it's a serum, you know, day 21 or day three, like estrogen, or, you know, we use a lot of the Dutch test in our clinic as well.

34:14Get to know where you're at before you heavy supplement on bringing estrogen down. But I do love resveratrol. I do love sulferaphane. And I know you have, you know, this hormone balance supplement. Yeah, balance hormone supplement. Which only has 50 milligrams of DIM. Yeah. And people are always like, this is too little dim because I heard you need a hundred or more. I'm like, do you want to hate your life? Because no matter what age you're at, if you start taking, like I have had people that are like, oh, dim gives me massive migraines. I had hot flashes. I felt horrible. I've seen this at so many ages.

34:50And there are supplements on Amazon that are like 500 plus milligrams of dim. And I think you just tanked your estrogen super, super hard. But yeah, it has dim it has sulferaphane it has resveratrol it has mustard seed which is actually how you activate that sulferaphane so yeah we've put it together in a way where it is gentle but i do not recommend it for late stage perimenopause when your estrogen is declining rapidly or just not there or you're in menopause unless you're on hrt and so i always try to caveat that because sometimes I get women that are like, I tried this, I didn't feel better.

35:28And then my customer service is like, how old are you? And they're like 62. I'm like, this is not for you. Like, this is, sorry, your ovaries, they're not jumpstarting again. Yeah, exactly. And I think you have to look at where you're at in your age. And I'm also like, what are your goals? Because I think if we try to track everything with endometriosis, it's hard. Like we take a very goal approached, you know, a goal focused approach. Like what is your immediate two goals? Is it quality of life back? Is it fertility? You know, is it this endo belly and maybe just this endo weight that you're carrying?

36:02You know, what are your goals? Because, you know, some people are like, I just want more energy. Like endo fatigue is real. And I'm like, it's not because you're lazy. It's not because you're just tired. Like it is like immune driven, this fatigue that's coming up for you. So really get to know your goals and then get to know like, what are your boundaries? You know, is food easy for you or not? Or maybe we should go to supplements. And that way, get your data and build out a supplement plan that works for you. You know, because otherwise, I mean, do you know how many people, I mean, I've been there before too, Guinea Pig too, like where I have a cabinet of supplements, it's just expired.

36:36Because I'm like, I'm trying everything and anything that like, oh, my, you know, my friend's neighbor, like, you know, suggested because everything got better for her after that one supplement or one, that one food. Yeah. It's called a supplement graveyard. And the reality is, is that a lot of times too, I think people aren't patient enough to recognize like, they're like, I take ibuprofen, I have no pain. So I take turmeric and I have no pain. I take NAC, I have no pain. It doesn't work that way. Magnesium, I will say that one, like that one's a little more instantaneous. But when it comes to supplements and natural therapies, like changing your diet, that's going to take two to three months before you're like, I'm noticing a significant difference.

37:18And on that same note, if you're having the worst period of your life, it's not what you did two days ago. It's usually what you did two months ago. And we don't, we don't frame things in that way within our society to actually understand that the menstrual cycle, the impact on the menstrual cycle, it goes back months. And so three months to change your menstrual cycle for the worst or for the better and you get to choose. Yeah, absolutely. And we get this comment like, oh, like my hair. And I'm like, what happened three months ago? That's my first question. When I get a symptom of like, or someone's coming new to us and they're like, well, I have this going on.

37:56I'm like, you know, and they might just been working like one week in supplements. I'm like, okay, but like what happened three months ago? Tell me about it. Talk to me about it. And it's usually a life event. They've moved, they change jobs, you know, or there was a stress or maybe, you know, uh, they, they had another like pill that they had just stopped and, you know, they don't notice the side effects of it until a few months after. So you're absolutely right. And, you know, but a lot of women are educated in this too. I want to just acknowledge that too, is that, you know, you said, you brought it before is like, women should be heard.

38:29And how many times I got asked if I'm in the medical field when I was like an engineer. They're like, oh, are you in medicine? I'm like, no. I just had to go to the library and read everything and study everything because I felt like that five minutes, all they told me was the same thing they told me two months ago, my last appointment. And so many women feel like they have gotten a PhD in this. And it's just not fair. Like we should not have to spend, you know, half our lives studying all of stuff just to go to an appointment and then be dismissed or gassed it again. Yeah. Well, that's the thing that I just want to highlight what you said.

39:06Women are, one, having time away from their life, stolen from them because they are in pain. And even if it's not pain, you're gaining weight, you're fatigued, you have anxiety, you have insomnia, you have the myriad of symptoms that can come with endometriosis. Then you have to spend even more time researching everything about endometriosis. Then you have to spend your resource of your time and your money to go to a doctor who then dismisses everything, even if you bring them studies sometimes. And you're right. It's absolutely not fair because you're losing such a significant portion of your life.

39:38And it's an impact beyond just period pain. Going back to what you said earlier, you brought up endo belly. Let's talk about that. So, you know, maybe not everybody listening knows what endo belly is. So let's start there. Yeah. I mean, 80 % of women with endometriosis are shown to have like dysbiosis or like a gut disruption. And, you know, it manifests in different ways for individuals. We see a lot of constipation. We also see a lot of, you know, loose bowels, but we also see a lot of distended bellies. And so, you know, you're like, oh, I woke up and I was like, you know, pretty flat and I drank some water or I just had one meal and then boom, I look five months pregnant.

40:17You know, and how many times, like when I was in my, you know, infertility years, I was like, people would say like, are you pregnant? Oh, like you're pregnant. I'm like, no, no, it's just inflammation. And it's just this inability to like get down again, no matter how much I exercise and no matter how much Pilates I do, that did not change it. And so really it is about, you know, kind of like that, that this bias is a dysregulation of your gut bacteria and its ability to just regulate, you know, the enzymes, you know, all of the digestive processes. And people are like, but I don't even eat bad.

40:53I've been eating clean. and that's the tiring part of it is so many women they've you know they've gotten gluten-free they've gotten dairy-free they've gotten sugar-free they've even gotten meat-free you know and i did that too i went vegan because i was like okay i got a little bit better yeah i was a picky eater right and then i added some vegetables in like this is great and then i changed my food even more i'm like this is great and then i went vegan because i was like okay veganism this is this is the way and i did feel great and i thought that this is it like guys like i feel great but it still didn't knock out that endo belly and it didn't knock out like my infertility.

41:26It didn't knock out, you know, all of those underlying symptoms, even though generally I did feel better. And that's what I'm saying is like diets may change your inflammation and get you feeling, but then there's this underlying mechanism that might still be out of balance. And so for me, like, you know, that diet, trial and error, I've been there and done that, especially for endo belly, because it just sticks out. And at this point I'd lost some weight, but I didn't lose the endo belly. And so the endobelly is really about rebalancing that gut microbiome, getting to the right fibers for you so that you can get things like short chain fatty acids and other things to work within your gut lining and get the gut lining soothed.

42:03I always say that that's your terrain. It's not necessarily your diet, but something in the terrain like your digestive tract is off. It's going to be different for you than it is going to be for someone else. So as much as you hear, and that's the challenge with Instagram these days and TikTok is like, there's almost like now too much information. And you're like trying to say, okay, like post-it notes and you just keep saving all these post-it notes, post-it notes. And then you have like a thousand post-it notes of like, which one should I try? Because they're all saying I should do AIP for endobelly.

42:35I should go vegan for endobelly. I should take probiotics for endobelly. But that flares up my endobelly. So I think endobelly is probably one of the most complex, but if you get down to the simple way to approach it, here's what I would do. I would first, again, I'm going to go back to sleep. Making sure you sleep and take an overnight fast of like 14 hours. Let your gut get a break and do its work. I feel like our bodies are so powerful if we just, you know, give some, sometimes give it a break. And so for me, sleep was one of my biggest things of waiting to regulate that nervous system because when I was awake, I was on.

43:12My brain was like an overthinker. I could think a million miles a minute. So being able to get to sleep, allowing my gut to clear, have bowel movements, adding in some of the right fiber, but also electrolytes. I was really depleted and dehydrated. And I'm like, I'm drinking water and then I'm loading. So I don't need more water, do I? Yes, I did. I just needed to be hydrated in the right way. So adding in electrolytes really helped me too. Well, I want to emphasize, you said that endobel, you mentioned inflammation. So for people to understand, because whenever we're bloated, people think gas, this is not gas.

43:48It is full blown inflammation. Your intestines are actually inflamed and it is, the endobel isn't just uncomfortable. It's painful because nerves are getting stimulated as things get stretched. You're not meant to be extended. This is not a normal way to go about life. I dealt with endo belly personally, actually posted pictures online where I did look like four months pregnant. And it was just unbelievable, like how bad the bloating was and like praise stretchy pants, because if it wasn't for the elastic waistband, like I'm like, you know, I actually went and bought like, um, muumuu kind of dresses.

44:24Cause I was like, if I have this kind of flare, like I just can't have anything on my abdomen. And you brought up the right fibers for something that I incorporated is cold potatoes. So I cook the potatoes, pull them, and then eat those. And this is another thing that became like a full-time job of like making sure I got enough fiber diversity in, but the resistant starches, they really helped. It took several months for that to go away, but eventually it did. The other thing is that I have a women's probiotic and it has a particular prebiotic that's compatible with SIBO. And I've had a past history of SIBO.

45:02So I was like, I know this will work and I can incorporate this as well. And I think it's so important, like you said, to make sure that you're also looking at your fibers. Because the first thing I think a lot of people think is fiber feeds bacteria, bacteria produce gas, I've got gas, I don't need that. And in reality, we need to increase diversity in the intestines because the gut bugs will work for you. Sometimes we do need antibiotics. We need antiparasitics. We need antifungals. We need something that's antiseptic like rifaximin. Sometimes we need those things, but your gut unlikely has a pathogenic organism.

45:42That's more rare to see, something that's disease causing as much as it has commensal flora that are imbalanced. And commensal flora, for any woman who's had a yeast infection, you're familiar with that. You have yeast in your vagina. Given the opportunity, that commensal flora is going to overgrow. So how do we keep it in check? Well, lactobacillus acidophilus is like one of the primary species that helps keep it in check. Within your gut, if you eat diversity of fiber, you have diversity of organisms, they can also help keep that in check. But it is really painful. And sometimes women, I mean, I've seen women who are like, I only want to water fast.

46:19You know, when I have a flare like this, like, what do you recommend in terms of like soothing foods if you're in an endo belly kind of flare situation? Yeah, it's a great question. I mean, there are some women who just like, they're like, yeah, they want to avoid food. I have so many that just don't eat all day, because it's going to create a flare. It's going to create this distended belly. They don't want to go to work with this distended belly. They'll drink some coffee, get through the day, and maybe eat a meal at night. And that's not the route to healing the gut. We love to add in things like aloe vera.

46:56I like to add in L-glutamine, but we have to be careful if there is SIBO because that can sometimes... Glutamine and magnesium are great, but with SIBO, you have to dose that really correctly. But aloe vera, the inner leaf of it is always super soothing. Bone broth, we love that. And, you know, having those teas of turmeric and ginger with some black pepper in it, those are some of the three things that I would say, you know, over a month or two, you are going to see the soothing effects of it. But then you have to look at how do I not avoid skimming meals? Because that is not the solution. And that actually probably isn't the problem either.

47:36When you eat, it's not like it may feel like that is the problem, but that's not the problem. The problem really is, like you said, that imbalance of bacteria. If your endometriosis pain is still ruining your life, something was missed. This disease is complex and without specialized evaluation, it's easy to manage symptoms without addressing the full scope of endometriosis. Endoglobal focuses specifically on advanced imaging review and excision planning, and they offer affordable options, including a complimentary consultation to evaluate your case and determine whether surgery is appropriate for you.

48:16You do not have to guess on your next step. Visit drbrighton.com slash endoglobal to book your complimentary consult today. that's d-r-b-r-i-g-h-t-e-n dot com slash e-n-d-o-g-l-o-b-a-l and we know that there is you know this lots of studies that there's like you know a meta-analysis done on studies but the gut microbiome with women with endometriosis it is imbalanced so working slowly to rebalance that because it doesn't happen overnight you can't just take a probiotic and expect that in a couple of days, everything's going to be great. Absolutely. You can add in supplementing. It would be so great, everyone, but it's not that way.

49:00You know, like probiotics, prebiotics. I love, you know, like you can supplement that. You can add in resistant starches. There are, you know, also resistant starches supplements. If, you know, if you feel like the food is not there, there are resistant starches. You know, there's, I think RS Fiber from Designs for Health makes one. I think there's Sun Fiber. You know, these things add in, you know, the support for short chain fatty acids that will help our gut over time. But again, patience. And this is the difficult part is finding a couple of these supplements, trying some of these foods that we've talked about through this episode here and putting them in play with consistency and giving your body some patience.

49:38And it's so hard. And it feel almost like bad asking for women because they've had patience. They've tried a lot and they've suffered a lot. And they're doing this on the side of their desk, on the side of their families. But if you can give yourself some consistent, you know, support through two to three months, you will see that your terrain does respond. Mm-hmm. Yeah. And just to underscore, giving yourself two to three months is so important because again, the, you know, endometriosis isn't something that developed overnight. You had stage four, I had stage four, it's kind of worthless actually to even use the stages anymore because the Ensign score is really such, is so much more telling about where it is in your body and what is going on.

50:27But, you know, for people who don't know, stage four is like worst of the worst, like worst case scenario. And that's not something that like, just because you got your period the first time and it's painful, like you automatically just had stage four. I mean, for most of us, this condition is developing over years. And we're, most of us are also being neglected. You know, as we were talking before we recorded, I told you, you were like, oh, thank God you wrote Beyond the Pill. And I was like, yeah, I wrote it. And I was like, stop giving women the pill for period pain because it turns out to be endo later and you need to work them up.

51:01And then it's me 29 years later after 10 years on the pill. And I'm like, damn it. I'm the person from Beyond the Pill who had endometriosis. But I look back and I'm like, I'm so angry. And it's really funny because I've worked with like therapists and intuitive healers and stuff. And everyone's like, you need to let go of this anger. Like you need to let it go. And I'm like, no, it's mine. I won't let it go. And I'm not holding it in. I'm taking this anger and I'm putting out information where I'm like, no one else is who comes into my space is ever going to have to deal with this again and have this level of medical neglect and have this much pain and have this much heartache because I'm going to take this anger and every time I feel mad about it, I'm going to make content about it.

51:46I'm going to write about it. I'm going to put information out to try to change the world. So I'm like, I'm not, I don't want to work on like, just let it go. I'm not freaking Elsa. I'm not going to let it go. I am very much going to build a blizzard that is going to like take down the medical empire that just profits off of us. Yeah. Oh my gosh. I love all of that. I love all of it because, you know, it has a purpose, right? Like in that pain, like that same thing with me, my pain turned into my purpose. You know, I was suffering when I was in my engineering degree. Like I could not walk. I had an accessibility parking bus.

52:19I had to park inside my university. So much shame and embarrassment in this because I did not look sick. And then when I got into corporate, I was in technology and then slowly into management consulting. And I had no business being where I am today, but the endo was so bad for me. my VP was once like, but you look fine. He's like, but I don't get it. Like you're shady. You don't attend work often. Um, but the business loves you and they rave about you. So I'm not sure what's happening, but, and then like literally he just walked out of the room at that point. I handed him my notice a month later, but the, you know, the moment that this came true for me was I had five surgeries.

52:54I had gone through like the Lupron, like I was in a room dark. I didn't want anyone to open that door. I would scream at you. You know, the doctor gave me anxiety pills. I was like, okay, then you need this on top of it. And then maybe we'll do another surgery because now hopefully it's all like tamed down. And I don't want another thing of that, nor do I want another anxiety pill. I'm done. And I just was like, I don't know what the other way is, but I just know that that is not the way. Like you can't keep telling me that I need to be cut open over and over and over again. Like five is enough.

53:24And then when I went on this journey and made myself a guinea pig and spent hours, like tens and hundreds of hours researching this and trialing around myself. And I finally got to this place where I was bleeding. I was like, I'm having my period. And I didn't feel it. I didn't have spotting. I didn't have a migraine. I didn't throw up. I didn't, I wasn't on the floor crying and sobbing. Like, and this is my body. It was like, oh my God. And I did. I felt angry for everything that I put my body through thinking that it was so broken and thinking that I was just never going to get better. And I like, it really hurts if I think about it.

54:00At one point then I told my husband, like, I never want to say the word endometriosis again. I literally said that to him. And lo and behold, I then went into the infertility journey. You're like, and I'm the endometriosis. You know, but then we went into, but then what the doctor said of you may not have kids because it was that bad on the ovaries. And my FSH was like in my twenties, in its twenties. I think that like, she's like, your premenopausal from your, from your ovary reserve perspective, you know, um, the clinic's like, we don't know what to do with you either. It's unexplained infertility.

54:30You know, we can do the, we did the IUIs, we did this and that. And like, we don't know. And then lo and behold, got pregnant on my own. We have three children and it was my doctor who did the surgeries and had to help me deliver the kids who said more women should do this. She's like, we remember we were debating a hysterectomy for you. And, and in that moment I decided, because I, by then I I was like, I talked health all day long in my family. Like I, like every woman, I got the PhD, unofficial PhD. But I was like, yes, more women need to follow this. And I too, I took that in pain and made it into a purpose.

55:05And lo and behold, this is where I'm at. And I had no business turning it. My parents were like, what are you, you becoming a nutritionist? Like they were just confused. They're like, you're fine. Like you're living your life. Why are you going to go do this? I'm like, because too many women are suffering. I want to talk about what you did with nutrition and fertility, because I think that's really important in this conversation. But I want to start going into the fertility piece with you recently speaking out against ACOG's recent statement. And I'll say ACOG's recent statement basically said, there's no reason to investigate, calling it unknown infertility.

55:44That's enough. Like, we don't know the cause of it. Like, and we don't need to know the cause of it. We just need to get women into IVF. And by them pursuing the cause of it, them pursuing endometriosis diagnosis, ACOG, I'm coming for you. But them pursuing all that, they're wasting their time when they could just get to IVF. And the reality is, is that a lot of unexplained infertility does turn out to be endometriosis. That was my story. I was told I was old. I'm like, I had a baby at 40. They're like, well, now a year later, you're just old and your eggs don't work. And so like the only thing we can do is IVF.

56:25And I had so much blood work, so much testing done. And I go through IVF and here's the thing. I had horrible periods, my entire, you know, jumpstart to my period journey. I get put on the pill for that. I then think I'm so clever of like, I just won't even have a period because even on the pill, they still sucked. They still hurt. It wasn't better. I had multiple ruptured ovarian cysts. At any point, someone could have clocked this as endo. And then I come off, I've already got a nutrition degree. My period goes missing. So I'm like, I got to get that back. And then it comes back and it's hell all over again.

57:03And I worked on that from nutrition and lifestyle got out of pain. So the doctor said, this couldn't be endometriosis. You have no pain. That's not what's going on. It was going through IVF that flared my endo so bad. So, so bad. And nobody talks about that. My third A retrieval, I couldn't walk and it was three weeks and they were like, take oral NSAIDs and take it under the tongue. And how about some tramadol, which is an opioid as well. And I'm like, none of this touches the pain. None of it is touching the pain. And I I found the endometriosis on, I just incidentally, Prunovo was like, hey girl, want a full body MRI?

57:43If you post about it, we'll trade. I'm like, cool. You guys know I'm full transparency about stuff like this. I got that done and they were like, hmm, this sure looks like endo. We can't diagnose that. You need to get this worked up further. And when I went to my fertility doctor, so I had one fertility doctor. She left, get put with this other guy who's the head of the clinic. And I'm like, look, I got endo and I have adenomyosis. And he's like, adenomyosis is just new trendy diagnosis, like ADHD. I'm like, well, I freaking have ADHD too. And there's actually a connection to all this. But he was like, your endometriosis doesn't matter.

58:16Just keep doing cycles. Just keep transferring. And that is exactly what ACOG is getting behind. And their entire statement is based on profit and not the well-being of people. IVF is so inefficient. I was looking at a recent study that was just like hundreds of millions of cycles and like, like I think it was like 38 million success out of like, I'm probably skewing these numbers right now, but I just looked at the percent of success. It's less than 50%. In fact, in a lot of cases, it's less than 30%. You're going to go through IVF. You're going to spend$30 ,000 per cycle. You're going to have to do four or more cycles.

59:01Like, what are we looking at? Like hundreds of thousands of dollars with less than a 30 % chance success rate. And ACOG is like, just get there. Just do it. Just pay the bills. And they're not even recognizing that there are things that can be done. I mean, why wouldn't we want to do nutrition? If you're not fertile, something is going on with your body. We need to figure out why, because that's not a natural state. And whatever it is, is going to affect the outcome of a baby. Like, why wouldn't we want to offer women that? Anyhow, I could rant forever, but I want you to say your piece on it because I know you also spoke out.

59:37And I felt like there was only a handful of us in those comments saying this. Like I was, there was in terms of practitioners, because it was all of these patients, especially women with endometriosis being like, we don't get diagnosed on average for seven to 10 years. We live with horrible, horrible symptoms. You do nothing to actually train the detection of this. ACOG does not make sure that only the right people are operating on this. They offer no protections. And then they're out here just being these greedy little goblins being like, oh yeah, just get to IVF. Let's take your money on this.

1:00:11And it was you and me, endosurgeon Jeff, like a few practitioners in there, but so many patients in the comments being like, this is wrong. And that's why in my comment, I was like, you need to listen to women. Like, why are you not? Look at all what these women are saying. And you're just out here just being like, just pay us. Keep going. Keep pushing through, you know, and keep hurting yourself. Because that's what it is. If you're in a flared up state, if your hormones are imbalanced, your immune system signaling, you know, fires everywhere, and you just throw yourself into another retrieval cycle, like it is, women are coming out feeling horrible.

1:00:48Yeah. And then they're like, oh, no, let's go into your transfer now. And they're like, they can't even imagine. then you should transfer let's flare you with inflammation knowing damn well at least you should know because you're a freaking doctor that you know this flare is going to raise natural killer cells those are going to kill a fetus like i say that as somebody who has lost multiple embryo transfers and i look back at this and i'm like god if i had the knowledge that i had now like things would have been so different. But the idea that like, we're going to do a retrieval, we're going to flare you, we're going to make a hostile environment in your uterus, and then we're going to just put an embryo in there.

1:01:29And so much of this is also being driven by private equity groups. And I want people to understand that. IVF and women's fertility and these predatory behaviors are because private equity groups are like, push women into as many cycles as possible. I mean, it is an opportunity financially, if you think about how much infertility is on the rise, our fertility rates are dropping, right? And we have to look at what's going on. What is going on? And there's many reasons when it's, I mean, it's unexplained, or is it we just didn't have the time to go through and explain it? We have a label for you, it's unexplained.

1:02:03But really, there might be lesions. You know, there might be endometriomas, right? There might be egg quality issues. There might be immune dysfunction, right? Because that That home, that uterus, it is brilliant. I always tell our clients, it is brilliant. It knows when it's safe enough to receive. And it has the blueprint for human development. It's not going to just listen because some signaling's coming in and saying, grow a baby now. It's going to be like, no, sorry, not working. And so we really have to, like you said, listen to women because I've had clients that come with three, four, five failed IVF cycles and they're depleted.

1:02:40And it takes us anywhere from four months minimum to one year to get them out of that flare. Post all of these cycles that they've been through. Getting their body just to really find safety again. And get their hormones, you know, to balance out. Get that gut, you know, nourished again. Get those eggs nourished again. And then we are very supportive of saying, hey, let's support you into your IVF cycle now. because now your body's feeling good. It feels right. You know, maybe it's, or maybe it's a retrieval. So we've had supports of women going into retrieval cycles that have been very successful into IVF cycle, but it requires a full integrative approach.

1:03:23And I know you had that episode, I would think with, when maybe it was your own surgeon, where we talked about endomapping and mapping that whole body out, understanding what's going on. Look at your nutrition, look at your terrain because anti-inflammatory isn't just a diet. It's a state of your body, in the metabolic state of your body, the hormonal state of your body. All of these are so important. And if you're spending tens of thousands, you're throwing yourself like it's a baby. A baby is a lifelong commitment. Give yourselves, you know, that voice to say, you know what? I want to take three, six months and really do these foundational things because that's what they are.

1:04:00They're foundational to get back to a fertile state of the body. Yeah. Yeah. And I think that it's so important to recognize that you don't have to forego IVF if that's what you think is your best chance, but you have to recognize. So something that I found really helpful, I did a fourth retrieval. So my women's hormone support, I actually went on that. I was like, I need to clear estrogen and have the right estrogens. My doctor supported me on that. why did I so this was like my fourth retrieval I wanted a little bit of a flare too because I was going to go into excision surgery I'm like I want you to find everything but what happens in IVF is that when you're doing an egg retrieval you're injecting yourself with FSH typically LH as well and that is causing your estrogen levels to rise I mean your estrogen levels they can be in like the 300s sometimes women are much higher than that that is going to stimulate that endometriosis tissue.

1:04:59So wherever it is in your body is going to grow. So I don't want women. So like, I don't know. I feel like I just have to be clear on this because I think sometimes women are just like, oh, so you're anti-IVF? No, because like I clearly did IVF. It's always like when people are like, oh, you're anti-birth control because like you're criticizing it. Are you anti-surgery? I'm like, no, I'm not anti-anything. I'm like, whatever is right for you. Absolutely. And an integrative approach with a little bit of a pause before you go into anything. Let's just pause and like look at everything because the whole rush and quick fix and like, you know, fast food approach to this is what I don't like.

1:05:32Yeah. Well, let's talk about nutrition specifically. So let's talk about nutrition in general. So for supporting fertility, and then we can get more nuanced on like supporting someone through an IVF cycle. Yeah. So for fertility support, it is really important for us to get into kind of like reducing oxidative stress, you know, reducing inflammation. And so I love, you know, these fatty fish, you know, omega supports. I love flax again. I love all of those. I love arugula and a lot of bitters like dandelion as well, whether it's milk thistle tea you like for your liver. So really taking a diverse approach.

1:06:09I love my blueberries. I love my, you know, unpeeled carrots. Like I always say, like easy snacks to have, but eggs as well, like for the choline and just all of those, you know, those rich vitamins. So we like dense nutrient foods here for fertility. And I also love supplementation here. So things like CoQ10, again, resveratrol will come back in here as well. I love magnesium. And then instead of supplementing with melatonin, I always say sleep is huge for fertility support. So optimizing that cortisol cycle with melatonin is probably where we start. where like your monthly cycle for fertility needs your daily cycle to be supported.

1:06:50So get out there in the morning, you know, get some sunshine, get that cortisol signaled from your body because it could be high, it could be low. We see both of them. But get some sunshine, get outside, get that lymphatic system moving as well because that lymphatic system is going to help you clear out toxins, clear out inflammation. So move your body, get outside in that morning sun for cortisol. And then at nighttime, get your blue light blockers on so that melatonin can start to peak before midnight. I always say it's important for melatonin to start rising well before midnight. So this doom scrolling or TV, the blue lights or even the pot lights in our house, get your blue light blockers on and get to sleep at a decent time.

1:07:35That's going to be my number one place where I start with fertility is is your 24-hour cycle. I do appreciate fasting because we've seen this. It does help with fertility rates as well. It's not just fasting, I would say, because I'm not a fan of intermittent fasting. I'm not a fan of skipping meals. But what I am a fan of is at least 12 to 14 hours overnight to induce that autophagy. We really have a cellular cleanup. We have a mess in ourselves when there's endometriosis. It's just, you know, something that we have to accept and love about ourselves. But how do we induce that cleaning mechanism is a lot of it is being able to give ourselves a digestive and, you know, sleep break at night and induce that autophagy process where I call it, it's like our Pac-Man come out.

1:08:18Our Pac-Man come out and clear out cellular debris and things that don't belong, you know, and really that is essential because it goes right into the ovaries too, you know, into that pelvic cavity and clearing out things and re-regulating all of that signaling that's happening within our body. Yeah. And I love that you emphasize melatonin. Melatonin actually has been shown in the research to be helpful for endometriosis pain and it acts as an antioxidant in our ovaries, also our brain as well. So we love that. And so that's really, I think, important one that we highlight there on top of, you know, the ways that we can be eating to overall just be supporting the, you know, the detox capacity of our body.

1:09:01Often people will say like, you don't need to detox because your body does it for you. And I'm like, I always say, how are your kidneys working without water? How's that going? There are inputs. You're like, you're an engineer. So I feel like this is your language. There are inputs. If you want the machine to like have the output and the outcomes that you want, you have to put in the right inputs. So I want to shift to around somebody going through an IVF cycle. They have endometriosis. You were talking about prepping their body several months before. We know the egg can take around 90 days to really need, you know, well, it's going to take 90 days at least for that, the final maturation process.

1:09:37So that's when we really want to be emphasizing our nutrition. A year in advance is even better. I always say that. Like whenever you want a baby, you want a baby yesterday, you want to be in your arms now, you don't want to be like, oh, I'm going to give myself a year. Like, so like I just say that like a year is great if you have the time to think about it, but if you don't, what can they be doing right now? Yeah. There's a lot of things that you can be doing right now is making sure you get enough fat and making sure you get enough vitamin D as well. Alongside that is just making sure, we all talk about the vitamin D, cholesterol synthesis, and the entire sex hormone pathway.

1:10:14So really making sure you get fats, but then you support yourself with good vitamin D, sunshine exposure to and bile and gallbladder support to help you know move all those fats through the system as well that's going to be one thing so whether it's eggs whether it's fatty fishes you know flax and chia seeds i love pumpkin seeds they have a lot of good minerals in it some flower seeds so i even do seed cycling with individuals just so that you're not feeling like you're eating all the seeds all the time and and some people can't do seeds and that's okay to. Like, you know, if your gut doesn't like seeds, you know, we see it a lot.

1:10:48That's okay. There's another, there's a whole bunch of food. There's food for everybody. And also there's, there's going to be a post or a study somewhere that will promote each food. And there'll be one that probably says this food is not good for you. And that's the confusion out there. So I say, do what fits best with you, but yeah, eggs, fatty fish, getting in some, you know, protein. I, for my own body, even though I went vegan and trial and error that, I feel like animal protein does better for me. I digest it better. But initially I didn't believe that. And this is the challenges because we do need protein and fat with women.

1:11:24If you feel like, oh, I don't do well with proteins, especially meat proteins, or I don't do well with fats, I would say, let's look at your digestive tract. How can we support your gut? Is it some enzymes? Is it something like as simple as lemon water or apple cider vinegar to boost that acidity in the gut? Because we all need fat and we all need protein. So starting there, and if you're already sharing, like legumes are great. And I love tempeh as well. Just make sure you soak your legumes properly over 24 hours so that it's easier to digest. And then in terms of like, you know, we love like all of the colors of, you know, fruits.

1:12:00So we like, you know, all of our raspberries has good fiber in it, blueberries as well. I love the vegetables, the cruciferous vegetables, but I love like garlic here, onion here, leeks here, asparagus, artichoke. These are all great foods to have. And then, you know, for your carbohydrates, like you said, cooled potatoes, definitely probably, you know, a great one. And then like sweet potatoes, carrots and beets as well. I would minimize in the fertility journey, we do minimize grains. We find that with the insulin balancing and carb tolerance, It is safer to go low-grain or no-grain for the three months before.

1:12:38But that's not low-carb. Can you explain that to people? I always say low-grain and ensuring it's your carb tolerance. So everybody has a different carb tolerance based on your metabolic state. And so you might have numbers like your fasting insulin checked or your HbA1c or hemoglobin A1c checked, or you may have even leptin checked. So these are indicators of where is your metabolic state right now. But also you can tell yourself when you eat different grains and different carbs, how do you do? No carb versus low carb is completely two different things. Vegetables that are very starchy and grains that are very starchy will spike your blood sugar.

1:13:18And that can trigger inflammation in a lot of individuals. So what we want to do is be low grain and low starch carbs. And that means we have a lot of vegetables in us and these are high in carbohydrates. They're all carbohydrate rich, but they are not going to spike your blood sugar. And that is important. It is very important to not spike blood sugar ahead of a fertility journey. Why? Because it induces inflammation. And that inflammation is going to go to all of those neuropathways, right? That anxiety, the gut, and then our ovaries. And our ovaries are highly sensitive to the cycles of blood sugar.

1:13:57and we want to make sure that as much stability we can give to our you know from a cortisol perspective or a blood sugar perspective those two being stabilized will then further stabilize our estrogen progesterone too and for women with PCOS this is especially important because while you make lots of follicles that insulin going up stimulates the ovaries to produce testosterone and that can be detrimental to the quality of your eggs and so whenever I see people in Lyme that are like women with endometriosis, we have, or excuse me, women with PCOS, we have so many eggs. So we're going to be able to get pregnant.

1:14:33And I'm like that they're not very good quality because of the inflammation, the insulin and the testosterone, but we can change that. That can be changed. I always feel like, you know, with men, they get a sperm analysis that's not so good. And they're like, well, like I feel bad about myself. And I think with women and when we hear like our egg quality is not good, we also feel like something like, like, you know, a letdown in ourselves, like something is wrong with us. But a lot of times, you know, there's certain situations we can't, but a lot of times we can influence the egg quality. And I know that there's research studies saying like, no, that's not possible.

1:15:07I have seen it with patients. I've personally done it myself. You know, one of the things that you haven't mentioned, which was a game changer for me was NAD and bringing in NAD. I did IV and then I was doing sublingual, you know, for a while. I was doing IM shots of it as well, or subcutaneous actually. There's seriously so many shots in IVF, which I was like, which one was that? But that was the subcutaneous that I did for a while. These NAD really, I mean, it was one of the many things that I did that took me from no euploid embryos, my first retrieval to three euploid embryos, my third retrieval.

1:15:47So that was something that I can definitely attribute to having better results as part of the kitchen sink approach that most of us have to take. And fortunately, it's not very easy to study. But so let's say someone's going, they're going to be in the IVF cycle. They have endometriosis. So that cycle is going to be anywhere of 10, maybe 14 days. What are they doing during that period of time? Yeah. And I do think that there is the right, not like the full kitchen sink, but the right kitchen sink. So yes, we do, you know, when you're at that point where you've tried it all and you've done this integrative life cycle, you know, for three months, and then you're at that point where you're getting ready.

1:16:26Yeah, it is about the kitchen sink because you have a big goal and we want to support it. So we are going to ramp up on antioxidants. So we ramp up on antioxidants. Nutrient wise, if we want to do, you know, vitamin C, E, NAC, resveratrol, you know, or a blend of those, those are going to go up. You know, we love krill oil as our omega-3 at this point because it's an antioxidant type of krill oil as well. And hopefully leading up to it, you've done maybe some Vitex to support the progesterone. We also see that things like calcium D is important ahead of this, but then we stop it. So we do stop some of the estrogen and progesterone balancing hormones right before the cycle comes out.

1:17:08And we really focus on getting good sleep in. Like you said, the melatonin comes in here. We've used different types of herbs as well for individuals, but those are really personalized. And I would say making sure that you have a support system during the 14 days ahead. I can't emphasize how often it is like, hey, if no one else, come text us, chat with us in our platform and say, hey, this is how I'm feeling. Because that's where that mind-body connection can really take over. And even the simple things like you can't sleep anymore. You're not even able to get for your daily walk. You're overthinking your results.

1:17:48You're getting into that fear mindset. And then mind-body connection piece is really important those two weeks ahead, even to stay consistent with your food and supplements. It's really grounding yourself every day. So literally getting into whatever grounding tools are good for you, finding a support system and staying consistent with those few supplements and that few diet and allowing for all the tools and accepting. At this point, I'm like, also accept everything that's being injected into you and seeing it as also the right fuel. You know, because sometimes we have this trauma from IVF cycles and then you're going back into that cycle and you're just like, oh my gosh, like your fear, you're afraid of the shots again.

1:18:28You're like, what are these shots going to do to me? And it's about supporting yourself through that and accepting that, okay, this is now like the right way to do this for myself and finding safety as you progress through. What would you say to a client whose doctor is telling them this is just unexplained infertility, just do IVF? I would ask them to find another doctor first and really, you know, maybe get educated on saying like, what are possible explanations and say, okay, if you find this is unexplainable. What are some potential explanations that there could be out there? You know, and when you look at it from an IVF perspective, what supports do you have that you believe will work for me?

1:19:12And if you ask them that and say, hey, so why do you think that that will work for me? Why do you think I need to be on antibiotics? Why do you think I need to be on thinners? Why do I need to be on steroids? What are the, what are those addressing? Because are those potential insights into what might be off in my body? Like if I need to be on prednisone, If I need to be on dexamethasone now, because the prednisone wasn't strong enough. Now they're saying dexamethasone. Why? What are you reading of my body? And getting to share that and having that back and forth conversation to understand if they're using something that's potentially addressing something that's not working inside of you.

1:19:48And is there a way for you to support that as well? I love that. You've brought up that, you know, there's information that you find online, Instagram, TikTok, YouTube, like all of the places, there is so much conflicting information around endometriosis. What advice would you give people to navigate in the online space? Yeah, this is a, I mean, a most difficult question because there is information overload and you already feel like loss of where to start. And now you see there's like, it's not a fork in the road of like two to three options. There's like a million paths you can go down. And it's like, what's the path of least resistance for you?

1:20:31Like, is there someone where you connect with, you know, and you want to like give yourself some chances to make small changes? You know, I would say that's where you want to start is pick one path, make some small changes. The path of least resistance is always the best and listen to your body. You already have that intuition, but too often in this journey of chronic illness, we keep giving our power away. We keep giving our power away. But like a lot of the answers are within you. I can't tell you how many times when we're working with clients, I'm like, if I sit down with you for five minutes, you've given me half the answers yourself.

1:21:06You have the clues. You have the knowledge and the wisdom, but we have to trust ourselves. And then, yes, there's some science on nutrition and supplementation, you know, potentially surgery or other aspects that, you know, experts can guide you with. But also learn to trust yourself in this journey. And so intuitively, if you connect with, hey, I'm going to try this path. This seems easy. Like it might be, hey, I'm going to go AIP for a while and I'm going to try that out. If that suits you, try it out. You might feel like, hey, I do feel better. And then you can go further and explore. But you can't try all of it at once.

1:21:38That's what I say. There's no all at once approach. Even with our clients, our approach, first of all, you can't work with us less than four months because we won't see the results. So we know that. And the second thing is we don't make one change more than once. We actually don't even talk about nutrition. until three weeks into nervous system stabilization. Well, thank you so much for this conversation. This has been super helpful, I know, for many women getting to navigate through all the online noise and just get into what is actually working for women with endometriosis. So I really appreciate your time.

1:22:13Thank you so much for having me. I love what you're doing. And I know that millions of women are listening to your voice. And now with that endometriosis journey and that lived experience, it's an even deeper connection that women make. It is really woman to woman that we find trust. And when we see ourselves in some other women, that we feel inspired and feel even more motivated to go after our own health. So well said.