May 2020 -

Nutrients under the microscope: zinc and resveratrol

There are various nutrients that contribute to either improving your digestive or your immune system. Over the next 4 weeks I will look at some supplements that may be helpful with your symptoms.

I’m starting with zinc and resveratrol.

Zinc is a mineral that has been well-tested in relation to the immune system. It is needed for the normal, healthy development of various immune cells and a zinc deficiency makes cytokines function less effectively.

It has important role in regulating the immune system. It is also a powerful antioxidant. It strengthens cells’ membranes, so they are less vulnerable to free radical damage.

It can also help heal damaged endometrial tissue. And finally, a zinc deficiency can affect your fertility.

I recommend a zinc supplement if your main symptoms are pain and/or recurring endometriomas, and if your main aim is to fall pregnant.

If you start to notice a metallic taste in your mouth; increased nausea, diarrhoea, or headaches, stop taking the zinc as it means you are getting too much.

The second nutrient I want to look at in this post is Resveratrol.

Resveratrol is a compound found in the skin of grapes, blueberries, raspberries, mulberries, and peanuts. It’s also found in red wine, but to get the amounts of resveratrol you’d need for a health benefit from red wine you’d need to drink an awful lot of it, which would completely defeat the purpose.

Resveratrol has an anti-inflammatory action by helping to reduce the release of pro-inflammatory immune cells and chemicals.

In recent years, resveratrol has been studied in connection to Endometriosis. Unfortunately, mostly in mice or laboratory tests so far, but the results are interesting and indicate that taking resveratrol could be useful in humans as well.

Its power lies in its ability to stop the growth of new blood vessels – a key element in the development of endometriomas and the growth of lesions.

Another effect of resveratrol that has been shown in a couple of studies using humans, is its ability to reduce pelvic pain.

If you think that taking either of these nutrients as a supplement to improve your Endometriosis symptoms, please contact me.

N-Acetylcysteine – a key supplement if you’re trying to fall pregnant

For many women, seeking an explanation for why they are not able to fall pregnant is the time they get their Endometriosis diagnosis.

These are some worrying statistics:

Between 25 and 50% of women who have difficulty falling pregnant have Endometriosis; and
Between 30 and 50% of women with Endometriosis have fertility problems.

The supplement N-Acetylcysteine, or NAC, plays an important role in improving fertility outcomes for women with Endometriosis.

Firstly, what is it?

NAC is the supplement form of the amino acid (protein) cysteine. It’s key role is in helping to replenish the most important antioxidant, glutathione. Glutathione has many important functions, some of which are the regeneration of vitamin E and C; detoxification; functioning of the mitochondria (parts of cells where energy is produced); and the regulation of cell growth and death. Chronic inflammation reduces the amount of glutathione available, and cysteine is needed to produce more.

NAC has been well-researched in relation to Endometriosis and here are a few interesting results:

In one study of 92 women, treatment for 3 months with NAC caused endometriomas to reduce but the group that didn’t get the treatment had their endometriomas grow significantly. The same study also saw pain reduction as well as eight pregnancies.
In a study of 398 women treated with a NAC in combination with 2 other nutrients, pelvic pain reduced significantly after 3 months, and even more after 6 months of treatment.

The ability of NAC to reduce the size of endometriomas is particularly interesting when we look at infertility: endometriomas are cysts within the ovaries, and they often don’t respond well to medical treatment. They make it more difficult to retrieve eggs and if you are undergoing ovarian stimulation during IVF they can cause severe (additional) pain. They also interfere with ovulation and even damage ovarian tissue.

If you are trying to fall pregnant, I highly recommend taking NAC as a supplement in addition to following an anti-inflammatory diet, especially if you have a history of endometriomas.

If you would like to discuss NAC supplementation or whether a nutritional approach would be beneficial for managing your Endometriosis, why not book an obligation-free Exploratory Chat? You can do so here, just make sure you select Exploratory Chat.

Why I recommend you take palmitoylethanolamide, or PEA to reduce pain

I know, what a name! I can’t pronounce it or type it quickly, so I’m just going to call it PEA.

It is a compound that our bodies produce when it is needed to help regulate pain and inflammation. It is found in both the central nervous system and in immune cells. And many foods, like mild, beans, peas, tomato, alfalfa, corn, soy and peanuts also contain it but not in enough quantities to be able to provide any therapeutic benefits.

The main therapeutic benefit of PEA in managing Endometriosis is pain reduction (chronic pelvic pain, migraines, period pain, ovulation pain). So how does it do that?

When the immune system is activated, certain cells are stimulated to start the inflammatory process. This process involves both swelling and pain. The purpose of the pain is to avoid further danger to the injured area. The pain stops us doing what we’re doing and do something about it. At this point, the body releases PEA to regulate the activity of those cells that initiated the pain and swelling. Over time, the inflammation disappears with the pain when the initial cause has been removed (e.g. the wound has healed).

Endometriosis inflammation is not acute, it is chronic. Which means that there is no resolution, it doesn’t disappear. Even the smallest immune incident can cause a major immune response and the cells responsible for clearing it up are confused, creating constant pain to warn you to do something about it.

PEA is able to calm down these cells.

Another cause of your chronic pain comes from damaged nerve cells because of inflammation. Damaged nerve cells still have a ‘pain memory’ creating a lower pain-threshold in the pain receptors.

PEA regulates the firing of these nerve cells. It also helps to produce more anti-inflammatory compounds and compounds that protect nerve cells.

So which symptoms has it shown to improve?

Chronic pelvic pain: 56 women took PEA for 9 months. After 6 months pain had improved significantly. In another study pain was reduced after 90 days, many women had stopped taking pain medication, and there were some reductions in the size of endometrial lesions.
Leaky gut: in a lab study, PEA reduced the permeability of the gut.
Migraines: a group of 50 patients took PEA (they were able to continue their normal medication as well) for 3 months. They reduced the number of days per month with migraines from an average of 10.7 to 5.8, and the intensity of the migraine reduced by 71.4%. A control group who took just their normal medication saw no improvement. Other studies showed improvements in migraines with aura, chronic migraines.
Depression: in one study of 58 patients with severe depression, improvement was seen after just 2 weeks and after 6 weeks all had improved at least 50%.
Colds and flu: not directly related to Endometriosis, but in a total of 4000 people who took PEA for 12 days when they had fever and pain, saw a pain and fever reduction of 45.5% compared to people who didn’t take it and there was a significant reduction in sick days.

I know this has been a long post, but I want you to understand that I’m not recommending the latest fad in supplements. I’ve only recently learned about PEA and have not yet had direct experience with its results, but the research is solid.

Now again a word on supplements that you can buy in the supermarket or at the chemist: you might be able to find PEA there. But the product will say ‘Pure PEA’ which sounds great, but isn’t. It means it hasn’t been ‘micronised’ or made smaller. Pure PEA contains particles that are too large to be absorbed, so you would not get much benefit. And for PEA to be beneficial, you need very high doses.

You will need a practitioner-only version that is micronised or ultra-micronised to get the results PEA can give you.

To take probiotics or not take probiotics – that’s the question

Probiotics have become immensely popular over the past few years and are claimed to cure just about any health complaint. So, do probiotics help to reduce your Endometriosis symptoms?

Well, that depends … What symptom are you trying to improve?

The challenge here is that there are many different types of probiotics and within each type there are different strains. What you need to remember is that probiotics are bacteria and there are more variety and strains of bacteria then there are people in the world.

Different types of bacteria do different things.

So it is crucial to get the right type of probiotic for a specific health concern and then within that type you need the right strain.

For example, let’s say you want to take a probiotic to help reduce your constipation – a common symptom in Endometriosis. Popular probiotics that you can buy in the supermarket or from the chemist claiming to be good for constipation usually contain Lactobacillus acidophilus. Unfortunately there is no scientific evidence that Lactobacillus acidophilus has any effect on constipation at all. So you’d be taking a supplement that is not improving the symptom you’re trying to improve!. A better probiotic that has been tested with women who were constipated is Bifidobacterium animalis or Escherichia coli Nissle, which you won’t find in any over the counter probiotics. Lactobacillus casei Shirota can also reduce constipation. It is mostly know as a dairy-based drink, but not recommended if you are on an anti-inflammatory diet.

There is one specific probiotic that can help to reduce menstrual pain and has been tested on women with Endometriosis: Lactobacillus gasseri. It has also shown promise in preventing further growth of endometrial tissue and reducing existing tissue.

As I wrote in a previous article ‘Should You Take Supplements’, supplements that can be bought in the supermarket or at the chemist are mass-produced, cheap and non-therapeutic products. They may contain a range of ‘fillers’ and in the case of probiotics, the strains included are those that are easiest to source.

A practitioner only probiotic is designed for therapeutic use and contains probiotic strains that have been proven to improve certain conditions.

A final note on taking probiotics: a probiotic adds good bacteria to the microbiome, but unless you also provide your gut with prebiotics those bacteria have nothing to eat and will starve. Eating a wide variety of high-fibre foods, such as fresh fruit and vegetables, legumes, pulses and whole grains (gluten-free), you’ll be wasting your money!

Totally Tremendous Turmeric

Ah turmeric! Such an underappreciated spice. It is nature’s anti-inflammatory. And with inflammation such a key factor in Endometriosis, we have to consider if turmeric can be of benefit. . I know you probably know it as a cooking spice, but how about its medicinal properties?

Turmeric is a root, from the ginger family, and contains a compound called curcumin. Curcumin is both an anti-inflammatory and an antioxidant.

As an antioxidant, its two main functions appear to be that it increases the activity of certain other antioxidants and by acting as an antioxidant itself.

As an anti-inflammatory, turmeric blocks the activation of certain cells that regulate inflammation, as well as directly suppress inflammation.

Turmeric is especially useful if your Endometriosis, because it also helps to reduce gut inflammation and gut permeability (Leaky Gut). It does this by increasing the amount of mucus in the gut wall and improving gut microbiome.

One of the problems with turmeric is that it is processed so quickly in our digestive system, that not much gets absorbed. But here’s a neat little trick: when it is combined with black pepper, you can increase absorption by 2000%.

There are two ways you can increase the amount of (or start adding) turmeric to your diet:

Add it to your food. Many curries contain turmeric and some popular drinks like Chai also contain it. Make sure that when you are adding turmeric to your dishes that you also add black pepper to increase the amount you’re absorbing.
Take a supplement. A turmeric or curcumin supplement can be a good option to help your body reduce its chronic inflammation and start to heal your gut. I don’t recommend you buy an over-the-counter version in the supermarket or at the chemist, as the quality of ingredients used will not be as good as a practitioner only supplement. Plus, the shop-bought brands tend not to contain the black pepper component, so not much of the supplement would actually be absorbed.

If you’d like to start using a turmeric supplement, I can help you get access to high-quality, practitioner-only brands. Just get in touch and I’ll get it organised.

And if you're ready to start bringing your chronic, systemic, inflammation down through diet, I'd love to welcome you in my program: "12 Weeks to Eat Your Way to Less Pain".