You wake up each morning, and instead of feeling refreshed, you're greeted by a wave of exhaustion that permeates every fiber of your being. Simple tasks like getting out of bed and preparing breakfast become monumental challenges.

Your body feels heavy, and even the thought of going about your day feels overwhelming. As you try to muster the energy to face the world, a fog settles in your mind, making it difficult to concentrate or remember things clearly.

Beyond the physical fatigue, you experience a rollercoaster of emotions. Frustration bubbles up as you struggle to keep up with responsibilities and commitments.

You may feel isolated as fatigue limits your ability to participate in social activities. Even your loved ones may find it hard to comprehend the constant exhaustion you face. “Like, can’t you just drink coffee and get on with your day?” I wish! Emotions fluctuate from sadness to irritability, and you long for a day when you can feel energized and vibrant once more.

Sound familiar? It certainly did to me! This was me in a nutshell back when chronic fatigue was seemingly the epicenter of my life. I would Google “why so tired endometriosis” without any good answers. And while there are definitely different contributors for so many different people (like thyroid issues, iron deficiency, etc), today I want to talk about a real root driver for just about all of us: chronic inflammation.

What is Inflammation?

Inflammation is a natural and vital part of the body's immune response. When tissues are injured or exposed to harm, the immune system protects us against potential threats with an army of immune factors. The buggers have neat robot names (like IL-4, IL-8, NFkB, and more) all work together to isolate and eliminate these threats with their weapons… imagine knives and baseball bats.

This is great when needed! Those knives and baseball bats protect us against bacteria, viruses, foreign proteins, cellular damage, and more. This is called acute inflammation, inflammation that happens for a little bit of time because of an acute injury/infection.

Symptoms of acute inflammation can vary depending on the affected area of the body. For instance, if you get Covid, acute inflammation can occur in the respiratory system, leading to coughing and difficulty breathing. A sprained ankle (acute joint inflammation) may lead to stiffness, swelling, and limited mobility. Travelers’ diarrhea (acute intestinal inflammation), can manifest as bloating, abdominal pain, and diarrhea.

The good thing about acute inflammation is that it ENDS. All those symptoms go away because the immune system did it’s job, and now it chills out.

When is Inflammation Bad? When it’s Chronic Endometriosis Inflammation

While acute inflammation is a crucial part of the body's defense mechanism, chronic inflammation is a different story… and it’s is gnarly. Those “cute” robot-named immune factors, attacking without end, can lead to tissue damage, scar tissue, adhesions, immune dysfunction, infertility, and chronic pain conditions. Yikes!

And, with endometriosis, we actually have two areas of chronic inflammation in the body (that I discuss at length in my endometriosis book):

1. Localized wherever your endometriosis lesions are: This is usually within the peritoneal cavity and what leads to scar tissue and adhesions, but it can also be anywhere in the body. Symptoms of this type of inflammation are usually acute, such as an endo flair, pain with sex, exercise, or menstruation.

2. Systemic inflammation throughout the body: This is the type of inflammation that will give you skin conditions, migraines, joint stiffness, chronic fatigue, anxiety, depression, digestive issues, and exhaustion.

In contrast to a normal inflammatory response that resolves once the threat is eliminated, chronic inflammation persists for weeks, months, or even years. It often goes unnoticed and silently wreaks havoc on the body, gradually sapping energy and affecting overall well-being.

How Does Chronic Inflammation Lead to Chronic Fatigue?

There are numerous ways that this can happen, one of course just having your immune system on “attack mode” all the time (even if your body isn’t really sure what it’s attacking).

Think of the last time you had a cold or flu, and how darned exhausted you were! The exhaustion of a chronic immune attack (i.e. chronic inflammation) is real, as your body prioritizes using energy to fight rather than mending and healing.

Now comes the aftermath. Without prioritizing healing, mending, or parasympathetic activities that help calm and cool the body, the rest of the body can’t function as well. This leads to issues like:

Muscle Atrophy:

It’s why someone with chronic inflammation needs up to 2x more protein than someone without that inflammation to prevent your body from eating your muscle! Without healthy amounts of muscle (that helps create energy for you), this atrophy process will become a serious energy sink.

Nutrient Depletion:

An immune attack requires a TON of nutrients. Not just to fight but also to fix and repair the damage. Zinc, iron, vitamin E, C, A, omega 3’s, and more! These are all nutrients those with endo are shown to be deficient in, and if you’re deficient in essential nutrients, your body and brain function will also take a hit. You simply won’t have the extra spark required to power your day.

Poor Sleep Quality:

Chronic inflammation also disrupts our sleep patterns. Pro-inflammatory cytokines, like IL-1, IL-6, and TNF-alpha, released during inflammation (and all associated with endometriosis), can cross the blood-brain barrier and interfere with the sleep-wake cycle. They hamper the production of sleep-promoting neurotransmitters, while promoting wake-promoting substances like orexin. The result? Compromised sleep continuity and quality.

Conversely, insufficient or disrupted sleep contributes to increased inflammation! During sleep, our body undergoes vital restorative processes. When sleep is inadequate or disturbed, these processes are compromised. Inadequate sleep leads to elevated production of pro-inflammatory cytokines and activation of inflammatory pathways fostering an inflammatory state, and with time, this cycle can extend to our overall health. Now we’re not waking up RESTED, so we don’t even have a “good night sleep” to depend on in combatting the fatigue.

Making you a more susceptible host:

Sick a lot? Sinus Infections regularly? A body under fire, underslept, and undernourished will be more susceptible to sicknesses. Welcome to even more exhaustion as your body struggles to keep up. [Side note: I would also frequently Google “why sick all the time endometriosis”]

Step 1: Endometriosis Fatigue by Addressing Inflammation

If you’re exhausted by your endometriosis fatigue, make it your goal to STOP CHRONIC INFLAMMATION (sorry to yell, I had to wake you up :).

To effectively address inflammation, understanding its root causes is essential. Here are 5 functional root causes of chronic inflammation associated with endometriosis, each contributing to reduced vitality.

Endometriosis, Bacteria, and Gut Health

A healthy gut is crucial for overall well-being, as it plays a significant role in the immune system and inflammation regulation. With endometriosis, we know there is an obvious link with dysbiosis. An imbalance of gut bacteria can disrupt the delicate ecosystem, leading to a condition known as leaky gut. In leaky gut, the intestinal barrier becomes permeable, allowing toxins, undigested food particles, and harmful bacteria to leak into the bloodstream. This triggers an immune response, causing inflammation throughout the body.

Moreover, harmful bacteria in the gut can release toxins known as lipopolysaccharides (LPS). These toxins, also called endotoxins or LPS, can provoke a heightened immune response, resulting in chronic inflammation. Additionally, poor gut health can impair nutrient absorption, leading to deficiencies in essential vitamins and minerals that are crucial for energy production. I talk about all of this in my post on bacteria, dysbiosis and endometriosis.

Chronic Stress

Chronic stress is a modern-day epidemic that can wreak havoc on the body, including promoting inflammation. Not to mention stress also makes endometriosis worse. When you experience stress, the body releases cortisol, a stress hormone that initiates the "fight or flight" response. While this response is essential for survival in acute situations, prolonged exposure to cortisol can lead to chronic inflammation.

Stress-induced sleep disturbances also play a role in exacerbating inflammation. Lack of quality sleep compromises immune function, leading to an increased susceptibility to inflammation-triggering factors. Moreover, inflammatory cytokines released during periods of stress can impact energy-regulating pathways, contributing to feelings of fatigue and low energy levels.

Sedentary Lifestyle

Our modern sedentary lifestyle, characterized by prolonged periods of sitting or physical inactivity, has a profound effect on inflammation. Regular physical activity releases anti-inflammatory substances in the body, helping to reduce chronic inflammation. On the other hand, a lack of exercise hinders circulation and impairs the body's ability to regulate inflammation effectively.

Moreover, sedentary behavior is associated with increased levels of pro-inflammatory markers, further promoting inflammation and its related effects, including fatigue. Individuals who lead a sedentary lifestyle may experience higher levels of inflammatory cytokines, contributing to feelings of exhaustion and reduced vitality. This may be why regular movement was shown to reduce endometriosis-related pain more than pain-killers

Pro-inflammatory Diet

An unhealthy diet, high in processed foods, sugars, and unhealthy fats, is a major contributor to chronic inflammation. Processed foods often contain artificial additives, preservatives, and trans fats, which can trigger an inflammatory response in the body. Additionally, excessive sugar consumption leads to elevated blood glucose levels, promoting the release of inflammatory cytokines.

Furthermore, nutrient deficiencies play a crucial role in inflammation. Antioxidant vitamins like vitamin C, vitamin E, and beta-carotene help neutralize free radicals and reduce oxidative stress, but their absence in the diet can lead to increased inflammation and cellular damage. Similarly, insufficient intake of omega-3 fatty acids, found in fatty fish, flaxseeds, and walnuts, deprives the body of essential anti-inflammatory compounds, exacerbating the inflammatory process. See the best endometriosis diet to follow.

Environmental Toxins

In our modern world, we are exposed to a plethora of environmental toxins daily, and they can have a significant impact on inflammation. Pollutants in the air, chemicals in household products, pesticides on fruits and vegetables, and heavy metals in water and soil can all trigger inflammation when absorbed by the body.

Exposure to environmental toxins can lead to a phenomenon called systemic inflammation, where inflammatory mediators circulate throughout the body. This process can provoke an immune response and contribute to fatigue, chronic pain, and other health issues. Moreover, certain toxins disrupt cellular function and damage DNA, further contributing to inflammation and compromised energy production.

Read this if you want to better understand the connection between these common chemicals and endometriosis.

Endometriosis Lesions

While many functional medicine experts will help you get to the “root cause” of your endometriosis, remember that endometriosis lesions themselves can be a root cause! Endometriosis lesions produce inflammatory immune factors, like little annoying factories, as well as pain-provoking chemicals (ouch) and mast cells (allergies, anyone). They can infiltrate the bladder (urinary issues), intestines (digestive issues), or, well, anywhere else.

So while, yes, it’s important to seek root causes for this complex issue, remember that endometriosis is more like cancer than a typical autoimmune disorder, and may absolutely need removal by a skilled excision surgeon. I like to recommend icarebetter.com as a place to find a vetted surgeon near you.

Affordable Chronic Fatigue and Inflammation Relief

Taking proactive steps to reduce inflammation can transform your well-being, yet so many of us have real time and/money constraints. Luckily for us, healing from chronic inflammation really starts at home, for free. Think of it as your first baby step, and you may be surprised just how much progress can be made with these effective tips to combat chronic inflammation naturally.

Please note that these tips are intended as general information and should not replace personalized advice from a qualified healthcare professional. If you are experiencing chronic inflammation, it's essential to consult with a naturopathic physician or other healthcare provider for comprehensive evaluation and guidance tailored to your specific needs.

supplements for endometriosis fatigue

Omega-3 Fatty Acids:

These essential fats, commonly found in fatty fish like salmon, mackerel, and sardines, are potent anti-inflammatory agents. They play a crucial role in modulating the body's inflammatory response by reducing the production of pro-inflammatory substances like cytokines and prostaglandins.

Additionally, omega-3 fatty acids promote heart and brain health, further supporting overall well-being. Incorporating omega-3 supplements into your daily routine can help alleviate inflammation and its associated symptoms, including fatigue.

Turmeric/Curcumin:

Turmeric is a vibrant yellow spice that contains curcumin, a powerful anti-inflammatory compound. Curcumin inhibits the activity of various inflammatory enzymes and molecules, effectively reducing inflammation throughout the body.

Studies have shown that curcumin's anti-inflammatory properties are comparable to some anti-inflammatory drugs but without the side effects. Including turmeric in your diet or taking curcumin supplements can be beneficial in managing chronic inflammation and supporting overall wellness.

Ginger Extract:

Known for its distinctive flavor and numerous health benefits, ginger is another natural anti-inflammatory powerhouse. Ginger contains bioactive compounds like gingerol and shogaol, which have demonstrated strong anti-inflammatory effects.

Consuming ginger or using ginger extract can help reduce inflammation and ease digestive discomfort. By calming inflammation, ginger can contribute to increased energy levels and improved overall vitality.

Iron:

Reversing iron deficiency can be a GAME CHANGER for endometriosis patients. Please do me a favor and test first, to make sure you know you’re deficient, and then work with a practitioner to bring you up to sufficiency. Read this detailed blog on iron for endometriosis fatigue here for more details.

Foods to Eat vs. Foods to Avoid for Endometriosis Fatigue:

Foods to Eat in Your Endometriosis Diet

Leafy greens

Spinach, kale, and other leafy greens are rich in antioxidants and phytonutrients, which help neutralize free radicals and reduce inflammation. These nutrient-dense foods also provide essential vitamins and minerals that support energy production and overall health.

Berries

Berries, such as blueberries, strawberries, and raspberries, are packed with antioxidants called anthocyanins, which have potent anti-inflammatory properties. Adding a variety of berries to your diet can help combat inflammation and provide a natural boost of energy.

Fatty Fish

Fatty fish like salmon, trout, and mackerel are excellent sources of omega-3 fatty acids. These healthy fats reduce inflammation and support brain health, helping to improve cognitive function and mental clarity.

Nuts and Seeds

Almonds, walnuts, flaxseeds, and chia seeds are rich in omega-3 fatty acids, fiber, and antioxidants. Incorporating these nuts and seeds into your meals or as snacks can help reduce inflammation and provide sustained energy. If whole nuts are hard on your digestion, consider nut butters.

Foods to Avoid

Avoid processed foods, excessive sugar, refined carbohydrates, and trans fats: Processed foods and those high in refined sugars and unhealthy fats can trigger an inflammatory response in the body.

These foods promote oxidative stress, disturb gut health, and contribute to chronic inflammation. Reducing or eliminating their consumption can lead to a significant reduction in inflammation and improved overall well-being.

Other Lifestyle Tips to Reduce Endometriosis Fatigue:

Prioritize Stress Management:

Chronic stress elevates cortisol levels, promoting inflammation and contributing to fatigue. Incorporate stress-reducing practices into your daily routine, such as mindfulness meditation, yoga, or deep breathing exercises. Managing stress effectively can help lower inflammatory markers and restore energy balance. If you want to reduce stress with endometriosis, read this.

Get Quality Sleep

Quality sleep is essential for the body to repair and regenerate, including the modulation of inflammation. Aim for 7-9 hours of restorative sleep each night to support healing and reduce inflammation. Establishing a consistent sleep schedule and creating a relaxing bedtime routine can promote better sleep quality and increased energy levels.

Stay Active

Regular physical activity is vital for increasing energy and combatting endometriosis! Sounds counterintuitive, but you need muscle to help energize you, it’s kind of like your battery pack, and you need regular movement to help your body’s internal working function well. Make sure to engage in activities you enjoy, such as walking, swimming, or yoga, as they can be both physically beneficial and emotionally rewarding. Aim for at least 150 minutes of moderate-intensity exercise per week to promote a healthier inflammatory response and boost energy levels.

Detoxify Your Environment

Minimize exposure to environmental toxins, which can contribute to fatigue and chronic inflammation. Use natural cleaning products and air purifiers to reduce indoor air pollution. Additionally, consider choosing organic produce to limit exposure to pesticides. Supporting your body's detoxification pathways through a healthy diet and lifestyle can help eliminate toxins and reduce inflammation.

Step 2: Advanced Steps for Combatting Fatigue

Some of us will need more help in combatting our own endometriosis fatigue. That’s because we’re all different, and while some will make dramatic gains from these tips alone, some may really need additional testing and treatment. If this is you, consider testing for other autoimmune disorder, thyroid health, lingering or recurrent viruses (like Lyme or EBV), or more.

Partnering with a doctor that understands these facets can be a really big help!

Living with chronic inflammation can be debilitating, but there is hope for healing and rejuvenation. By addressing the root causes of inflammation through naturopathic approaches and implementing lifestyle changes, you can reclaim your vitality and well-being

If you want more in depth information on endometriosis, fatigue, and healing anew, make sure to read my book, Heal Endo: An Anti-Inflammatory Approach to Healing From Endometriosis