Eating gluten when you have endometriosis

Going gluten free can definitely help reduce symptoms of Endometriosis.

Bloating, abdominal pain, headaches, fatigue, depression, anxiety and anaemia. Sound familiar? These are commonly reported symptoms for both Endometriosis and gluten intolerance/coeliac disease. Many women with Endometriosis will test positive for the coeliac genotype, but even if they don’t they will always experience symptom improvement by cutting out gluten from their diets altogether.

What is gluten

Gluten is the general name for the proteins found it wheat. It is the thing that makes fresh bread wonderfully sift and bendy. But it is also one of the most inflammatory food molecules you can eat.

Many people often confuse wheat allergy with gluten sensitivity Non-Coeliac Gluten Sensitivity (NCGS)/coeliac disease. But there is a very important difference. Going wheat-free only cuts out wheat, but fails to cut out other products that use gluten extracts from wheat as additives (for e.g. in soy sauce).

Gluten’s link to the immune system

Gluten can create two different types of immune reactions in the vulnerable:

  1. Coeliac disease – an autoimmune disease often found in women with Endo that can possibly drive the disease. It has also been association with increased risk of infertility, miscarriages and still births. This can be diagnosed via a blood test (serology and coeliac genotype HLA-DQ2 and HLA-DQ8) and via endoscopy with a qualified gastroenterologist.
  2. Non-Coeliac Gluten Sensitivity (NCGS) – which is hugely common but often missed by the medical community as it cannot be diagnosed via standard blood tests.

If you have Endometriosis (or another linked autoimmune disease, like Hasimotos disease), you are immediately at higher risk from suffering from either of these reactions. You are also likely already experiencing a level of immune dysfunction (triggered by inflammation and potential microbial disease) that not only fails to suppress lesion growth, but actively promotes it.

Gluten effect on the gut can worsen Endometriosis symptoms

Gluten can negatively impact gut function thus worsen symptoms of Endometriosis by:

  • Causing leaky gut – which drives inflammation. Leaky gut also allows for high levels of Lipopolysaccharides (LPS) & gram-negative bacteria leaking into the pelvis which can drive general reproductive inflammation and symptoms of Endometriosis.
  • Increasing histamine levels by reducing diamine oxidase (DAO) production in the gut (DAO is the enzyme that breaks histamine down).
  • Increasing the risk of IBS (constipation/diarrhoea)
  • Potentially adding to symptoms of Small Intestinal Bacterial Overgrowth (SIBO) (as many wheat products contain FODMAPs).

Glutinous grains often contain Glycophosphates and other pesticides

Most conventional, non-organic grains are sprayed with endocrine disrupting chemicals such as Round Up (rich in toxic Glycophosphate) and sometimes Organophosphates which have been linked directly to Endometriosis in some scientific literature.

To avoid this sort of chemical exposure, always opt for organic, gluten-free grains and products.

Sources of gluten

After reading everything above, you can see why cutting dietary gluten out altogether is a fast way to to lower both your immune reactivity and levels of inflammation (thus symptoms of Endo).

The primary sources of gluten include wheat flour based products such as breads, pastas and cereals (you need to always check the label); bran, breadcrumbs, bulgar, cous cous, cracker meal, baking flour, kamut, seitan, semolina, traditional tabouleh (as it uses cous cous) and wheat. If you see these on a label, you want to replace them with gluten-free substitutes.

NOTE – this does not mean cutting out all of your favourite comfort carbs, which are essential to your mood, digestion and thyroid function. All you need to do is substitute with good gluten free options. If you would like more information on how to efficiently swap glutenous products for equivalent great gluten free ones, please click here for a copy of my Gluten free diet sheet.

But what about Oats, Sourdough and Corn?

Oats depend on where they are grown. In Australia, non-organic oats are grown next to wheat fields so always run the risk of cross contamination. Organic oats are a safer bet, except for those with coeliac disease who should avoid oats altogether to minimise any exposure risk.

Sourdough is bread that many perceive as ‘healthier’ and ok to eat on occasion with a gluten sensitivity. Whilst sourdough is a better quality of bread it still contains gluten (as well as yeast and histamine) which even in small amounts can cause inflammation and flare symptoms of Endo.

(Hundreds of years ago, the bread dough was left sitting to ferment sometimes for a week before it was baked. Thus “gluten intolerance” back then was not an issue. This also likely has a lot to do with the pesticides sprayed on conventional wheat crop (more on that below). The advantage of this long fermentation process was that it allowed bacteria to break down all of the gluten and some of the carbohydrate in the bread thus making it easily digestible and very light on gluten. Michael Pollan talks a lot about this on his Documentary “Cooked” on Netflix. These days, that sort of bread is a hard to come by unless you make it at home – most artisan bakers don’t leave the dough to sit for more than two days.)

Corn (and its derived products) also contain a type of gluten called Zein so can effect the immune system in a similar way. So it is best to avoid corn too when going gluten free.

Have you found going gluten free helps reduce your symptoms of Endometriosis? Leave a comment in the box with your stories.


? Editorial Illustration by Antoine Dore: “Fear of Gluten Phobia”