This month’s case study is 35 year old ‘Abigail’ who came to the Clinic with a diagnosis of endometriosis.

I had been suffering with painful periods from the age of 30 and they had become increasingly debilitating. Having relied on painkillers, which I think I was becoming resistant to, I thought it was time to seek help. I suppose I was putting off going to my GP because I was scared of what the outcome would be. He talked me through the options and recommended that I get referred to a gynaecologist for further investigation.

My appointment came through fairly quickly and when I saw the gynaecologist he recommended I have a procedure called a laparoscopy – an exploratory procedure to look at my ovaries and womb to see what, if anything, was causing my painful periods. I was very nervous because I hated going to hospital, but I had got to the point where I needed to find out why I was in so much pain. After the procedure the gynaecologist diagnosed endometriosis, (a condition where the womb lining migrates and grows outside of the womb). He said it was quite advanced and I had patches of endometriosis growing over my ovaries and around my bowel, which is why I would also experience pain with a bowel movement. During the laparoscopy, the gynaecologist removed the patches of endometriosis with a laser which would stop the pain, but he explained that this was not a guarantee that it would not grow back.

 

The first three periods after my operation were relatively pain free, which was amazing. But after that the pain returned, albeit less intense. I decided to research into endometriosis to see if there was anything I could do to support myself. I had heard that complementary therapies could be useful. I looked on the internet and came across the Dr Marilyn Glenville Clinic, which specialises in women’s conditions and endometriosis was one of them. I decided to download an ‘e-book’ on endometriosis. It was very useful as it explained what the condition is, how it can develop and both the medical and natural treatments available. Although the e-book was helpful, I knew I needed some more help so I called the number at the back to find out more about having a consultation.

 

I spoke to a very helpful receptionist at the Dr Marilyn Glenville Clinic who explained how the clinic worked and what I could expect from my first session with one of the nutritionists. It sounded exactly what I was looking for, so I went ahead and booked a consultation. I was sent a comprehensive questionnaire to complete and return before my consultation, which allowed me to write down what my main health concerns were, symptoms I was experiencing and my diet! After I had completed this I was appalled at how much alcohol I was consuming over the two days. (I thought it was better to be honest than to write down what the nutritionist wanted to hear!)

 

I met with the nutritionist 2 weeks later and we went through the questionnaire in detail together. I felt very encouraged by this because no one had ever taken so much interest in me and ‘my condition’. The nutritionist explained that endometriosis is a condition in which the lining of the womb (the endometrium) implants and grows outside the womb itself. These endometrial implants can grow in the pelvis, fallopian tubes, ovaries, bowel and bladder. More uncommonly, they can also crop up in the lung, heart, eye, armpit or knee. Wherever it grows, the womb lining responds to the natural hormone cycle and bleeds every time a period occurs. When women bleed normally throughout menstruation, blood leaves the body through the vagina. However, in the case of endometriosis the blood has no outlet and becomes trapped in the tissue, causing pain, inflammation, cysts and scar tissue.

 

Endometriosis is stimulated by excess oestrogen, so one of the main dietary principles is to keep this hormone under control. Oestrogen is found in meat, dairy products and the water supply and even in preservatives that are routinely put into our everyday skin creams and shampoos. Our liver is the organ that helps controls levels of oestrogen by detoxifying the hormone and ensuring elimination, so it’s important that it is functioning well. Liver function can be compromised by alcohol and caffeine, preservatives in our diet and taking drugs (painkillers etc). The nutritionist explained that we are more exposed to these ‘xenoestrogens’ (foreign oestrogens) than ever before because of the way our food is processed, pollution and increased use of chemicals.

 

The pain associated with the endometriosis is due to inflammation, so cutting out foods that are pro-inflammatory (causing inflammation) and eating plenty of foods that are anti-inflammatory was recommended. Pro-inflammatory foods include red meat and dairy products and anti-inflammatory include oily fish, nuts and seeds and avocados. I had been drinking a lot of milk and I loved cheese, but the nutritionist gave me plenty of alternative options. It was recommended that I eat a daily serving of dark leafy green vegetables because of the mineral magnesium, which is a natural muscle relaxant and has been shown to reduce cramps and spasms associated with endometriosis.    

 

To support the liver I was advised to cut back on my caffeine (I was drinking 3-4 cups of strong coffee daily), alcohol and processed foods – which can be a strain for the liver to process, which in turn reduces its ability to process the extra oestrogen that my body has to deal with. She explained that some food/drinks can naturally have a supportive effect on the liver. Broccoli and brussel sprouts are particularly useful because of a compound within them that promotes oestrogen detoxification. She also recommended I drink nettle and dandelion tea, which are good for the liver.

 

The nutritionist also explained to me the importance of using natural skin and hair products because they can contain ‘parabens’, which are synthetic preservatives that have been linked to oestrogen related breast cancer and may also be linked to endometriosis. She recommended specific brands, which made it easier than trawling through the shops!

 

I was also advised to take some specific nutritional supplements to address the high oestrogen, using a combination of herbs and liver support. I also took natural anti-inflammatory supplements like fish oil, ginger and magnesium, which was just amazing for the cramps! It is often known as ‘nature’s tranquilliser’ and this certainly was the case!

 

I booked a follow up consultation for 8 weeks time so the nutritionist could see how I was getting on. She decided on 8 weeks because I would have had 2 periods in that time and we could get a better idea of how I was getting on with the programme. I kept a food and symptom diary and even with my first period, I definitely had less pain. I only had to take 1 painkiller where I would usually take at least 6 over the duration of my period. By my second period I had virtually no symptoms! It was amazing. Not only had my menstrual symptoms disappeared I generally felt I had more energy, clearer skin and had lost weight, which wasn’t intentional but was certainly appreciated! The nutritionist did say it was a good thing that I had lost the weight because fat cells produce oestrogen.

 

Six months on and my diet consists mainly of fresh fruit and vegetables, some organic poultry, fish, beans, nuts and seeds, brown rice and oats. I also largely avoid dairy and wheat, which I really feel has helped enormously. I am disciplined with my diet but do have occasional lapses, which the nutritionist said was ‘ok’ every so often! But the truth of it is I actually don’t enjoy eating or drinking those foods when I do have them.  

 

I am so pleased that I decided to book the consultation and I feel so much more in control of my endometriosis, because I understand the condition. This is what I found frustrating about my gynaecologist – there was no explanation and I found it quite depressing to think my only option was surgery. The nutritionist did recommend that I go back to my gynaecologist in another 6 months to review, because endometriosis can ‘grow’ back, but with the change of diet she hoped this would not be the case or at least it would slow it down. All I can say is thank you so much to my nutritionist and all the team at The Dr Marilyn Glenville Clinic for their help and support.  

 

 

  

Marilyn’s Comment

 

This is a wonderful case of how powerful nutrition can be in dealing with hormone imbalance. It is not just endometriosis that can be supported with nutrition, but fibroids and PCOS too, which are also hormonally driven. Unfortunately we’re seeing so many more cases, especially in young women. It is important to always have painful periods checked by a medical practitioner for a diagnosis. With the case of Abigail her endometriosis was at a severe stage and required surgery, but if it is less aggressive, it may be that you have a 6 month ‘window’ to really focus on the nutritional approach rather than going down the medical route straight away. 

 

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Scientists from Harvard medical school studied 341 three year olds and found that those whose mothers had eaten at least two servings of fish a week during their pregnancy did better in tests. Fish contains omega 3 fats, which help brain development. But larger oily fish like swordfish, contains higher levels of mercury which can hinder brain development, so stick to smaller fish like salmon and mackerel or take a fish oil supplement if you’re not keen on eating oily fish.  

If you find yourself yawning a lot, or even nodding off as soon as you sit down on a chair or sofa, you may be suffering from fatigue or as it is often called these days – TATT – ‘tired all the time’.  With many of us leading increasingly busy lives – juggling work and family – it is hardly surprising that lack of energy is increasingly common. Feeling energetic all of the time isn’t possible and it is perfectly normal to feel tired at the end of a busy day or to have temporary dips in energy during the day but if you feel persistently tired and haven’t got enough energy to get through the day, what you eat could play an important part.

A well-balanced, healthy diet is essential for high energy levels. At its most basic level, the food and drink you consume is the fuel that your body and brain needs to function at its peak. Skimp on the quality of that fuel and you will pay the price with weight gain and low energy. Skipping breakfast, not drinking enough water, over eating, dieting, eating on the run, consumption of caffeine and alcohol, and eating a lot of refined, processed food are the major causes of low energy levels.

 

Rate Your Diet:

 

–          Do you eat breakfast every morning?

–          Do you eat at least 2,000 calories each day, mostly comprised of healthy, freshly prepared whole foods?

–          Do you grab a piece of fruit and a handful of nuts and seeds instead of a bar of chocolate to fight your mid afternoon doldrums?

–          Do you limit yourself to fewer than three cups of coffee every day?

–          Do you drink six to eight glasses of fluid every day (colas, coffee and alcohol don’t count!)?

–          Do you make sure you eat something every couple of hours?

–          Do you sit down and take your time when you have a meal, chewing your food thoroughly?

 

More than one ‘no’ answer suggests that your diet may play a role in your energy crisis. Follow my eating for energy diet rules below and you should see your energy levels improving within a few days or weeks.

 

Breakfast: If you skip breakfast your energy will almost certainly dip in the mid morning so make sure you always eat a healthy breakfast. You may be tempted to reach for sugary foods in the morning, like sweet cereals or marmalade on toast, to give you an energy boost but this will only give you a quick kick-start followed by a dip which leaves you craving more sugar. Instead go for a healthy breakfast that will keep your blood sugar levels balanced and digested slowly so that you have sustained supply of energy in the morning ahead. Try a bowl of oat porridge with some ground nuts or seeds sprinkled on the top or scrambled or poached eggs on wholemeal toast with mushrooms and tomatoes. Avoid black tea and coffee, have a herbal tea like peppermint instead.

 

Take a multivitamin and mineral: As an insurance policy to make sure your body is getting all the nutrients it needs to keep your energy levels constant.

 

Elevensies: Steer clear of coffee first thing in the morning as it will just unsettle your blood sugar levels and make you feel tired later in the morning. Don’t skip your mid morning snack, though, as eating little and often is essential for keeping your blood sugar and your energy on an even keel. Have some herbal tea and an oatcake with some pure fruit jam or a handful of nuts and seeds and an apple.

 

Lunch: Be sure to include protein rich foods in your lunch, such as tuna or mackeral, pulses like baked beans, or tofu or quorn. Protein will help boost concentration and beat the afternoon energy slump. Add some slow release carbohydrates, such as a whole grain roll or whole wheat pasta, and finish with some fruit to give you the best possible chance of staying focused and energetic in the afternoon.

 

Time for tea: Herbal tea that is – ordinary black tea is a stimulant, like coffee, that will unsettle your blood sugar and your energy levels. Remember, stable blood sugar levels are essential for sustained energy and the best way to keep your blood sugar levels stable is to avoid stimulants like sugar, caffeine, chocolate and processed foods and to eat a healthy meal or snack every three to four hours.  

 

Dinner: research from the University of Sydney in Australia has found that eating slow release carbohydrates within four hours of going to bed helps you to sleep well – and a good night’s sleep is vital for beating fatigue. So have a serving of brown rice or whole wheat pasta with your dinner. Don’t forget to have a good serving of vegetables and to eat some healthy protein too, such as oily fish, eggs, nuts, seeds and legumes as eating a little healthy protein with every meal and snack also helps keep your blood sugar levels stable. Oily fish, eggs, dark green vegetables, baked beans, nuts and seeds are also great sources of iron. Iron is the mineral that circulates oxygen in your blood and a lack of it can cause tiredness.

 

Throughout the day: Stay hydrated by drinking between six and eight cups of water a day; more if you exercise or sweat a lot. Herbal teas and diluted fruit juices are also great. Not drinking enough can make you feel tired, stressed and irritable. And finally, aim for at least 30 minutes of exercise, preferably in the fresh air so you get all the energy boosting power of daylight. Regular exercise releases feel good hormones and lowers stress hormones and encourages a good nights’ sleep so it is a fatigue-fighting essential.