Many of the greatest medical discoveries were found by clinicians recognising patterns of symptoms linked via a root cause.
They had no RCT with a placebo control to go by and no “published peer-reviewed evidence,” but they saw reality.
That may then trigger a case study or case series and then onto a full research study to “prove” it, but the results are there for you to see.
But when you are getting proper results, you do not need a questionnaire and a P value to know it is working. It is obvious.
In clinic, I routinely recommend a trial 2 week gluten-free diet to see if patients’ overall health and wellness improve with a view to getting good functional changes in the neuro-mechanical issues that usually bring them to see me.
About 20 years ago, a female colleague mentioned she had removed gluten from her diet and her endometriosis had improved significantly.
And so I started recommending this to any patients I saw with endometriosis.
And the results are very positive, though they vary in % terms of benefits.
Endometriosis is a chronic, oestrogen-dependent inflammatory condition affecting approximately 10% of women of reproductive age.
Its hallmark symptoms include pelvic pain, dysmenorrhoea, dyspareunia, and infertility. However, many women also report gastrointestinal symptoms such as bloating, constipation, and food intolerances—often overlapping with irritable bowel syndrome (IBS).
It is worth noting that these gut symptoms may be the spread of endometriosis to the colon, particularly the rectosigmoid region, and this form is known as bowel endometriosis or deep infiltrating endometriosis (DIE) when the lesions invade more than 5 mm into the tissue.
It’s one of the most severe and painful manifestations of the disease and often misdiagnosed as other gastrointestinal conditions like IBS, Crohn’s disease, or even colon cancer.
Gluten sensitivity also exists at the center of many conditions known as gluten related disorders. One of which is gluten-sensitivity with enteropathy aka celiac disease.
But there are many other conditions and diagnoses that are caused by the immune reaction to gluten, with the effects being medicated by the inflammatory damage.
And yes, one of those is endometrosis.
There are several plausible biological mechanisms by which gluten sensitivity may influence endometriosis:
Immune System Overlap: Both conditions involve immune dysfunction. Endometriosis is associated with an activated immune profile, including increased macrophages and inflammatory cytokines in the peritoneal cavity.
Similarly, gluten sensitivity involves immune activation and production of pro-inflammatory cytokines, which may exacerbate pelvic inflammation. Note the colon lymph system partly drains into the pelvis as well.
Microbiome and Oestrogen Metabolism: Dysbiosis which is common in both endometriosis and gluten sensitivity, can alter estrogen recycling and metabolism, potentially fueling oestrogen-dependent tissue growth seen in endometriosis.
Remember gluten may be the root of dysbiosis by creating a inflammatory gut microbiome that upsets the good bacteria and increases the success of pathogenic bad bugs.
And there is some evidence to back this up.
207 females with chronic endometriosis , 12 month GF diet, no control group, though I have never seen any spontaneous remission of endometriosis without intervention so it is not the big negative.
75% reported improvements, though let’s be clear not remission. But for a low-hanging fruit to pick, this is pretty easy.
They also followed up with deep infiltrating endometriosis and a GF diet.
In this study, they compared progesterone mimicking drugs alone vs progesterone mimicking drugs and a GF diet for 6 months.
With a GF diet I usually recommend 2 weeks, but for endometriosis they are going to need to commit probably to a full month menstrual cycle.
Also, as it is oestrogen dependent, ladies you have got to have the liver working detoxification well.
Key routes to removing oestrogen:
– Methylation – B12, folate, B6, TMG or grab some METHYL B HERO.
– Glutathione – built from glycine, cysteine and glutamate.
– Sulphate – built from HOMOCYSTEINE via B6 or take MSM.
Note all of the above are related to methylation and its partner pathway for cysteine.
See how much easier clinic is once you have CORE CONCEPTS?
– Glucuronidation – I use Calcium D Glucurate for this, also great for people with Gilberts syndrome, which is a gene issue on the glucuronidation pathway leading to raised bilirubin.
DIM (Diindolylmethane) is a bioactive compound formed in the body when you digest indole-3-carbinol (I3C) — a substance found in cruciferous vegetables like broccoli, cabbage, kale, and Brussels sprouts.
It supports the oestrogen pathways to ensure better forms of oestrogen are produced.
And sorry ladies, a healthy liver means you can’t get battered on the weekend or drink wine every night, it is simply a poison.
Occasional glass yes, anything more than that, no.