Endometriosis: A Painful Reality

Endometriosis is a chronic condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus. It can cause a variety of symptoms, including:   

• Chronic pelvic pain

• Painful periods

• Heavy bleeding

• Irritable bowel syndrome (IBS) symptoms

• Difficulty getting pregnant

Diagnosis and Treatment

Unfortunately, there's no cure for endometriosis. However, the gold standard for treatment involves excision surgery by an endometriosis specialist. Excision surgery removes the endometriosis implants, aiming for long-term symptom relief. Diet can't treat endometriosis, but research suggests it can play a role in managing symptoms.

What is the Carnivore Diet?

The carnivore diet restricts everything but meat, fish, eggs, and low-lactose dairy products. While proponents claim it can improve various health conditions, no studies specifically link it to endometriosis. This includes claims of "healing" endometriosis—these are based on anecdotal evidence only.

Nutrients for Endometriosis

While diet does not cause or cure endometriosis, peer-reviewed research indicates that certain foods and nutrients are associated with reduced pain and symptoms. Research suggests these nutrients may be beneficial for endometriosis symptoms:

Omega-3 fatty acids: Found in fatty fish like salmon, tuna, sardines, walnuts, chia seeds, and flax seeds, omega-3 fatty acids have anti-inflammatory properties and are associated with reduced endometriosis pain.

Vitamin C: A powerful antioxidant found in citrus fruits, berries, bell peppers, and leafy vegetables, vitamin C is beneficial for reducing inflammation.

Vitamin E: An antioxidant present in nuts, seeds, and olive oil that reduces inflammation.

Vitamin D: Reduces inflammation, supports calcium absorption, and aids the immune system– found in fatty fish, mushrooms (exposed to sunlight), and fortified foods.

The Carnivore Diet for Endometriosis: Potential Pitfalls

While the carnivore diet eliminates some potential dietary triggers for endometriosis, it also cuts out critical dietary sources of beneficial nutrients. It is high in nutrients that are associated with increased endometriosis pain.

High saturated fat intake: Red meat is a significant source of saturated fat. Research suggests that eating more than two servings of red meat per day may increase endometriosis pain.

Trans fat intake: Intake of trans fats is associated with increased endometriosis pain. Naturally occurring trans fats are found in cow and sheep products.

Feeling Better on the Carnivore Diet? Some Potential Reasons Why

There might be a different explanation for why some people experience symptom relief on the carnivore diet:

Gluten elimination: Many people with endometriosis have undiagnosed gluten sensitivity. Eliminating gluten-containing grains can improve symptoms.

Reduced FODMAP intake: FODMAPs can exacerbate digestive issues that are common in endometriosis patients.

Ketogenic effects: The carnivore diet induces ketosis, a state in which the body burns fat for fuel. Ketosis can improve energy and blood sugar, cause weight loss, and reduce inflammation.

Potential hormone changes: Endometriosis is known to be an estrogen-dominant disease. Diets high in sugar and processed foods are associated with increased estrogen levels. Reducing these foods may lower estrogen levels and improve endometriosis symptoms.

Pesticide exposure: Pesticides used in conventional farming can act as endocrine disruptors, interfering with hormone function and potentially exacerbating conditions like endometriosis. Eliminating produce and grains may reduce exposure to some of these pesticides. However, animals also come in contact with pesticides regularly. One strategy for reducing pesticide intake without eliminating produce is prioritizing organic options for fruits and vegetables with the highest pesticide residues (like the items on the Environmental Working Group's "Dirty Dozen" list).

The Dangers of Restrictive Dieting

While restricting certain foods might be helpful, long-term restrictive diets have serious downsides:

Nutrient deficiencies: The carnivore diet lacks fruits, vegetables, and whole grains, which are essential for a balanced diet. The absence of plant-based foods can lead to deficiencies in essential vitamins, minerals, and fiber.

Kidney and heart health risks: High saturated fat and protein intake can negatively impact kidney and heart health.

Mental health issues: Highly restrictive diets can contribute to disordered eating patterns, exacerbate eating disorders, and negatively affect mental health.

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.

Conclusion:

As an endometriosis dietitian, I do not recommend the carnivore diet for managing endometriosis. While it may temporarily relieve certain symptoms, the long-term risks far outweigh the benefits. Instead, a balanced diet rich in anti-inflammatory nutrients and low in processed foods and red meats is more sustainable and beneficial for overall health and well-being.

For those seeking dietary approaches to manage endometriosis, focusing on nutrient-dense, anti-inflammatory foods and consulting with a healthcare professional or a registered dietitian can provide tailored and effective strategies to improve quality of life.

Do you feel lost and unsure of 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.

Sources:

https://www.health.harvard.edu/nutrition/what-is-the-carnivore-diet

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