Hypermobility might have earned you a few “oohs” and “ahhs” growing up—maybe you could twist into strange positions or casually bend your thumb back to your forearm. But for many, it’s much more than just flexible joints. Hypermobility can influence everything from gut health to circulation, immune response, and even your sense of balance.

So let’s unravel this bendy mystery, look at what it really means, and talk about how to support a hypermobile body—without needing to become a contortionist yogi.

Is This You? Signs You Might Be Hypermobile

Everyone experiences hypermobility differently, and it can often show up in subtle ways that are easy to overlook. Some signs to keep an eye out for include:

• Your thumb can be bent back to touch your forearm (no, that’s not a universal party trick).

• Your knees or elbows extend backwards a little when straightened (this is called hyperextension).

• You experience poor posture or feel like standing upright is more effort than it should be.

• You often feel clumsy or struggle with coordination.

• Aches and pains are a regular part of your day.

• You have flat feet or trouble with foot stability.

• Your skin is stretchy or has a “velvety” texture.

• You’re prone to hernias, varicose veins, or even pelvic organ prolapse.

• Piezogenic papules – small, soft bumps that appear on the heels when standing, caused by fat herniating through connective tissue (see picture below)

• Frequent fatigue, headaches, and a need to lie down or rest often.

• Frequent headaches or migraines.

• You bruise easily or heal slowly from cuts and injuries.

• If several of these feel familiar, hypermobility might be a piece of your health puzzle.
• 

Hypermobility or Ehlers-Danlos Syndrome?

Now, let’s clear up a common confusion: hypermobility and Ehlers-Danlos Syndrome (EDS) aren’t exactly the same.

• Hypermobility refers to joints that move beyond the normal range. This can be totally benign or part of a broader condition.

• Ehlers-Danlos Syndrome (EDS) is a group of connective tissue disorders. The most common subtype, Hypermobile EDS (hEDS), includes joint hypermobility, but also often involves additional features like stretchy skin, chronic pain, frequent injuries, and systemic issues like digestive or immune challenges. The other types of EDS are considered to be rarer and are often connected with specific genetic mutations, whereas hEDS does not have a genetic testing option. It is one of the oldest known causes of bruising and bleeding, and it was described first by Hippocrates in 400 BC.

The difference? EDS, particularly hEDS, has more defined diagnostic criteria, it’s often familial and tends to present more extensively across different body systems.

If you’d like to explore the official diagnostic criteria, the Dysautonomia Support Network has a comprehensive guide here.

The Many Faces of Hypermobility

Hypermobility doesn’t always present the same way for everyone. Some people experience it more internally (such as digestive and reproductive health impacts), while others might deal with more vascular symptoms like varicose veins or POTs. Then there are those whose joints pop and click their way through the day, facing subluxations, dislocations, or even hernias and prolapses. And for many, inflammation is a key player, showing up as histamine issues, migraines, or autoimmune conditions.

Here’s a non-exhaustive list of conditions often linked with hypermobility:

• POTs (Postural Orthostatic Tachycardia Syndrome)

• ADHD & ASD

• Lipoedema

• IBS & gut concerns

• Endometriosis

• Autoimmune conditions

• Migraines

• TMJ & dental issues

• Fatigue and sleep problems

• Dysautonomia

• Venous insufficiencies

In one study, 51% of neurodivergent individuals were hypermobile, compared to just 17.5% of neurotypical people. These overlapping conditions often come as a “package deal” thanks to shared root issues like immune dysregulation and chronic inflammation.

Photo by David Hofmann on Unsplash

What’s Going On Beneath the Surface?

Hypermobility is often viewed as a structural issue—joints that bend too far, ligaments that stretch too much—but that’s only part of the picture. Underneath it all, immune dysregulation and chronic inflammation are key drivers. And they don’t just influence joint laxity—they ripple through many systems in the body.

Chronic inflammation plays a central role not only in hypermobility but also in conditions that commonly appear alongside it—like endometriosis, autoimmune disorders, IBS, POTS, ADHD, and more. When the immune system is constantly switched “on,” it uses up valuable resources, contributing to fatigue and leaving the body more vulnerable to further dysfunction.

Gut, Glands, and Gut Feelings

Weakened connective tissue doesn’t stop at the joints—it affects internal structures too. In the gut, this can mean altered motility, leading to constipation, diarrhoea, or both. There’s also an increased risk of SIBO (small intestinal bacterial overgrowth) and intestinal permeability (aka “leaky gut”), which can heighten food sensitivities and drive inflammation even further.

The nervous system often gets caught in the crossfire. Dysautonomia, a dysregulation of the autonomic nervous system, is common in hypermobility. It keeps the body stuck in sympathetic “fight or flight” mode—affecting digestion, hormone production, immune response, vascular function, and even emotional regulation. It’s like the body’s internal control panel is out of sync.

Structural Stress and Muscle Overload

When collagen—the body’s main structural protein—isn’t working optimally, ligaments can’t do their job properly. Joints become less stable, and muscles are left to pick up the slack. This muscle overcompensation means they’re often overworked and tight, leading to fatigue, stiffness, and a higher risk of injury.

Nearby nerves may also become pinched or overstretched near unstable joints, contributing to chronic pain or sensitivity. Over time, this can lead to altered pain responses—where the body becomes hypersensitive even to minor stimuli.

Hormones and Histamine

It’s not just joints and nerves—internal organ health can also be affected. Lax pelvic ligaments may result in the uterus sitting differently, contributing to pelvic pain, overactive pelvic floor muscles, or prolapse. On top of that, many hypermobile individuals experience increased histamine levels, which can worsen period pain, fuel endometriosis, and further fan the flames of inflammation and immune dysregulation.

Blood Flow and Brain Fog

When blood vessels are stretchy too (as they often are in hypermobility), they may not efficiently send blood back to the brain and upper body. This can lead to orthostatic intolerance and POTS symptoms—things like dizziness, racing heart, heavy legs, tingling, brain fog, and even anxiety. And because the body interprets these blood flow issues as stress, it can perpetuate the sympathetic nervous system loop, feeding into fatigue, inflammation, and emotional overwhelm.

The Viral Connection

Interestingly, certain viral infections like COVID-19 and Epstein-Barr virus (EBV) can worsen hypermobility-related symptoms. These viruses can increase inflammation, unbalance the immune system, and act as triggers or amplifiers for symptoms that were previously manageable.

Support Strategies for Hypermobility

While it’s not always possible to “fix” hypermobility, there are powerful ways to support your body and improve quality of life, these are a few of them:

• Strength Training: Carefully guided resistance training can help stabilize joints, improve proprioception, and reduce the risk of injury.

• Adequate Protein: Essential for tissue repair, strength, and energy. Adequate protein also helps with blood sugar level stability, an important factor for those with hypermobility.

• Mineral Balance: Key minerals like magnesium, calcium, and zinc support nervous system regulation and muscle health. We can assess mineral status through a HTMA (hair tissue mineral analysis) and also look into your diet to assess for potential gaps.

• Gut Health: Focus on restoring the gut lining and supporting a healthy microbiome to reduce inflammation and improve nutrient absorption.

• Nervous System Support: Practices like mindfulness, breathwork, and even vagal nerve stimulation can help reduce stress, improve digestion, and support immune balance.

Let’s Work Together

If you’ve been nodding along and thinking, “This is me!”—we’re here to help. Whether you’re newly exploring hypermobility or have been managing symptoms for years, working with a practitioner who understands the full picture can make all the difference.

Get in touch today to book a consultation. Let’s build a plan that’s tailored to your unique body and needs.

Because living in a bendy body shouldn’t mean bending over backwards to feel good.

References

1. Caliogna, L., Guerrieri, V., Annunziata, S., Gagliardi, F., Sessa, F., & De Caro, R. (2021). Biomarkers for Ehlers-Danlos syndromes: Is there a role? International Journal of Molecular Sciences, 22(18), 10138. https://doi.org/10.3390/ijms221810138
2. Castori, M., Camerota, F., Celletti, C., Danese, C., Santilli, V., & Grammatico, P. (2015). Neurological manifestations of Ehlers-Danlos syndrome(s): A review. Iranian Journal of Neurology, 13(4), 190–208. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300794/
3. Castori, M., & Voermans, N. C. (2023). Pain in Ehlers-Danlos syndrome: A non-diagnostic disabling symptom. Diagnostics, 13(8), 1443. https://doi.org/10.3390/diagnostics13081443
4. Chopra, P., Tinkle, B., Hamonet, C., Brock, I., Gompel, A., Bulbena, A., & Francomano, C. (2017). Pain management in the Ehlers-Danlos syndromes. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), 212–219. https://doi.org/10.1002/ajmg.c.31555
5. Eccles, J. A., Owens, A. P., Mathias, C. J., Umeda, S., & Critchley, H. D. (2022). Joint hypermobility links neurodivergence to dysautonomia and pain. Frontiers in Psychiatry, 12, 797165. https://doi.org/10.3389/fpsyt.2021.797165
6. Glans, M., Bejerot, S., & Li, X. (2021). Association between adult attention-deficit hyperactivity disorder and generalised joint hypermobility: A cross-sectional case control comparison. Journal of Psychiatric Research, 143, 334–340. https://doi.org/10.1016/j.jpsychires.2021.07.006
7. Kanjwal, K., Saeed, B., Karabin, B., Kanjwal, Y., Grubb, B. P., & Karabin, B. (2023). Dysautonomia, hypermobility spectrum disorders and mast cell activation syndrome: A review of overlapping conditions. Frontiers in Neurology, 14, 1458385. https://doi.org/10.3389/fneur.2023.1458385
8. Wang, E., Ganti, T., Vaou, E., & Hohler, A. (2021). The relationship between mast cell activation syndrome, postural tachycardia syndrome, and Ehlers-Danlos syndrome. Allergy and Asthma Proceedings, 42(3), 243–246. https://doi.org/10.2500/aap.2021.42.210034

The post Hypermobility and the Whole Body: Why It’s Not Just About Joints appeared first on Alison Mitchell Naturopath.

It’s becoming more common nowadays for people to be intolerant or allergic to certain foods, and while some may disregard this concept as a fad, a cry for attention or perhaps an attempt at being trendy – food intolerances really do exist. Improperly managed they can cause a wide variety of symptoms that can be extremely uncomfortable and can significantly affect your quality of life.

It is estimated that one-fifth of the population believe that they have a food intolerance. (1) Many people with food intolerances know that there is a food that is disagreeing with them, but they can’t quite put their finger on what it is. Sometimes there’s a reaction and sometimes there isn’t, it all seems so vague and confusing that it’s easier just to throw your hands up, give in and eat whatever (or practically nothing, as some people chose to do).

If you suspect that you’ve got a food enemy, this article will hopefully show you some of the avenues that you can investigate to find what it is that you’re reacting to, and what you can do about it.

Food allergies are a reaction by the immune system to a specific part of a food, usually one of the protein components.  Symptoms of food allergies can include hives, swelling around the mouth, rashes and/or vomiting.  The worst case scenario is an anaphylactic reaction, which can be life threatening.  Food allergies do not disappear and are usually present from birth. Most commonly these reactions are to foods such as peanuts, cow’s milk, egg, tree nuts, soy, fish and shellfish, however it’s possible to be allergic to anything (1).

At this point of time there isn’t much we can do about it except for avoid the foods and be ready to administer first aid should exposure occur.

There is however, some hope for future treatment for allergy sufferers. A recent trial by the Murdoch Children’s Research Institute found that use of a certain strain of probiotics was able to reduce peanut allergy in 23 out of the 28 children studied. This is only a small study so far, so it’s unlikely that this will be a widely accepted treatment for a while to come, and it’s not recommended to try this at home due to the life-threatening nature of these allergies, however it does highlight the importance of keeping your gut healthy and also provides some hope. (2)

Recognising the difference between an allergy and an intolerance is important, as the incorrect use of these terms is often what leads to the general confusion about the whole area.

Food intolerances are reactions to foods that are not classed as an allergy. In some instances it can be due to a lack of enzyme such as in lactose intolerance, and in others it can be due to a reaction from the IgG or IgA immune cells. Unlike fructose malabsorption and coeliac disease, this is not a widely accepted phenomena and research into this area is still in its infancy.

Food intolerances are usually developed as a result of gut flora imbalances and/or damage to the lining of the digestive system (often referred to as intestinal permeability, or leaky gut) however they can occur when a food is regularly consumed in large quantities (3) (4).

Food intolerances are not life threatening like an allergy, and the symptoms that can occur from eating something you are intolerant to are usually digestive (bloating, heartburn, diarrhoea, constipation, cramping and gas) however if you’re eating food intolerances too frequently then it can create symptoms elsewhere in the body that are less likely to be related to food (1). These include brain fog, headaches, mood swings or weight gain.  Food intolerance symptoms are often delayed in their onset (they can come on 48 hours after eating) which means they are much harder to identify as the culprit for your symptoms.

Fructose malabsorption can be a common issue for many people with digestive complaints, especially bloating, pain and diarrhoea.  It is estimated that up to 70% of people with IBS (irritable bowel syndrome) have fructose malabsorption (5).  The diet to manage this is known as the FODMAP diet.

The FODMAP diet was originally developed by Dr Sue Shepherd, an Australian dietician. She has proven, through her pioneering PhD research, that limiting dietary FODMAPs is an effective treatment for people with symptoms of IBS. Several research papers have confirmed her work and so this diet has become better known in the last few years, even being accepted overseas.

Fructose is a naturally occurring sugar found in certain fruits and vegetables, and in some people this sugar cannot be effectively processed in the small intestine.  As a result it is left to ferment, which can cause bloating, diarrhoea and/or constipation, flatulence, stomach pain, and even mood imbalances (6).

As wheat contains FODMAPs, some people attribute non-coeliac reactions to gluten to fructose malabsorption.

It is important to remember that high FODMAPs foods are not always the only culprit for IBS symptoms.  Consider being aware of your reaction to fatty foods, caffeine, alcohol, fibre (excess or lack of), medications and stress, which may also influence your symptoms. Hormonal problems and bacterial imbalances can also be responsible.

Contributing factors towards the development of fructose malabsorption include:

• Diabetes (especially type 2)
• Diets that are high GI (glycaemic index)
• Stress
• Certain medications including Corticosteroids and Metformin
• Digestive damage from excessive alcohol, smoking and other factors

As you can see from the above list, fructose malabsorption is likely to occur from poor blood sugar regulation and digestive damage – commonly seen in inflammatory bowel disorders such as Crohn’s disease and ulcerative colitis (6).

Diagnosis

Fructose malabsorption can be diagnosed using a hydrogen breath test, which recognises unabsorbed fructose.

The FODMAP elimination and challenge diet is also a way of determining whether you react to FODMAPS, and narrowing down what types and how much. The FODMAP diet is very strict, so it’s not a long term solution but rather a means to identify which foods in this group you are reactive to.

The FODMAP diet

FODMAPs are found in the following foods:

• Fermentable Oligosaccharides (e.g. Fructans and Galactans)
• Disaccharides (e.g. Lactose)
• Monosaccharides (e.g. excess Fructose)
• And
• Polyols (e.g. Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt)

The list of foods that are to be avoided in a full FODMAP diet is rather large, but it includes a lot of fruits, honey and some other sweeteners, wheat products, most dairy sources, soy milk, legumes, and certain vegetables including garlic, onion, mushrooms and asparagus (8).

Chemical sensitivies.

There are a number of substances that are naturally contained in foods which can cause reactions in some people, including rashes, headaches, fatigue, digestive symptoms, hyperactivity and irritability. The main food chemicals which can cause symptoms are salicylates, amines and MSG.

Salicylates can be found in a wide range of fruit (especially in unripened fruit) and vegetables (more concentrated in the outer leaves), as well as nuts, herbs and spices, jams, honey, yeast extracts, tea, coffee, bear and wines. Aspirin also contains salicylates.

Amines are high in foods such as deli meats (salami, bacon, ham, frankfurts), tinned fish and tinned meats, tomato paste and pasta sauces. They are also present in cheese, chocolate, wines, beer and yeast extracts.

MSG (monosodium glutamate) is well known for the reactions it can cause, particular when used as a flavour enhancer in some Asian cooking, soups, sauces and packaged snack foods. It is also found in high amounts naturally in some foods such as tomatoes, blue and parmesan cheese, mushrooms, broccoli and some meat and yeast extracts.

Sulphites can cause a worsening of asthma symptoms, headaches and fatigue. The food additives to watch out for in this category are the numbers E220 – E224, E226 and E227. They are found in a lot of dried fruits, packaged salads and fruit salads, some dried foods such as garlic, ginger, potatoes, soft drinks and fruit drinks, pickles, sauerkraut and corn syrup. People who are very sensitive to sulphites may benefit from increasing their intake of the mineral molybdenum.

Histamine intolerance often mimics the symptoms of a food allergy, however it is an inflammatory reaction caused by an impaired ability to breakdown the chemical histamine, which is naturally present in many foods. Symptoms of histamine excess include hives and itching, racing pulse, anxiety, swelling of the face and throat, runny nose, conjunctivitis, headaches, digestive upset, fatigue, confusion and irritability. This problem is often developed after some form of disruption to the digestive system, usually an infection or course of antibiotics, but can also be triggered by stress and other digestive problems. Some medications such as painkillers, asthma medications and sleeping medications can also interfere with the enzymes that process histamine. Methylation problems can also affect histamine levels, and people who are in this category are more likely to experience mood disorders such as depression and OCD. Some of the main food triggers include red wine, fish (unless very fresh), smoked, processed or fermented meats, left-over foods, most cheeses, citrus fruits, pineapple, raspberries, prunes, tomatoes and tomato products, spinach, red beans, eggplant, olives, pumpkin, pickles and relishes, chocolate, soy sauce, most alcohol drinks and tea. (9) (10)

Coeliac disease

is one of the most well known forms of food intolerances, first discovered in the 1950s it was originally thought to only be a childhood disorder. The prevalence of this condition is increasing, however it is thought that there are many people with this condition who are still undiagnosed.

It is not an allergy or sensitivity, but rather an autoimmune reaction to gluten, which is often genetically inherited.  In people with coeliac disease the immune system causes severe damage to the cells of the small intestine, which causes digestive symptoms and significantly impacts on the absorption of nutrients, resulting in nutritional deficiencies. At a microscopic level, your digestive lining should be coated in hair like protrusions called vili – essentially it looks like a shag pile rug – and this creates lots of surface area to absorb nutrients. When damage has occurred in people with coeliac disease, these vili become flattened and fried, resulting in malabsorption problems.

Diarrhoea, cramping, bloating and constipation can be caused by celiac disease. However not everyone with coeliac disease experiences digestive problems, and so it can go undiagnosed for a long period of time, wreaking havoc in secret. Fertility issues, anaemia, osteomalacia, osteoporosis, autoimmune problems and mood disorders can all be related to undiagnosed coeliac disease (11) (12) (13).

Having the gene for coeliac disease does not automatically mean that you have the condition, but you cannot have coeliac disease without having the gene for it.

If you suspect that you have coeliac disease but have been avoiding gluten, then you can get yourself tested for the coeliac genes first.  If you do have the genes, you will need to eat gluten containing foods for 6-8 weeks before doing the antibody tests (as these would not be accurate without having eating gluten previously).  This will confirm whether you have coeliac disease or not. In some cases your doctor may refer you to get a biopsy performed, which is considered to be the most conclusive diagnosis.

Many people who are avoiding gluten have not been adequately screened for coeliac disease before commencing a gluten free diet and so coeliac disease often goes undetected (14).

In people with gluten intolerance/sensitivity or fructose malabsorption they can often handful small amounts of gluten with experiencing problems, however with coeliac disease you might get away without experiencing symptoms, but the damage to the vili will always happen. This means that having the diagnosis of coeliac disease gives you the knowledge of whether you need to be 100% strict with gluten avoidance or not.

Some ways to make life easier for yourself:

It can be very overwhelming and stressful to get a diagnosis of a food intolerance or allergy, particularly if it is a common food such as wheat or dairy. Thankfully due to the magic of the internet there is more help than ever for people trying to manage their diet around food intolerances.

Join a support group. There are plenty of Facebook groups and online forums dedicated to specific food intolerances, and often the people in these groups have done plenty of research so will be able to share resources and recipes with you.

Research food substitutions. Instead of giving your favourite recipes the flick, try substituting ingredients you can’t have for foods which will create a similar effect. For example, eggs, which are commonly used to bind dishes can be replaced with a little corn meal or extra kneading; cheese can be replaced with ‘vegan cheese’ which is often made with cashews and nutritional yeast; cow’s milk can be replaced with oat, nut or seed milks and wheat flour can be replaced with several gluten free flour options. Keep your pantry stocked with these and that way you won’t be disappointed if you get a whim for cooking a particular dish.

Plan your meals in advance. Meal planning and prepping can make life easier for everyone, but especially so for those dealing with food intolerances. Create a list of meals that you can have and rotate through these. Try a new recipe each week and eventually you will have a big repertoire of recipes that you are familiar with.

Call ahead. If you’re going out to eat, call ahead and advise of any food intolerances so that the kitchen can have options prepared.  It can be a good idea to ask if they’re okay for you to bring your own gluten free bread or milk alternative.

Educate your friends and family. Share this article and other information with friends and family who might be struggling to understand, and discuss with them what foods you can and can’t handle and how much you can tolerate, if any. Most people will be happy to accommodate your requirements as long as they understand.

You may be interested in:

Ultra low histamine 4-week meal plan and recipe eBook

Low Salicylate Meal Plan (one week)

Bread or Dead by Allison Jones

Coeliac Disease; How to take control of your health and healing your gut with herbs.

Works Cited

The post The Many Faces of Food Intolerance appeared first on Alison Mitchell Naturopath.

Guts and Girl Bits Episode #50

As we reach the end of Endometriosis Awareness Month I wanted to release a little recording I made a while ago for women’s health week, in which I spoke about Endometriosis.

Endometriosis is a condition that can significantly affect a woman’s quality of life, however, there is a lack of awareness and understanding of this condition.

It is estimated that 1 in 7-10 women may have this condition, however it can take many years to receive a diagnosis. In this video discuss some considerations of addressing this condition with naturopathic medicine, addressing the root causes of immune imbalance.

Watch the Video:

Listen to the audio:

Subscribe and listen to the other podcasts here:

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Related posts:

Endometriosis

10 Ways to reduce period pain

Updates on Endometriosis

Heavy periods

Choosing the right products for that time of the month

Thrush

Transcript

0:08
Hi, everyone, you’re listening to Guts and Girl Bits. I’m Alison Mitchell, a practicing naturopath and I hope to share with you all sorts of information about women’s health and digestive health to educate and empower you to make informed choices about your own health. Please remember that all information is general and does not replace consulting with a healthcare practitioner.

0:31
It’s the end of March and March is Endometriosis Awareness Month. So I wanted to share a little video that I recorded a couple of years ago for Women’s Health Week as my latest podcast because in that video, I share all sorts of information about endometriosis, and about how to get to some of the underlying drivers that causes it. So I hope that that’s helpful for you. There has been more research coming out since then, as well. But most of the new stuff that I shared in that one is still relevant. So if you want to hear more information, then please subscribe to me on @gutsandgirlbits. And stay tuned as well for all my e courses that are coming out all about how to understand yourself by understanding your cycles and understanding your hormonal balance in more depth, which you can find over at my teachable account, which is gutsandgirlbits.teachable.com

1:30
Hey, everyone, I want to talk about endometriosis today. This is the last day of Women’s Health Week. So I wanted to finish it off by talking about a condition that I really love treating and that’s that’s endometriosis. So if anyone doesn’t know what endometriosis is, basically, it’s a painful condition that affects women. And it affects almost one in seven women approximately. And it can cause quite a lot of issues. So what’s what seems to be happening is that we women get these endometrial cysts, also known as endometriomas, or chocolate cysts, which are basically the content of the lining of the uterus being where it shouldn’t be. So when we normally have our period, what should be happening is that the lining should just you know, break down and dissolve and come out as normal menstrual blood. But sometimes what’s happening is that this isn’t staying in the uterus. This is actually forming little adhesions or cysts elsewhere in the body, such as around the lining around the outside of the uterus or in the fallopian tubes or stuck to the ovaries. And it can also happen in their peritoneal cavity where it’s actually attaching to the intestines, the bowel, bladder and those sorts of things.

2:55
So back up back when I was a student naturopath, we were taught that endometriosis is a condition caused by a hormonal imbalance. But with recent research, what we’ve come to understand is that endometriosis is actually an immune condition or an inflammatory condition. So it does have a hormonal component. There is certainly a hormonal driver behind endometriosis. And that is estrogen, but the immune system is actually the biggest player when it comes to endometriosis. And so there are a lot of different factors that actually feed into why the immune system is disrupted in the first place. But what we what we’re finding is that inflammation, in particular, coming from histamine imbalance, and coming from genetic imbalances and gut health is some of the biggest issues that seem to be driving our immune immune dysfunction. So there’s currently not really a great testing option available for endometriosis. It’s unfortunately something that can only be definitively diagnosed with a laparoscopy, which is a type of keyhole surgery where there will be some small incisions made in the abdomen, abdomen, and then they go in with a little camera. And so if they can see the presence of these chocolate cysts, then that’s confirmative of endometriosis. But the laparoscopy at the same time can be used as a treatment. But that’s not that’s not always the best option for every woman. Because for some women who are particularly inflamed or have a strong immune activation, then the actual incision or the actual surgery itself can actually worsen endometriosis. There, they will find that they might actually get some further adhesions developing where those original cysts were removed. There seems to be more of an issue when the laparoscopy is performed with the laser where it’s actually burnt off rather than incised. And that’s that’s something that again, has only really been discovered recently, but it seems to be

5:00
You know, while it’s a good thing for some women, but not for every woman, and again, it goes to show that endometriosis is a really, really complex condition. And so because of that complexity, everyone needs to be treated a little bit differently. And we need to try and figure out the cause of what’s going on for those women. So there’s a few, you know, possible causes as to why women can have that particular immune imbalance. And one of those things is a gut imbalance, so and or an infection. So if you’ve got an infection, then your immune system is going to be disrupted. And then if you’ve got that genetic tendency for endometriosis to go wrong, then that’s where it’s going to go out of whack for you. There’s some some naturopaths in the field at the moment that are doing research in this and they’re finding that there’s actually a whole different microbiome, which is your bacteria balance within the peritoneal cavity, which is basically the fluid that our organs swim in, and also within the vagina itself within our reproductive organs. And so if they are out of balance, if that microbiome in that area is out of balance, and our immune system is going to be unhappy, and correcting that can be helpful. Dealing with infections can also be really helpful to under to address that underlying imbalance. Now, the other thing that can sometimes happen is because what we know that it’s an inflammatory condition, and there’s an immune imbalance going on, but there’s certain genetics that are involved in that issue. And I find that the mthfr gene, which is a pretty common gene to have, and it doesn’t having the gene doesn’t always mean that there’s an issue, but it’s if that gene is not acting properly, then it affects the enzyme that deals with a lot of different processes in the body. But in regards to endometriosis, in particular, it affects our our main antioxidant recycler, glue to fire recycling of glue to fire. And now, if we don’t have enough antioxidants in endometriosis, then we can’t really mop up all that immune damage that’s going on. So it makes the inflammation worse. And so then, as a result, that makes pain worse. And that can also, you know, make all those other sorts of reactions worse as well.

7:17
One of the things that we also find going on is that mthfr gene affects the detoxification of certain hormones throughout the liver. And if we’re not detoxifying our hormones effectively, then we get that recycling and that uptake of those hormones through through the system, and so then we lead to having too much of certain hormones where they shouldn’t be.

7:41
In the case of endometriosis, what we used to think, as I said before was that it was a excess of oestrogen. But in this case, it seems to be that it’s a displacement of estrogen. So there’s too much estrogen being activated in the area of the endometrial tissue lining going on. And that’s causing a reaction with some of our other immune chemicals. So one of these immune chemicals is histamine. So histamine, can you probably know about histamine as an allergic sort of issue like, you know, hay fever and sneezes and rashes, and, and all of those. Well, when are mast cells, the immune cell that causes the histamine to be in excess is actually in reaction to the estrogen. And that causes more of that inflammatory reaction. And so then, you know, you get the pain and the redness and, and those painful reactions, that’s so common with endometriosis. And as a result of the inflammation that takes place, then when there is that, I mean, immune activation in that area, that’s why we’re more you’re more likely to actually get adhesions forming. And so this can be a really big problem for women with endometriosis is that the adhesions can cause a lot of damage, they can stick for free, you can stick your organs together, you can get the uterus can be stuck to the bow or bits of the bow can be stuck together. It can, you can have the bladder being involved as well. And all of that can cause quite a lot of pain. And it can also affect fertility quite significantly as well.

9:14
Now, and adhesions do seem to have a bit of a problem and that they can only really be resolved with surgery. So as we were talking about before that surgery isn’t certainly a good option for some women, but it’s not not the first line option for every woman. It’s actually better if you can try and get on top of endometriosis in the early days. But the thing with endometriosis is that it’s actually a condition that a lot of people are getting dismissed and missed about, if that makes sense. What I mean is that women are going to and young girls are going to their doctors and they’re complaining of pelvic pain, period pain, and they’re basically getting dismissed and it seems to be about 70% of young women with endometriosis are getting dismissed and that’s a huge number 70% so if we can get on top of this condition in the early days before adhesions formed and things are going to actually work out a lot better for these women what we need to do is we need to have the funding into a better research system but we also need to have more awareness and women need to be more empowered and educated so that they can make make these make these choices make ask the right questions so i think the fact that the main testing method is a form of surgery is probably pretty off putting but we can do a lot in terms of natural treatment and dietary techniques to actually take this under control one of the things we need to do is to get our gut flora and underbalanced under control and we also need to look at reducing our inflammation levels throughout diet for a lot of women with endometriosis one of the main inflammatory things that’s going on is that they intolerant to certain foods and the key food that i find a lot of women are reacting to is is actually dairy or cow’s protein in particular and this can be you know pretty hard to give up for a lot of women but getting that out of the system can make a big big difference now we also need to look at supporting that mthfr gene which is the one that i was talking about before so the mthfr gene basically it works on a particular enzyme which is can never remember the name of it and let me find it – methylenetetrahydrofolate reductase – and basically that works on the conversion of our fault for late into its activated form in the body now it’s more than just taking folic acid in fact if you’ve got issues with this gene you probably shouldn’t be taking folic acid you should be taking different b vitamins or activated b vitamins and so this is where it gets pretty complicated because depending on what you’ve got going on with this whole methylation pathway taking methylated b vitamin can actually make you feel a lot worse because you can be methylating too fast or too slowly and so if you’re methylating too slowly and you take methyls then that’s going to make you feel like help so we don’t want to do that so that’s where you know seeing a practitioner can come in really handy but if you can get your methylation under control that does a few things it brings histamine into balance it improves your detoxification of your hormones through the liver and it can dampen that immune dysregulation and therefore inflamed inflammation that’s going on so those are some really key things that’s going on and one of the other things is that it really really really helps with your glue to fire and recycling which is what you need to mop up all that damage that’s taking place now there are a lot of other things that we want to work on with endometriosis and as we’ve said a few times get that inflammation level under control so one of my favorite things to do is Turmeric. now turmeric does have a little bit of a blood thinning properties so depending on what your your bleeding is like if you tend to be quite heavy bleeder it might not necessarily be the thing there’s something called VAGF which is basically your some women have a higher level of capillary growth to these endometrial lining and certainly doesn’t happen with everyone but actually getting improved mop up of that area can be quite helpful with certain again immune herbes and things like that as well we also want to again work on those antioxidant levels so working on methylation is helpful but herbs and nutrients that will actually help with your antioxidant levels can be helpful to one of those is n acetylcysteine or you potentially taking gluta thione itself but n-acetylcysteine is a lot cheaper and also it can be converted into the body in the body to glorify and so that’s something that can be quite helpful for people as i was talking about before in terms of diet you want to reduce the foods in your diet that you might potentially be intolerant to that could potentially cause some inflammatory reaction for you so those are some things that you want to do and you also want to work on while it’s not hormone only cause to condition it is hormonally affected so if we can work on getting estrogen detoxification under control then that’s going to help with the estrogen displacement that’s going on some people might know that sort of concept as estrogen dominance what’s really happening though is that there’s too much estrogen in the wrong place not that there’s necessarily a lot of estrogen everywhere going on because for women with with this sort of condition they might actually experience some symptoms of estrogen deficiency like you know brain fog or hair loss and skin dryness and thinning and that sort of thing but then in other instances they’re going to be experiencing symptoms of estrogen excess such as their their period abnormalities and or pms symptoms and those sorts of things so again it comes down to the individual so that’s where you know seeing a practitioner can actually be really helpful to get that under control

15:35
so i think i’ve kind of rambled a little bit there that seems to happen when there’s topics that i’m quite passionate about i guess one of the take home points that i really want to say with endometriosis is that we know a lot more about it now we know more about the immune involvement about the inflammatory involvement and so because of that we can actually do so much more for it we can actually get really better treatment happening and so if you know if you if you were seeing a naturopath for endometriosis five or 10 years ago you’d get completely different treatment most of the time now so i would say you know if you want to get some treatment ask your naturopath what they think is the main cause of it what they would do to treat it and if they’re talking about some of these new research that’s going on then give it another try because i have a lot of patients with endometriosis nowadays that i get real good success with and we follow these these routes of look at the infections that might be driving immune imbalance and support methylation support the detoxification of the estrogen but as less of a priority you got to get all those other factors under control get that inflammation down once that see improves things start to get better for them much quicker than it used to back when i first started trading where it would take you know a good half a year’s 12 months maybe to get things much better under control whereas now it’s it’s you know half a year mostly it does always depend on the person always depends on the severity of the condition as well you know for some women their endometriosis is so severe that you know surgery is what is really really required and sometimes even going on something taking something like the marina or getting the marina in is important because that actually helps to improve local progesterone in the uterus and so that can help to improve that imbalance and so if you’ve got less of that estrogen activity taking place then you get to have less of that histamine reaction most of that immune reaction going on so you know one of the first things i would say is get your gut the gut microbiome in the gut and also in the vagina under control is blackmores women’s bio balanced is a product that i do recommend as a retail option there’s also practitioner ones that i use Femex have you know a really fresh diet full of antioxidant rich foods lots and lots of veggies eat your rainbow every day those things are really really important and you also really want to get your stress under control because i mean as you know stress has a big role and a lot of different things so we’ve got this thing called the the hpa axis hpo axis hpt axis where all of our hormones are talking to each other all of the time and if there’s some other things going out of balance for instance our hpa axis which is where our adrenal glands are out of balance that’s going to throw out our hbo axis which is where we’re talking to our reproductive hormones so we want these to be under control and calm so doing some mindfulness and some meditation taking stress herbes taking all your nutrients those are really important too in regards to nutrients i mentioned in acetylcysteine i think that can be really helpful but i also do think that you need to get your core reproductive nutrients under control so that’s firstly get using copper ratio right because excess copper can affect your estrogen levels i also think that you need to get adequate magnesium for your stress levels also to reduce into smooth tissue cramping and calcium is important too you need to have that right ratio going on and i and is is really important so you don’t want to have too much iron because iron in excess can cause oxidative stress which can be inflammatory but if you’re into if you’ve got insufficient levels of iron then you’re going to be more likely to bleed more and that’s going to be a big factor for a lot of women a lot of women with endometriosis have really really heavy blades so we don’t want that that with iron that’s one of the things that i always recommend getting iron levels tested before starting supplementation and get the dose, right? I think vitamin D is important vitamin D is really important for your immune health. And I recommend getting your vitamin D levels over, over 80. You don’t want it to be higher than 150 or so.

20:19
And you also need to be considering things that are going to help to bring down your inflammation levels. As far as Herbs and so I’ve said, I’ve said tumeric, I do love tumeric. But again, you just got to be a little bit careful with it, depending on the periods. And I also think that good quality, facials can be helpful, but the same same sort of thing. Although they do they, we’ve always had this bit of a concern with fish oils is that you know, they can cause they can cause a blood thinning activity, or they could cause excessive bleeding. But some studies that actually measured the amount of bleeding that you create with officials has shown that it doesn’t seem to actually cause that greater quantity. So it’s not like you know, you’re going to bleed out or you’re going to have like massive amounts of blood loss or anything like that. Anyway, so activated B vitamins and stay away from synthetic B vitamins, and try and also stay away from foods that are fortified with synthetic B vitamins too, because while not everyone has this mthfr gene, if that mthfr gene enzyme gets unhappy, regardless of the genes presence or not, then that’s going to cause issues with all of those other factors. So it’s going to cause issues with the histamine, the hormones, the antioxidants. So all of those things that we want to work with. Thank you all so much for listening. I hope that you’ve enjoyed today’s episode. Please join me over at the Guts and Girl bits Instagram page and share any other words of wisdom that you would like to contribute as well. TGuts and Girl Bits now has a collection of E courses that you can view online. The primary course available at the moment is natural menopause support, which provides a whole heap of information on supporting yourself through the major symptoms of metaphors and easing through this transitional life. You can find the collection of E courses at ghttp://gutsandgirlbits.teachable.com. And then you’ll also find a course of understanding underactive thyroid, and coming up soon will be a courses called The Cyclical Woman, Navigating the teenage years, children’s health, nourishing the mother, and more. If you’ve enjoyed today, please leave a review and share this episode to help spread the word. Thank you

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Insights from the Endometriosis Symposium

I recently attended the ATMS Endometriosis Symposium, and boy did I nerd out. I have always had an interest in women’s health and period pain, having dealt with my own personal issues in this area but also because I have seen countless women who were dismissed, told to ‘put up’ with their pain, or given medication that the woman didn’t feel comfortable with.

During the seminar I went from feelings of excitement about the emerging research and treatment possibilities, to frustration that there is still so much we don’t know, to sadness about the extent to which this condition can affect a woman’s life, and anger at the issues women face in seeking effective diagnosis and treatment. A key statement during this Symposium was that women with endometriosis were frequently ‘missed and dismissed’.

What is Endometriosis?

For those that have never heard of endometriosis before, it is a condition that is currently considered to be an inflammatory disease where women can experience extremely painful periods, and 1 in 3 women with endometriosis have fertility difficulty. It is diagnosed when the tissue that is normally present in the lining of the uterus is present elsewhere, such as within the pelvis however it can possibly travel elsewhere in the body.  The only way to definitively diagnose endometriosis with via a laparoscopy, a surgical procedure, however for many women the diagnosis of endometriosis is suggested without having a laparoscopy, particularly is the risks associated with the surgery outweigh the benefits of the diagnosis.

I have written about endometriosis before here, however I would like to expand on some of the points made previously and discuss some of the newer information I received from this seminar.

A key point to remember is that endometriosis is a complex condition that we still don’t 100% understand or know the best treatment for, however we do know that holistically addressing the condition by working on it like a jigsaw puzzle provides better results.

The importance of a good laparoscopic surgeon, and excision vs. ablation.

One of the key speakers, Professor Jason Abbott who is one of the leaders of surgical treatments for Endometriosis in Australia imparted the importance of seeking an advanced laparoscopic surgeon if choosing to undergo a laparoscopy, and discussed his preference for excision (cutting) rather than abalation (lasering off of tissues), something that will hopefully become more commonplace as research supports this as well.

Neither pregnancy nor hysterectomy will cure endometriosis

If you’ve got endometriosis, chances are you’ll be told to get pregnant to cure the condition. Or maybe to have a hysterectomy.

Well unless either of these options are just what you want to do, don’t rush into it! It seems that neither option really provides long lasting relief, as the underlying causes of the condition will not be addressed and symptoms can come back, or still exist.

In the case of pregnancy, many women will find that not having a period for 9+ months is a welcome relief, and the hormonal and immunological shifts that occur during pregnancy also allow many endometriosis symptoms to ease. But the condition can come back, especially if the condition is driven from an imbalance in your immune system or pelvic muscles.

A hysterectomy should theoretically address endometriosis, but unfortunately many women with endometriosis experience problems that aren’t directly related to their period and so these issues can remain. Bowel problems, muscular problems and hormonal imbalances can still persist.

Nerve or Muscular issues in the pelvis can drive endometriosis

Having worked alongside osteopaths my entire naturopathic career I am well versed in the impact that tight muscles or structural imbalances can have on internal health. Seeing the ways that pelvic muscle tightness and nerve signalling issues can contribute to endometriosis was a lightbulb moment, as for many of my patients I have felt there was something ‘missing’ in my understanding of their complete picture, and I think this was it.

A physiotherapist who specialises in women’s health can assess the internal muscles of the pelvis to assist with conditions such as vulvodynia (pain in the vulva), dyspareunia (pain during intercourse) and dyschezia (pain with bowel motion), but it can also be extremely helpful for those with endometriosis. In my clinical experience I have also found that chronic vaginal and bladder infections may benefit from a women’s physio, as tight pelvic floor muscles can cause ongoing inflammation and tension which affects the bladder from eliminating properly.

think about what a muscle cramp in your foot or your calf feels like, then imagine this feeling as happening inside your pelvis or the vagina. The normal contraction and relaxation of a muscle allows blood to flow through, but if the muscle does not effectively contract and then relax it can cause hypoxia (reduced blood flow) which is itself very painful, and it also makes the pH of the muscle more acidic. In itself this can cause pain, but the lightbulb moment for me was realising the way this sort of issue can feed, and be fed by the inflammatory nature of endometriosis.

The constant pain in the pelvis that occurs in something like endometriosis can sensitise the nerves, so that even things which aren’t normally pain can become unbearable. The sensitised nerves can make you more likely to get pelvic pain, period pain and bladder pain, and there is actually an increase of inflammatory chemicals being produced, which worsens endometriosis, an inflammatory based condition.

On a side note, vulvodynia and dyspareunia, like endometriosis is an issue that many women feel ‘missed and dismissed’ about. These problems can have big impacts on a relationship. There may be an issue with the skin such as in chronic candida or lichen sclerosis  or there may be nerve sensitisation worsening the muscle spasms and pain signalling. If you experience these issues, or if your pelvic pain occurs at times other than ovulation and menstruation, consider that there may be a muscular component. If you experience pain when your bladder is full, then again when you have finished weeing, or pain during intercourse, a women’s physio may be able to help you.

Women with Endometriosis have a different type of immune system

There are many different types of cells with different responsibilities within our immune system, and the interplay between all of these can determine whether someone can fight off infections well, or if they are more prone to inflammatory type reactions. For women with endometriosis there have been an increase of some types of immune cells and inflammatory chemicals observed, and less activities of some immune cells which are responsible for ‘keeping things in check’. Interestingly, there is also communication between the hormones progesterone and oestrogen and our immune cells, and as women with endometriosis tend to experience progesterone resistance, the type of immune cells that these hormones normally work on are not able to be reined in.

Bacteria may affect endometriosis

The balance of bacteria within our digestive system has a dramatic effect on our immune system. Normally it can affect things such as how well we can fight off infections or whether we are likely to experience an allergic reaction, however for women with endometriosis there is also a reaction that occurs that worsens their inflammation.

On the coating of some bacteria there are substances which can break off, and the immune system reacts to this by releasing a lot of inflammatory chemicals. This substance is known as endotoxins, or lipopolysaccharides (LPS) and has been shown to be present in higher quantities in women with endometriosis, and the LPS works hand in hand with the higher levels of oestradiol  to then increase certain inflammatory chemicals.

The link between the gut bacteria and hormonal actions and subsequent severity of endometriosis is interesting. If there is an imbalance of good and bad bacteria (dysbiosis) which is very likely for those with endometriosis, it appears to be a key player that needs to be addressed for a holistic approach to endometriosis.

One of the papers referenced suggested that “there may be a direct link between pathological changes of the gut microbiota and the onset and progression of endometriosis”.

Addressing the gut bacteria can improve the severity of endometriosis, as this reduces inflammation and improves immune regulation. Specifically, using herbs that are antimicrobial to gram negative bacteria (such as those containing berberine) and using herbs and nutrients to support digestive lining health and motility, as well as promoting the presence of good bacteria are helpful treatment aims.

The role of histamine

Histamine is a chemical that works in a lot of different areas in the body. It acts a neurotransmitter affecting mood, and it is involved in immune and inflammatory responses. It’s well known for it’s role in allergic responses, causing dilation of blood vessels and stimulating white blood cell activity.

Histamine also has a role in endometriosis and period pain, as high levels of histamine stimulation oestrogen, and also feed the growth of dysbiosis. Oestrogen feeds back into this cycle by reducing the DAO enzyme, which is responsible for clearing histamine, and stabilising mast cells, one of the main white blood cells involved in the histamine response. There is also a stimulation of a chemical called VEGF (vascular endothelial growth factor) which causes the endometrial cysts to grow faster, and attracts more inflammation.

Methylation, involved yet again

Once again, methylation rears its head and as player. I have spoken about methylation before here and here, and while I consider it important to understand the role it has when not working properly, I firmly believe that addressing methylation by itself won’t solve everything.

Problems with methylation can worsen inflammation pathways, and dysbiosis can worsen methylation. Methylation problems can also affect oestrogen levels, histamine processing, and sensitivity to chemicals and toxins (such as mould, viral infections and parasites), all of which affect dysbiosis, immune balance and the inflammation levels.

Where to go from here?

It may seem confusing and overwhelming, realising how much is going on that needs to be addressed. That is completely understandable, but if you are able to find a naturopath or other health care practitioner that can help you, they will be able to guide you in your health journey. Ideally, having a team of practitioners such as a GP, a naturopath, a women’s physio, an acupuncturist and a gynaecologist and/or advanced laparascopic surgeon will mean that you are getting all your bases covered.

The first thing that should be address is pain. After the level of pain is scaled down to a bearable amount, then looking at the drivers of the condition such as gut health, diet, immune imbalance, infections, methylation, stress etc can be done.

Not everyone may want to or be able to afford the testing that can be done to get a clearer picture of the underlying imbalances and that’s okay. Your practitioner should be able to get a lot of information and ideas as to what needs addressing from a thorough case history.

The decision of what form of treatment to use is also very individual, and entirely up to you as the patient. I have not gone into detail about the forms of treatment, but there are many different options in terms of natural medicine, a variety in conventional medicine as well. Natural medicine can potentially be used alongside conventional medicine, or on its own. This is always something that is best discussed with your health care practitioner.

Resources:

Endometriosis Australia

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It is estimated that one-fifth of the population believe that they have a food intolerance. If you’re reading this article, you’re probably one of them. If you can’t quite put you finger on what food isn’t agreeing with you, then it’s time to get clued up.

In this article you can read about the difference between food intolerances and food allergies, plus 5 common causes that you can investigate, and practical tips to help manage your allergy or intolerance.

Want to learn more? You can read the full article here: http://casadekarma.com.au/the-ultimate-guide-to-food-allergies-intolerances/

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Health and Wellbeing Podcast #4

It’s time for podcast number four, and in this one I talk with fellow naturopath Laura Burton about stress, neurotransmitter health, adrenal health, ways to deal with and reduce stress via diet and lifestyle techniques.

Podcast Breakdown:

4:27 What have Laura and I been up to? Laura has been busy with her Tea Club and clinic life, and I have been busy in the clinic as well. I also have the Stress Talk coming up this Saturday at Windsor.

5:50 Stress has a big impact on our everyday life and it can be difficult to recognise stress because it comes in so many different forms. Sneaky stress!

7:00 The impact of over-exercising or the wrong forms of exercise on stress and adrenal health.

8:22 Stress impacts on nervous system balance.

8:54 The sympathetic and parasympathetic nervous system.

9:24 Serotonin

 10:45 Histamine

12:52 GABA

14:14 Dopamine

14:46 Adenosine

15:26 Laura talks about diet and nutrients for neurotransmitter and mood health

17:30 Digestive health is important in neurotransmitter health because we need to be able to breakdown our foods to absorb the nutrients required for neurotransmitter production

18:22 Vitamin C and other nutrients required for neurotransmitters and adrenal health

21:28 Iron supplementation risks, haemochromatosis and anxiety

22:40 Laura sums up how a balanced diet can usually provide the variety of

22:11 Adrenal health: How norepinephrine and epinephrine work in the body, and why high cortisol can impede muscle gain from exercise. Chronic stress can suppress out immune system and reduce our ability to heal from injuries.

24:50 Adrenal fatigue symptoms we’d look for in clinic.

26:36 Saliva testing for adrenal fatigue

28:00 Diet and lifestyle ways to deal with adrenal fatigue

29:29 Hugs for relieving stress!

30:39 Meditation increases dopamine and serotonin

31:09 Mindfulness, meditation and breathing exercises.  One moment meditation video can be found here: https://www.youtube.com/watch?v=F6eFFCi12v8

35:29 Changing our mindset and ways of thinking

37:43 Gratitude practice

40:31 Our favourite stress herbs

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