The Immune and Digestive Systems with Endometriosis

If you’d like to read Part 1 in this series – The Symptoms and Causes of Endometriosis – start here.

The immune system and Endometriosis:

The immune system has 2 main parts – Innate and Adaptive.

Innate immune cells should be cleaning up the misplaced endometrial cells, but with endometriosis this isn’t happening, allowing lesions (tissue damage) to develop.

Adaptive immune cells are “overactive” in women with endometriosis, creating an inflammatory state.

Regulatory T-cells (part of the adaptive immune system) that regulate the development of autoimmunity and dampen down an overactive immune response are reduced in women with endometriosis.

Progesterone should suppress the overactive Adaptive immune system, but with endometriosis there is reduced progesterone sensitivity. This means progesterone does not have the anti-inflammatory effect it normally exerts.

Within the peritoneal cavity (the largest “space” in the body that contains organs up to and including the liver, and the reproductive system) of women with endometriosis there is an altered immune environment. This results in a reduced ability of the immune system to clear of menstrual tissue and an increase in inflammatory cytokines (chemical messengers). Regulatory cells are decreased, wound healing is affected and auto-antibodies (antibodies against our own tissue, such as those that characterise autoimmune disease) are present.

Women with endometriosis have been shown to have an increased amount of gram negative bacteria (E. coli is an example of this type of bacteria) in the lining of the uterus (endometrium). These produce toxic lipopolysdaccharides (LPS) that are known to promote immune dysfuction and inflammation.



Autoimmune conditions and endometriosis are highly correlated, with endometriosis sufferers being more likely to have autoimmune conditions such as rheumatoid arthritis, lupus, MS, Hashimoto’s, etc, than those without endometriosis.

Auto-antibodies to the endometrium have been reported in a number of studies, although it is unclear whether underlying autoimmunity triggers the endometriosis, or endometriosis triggers an autoimmune response.

This high presence of auto-antibodies and the resulting inflammation may be the cause of endometriosis related infertility that can persist even after the lesions have been removed.


Digestive issues and endometriosis:

Approx. 80% of women with endometriosis also have IBS.

Endometriosis lesions and adhesions can occur on the bowel causing mechanical digestive problems, leading to constipation, pain, bloating, poor nutrient absorption. This occurs in 10% of women with endometriosis.

Even for those without bowel endometriosis, lesions and adhesions can create locations for pathogens – including parasites and bacteria – to thrive. This can lead to bloating and other digestive problems.

The inflammatory cycle created by endometriosis can lead to IBS symptoms such as diarrhoea and intestinal cramping.

Digestive issues caused by incorrect diet can also worsen endometriosis symptoms.

Intestinal permeability (often a precursor to autoimmunity) promotes inflammation, which worsens endometriosis and IBS symptoms. Can be aggravated by NSAID use (i.e. asprin, ibuprofen, etc), gut dysbiosis and an inflammatory diet

Constipation pre-period reduces the capacity for oestrogen clearance via the bowel, can be aggravated by analgesics such as codeine, pathogenic bacteria, poor diet, dehydration, adhesions, etc.


Inflammatory processes

What all these factors have in common is that they create, are created by, or perpetuate an inflammatory state. A certain amount of that is out of our control, such as exposure to environmental toxicants (“dioxins”) inside the womb, there’s nothing we can do about that. But what we can do is reduce the amount of inflammatory stressors we expose ourselves to on a daily basis, and in my case that relates to diet and lifestyle.

The next part in this series will address ways we can reduce inflammation using diet and lifestyle.

If you’d like my help in managing endometriosis, autoimmunity or any other inflammatory disease, through diet and lifestyle, please email me at

The Symptoms and Causes of Endometriosis

As I’m writing this, today is national Women’s Day, which somehow seems ironic when we’re so often treated like second class citizens. March is also Endometriosis Awareness month, which is one reason why the subject has been on my mind. This morning I was having a chat with a friend about contraception and it made me really angry that its so normal for women to be prescribed synthetic hormones to mask or interrupt their own hormonal cycles. This may be for birth control, or to “regulate” periods and PMS symptoms, or to “ease” the pain of endometriosis, or to “help” PCOS, or to get rid of acne, etc. And this is often without exploration of the underlying cause of these diseases or symptoms, and without explaining the impact on our bodies of the cessation of our natural hormonal cycle.

It also amazes and frightens me how many women think it is “normal” to have painful periods, heavy bleeding, clots, etc. This is not normal. Yes it is common, and it is often dismissed as “normal”, but it is a sign that our body has underlying problems that need to be addressed. Continue Reading

The Art of Eating Out….on AIP!

Petty Cash

(Above image features my fave reintro foods – coffee and eggs!)

Before cleaning up my diet (pre-Hashi’s diagnosis back in 2013) I would eat out at least 4 times a week. And that was just dinner. Factor in work lunches and weekend breakfasts and that’s a lot of eating out! Fast forward to when I started AIP, and eating out had to be one of the first things to go. I just couldn’t deal with the stress of explaining to another person what I could eat and couldn’t eat when I was still trying to grips with it myself, and that look in their eye of “urgghhh….another customer with so-called “food allergies”!”. Continue Reading

How to Go Gluten Free for Gluten Intolerance

how to give up gluten


As a clinical nutritionist it’s my job to help people make dietary changes to improve their health and symptoms. But changing your diet can seem really daunting, particularly if you are doing it to help manage chronic disease. I know, I’ve been there (read about it here)!

I initially made changes to my diet about 6-7 years ago,  when I was diagnosed with autoimmune disease Hashimoto’s Thyroiditis (read about that here and here), so the tips I’m giving here are what worked for me, plus a few things I learned along the way. Continue Reading

Tips for Blood Sugar Regulation



If our blood sugar levels aren’t regulated (a rollercoaster characterised by sugar highs followed by the crash) we can experience symptoms such as fatigue, brain fog, anger (the hangries!), sugar cravings, inability to concentrate, dizziness, palpitations, anxiety, “the shakes”, etc. Personally, before my Hashimoto’s diagnosis (and starting AIP) I’d experience these feelings on a regular basis and would “resolve” them by eating a processed carb or a piece of fruit (yay, back on the sugar roller coaster!). However, this wouldn’t actually resolve the issue and unless I ate a balanced meal I’d be experiencing that sugar crash again. I’d even experience panic attacks which, looking back, I think was due in part to poor blood sugar management.

Continue Reading

A Rather Exciting Announcement…..


le bump

le bump


Well, I’d say I owe you guys an apology… has been 9 months since my last blog post!!!! I do have my reasons, the first being that we started renovating our house (which is still on-going) so trying to stay my shade of AIP without a kitchen didn’t make for particularly creative meals, and intermittent internet just made the whole thing too annoying to attempt. Buuuuttt… renovations aren’t anything to do with the exciting announcement. No. The exciting announcement is, that after 4 years of trying, about 1 year of AIP and 4 IVF treatments we are finally pregnant, and in fact due very soon, towards the end of March! Continue Reading

Are Chickpeas Sexy? Lets see…Post AIP Redux!

Lovely Legumes

Lovely legumes at Alfalfa House, Enmore, Sydney


Ok, so this post has been on my mind a bit lately. I first published it over a year ago and, nutritionally speaking, I was in quite a different place back then. Wholefoods were very much my focus, but I hadn’t considered foods beyond “wholefoods good processed foods bad”. I hadn’t yet decided that I was going to start the Autoimmune Protocol (AIP), and I wasn’t Paleo either, and I’d probably eat tinned legumes about once a week or so feeling quite virtuous for doing so. But things have changed somewhat since then! And yesterday I received an email asking my position on legumes as a post AIP elimination phase reintroduction, based on the original version of this post. So I thought now would be a good time for an update!  Continue Reading

Homemade Chocolate – with Stage 2 AIP Reintros (and Not Much Sweetener!)

I want to eat you....

I want to eat you….



I really quite like chocolate. Not in an obsessive “I have to have it all the time!!!” kind of way, but in a “I’d quite like some chocolate now so I’m going to have some kind of way. So eliminating chocolate for AIP was, hmmm, less than ideal! And I have to admit, it was one of the few things that the longer I didn’t have it the more I wanted it (I’m sure we’ve all been there)! Continue Reading

Adventures in Wardrobe Capsuling



It’s the start of a new season, the perfect time to work out your new capsule wardrobe! Now, I haven’t had a capsule wardrobe before, and I kind of thought it sounded a bit boring, and rather unlikely. “30-40 items of clothing to see you through 3 whole months?! Nahhhh!!!!” But now I am oh so much older and wiser (!) and no longer working in the industry that kept me in its thrall with such beautiful new delights each and every season (that fickle friend, “fashion”) I find myself very much attracted to less of everything. Continue Reading