May 10, 2019

Endometriosis with Dr. Jordan Robertson

33 minutes

In this episode of The Functional Medicine Radio Show, Dr. Carri’s special guest Dr. Jordan explains endometriosis – causes and natural treatments.

Dr. Jordan Robertson is a naturopathic doctor and women’s health author. Through her experience in medical literature review, critical appraisal and research, Dr. Robertson has published over 12 literature reviews on women’s health, and has worked closely with McMaster University, writing and facilitating courses on integrative medicine for the last 10 years, speaking for their medical school and working off-site for the Endometriosis Clinic at McMaster Hospital. Dr. Robertson has most recently lectured for the Ontario Association of Naturopathic Doctors convention on PCOS, PMS, PMDD and Endometriosis, and has published a book for women, Carrying to Term, on reducing miscarriage risk. In her clinical practice she focuses on women’s health issues including PMS, PCOS, infertility, menopause and breast cancer recovery.

Main Questions Asked about Endometriosis:

What is endometriosis?

What causes it?

How would you assess and treat the various aspects of endometriosis in patients?

How long should it take to see improvements?

Key Points made by Dr. Jordan about Endometriosis:

Endometriosis is a gynecological concern, where women have abnormal growth of endometrial tissue outside of their uterus.

Unlike the normal menstrual experience, where the endometrial lining is shed every month, these satellite lesions create chronic inflammation, chronic pain, and a chronic immune response, given that they are growing and bleeding, but with nowhere to go.

2002-2003 was sort of the first glimpse we had at endometriosis being an immune-triggered condition, we were starting to realize that the immune system in those women was not behaving normally, and almost more like an autoimmune-like tendency, where the immune system, rather than helping these women, was actually perpetuating inflammation, and that their T cells, and the cells related to what would typically be related to a sort of cleaning up cells that are where they don’t belong in these women weren’t behaving properly.

There’s some evidence that these women may metabolize hormones differently, that they may metabolize environmental estrogens and hormones differently than other women, and so, they have, say, a more difficult time of clearing environmental estrogens from their body than women without endometriosis. The one that they’ve spent the most time on in the research are the dioxin family of toxins; and we also know that those women differ in their progesterone reception.

I think we underestimate how many women suffer with endometriosis, because the gold standard for diagnosis is laparoscopic surgery.

Some of the advances in research and assessment is identifying that there is a blood test that can rule in endometriosis for women. It’s called CA 125, which was typically a cancer marker for ovarian cancer. It actually does run positive in many women with endometriosis, and so, just as a starting point, women can have that blood test, and rule in endometriosis.

We know that vitamin D is really concentrated in the decidua, which is the uterine lining, and really influences the immune system. Best example of this is the impact that vitamin D has on miscarriage reduction, the same thing happens with endometriosis, and we know that the lower their vitamin D status, the greater their pain, the greater their use of analgesic drugs. So that from an assessment perspective, I think that’s sort of the best sort of surrogate marker for immune function.

The hormonal stuff is interesting, because we generally, conventionally treat endometriosis just by suppressing all hormonal function, which from a fertility perspective, is not really an option for women to have their cycles suppressed like that, ongoing. At some point, they need to come off the drug therapy. But those women actually do benefit from additional progesterone supplementation, especially around cycles where they’re attempting to get pregnant, because their progesterone receptors are lowered in their endometrial lining, and they’re not as sensitive or responsive to their own progesterone.

When it comes to environmental toxins, I would say I just usually treat it empirically. We have collected data on thousands and thousands of women, we know that they eat more saturated fat, they eat more high fat dairy, they eat less polyunsaturated fats in their diet, they eat more refined carbohydrates, they eat less antioxidants, and they drink more alcohol. Their diets naturally, even if we just watch women with endometriosis, are higher exposure to dioxin compounds, or estrogen-like compounds through their food.

So, I coach my women to decrease the frequency of consuming foods that we know have a high dioxin content, and then try and reverse what we see observationally in women with endometriosis, and so, higher vegetarian protein, higher flax, higher polyunsaturated fats, higher olive oil, higher antioxidants.

The last thing I’ll say is my primary role with most women is looking at analgesic reduction, and there’s two great studies that I want to point out, that are looking specifically at reducing the need for analgesics, and I track this in my patients.

Both those anti-inflammatory/ antioxidants (ginger and melatonin) have pretty significant data for reducing the number of painkillers women use in a given month; and that’s a very sort of tangible outcome we can have with patients that really change their quality of life, and their ability to function from month to month.

I think just using supplements alone is probably gong to have some limitation in how much improvement patients can expect, but if patients are willing to comply with the diet, and add in the supplementation, my expectation is that we should have some pretty significant improvement by the 12 to 16 week mark, and then it starts to build on itself.

Resources Mentioned for Endometriosis:

Book – Carrying to Term: A Practical Guide to Reducing your Miscarriage Risk

Dr. Jordan’s website

Dr. Jordan on facebook

Dr Jordan on Instagram

Book – Reclaim Your Energy and Feel Normal Again

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