Welcome to our final week of Anti-Inflammatory Functional Foods for Endo!

We couldn’t end this 4-week plan on functional foods for endo without talking about the endo-oestrogen connection.
 
It’s no secret that endo is an oestrogen dependent disease.
 
Oestrogen is prolific - meaning it helps cells to multiply, such as breast tissue, and it’s the main hormone responsible for thickening our uterine lining.
 
But what happens when endo is present too?
 
Oestrogen has a prolific effect on endo lesions as well - keeping it active and fuelling growth, inflammation and pain.
 
Whilst that may make you think that the pill is the answer (by suppressing oestrogen), endo, the clever little mofo that it is, gets most of its supply from… itself.
 
Yep. Seriously. Endo makes oestrogen.
 
It regularly runs itself a lovely bath of the stuff, and soaks away in it.
 
This may be why oestrogen suppressing treatments have been shown to be successful for pain and symptoms in only half of patients.
 
Additionally, whilst oestrogen supports endo growth in the same way it supports growth of the uterine lining, when it comes to their responses to progesterone and synthetic hormones that behave like progesterone (such as progestin), they act very differently indeed.
 
Progesterone puts the breaks on oestrogen’s prolific party ways. It gets it to calm the f- down and stops it from padding up the uterine lining too much.
 
But the endometriotic lesions do not respond this way, because the majority of endo cells are resistant to the powers of progesterone.
 
And this is the same for synthetic progestins - whilst the uterine lining does indeed thin when exposed to these treatments, endometriosis growth is not predictably halted.
 
This is not just due to endo’s progesterone resistance, but other growth factors like the presence of oxidative stress, immune dysfunction and certain bacterial strains that trigger growth.
 
Oestrogen is only one part of the puzzle - all of these factors need to be addressed.
 
Now, whilst most of endo’s oestrogen supply comes from its own production, it still gets some from our circulating oestrogen levels(meaning, how much we have floating around in our blood stream), so, we want want to target both to get the best bang for our buck.
 
However, we don’t want oestrogen to drop too low because oestrogen plays a massive role in helping us to feel well.
 
It supports our feel-good neurotransmitters like serotonin, keeps our skin, hair and nails healthy (low oestrogen is why our hair thins and wrinkles form in menopause), protects our heart (again, the lower oestrogen levels if why menopause is associated with a greater cardiovascular risk) and keeps bones strong (once more, low oestrogen in menopause can lead to osteoporosis).
 
Not to mention, it plays a major role in energy production, sex drive, feeling sociable and so much more.
 
This is why for many people (like myself) ongoing use of hormonal treatments that suppressed oestrogen comes with intolerable side effects, and why certain treatments can be only used for a short while, due to risk of bone density loss, etc.
 
Now, this is not about judging you if you’re using hormonal treatments. I work with clients and students who use hormonal treatments, as well those who don’t. You absolutely have to do what’s right for you and every case is individual! Some people find these treatments life changing.
 
But what can we do to manage oestrogen on our own?
 
Firstly, we want to keep our hormones balanced. Whilst it’s true that progesterone resistance is a problem in the endo lesions, it’s not in the rest of our bodies, and if progesterone isn’t high enough in the luteal phase, that just allows oestrogen to dominate and ping around causing more oestrogenic and endo symptoms.
 
The other thing to consider here is what happens when our oestrogen levels are too high?
 
There are several genetic factors in people with endo that can cause us to have elevated oestrogen levels (we’ll get into those another time!), so that means we need to give progesterone extra support and oestrogen clearance extra support.
 
We can also reduce the amount of oestrogen endo is making locally too.
 
Because this is a mini-e course and there’s only so much we can fit in, I’m not going to dive into all of this today. Instead, we’re going to primarily focus on oestrogen clearance.
 
But, if you want to support your progesterone production, here’sa blog post/podcast on nutrients that raise progesterone!
 
So let’s consider how oestrogen is cleared from the body.
 
First up, it enters the liver, where it goes through two phases of liver metabolism (a.k.a. detoxification) and it then gets carried away through bile, into the intestines, where we poop it out.
 
All of these processes, from the liver work, to the bile transport, to the intestinal clearance, can get affected, which can result in either higher levels of oestrogen, or higher levels of certain, unhealthy oestrogen waste products, which are even stronger than oestrogen itself.
 
So I want to offer you three foods to support each of these processes.
 
Number one is broccoli sprouts
Broccoli spouts are the tiny micro sprouts from the shoots of broccoli seeds, so basically, teeny baby broccoli. They are packed with a potent level of the nutrient sulforaphane glucosinolate.
 
Sulforaphane glucosinolate helps to produce the enzymesresponsible for metabolising (detoxifying) oestrogen in the liver, and in fact, it’s also been shown to significantly help with some of those genetic problems I mentioned us endo folks can suffer with.
 
You can get broccoli sprouts fresh from health food stores, grow them yourself, or buy them freeze dried. A good amount is a couple of tablespoons or 1/4 cup a day, sprinkled on soups, salads, thrown into smoothies, whatever you fancy.
 
Now broccoli sprouts can sometimes be tricky to get hold of, in which case, don’t worry, because sulforaphane glucosinolate is also in cruciferous veg such as:
 

• Kale

• Cabbage

• Water cress

• Broccoli

• Bok choy

 
If you wanted to use sulforaphane glucosinolate as a supplement, this one is good, as well as this one (no affiliated links, etc). Just be sure to talk to your doctor if you have a thyroid problem, as high, therapeutic levels may affect those with Hashimoto’s (don’t worry about the food sources).
 
Number two is rocket, otherwise known as arugula.
This dark leafy green packs a powerful flavour punch with strong bitter and peppery notes, and it’s the flavour that creates the magic.

Bitter foods stimulate the production of bile, which is why bringing in rocket can help us with the next part of oestrogen’s journey out of the body.
 
The bonus? Rocket is a cruciferous veg that is also a great source of sulforaphane glucosinolate! Additionally, the bile stimulation is also essential for digestion, so can aid with endo belly bloating. If you want to reap these digestion benefits, have rocket at the start of your meal, to get digestive function going.
 
Aim for having rocket with at least one meal per day, as a side or starter salad, or garnish. You can mix it with broccoli seeds, to have a super oestrogen detox salad!
 
Number three is flax seeds.
Please don’t panic - I know they’re phytoestrogens, but that doesn’t make them bad for endo. Hear me out.
 
Flax seeds are rich in a type of fibre called viscous fibre, which creates a gel-like substance in the gut, and bulks out bowel movements, improving regularity and treating constipation.

This is absolutely essential for the last step in clearing out oestrogen - we want to be having at least one bowel movement a day to keep oestrogen at a healthy level.

Why? Well, when oestrogen is hanging out in the gut, not going anyway, it eventually ends up getting reabsorbed, creating higher levels of oestrogen once again.
 
This is especially true if we have elevated levels of an enzyme called beta glucuronidase, that can be high in people with endo, and recirculates oestrogen. The good news? Eating a diet rich in fibre (which flax seed offers in great amounts) helps to lower levels.
 
Flax seeds have also been shown to improve the metabolism of oestrogen through the liver, by increasing the amount of healthy oestrogen waste products (known as metabolites) and reducing the amount of the more potent, harmful ones I mentioned earlier. The dose used was 25g of milled flax seed per day for 16 weeks.
 
Finally, flax contains lignans, plant compounds that have mild oestrogen-like effects, but are no where near as potent as oestrogen. Structurally, they mimic oestrogen and so can bind to oestrogen receptors. Think of a receptor as the lock, and oestrogen as they key, when we turn the lock, an oestrogen activity like thickening of the uterine lining, is triggered. This can actually reduce the impact of high oestrogen levels, but also support low levels, in menopause, for example.
 
In fact, one study showed that the participants who consumed 10g fresh, ground flax seeds (uncooked), daily for three cycles had longer luteal phases and a higher progesterone to oestrogen ratio in the luteal phase as well.
 
Now, this is what the research shows, but everyone is individual, so if you find flax seeds make you feel more oestrogen dominant, please listen to your body, and I advise you listen/or read this and this, for more info on how to use flax for your body and endo.
 
Flax seed is best absorbed freshly ground (if you eat the seeds, you’ll likely just poop them out whole), sprinkled in oatmeal, put in smoothies, in recipes or in salads. A typical amount is 1 tbsp a day, though you may want to try seed cycling, which would give you 1 tbsp per day for your follicular phase only.
 
You could also mimic the above studies with 10g-25g pr day, but make sure you drink enough water to avoid dehydration and constipation, because flax is very absorbent!
 
Bonus tips
Okay, so earlier I said we can lower the amount of oestrogen being produced locally by the endo itself.

This is important because the amount of oestrogen being made by endo lesions is thought to be 100 times higher (100!) than that being made by our normal endometrial tissue in the uterus, and it’s the high oestrogen levels that are actually causing some of the progesterone resistance.
 
So, how do we lower the oestrogen? By lowering aromatase - the enzyme that makes oestrogen, and is found in super high amounts in endometriotic cells (endo).
 
Certain supplements have been shown to reduce aromatase and oestrogen production in endometriosis lesions, such as quercetin, curcumin, and ECCG (from green tea). Have a listen to this to learn about these supplements and their doses.
 
What’s next?
 
Okay, that wraps up our Anti-Inflammatory Functional Foods for Endo 4-We!
 
I hope you’ve found it helpful, and you’ve to some new foods and recipes to try. Take as long as you need to bring these foods and changes in, there’s no rush. :)
 
If you enjoyed this freebie, but you feel you need more tailored help on eating for endo, and learning which foods are right for you, reach out and we can discuss my single sessions and longer-term coaching packages.

Love,
Jessica xx