Natural Solutions for Endometriosis

Dr. Tori Hudson 0:00
As the presence of these endometrial like tissue outside the uterus, and it probably affects seven to 10% of women in the United States

and of women who have chronic pelvic pain, about probably more at least 60% of those women, the cause is endometriosis. And in women who are infertile, it’s probably the cause for about half of the women that are infertile.

Brian Strickland 0:31
You’re listening to the nutrition world podcast, a show about navigating the intricacies of holistic wellness. We’re a natural health food store located in Chattanooga, Tennessee, and we believe that optimal health and peak performance should be accessible to everyone.

Cady Kuhlman 0:53
Welcome to our podcast, our nutrition world podcast. I am Cady Kuhlman and I am one of the hosts of our podcast. I am co owner of nutrition world with my father, Ed Jones and have my master’s in holistic nutrition and so excited to be here today with Dr. Tori Hudson. I am a follower of Dr. Toria Hudson for probably the last 1213 years of my life, being raised in this health food industry and being raised in more holistic health. She has been one of the the people that I have followed and wanted to know more about about her practice and more about how she goes about treating women in a more holistic way as an OBGYN and so I want to hop in and welcome her but I want to introduce her for a second with a bit of her credentials, and then we’ll let her her hop into it. So Dr. Tori Hudson, a naturopathic physician graduated from the National College of naturopathic medicine in 1984. She has since served in the college in many capacities. She is currently an adjunct Clinical Professor at N U N. M. Southwest College of naturopathic medicine and Bastyr University. So she’s practice more than 35 years she’s medical director of her clinic. A woman’s time is our clinic in Portland, Oregon. She’s director of product research and education for the line Vitanica. We’re proud to carry that line in our store. She’s also the founder and co director of naturopathic education, a research

nonprofit for accredited naturopathic residencies. So I could go on and on about all that Dr. Hudson has done. And I you know, I could speak for five more minutes on that. But I want to hop in and give her a welcome. And so thank you, Dr. Hudson, for being here today with us. My pleasure, Katie. Thank you. Thank you. So today’s today’s topic we want to kind of focus on is endometriosis. So just on an average day in our store, we I would say we get about 400 customers a day. We’re a busy health food store. And I’m thankful for that. But I would say on an average day, we may even get five to eight questions a day on endometriosis. And so that’s quite of a common subject. I’m starting to hear a little bit, you know, more questions on and and people asking for referrals to different OBGYN around town. But I would love to hop in and just kind of just generalize what intermediary osis is for our consumers here.

Dr. Tori Hudson 3:12
Basically, it’s the presence of things that are only supposed to be inside the uterus, they find their way outside the uterus. So it’s the presence of these endometrial like tissue outside the uterus. And it probably affects seven to 10% of women in the United States. And of women who have chronic pelvic pain, about probably more at least 60% of those women, the cause is endometriosis. And in women who are infertile, it’s probably the cause for about half of the women that are in fertile women that are infertile, but you know, as there’s other causes of pelvic pain, and there’s other causes of infertility, but I think those numbers kind of helped to shape the impact of it and importance of it.

Cady Kuhlman 4:07
Definitely. So are you seeing it a good deal in your practice, then I guess with those type of numbers?

Dr. Tori Hudson 4:12
Yeah, absolutely. I mean, in terms of just a key, I wouldn’t say it’s a common complaint. People coming in just because they have endometriosis a regular complaint or regular issue but not not as frequent as some other things but in women who have chronic pelvic pain, yes. And women who have infertility, yes. And one of the things that finds a woman in my office who has an already a, you can’t really diagnose endometriosis. Absolutely, unless you’ve had a surgery called the laparoscopy that sees it and biopsies it And boom, there it is. So there’s a lot of, you might say, clinical diagnosis, she has this symptom, this symptom, that symptom and that symptom, it’s probably endometriosis. So there’s a lot of that, but to actually really know for certain it requires a surgery. So a lot of how women come who know who think or know that they have endometriosis come to me, either they, the treat the conventional treatment that they were given has not worked adequately. Or she doesn’t want to do the conventional treatment that is being recommended. Or she’s having side effects from the birth control pills, for example, which are typically the first line treatment. So those are kind of the, the basic reasons and the and so we explore, you know, the, the options of treatments, and from diet to nutraceuticals, and botanicals to conventional prescription management, not just for, to try to suppress the disease itself. And generally that’s with a progestin or a birth control pill, but also just managing the pain. So they’re sort of like managing the pain or symptoms of the disease, and then there’s managing the disease. And we have to do that in both natural medicine, we have to do that and conventional medicine. Sure. So sometimes, you know, we don’t want to get lost in the weeds of just, you know, the big picture, but she’s still in pain every day. Right?

Cady Kuhlman 6:49
Right. So tell me what is underlying cause of endometriosis and your opinion?

Dr. Tori Hudson 6:56
Yeah. Well, there are. The interesting and challenging thing about endometriosis is that there is more than one cause there’s a lot of hypotheses. Well, I should preface it preface this with what we don’t exactly know. So there’s a lot of hypotheses. And those hypotheses likely include more than one underlying cause. And so for one woman, it might just be one mechanistic pathway. But for others, it might be one or more of these possibilities. So and this makes it complex. So with endometriosis, the the mechanisms that have been identified is that there is too many prostaglandin etoos being produced, and maybe some other inflammatory pathway has gone awry. So they have the inflammation pathway, essentially. And then you have the growth factor, if too much growth factor pathways, and then you have the immune system glitches, whether that’s not enough natural killer cells are not enough of another kind of T immune. So that’s another pathway. Another pathway might be what’s called aromatization. And there’s too much aromatization, of androgens towards estrogens. There’s also what might be a inadequate cell death. So things you know, are growing and dying and growing and dying all the time. So it may be that there’s a lack of proper cell death of these normal endometrial tissues, but they don’t go through their lifecycle in the way that most likely it does. And then that kind of leads to this spread of this tissue in abnormal places. There’s even some other possible hypotheses one, the long standing one has been this idea of retrograde menstruation, which doesn’t really pan out but yet it kind of sticks around as a hypotheses. In other words, instead of shedding the lining every month out and done it, there is some kind of backflow or Retrograde flow of that tissue. There’s some gut flora gut dysbiosis hypotheses now emerging as well. Is that causation or is it just an association we don’t exactly know. And then there’s even iron overload might be a possibility. Another possibility might be too much, too much vascular. It’s called vasculogenesis or angiogenesis. So there’s two Too much growth factors of these blood vessel growths. And then what you haven’t heard me say yet is, what about hormones, in imbalance and it’s very common in and too common for my taste. It’s a very common point of view of an alternative medicine point of view or a natural or integrative medicine point of view that there’s hormone imbalance or that there’s estrogen dominance. And that is not played out in the research at all. And what what, in terms of a systemic estrogen imbalance or systemic estrogen dominance, what is true is that the endometriosis lesions themselves can express a local production of estrogen. And they can also express some dysfunction in aromatization. Another thing locally is endometriosis lesions seem to lack certain progesterone receptors in the lesions themselves. So um, so I’m not talking about systemic, though. So an approach that just that kind of that that says, Oh, you have estrogen dominance is it at best in complete, and at worst, naive and just wrong. And so I think we’re missing, there’s been a miss direct, and an attempt to help people and help women with a disease that we don’t know enough about. But just going this direction of hormone imbalance is either going to go nowhere, or just gonna go not nearly enough.

Cady Kuhlman 11:52
Gotcha. Okay. So for a lady that’s listening right now at home and is thinking like, oh, you know, I have a symptom that you meant pelvic pain, heavier menstruation, you know, would there be is there ever any irregular periods that could go along with this or does it not really affect the regularity of periods?

Dr. Tori Hudson 12:13
Yes, it can be your it can affect bleeding and more than one way it can it could affect bleeding in irregular either the longer cycle or a shorter cycle. It could affect it could affect the cramp? Menstrual cramps is the is the biggie. Yeah, the men’s menstrual cramping during menses is the biggie. And then pelvic pain at other times in the month is sort of the second Biggie, bleeding changes, not nearly so much. But in fact, if she has heavy bleeding, I would be thinking of you know, for other things far, far sooner than than endometriosis. But there is a condition Katie called adenoma meiosis, which is you might say, a relative or a sister to endometriosis. So we talked in the beginning about how endometrium lining gets up and out into the outside of the uterus and, you know, in the tubes on the outside of the ovaries in even other places. When in bad cases, you can get it on the on the intestines on the bladder. But add no meiosis, the endometrium doesn’t go up and out, it embeds itself into the glands of the uterus. And these women have pelvic pain. And they have this heavy meant they have a I’m sorry, they have menstrual cramping. In particular, and they have heavy menses, in particular, those two things combination would lead me to think possibly add no meiosis, which is a relative, sorry, add no meiosis also is only truly absolutely diagnosed on a surgery. Okay, by generally and what I’m talking about there is actually removing the uterus and then looking at the tissue microscope, but but ultrasounds now high tech ultrasound can identify some suspicions of adenoma meiosis, it can also identify not endometriosis, but can identify what’s called an ovarian endometrioma. So that’s where an endometriosis actually causes a certain kind of ovarian cyst. I hope we’re not getting too, too out there.

Cady Kuhlman 14:41
Now, that’s great. That’s good information for sure. I know. You know, I think when women are in a place of having menstrual issues are not feeling well with their their cycles and whatnot. It helps to have information to kind of pinpoint what to go into their office and start asking about and how to describe things a little bit more. thoroughly and all of that. So, no, I think that’s wonderful. So, so tell me a little bit more of like, you know, with endometriosis, then if it was diagnosed during a surgery During that surgery, that would also be where it would be taking care of like that what process is going on at that point? Okay. Okay,

Dr. Tori Hudson 15:19
right. So uh, laparoscopy surgery is, you know, two little incisions and they’re looking through a scope out, they’re not looking inside the uterus, they’re looking on the uterus, on the fallopian tubes on the ovaries, and they can see the certain characteristic lesions are gross, and then they see that so there’s a certain visual to it, and then there’s, they can also take a sample and look at it under the microscope, but then they remove those as zapped those with laser cautery or are actually, you know, excision. So, surgery is that kind of surgery, laparoscopic surgery is sort of a gold standard for conventional treatment. But usually what comes first in in conventional medicine for treatment is a suspicion of endometriosis. Oh, let’s try progestins or birth control pills to control the illness and pain management. So that’s kind of an if that doesn’t work and they don’t, then then then they would move on to laparoscopic surgery. The woman accepted that.

Cady Kuhlman 16:33
Okay, so tell me if someone came in and said, You know, I’d like to not go the route of birth control pills or surgery. Is there a protocol that you would kind of start trying as of you know, nutrients and potential deficiencies, folate, you know, things of that nature that that you could speak about?

Dr. Tori Hudson 16:52
Yeah. Well, the first thing, so there is some reasonable body of published literature on natural agents and endometriosis. So, when I approached this, I have one of the things I have in mind, okay, she’s in pain today or is going to be in two weeks when she has her period. So I have to have a more short term pain management plan. And then I have to have the here’s the plan for actually having endometriosis and trying to improve it if not cure it. And then there’s is it causing or associated with other problems like her infertility or her Airtel bow? So the all those things we have to juggle all those balls, the natural agents for endometriosis that have some published literature, there’s one study on melatonin 10 milligrams a day. There’s one study I believe only one study on an acetal so the melatonin idea the melatonin is a stimulates antioxidant enzymes and it’s a pretty potent anti inflammatory so we have those two mechanisms as part of our complicated map of underlying causes of endometriosis. So we’re targeting that there’s green tea is there’s been a study on green tea and, and it has it targets not only the antioxidant mechanisms, but remember I caught talked about unregulated like this proper cell death is not happening. So EGCG or epigallocatechin gallate from green tea is anti mitotic. And it also inhibits blood supply to endometriosis tissue. So that’s called anti angiogenic. So that’s sort of how and it can inhibit growth, certain growth factors that are stimulated by estrogen. So green tea, generally I give about 500 milligrams a day of that.

Cady Kuhlman 19:01
Okay, and for someone who’s going to be that’s not going to be through drinking green tea right, that’s more for someone taking a supplement at a higher dose.

Dr. Tori Hudson 19:10
Yeah, I think you’re gonna have to drink way too many cups of green tea. Generally 500 milligrams of EGCG you might be able to get with depends on the company and the label but it’ll have that listed on the back what percentage of the whole is EGCG and you want 500 milligrams of EGCG? Okay. The N acetyl cysteine or NAC this was a women who took 600 milligrams three times a day and about half the women who were scheduled for surgery for removal of their endometrioma that’s this is the endometriosis causing an ovarian cyst. About half of them had such improvement their says shrink in size on ultrasound, they had such improvement in their skin times they canceled their surgery. Wow. So NIC is probably is working through activation of the immune system and increasing glutathione levels and therefore having a cytotoxic effect of those natural killer cells. There’s also resveratrol resveratrol doesn’t get enough usage in my book and this is also a powerful antioxidant. It also has been shown to inhibit aromatase, you might vaguely remember I mentioned that early on that aromatization is higher in women with endometriosis. So resveratrol inhibits aromatization and it’s a powerful antioxidant. Now, I think this is only been studied in rat models within Dimitriadis lesions, but it’s pretty impressive. If you look at that, and if we can extrapolate to humans, they say somewhere between 204 100 milligrams a day, okay. And then there’s some other considerations maybe based like horsington, this anti inflammatory bromelain is anti inflammatory. You know, there’s some other ideas out there, botanically speaking, I would look at more more like pain management level managing, you know, like antispasmodics, like, wild yam cramp bark is a big one on my list. Ginger has been studied in menstrual cramps, not endometriosis specifically. But we know ginger is anti inflammatory mexus, Mexican wild yam and cramped Barker antispasmodic. There may be some effect on just immune modulation with things like ashwagandha and Angelica in terms of the pelvic area. I don’t know enough about Chinese herbs to speak smartly about that. But the last supplement maybe I would mention is we talked about there are these glitchy pro inflammatory mechanisms that that are occurring. So omega three fish oils like high dose three, four grams a day would be on my list. And even Tumeric not, I don’t think we have I could look at my slide deck here really quick, but I’m trying to remember if there was it might be based on mechanisms. But it might be based on many mechanisms M endometriosis, and then kind of extrapolating that to curcumin, but I’m trying to see real quick here, Katie, if there is a study on curcumin and endometriosis? I think not I think it was more laboratory looking at laboratory mechanisms in tissue sample in endometriosis tissue samples in the lab. Okay, and showing that curcumin inhibited the

Cady Kuhlman 23:09
growth. Gotcha. Okay, yeah, that’s a wonderful list. So, you know, if someone was sitting at home listening to that, would you want someone to start with a couple of those remedies? Ron at all of those remedies, I know that that’s an individual basis to and probably the level of pain they’re in as you were speaking, there’s different plans, depending on severity and levels of pain. For myself, I kind of run at things. And so that’s a little bit of my personality. So it would be, you know, maybe five or six remedies to see if that could really make a difference for me, but someone that was just hoping for a couple of remedies they would choose out of that that mix, or could you speak to maybe the three that you would start with?

Dr. Tori Hudson 23:53
Well, I I would target as many of those mechanisms that we theorized or that we think are going on as possible. So you want not just the antioxidant not just the anti inflammatory not just the inhibiting growth factor, not just the causing cell death, not just the increasing natural killer cells. So your instincts in this case are good in that we need to cover multiple mechanisms. And I mean, I’ve been doing this for almost 40 years now and with endometriosis. I found way early on when my when what we knew was even less than now. Both conventionally and alternative medicine wise. Just looking just targeting the hormonal piece was just really not working out at all. So I was like what is going on? So I really pushed myself to learn more about these, the dig into this other research that’s really showing these multiple mechanisms. So I I prefer if I were using the individual ingredients, I would really, I would definitely do the NAC. The melatonin and something anti inflammatory curcumin recipe, Vera trawl or fish oils. And then I like that, that EGCG. So I picked out for trying to target at least four mechanisms. But sometimes you get more than one mechanism out of one item like melatonin, you get the antioxidant and the anti inflammatory, but then like not everybody’s going to tolerate 10 milligrams of melatonin.

Cady Kuhlman 25:45
Right? You know,

Dr. Tori Hudson 25:45
they’re just going to be too dry, they’re going to have some side effects.

Cady Kuhlman 25:48
Sure. So tell me, do you have any feelings on castor oil packs at all helping with endometriosis? Or do you use that in your practice?

Dr. Tori Hudson 25:58
Long ago, I did. I might say I’ve sort of moved on because I feel like we have research that has helped us move on. So we can now utilize natural agents that actually have some published research. I think for immediate pain relief, the castor oil pack could still serve a role to treat the underlying cause I don’t I don’t really have any confidence in that.

Cady Kuhlman 26:27
Okay. Okay. So for anyone listening a castor oil pack is you know, putting castor oil topically on the outside of the the uterine area. So you know, applying it and then putting some type of flannel cloth or washcloth and then putting some type of heat source over it so that the castor oil is supposed to go into a deeper layer within the skin and what is the theory behind it? Is it supposed to pull something out or it’s supposed to detoxify? Or it just is helping soothe the pain in some way?

Dr. Tori Hudson 26:58
Well, I think that’s a good question. What is the what how is? What does it do? I think in this case, it probably reduces a little bit of the immediate inflammatory state that’s happening. Okay. And maybe it maybe you might say decongesting the area, okay. And I also, admittedly, Katie, over the years, I’ve gotten, you know, what will my patients do in a sustainable way, and not that many will do castor oil packs in a sustainable way, because it’s just kind of messy, and

Cady Kuhlman 27:38
I totally get that you got to meet the patient where they’re at. And if you suggest something they’re not gonna do then it’s useless. You know, I used to do castor oil packs with a casserole is really thick and sticky. And then it’s there’s clean up and everything. And, you know, that works for some, but there’s plenty that are not going to do that. So you got

Dr. Tori Hudson 27:55
to have plastic on the bed and garbage bags.

Cady Kuhlman 27:59
thing? Definitely, definitely. So tell me, if someone you know, say they handle their endometriosis or they were to get pregnant? Is it true that sometimes pregnancy can change the state of endometriosis to where it doesn’t grow back after? It seems like I’ve seen that happen a lot. I don’t know if there’s science behind that.

Dr. Tori Hudson 28:19
Well, I’m I the first thing that I would think of is was it really endometriosis? Okay. That that was my first question. And then the other one is, it does not. From my understanding of the literature, it does not cure endometriosis. But the hormonal changes during pregnancy might improve, and postpartum might ultimately improve those growth factors locally in those lesions. And I remember when I was a kid, I mean, I’m 71. And that was, you know, he was telling a teenager, well, when you get pregnant, this problem will not occur anymore, which is not really what you want to tell a teenager, I don’t think yeah, no. But the the increased progesterone levels in particular that’s occurred during pregnancy that can counter some of that local endometriosis proliferation based on the estrogen receptors locally. And that is why progesterone and progestin can be used therapeutically. But can it have a lingering effect? I’m not so sure. I’m just kind of taking a quick scan while we’re talking here. Pregnancies I can’t really Why? Tell? So I’m not sure if I’m gonna have any better answer than I’ve already struggled about.

Cady Kuhlman 30:07
Sure. No, that’s good. So I do I’m so interested to and just your day to day life. Tell us a little bit about what it looks like. And are you still delivering babies? Do you do annual pap smears?

Dr. Tori Hudson 30:19
I don’t. I don’t I don’t deliver. No, deliver? Yes. Okay. I don’t deliver babies. No, I’m a naturopathic physician would and so naturopathic physicians can deliver babies if they’re trained. I don’t do that. No, I think I did five when I was a student, that was enough for me. But my my day to day life kind of looks like this. I’m in my office and seeing patients every day. And so I see patients in my clinic a woman’s time in Portland, Oregon, I co own and formulate natural products for Vitanica. And we have over 80 products. And I have my I do some writing still. And I have my blog that I write things and postings for twice a month. But I also have a new book that just came out. It’s called the menopause companion. That actually I was the co author with with a with an author with a writer, Sasha Davies. So people might be interested in that. And then my old binder been around a while the Encyclopedia of natural medicine, that’s a chapter on endometriosis. It does have a chapter in the matrices, but it’s outdated, you know, of course, because that was like, I don’t know, 15 years ago. So some of the things that we’re talking about today are not in that book.

Cady Kuhlman 31:45
Okay. I do love that resource, though. I know, as you’re saying it’s a little outdated. But to me, that’s one of the best Women’s Health books that I think has been written. So I thank you so much for that. I probably about nine years ago had some strains of HPV that I’ve spoken about a little bit publicly, but obviously I’ll speak about it here. And I looked in your encyclopedia booked to see what your recommendations were. And I was thankful. I followed a large supplement protocol. And then I was able to find a doctor who actually did ask erotic treatments. And so I flew eight times to Chicago to get those those done. So I’m quite thorough, and what I’ll do at that links, you know, to do that, but it was a painting of my cervix with blood root and zinc and bromine and tumeric. And all that. And so you had you were the first person I had actually read anything about that on and it’s been nine years now and completely free of all those strains and all good, you know, in that in that department, so thankful that that research that you had, yeah. Yeah.

Dr. Tori Hudson 32:51
I’m glad to hear that story. Yeah,

Cady Kuhlman 32:53
yeah. Thank you. So that really, I mean, that covered so much for me with endometriosis. And I hope it did for our listeners as well, is there anything else that you’re kind of thinking of is critical that we missed or something that someone would really want to know before we wrap up?

Dr. Tori Hudson 33:08
Well, I would like to just put it in a plug for there is a time and a place for conventional medicine, a time and a place for hormonal management, there’s a time and a place for surgery. There’s a time and a place for procedures. And, and there and those things can be done in concert with natural medicine. It doesn’t have to be natural medicine, or it can be a collaborative integrative approach as well. Unfortunately, endometriosis is fortunately endometriosis is not, you know, a precancerous or cancerous condition. So we’re not risking, you know, some thing potential down the road. That’s, that’s gonna risk someone’s life, if they don’t get it taken care of. There might be more pain down the road. And there might be delayed fertility down the road, but it is something that people can try safely these natural therapies.

Cady Kuhlman 34:09
Awesome. Thank you so much for that. And thank you for your time, Dr. Hudson. It was an honor. So I’m so happy we got today and maybe I’ll see you again at another expo or if you’re you’re speaking somewhere so thank you.

Dr. Tori Hudson 34:22
Yeah, Katie, thank you for the opportunity. And thank you I can tell you’re sharp, studious woman. So thank you think you’re helping all the people that you’re helping.