The Autoimmune Protocol for Endometriosis
Navigating Nutrition for Symptom Relief
Endometriosis is a challenging condition affecting many women, causing symptoms like painful periods, heavy bleeding, digestive issues, and weight changes. As a registered dietitian specializing in endometriosis and fertility, I understand the importance of finding effective nutrition strategies to alleviate these symptoms. One approach that has gained attention is the Autoimmune Protocol (AIP). Let's explore what AIP is, which foods are allowed and restricted, how it can impact endometriosis, and its potential impact on food relationships.
Understanding Endometriosis
It's important to note that endometriosis is not an autoimmune condition; it's a chronic inflammatory condition where tissue similar to the lining inside the uterus grows outside of it. While some dietary protocols claim to reverse or cure endometriosis, such claims should be considered red flags. Currently, there is no known cure for endometriosis, and excision surgery is regarded as the gold standard of care. However, nutrition can be supportive in managing symptoms and improving quality of life.
What is the Autoimmune Protocol (AIP)?
The Autoimmune Protocol (AIP) is an elimination diet designed to reduce inflammation, support gut health, and manage autoimmune conditions. Although endometriosis is not an autoimmune condition, the anti-inflammatory principles of the AIP for endometriosis can still be beneficial for symptom management.
Allowed Foods on the Autoimmune Protocol for Endometriosis
Meat and Fish: Grass-fed, pasture-raised, and wild-caught options are preferred. These provide essential amino acids, omega-3 fatty acids, and minerals like zinc and iron.
Nutrients: Omega-3 fatty acids (anti-inflammatory), protein (tissue repair), zinc (immune function), Iron
Vegetables: All non-nightshade vegetables, such as leafy greens, cruciferous, and root vegetables.
Nutrients: Fiber (digestive health), vitamins A, C, and K (antioxidant properties, bone health), folate (cell function).
Fruit: In moderation, focusing on berries and other low-glycemic options.
Nutrients: Vitamin C (immune support), antioxidants (reduce oxidative stress), fiber.
Healthy Fats: Avocado, coconut oil, olive oil, and animal fats from AIP-approved sources.
Nutrients: Monounsaturated fats (heart health), medium-chain triglycerides (energy).
Herbs and Spices: Non-seed-based spices like turmeric, ginger, and garlic.
Nutrients: Curcumin from turmeric (anti-inflammatory), allicin from garlic (antimicrobial).
Fermented Foods: Sauerkraut, kimchi, and kombucha for gut health.
Nutrients: Probiotics (digestive health), vitamins K2 and B12 (bone health, energy metabolism).
Foods Not Allowed on AIP for Endometriosis
Grains: Wheat, rice, oats, and other grains
Dairy: Milk, cheese, yogurt, and butter
Legumes: Beans, lentils, peanuts, and soy
Nightshade Vegetables: Tomatoes, peppers, eggplants, and potatoes
Nuts and Seeds: All types, including nut-based oils
Processed Foods: Any food containing additives, preservatives, and artificial ingredients
Refined Sugars: All forms of processed sugar and artificial sweeteners
Why People with Endometriosis Often Feel Better on AIP
Many people with endometriosis find relief following the Autoimmune Protocol. One way that it may reduce symptoms is by reducing high-FODMAP foods. FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides, and Polyols) are short-chain carbohydrates that can be poorly absorbed in the gut, leading to bloating, gas, and abdominal pain. By removing these foods, AIP can improve gut health and reduce digestive discomfort. Additionally, the AIP diet is rich in omega-3 fatty acids and vitamins A, C, D, and E, all of which have been associated in research with reduced endometriosis pain due to their anti-inflammatory and immune-supporting properties.
The Challenges of Restrictive Nutrition Plans
While the autoimmune protocol for endometriosis can provide relief for some, it is essential to acknowledge the potential pitfalls of highly restrictive diets:
Sustainability Issues: Long-term adherence to restrictive diets can be difficult. People may struggle with social situations, meal planning, and finding suitable food options.
Feelings of Failure: Not being able to stick to a strict diet can lead to feelings of failure, guilt, and decreased self-esteem.
Disordered Eating: Restrictive diets can contribute to disordered eating patterns, such as orthorexia (an obsession with eating "pure" foods) or binge eating.
Eating Disorders: These are serious mental health conditions characterized by unhealthy eating behaviors and attitudes toward food and body image. Examples include anorexia nervosa, bulimia nervosa, and binge eating disorder. Restrictive diets can exacerbate these conditions, leading to severe physical and psychological consequences.
A Balanced Approach: Combining AIP Foods with Flexibility
Incorporating AIP-approved foods can be beneficial in managing endometriosis symptoms due to their anti-inflammatory and nutrient-dense properties. However, it is crucial to maintain a flexible approach:
Personalization: Tailor the AIP framework to individual needs and preferences. Rather than completely eliminating the "not-allowed" list, consider incorporating whole grains, low-fat dairy (lactose-free may be beneficial), and including the nutrient-dense foods the plan recommends regularly.
Balanced Diet: Ensure a well-rounded endometriosis diet by including a variety of foods. Balance is vital in preventing nutrient deficiencies and maintaining a positive relationship with food.
Mindful Inclusion: To maintain a healthy relationship with food and body, honor your hunger and include foods you enjoy regularly. This includes foods with added sugars and processed foods. We know from research that diets don't work long-term and are associated with poor health outcomes in the long term, weight gain, and bingeing. Rather than restricting these foods, include them when you are hungry for them without guilt, and focus on nutrient-dense foods most of the time.
Conclusion
The autoimmune protocol for endometriosis can offer temporary relief by reducing inflammation and supporting gut health. However, it is vital to approach any restrictive diet with caution, considering long-term sustainability and mental well-being. By focusing on AIP-approved foods while allowing for flexibility and personalization, individuals can find a balanced path to symptom relief and improved quality of life. Remember, diet is one tool in the endometriosis tool kit, but it is not curative, and symptom management often requires a multidisciplinary approach. As always, consult with a healthcare professional or endometriosis dietitian to tailor dietary strategies to your unique needs and health goals.
Do you feel lost and unsure what to eat for endometriosis, fertility, or other health goals?
You’ll love EatLove, a meal planning membership that provides recipe ideas, grocery lists, and restaurant ideas that meet your specific dietary needs (gluten-free, dairy-free, low FODMAP, etc). All plans are prescribed and approved by an endometriosis dietitian.
I'm Sarah, an Endometriosis Nutritionist offering telehealth appointments and a meal planning membership to help you improve your symptoms and quality of life with endometriosis.
Sources:
Arab A, Karimi E, Vingrys K, Kelishadi MR, Mehrabani S, Askari G. Food groups and nutrients consumption and risk of endometriosis: a systematic review and meta-analysis of observational studies. Nutr J. 2022 Sep 22;21(1):58. doi: 10.1186/s12937-022-00812-x. PMID: 36138433; PMCID: PMC9503255.
Barnard ND, Holtz DN, Schmidt N, Kolipaka S, Hata E, Sutton M, Znayenko-Miller T, Hazen ND, Cobb C, Kahleova H. Nutrition in the prevention and treatment of endometriosis: A review. Front Nutr. 2023 Feb 17;10:1089891. doi: 10.3389/fnut.2023.1089891. PMID: 36875844; PMCID: PMC9983692.
Influence of diet on the risk of developing endometriosis. Joanna Jurkiewicz-Przondziono, Magdalena Lemm, Anna Kwiatkowska-Pamuła, Ewa Ziółko, Mariusz K. Wójtowicz. DOI: 10.5603/GP.a2017.0017. Ginekol Pol 2017;88(2):96-102.
Marcinkowska, A.; Górnicka, M. The Role of Dietary Fats in the Development and Treatment of Endometriosis. Life 2023, 13, 654. https://doi.org/10.3390/ life13030654
Barnard, N.D., Holtz, D.N., Schmidt, N., Kolipaka, S., Hata, E., Sutton, M., Znayenko-Miller, T., Hazen, N.D., Cobb, C., & Kahleova, H. (2023). Diet associations in endometriosis: a critical narrative assessment with special reference to gluten. Frontiers in Nutrition, 10. https://doi.org/10.3389/fnut.2023.1166929
Yalçın Bahat P, Ayhan I, Üreyen Özdemir E, İnceboz Ü, Oral E. Dietary supplements for treatment of endometriosis: A review. Acta Biomed. 2022 Mar 14;93(1):e2022159. doi: 10.23750/abm.v93i1.11237. PMID: 35315418; PMCID: PMC8972862.
Amini L, Chekini R, Nateghi MR, Haghani H, Jamialahmadi T, Sathyapalan T, Sahebkar A. The Effect of Combined Vitamin C and Vitamin E Supplementation on Oxidative Stress Markers in Women with Endometriosis: A Randomized, Triple-Blind Placebo-Controlled Clinical Trial. Pain Res Manag. 2021 May 26;2021:5529741. doi: 10.1155/2021/5529741. PMID: 34122682; PMCID: PMC8172324.
