Endometriosis consists of the presence of an abnormally growing endometrium outside the uterus, that is, in the ovaries, fallopian tubes, ligaments, intestine, and bladder. Sometimes growth penetrates into the tissues of these structures. Less frequently, this tissue can migrate by coelomic metaplasia to other locations such as the lung, heart, brain, eyes, elbow, or knee. Once implanted, this endometrial tissue responds to the natural hormonal cycle, and then begins bleeding into the body cavity; Furthermore, since it lacks a drainage path, it is often the cause of inflammation, pain and infertility.
Endometriosis appears to be associated with infertility. 30% to 70% of women investigated for infertility turn out to have endometriosis, and 30% to 40% of these patients are unable to conceive.
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THYAMINE (Vitamin B1)
Williams and her team have studied the effects of impoverishment and thiamine enrichment on six white women. During the impoverishment phase, which lasted for 88 days, the following symptoms appeared: states of mental depression, general weakness, dizziness, back pain, muscle pain, palpitations, dyspepsia, false angina on exertion, insomnia, anorexia, nausea , vomiting, weight loss and muscle weakness. The most impressive features were weight loss, appetite disturbances, fat aversion, and mental symptoms (15).
Very especially before and during pregnancy, a diet with a high density of B vitamins and essential minerals is recommended to keep enzyme saturation levels high (16). A thiamine deficiency, initiated 11 to 15 days before coupling, resulted in 83% of the embryos being reabsorbed. If the deficiency was caused earlier, there were more animals without implants (if started early enough, it always inhibited ovulation) (17). A deficiency of any of the four B vitamins (B1, B2, B5 and B6), initiated 13 days before mating reduced the fertility of the mother rats by up to 80%, and if it went back 28 days before the hymen, in a 100% (18). The 'Basel Study' conducted in Switzerland of 6,400 adult employees found that on the 22nd, 8% of the women had a low saturation for thiamine (19). Cells in the process of dividing have a much higher demand for energy than cells that are not dividing.
Ovulatory maturation and embryonic development involve the highest rates of cell replication in the human life cycle, with high local availability of intracellular energy. It is clear that these deficiencies, when linked to patients with endometriosis, may be exerting their effects on fertility. In other mammals, the hypothalamus is more sensitive to thiamine deficiency than the gonads or the embryo (20). In Wynn's study at Hackney Hospital, the links found were the possible consequence of the low level of the hypothalamic-pituitary-ovarian axis (18). The Nelson and Evans studies conclude that "pituitary and ovarian dysfunction is involved in hormonal insufficiencies in vitamin-deficient animals." It is concluded from these studies, that the endocrine system intervenes as a mediator in the effects of many nutritional deficiencies and inhibits reproduction before such deficiencies have a direct effect on germ cells or embryos (17). Luteinizing hormone (LH) appears to be reduced by an inadequate diet (20). The conclusion reached by Schweppe, regarding women suffering from endometriosis, is that "endometriosis can only be cured through the permanent and complete elimination of endocrine influences" (21). This apparently drastic condition can be alleviated by the sensible use of nutritional supplementation.
RIBOFLAVINE (Vitamin B2)
Riboflavin is essential in the function of the adrenal glands and, therefore, in the control of stress. The adrenals control how and where fats are deposited in the body, and the mechanisms of hormone release (22). Many women with endometriosis report suffering from stress, and this detail could be an indicator for future research. Endometriosis thrives on the weakness of the immune system, related to stress and that can control the body and life of women (23). Stress or the birth control pill can also profoundly affect the adrenal glands, which make up 20 percent of total estrogen manufacturing (24). Since women with a higher incidence of anxiety, that is, with a higher sensitivity to stress, are less fertile,
The syndrome called LUF has been reported in up to 79% of women with endometriosis, in whom the oocyte is trapped in a torn Graafian follicle that has not ruptured (26). It is a phenomenon common to all mammals. Peritoneal fluid in women showing LUF syndrome has been postulated to be low in volume and contain low levels of steroid sex hormones. It is estimated that this could be one of the causes that contribute to infertility in women with endometriosis.
Riboflavin deficiency gives rise to hormonal imbalances, and is essential in homeostasis and in the elimination by the liver of steroid hormones (estradiol and progesterone), and its deficiency gives rise to excessive accumulation that inhibits the secretion of LHRH by the hypothalamus and gonadotropin secretion from the pituitary, with infertility as a result. Riboflavin and pantothenic acid (B5) are both co-enzymes, and animal reproduction has been reported to be impaired if enzyme saturation falls below approximately 80% (27). This could be relevant to the justification for new studies and research. In 98 patients with unexplained infertility, Thomas and Cooke (1987) diagnosed asymptomatic endometriosis in 51 cases (52%). This incidence in nonfertile women is also supported by other reports (28). If these data, together with those of Hull and his team (1985) regarding the incidence of unexplained infertility, are combined, then it can be estimated that between 8,000 and 9,000 non-fertile women each year in the UK would be diagnosed with asymptomatic endometriosis (11). From this, it is estimated that up to 2 million British women could suffer from this disease, the normal costs of which, together with diagnosis and treatment, could reach many millions of pounds sterling, not to mention the hidden costs of time lost at work or at work. the studies. The social impact on the family is high; many patients are rejected as neurotic when they do not respond favorably to the usual therapies, that have not yet been proven. Those who are still loved resist hopelessly, confused by the claims of the doctors, who insist that they have nothing. Endometriosis can affect the entire family (29).
PIRIDOXINE (Vitamin B6)
The pyridoxine deficiency gives rise to the reduction in the activity of the phagocytic cells, and thus it is impossible to properly carry out the total cleaning of the interior of the organism (30). Thus, endometrial cells, in retrograde menstruation, can be eliminated less efficiently, and remnants that could develop endometriosis may remain.
Pyridoxine deficiency gives rise to joint difficulties, depression, reduced muscle function, irritability, nervousness, personality disorders, weakness, insomnia and edema. The deficiency of this Vitamin B6 also triggers the deficiency of Vitamin B3 (14). Some of these symptoms are perceived by women with endometriosis as if they were linked to this disease. Vitamin B6 deficiency has also been associated with partial loss of both humoral and cellular immunity. This picture can give rise to an inadequate response in antibodies and that the organism becomes more vulnerable to diseases.
Pyridoxine influences the release of the neurotransmitters dopamine and serotonin, which regulate good or bad mood (agitation and depression) (23). Steroid hormones are known to influence the synthesis of brain amines, and especially serotonin, the action of which can be counteracted by pyridoxine (32,33). Vitamin B6 stimulates the production of dopamine, an important brain hormone that exerts a calming effect on the nervous system (34). Women with endometriosis are known to be prone to depression and anxiety, and Vitamin B6 appears to do well for some women, according to reports published in newsletters. A study by Slocumb and her team found that patients with pelvic pain considered themselves to be significantly more anxious, more depressed and with more somatic symptoms than patients without pain (35). The link between endometriosis and mood disturbances could, however, be mediated by hormonal factors.
Vitamin B6 stimulates the production of progesterone. Some research indicates that women with endometriosis have a slight imbalance between estrogen and progesterone over a period of the month (there is not enough progesterone for estrogen stocks) (4).
Pituitary and ovarian dysfunction has something to do with hormonal imbalances in animals with vitamin deficiencies. Nelson's conclusion that the endocrine system mediates the effects of many nutrient deficiencies and that it inhibits reproduction before such deficiencies have any direct effect on germ cells or the embryo (38) . In the course of evolution, this trait is likely to have weighed on survival, preventing reproduction when food supplies have not been satisfactory. In the context of reproduction, the endocrine system has developed to become the arbiter of nutritional adequacy (20). This could be, in part, an answer in women with endometriosis who are being inadequately fed. A study by Gallant has indicated that, if pyridoxine is useful in relieving symptoms of postmenopausal syndrome (PMS), this effect is likely due to pharmacological action or correction of marginal deficiency (37). This could also be a relevant factor in relation to endometriosis.
The three B vitamins (B1, B2 and B6) together with choline and inositol play essential roles in the breakdown of excess estrogen, because they are co-enzymes in liver function. Estrogen is involved in the disease process; Thomas claims that manipulation of estrogen secretion could exert its influence on the incidence of endometriosis (11).
MAGNESIUM
In women with endometriosis, low energy levels and infertility are fairly widespread symptoms. "How could I imagine that in such a short time I would feel so tired that the mere fact of taking a shower a day would become a feat" (4). Enzymes depend on the energy magnesium provides to do their job. Magnesium transfers this energy by activating the production of a special substance, adenosine tri-phosphate (ATP), which extracts energy from the food we eat and provides it to each of the cells in our body. Since 1900, a slow decrease in human consumption of magnesium has been observed due to the increase in the consumption of refined foods, but at the same time there has been an increase in the physiological needs of magnesium due to the increase in the consumption of alcohol, phosphoric acid in soft drinks, Vitamin D and contraceptive steroids (38). Magnesium deficiency reduces thiamine levels in the body's tissues. Thiamine cannot be used and is excreted if magnesium is lacking, thus generating a reduction in intracellular energy. Magnesium deficiency is also mutagenic (39). thus generating a reduction in intracellular energy. Magnesium deficiency is also mutagenic (39). thus generating a reduction in intracellular energy. Magnesium deficiency is also mutagenic (39).
The causes of magnesium deficiencies are, therefore: (i) the reduction of dietary intake; (ii) the reduction of absorption; (iii) reduction of utilization; and (iv) the increase in losses (40). Symptoms that lead to deficiencies include insomnia, nervousness, heart palpitations, cramps, and especially menstrual abdominal cramps (23). Fatigue affects the immune system, frequently giving rise to secondary stress. Women with endometriosis also frequently suffer from insomnia, cramps, and menstrual abdominal cramps. Doctors are finding that many people with constant fatigue conditions respond to magnesium supplementation along with potassium (41).
A compromised, weakened immune system can also contribute to the development and progression of endometriosis. At various levels of the reproductive system, immunoglobulins and IgA, IgG, and IgM supplements (a complex device of interactive proteins) are secreted, interactions with immunoglobulins occur to complete the response through the antibodies (42). There is a possibility that magnesium deficiency, along with those of other nutrients, may affect the response of the immune system in patients with endometriosis. Suppression of the immune system increases the risk or increases the incidence of symptoms of allergic manifestations that have been suggested as components of the general weakening picture experienced by patients with endometriosis (43).
Magnesium improves the fidelity of DNA replication and magnesium in the cell membrane prevents the changes that give rise to cancer. Magnesium from cell membranes helps cells stay together with a normal configuration. Magnesium is essential in more than 30 enzyme systems that have to do with the growth of cells and their division, aspects that are altered in cancer (41). The same is true of endometriosis, which mimics the ways cancer cells copy themselves. The nickname "benign cancer" has been applied by some researchers in their references to endometriosis. In some rare cases, endometriosis has developed into cancer. Mostoufizadeh and Sully have shown that a tumor or an endometrial implant must be in a phase of transition between normal endometrial tissue and abnormal cancer tissue. "If the two coexist at one point or at an unusual age, or if the patient has a long history of endometriosis with eventual development of a malignant (cancerous) tumor, this could be the consequence of that" (44). Cancer cells are known to carry cell surface markings that identify them to the immune system, and it is quite possible that endometrial cells may also be marked (45). or if the patient has a long history of endometriosis with eventual development of a malignant (cancerous) tumor, this could be the consequence of that "(44). Cancer cells are known to carry cell surface markings that identify them to the immune system, and it is quite possible that endometrial cells may also be marked (45). or if the patient has a long history of endometriosis with eventual development of a malignant (cancerous) tumor, this could be the consequence of that "(44). Cancer cells are known to carry cell surface markings that identify them to the immune system, and it is quite possible that endometrial cells may also be marked (45).
When magnesium is lacking in the muscles to balance calcium, they seize up and contract, causing cramps, irritability, twitching, and tremors. Magnesium acts on nerves to relax muscles and its deficiency is associated with muscle cramps (40). This deficiency could be associated with cramps in the abdominal muscles and joint pain that many endometriosis patients endure. All patients with endometriosis, examined for a heart defect called mitral valve prolapse, at the Omega Fertility Institute in New Orleans, led by Dr. J. Voros, were found to have prolapse (4). Low levels of magnesium in the cells of the arteries and the heart make it easier for calcium to contract, with nothing to oppose it (41).
ZINC
The drop in zinc levels damages the thymus gland and can lead to a decrease in the production of T cells, which would cause infection or excess production, in which case the T cells could actually attack the body, causing allergies and autoimmune diseases (48). Endometriosis may well be an autoimmune disease not unlike systemic lupus erythematosus, with which it appears to be frequently associated (47). Zinc deficiency affects immunity to the disease. Dr. R. Pekarek, of the Human Nutrition Laboratory, United States Department of Agriculture, in Grand Forks, North Dakota, has found that zinc deficiency affects one of the lines of the immune system,
A theory proposed by Dmowski in 1981 predicted that ectopic endometrial implantation "should occur in women with a specific type of cell-mediated immunodeficiency" and that "women with this disease may have an incidence or natural process of allergic diseases, autoimmune or neoplastic other than those of the general population »(49).
If endometriosis is finally found to be a true autoimmune disease state, infertility problems could be explained. Autoimmune disorders weaken the hypothalamic-gonadal axis and this alone would suffice to affect meiosis and give rise to a whole range of chromosomal abnormalities. Many studies discuss the origins of autoimmune diseases and it can be concluded that the portion of the genome that is involved with the immune system is particularly susceptible to damage caused by mutagenic influences (50). Subclinical zinc and magnesium deficiencies are considered by researchers to be the cause of this effect. An increasing body of research is supporting the thesis of a general immune system deficiency or suppression in women with endometriosis (43). Zinc deficiency has been shown in animal studies to be associated with reduced fertility, increased rates of miscarriage and birth defects. Los Angeles City University fed mice a zinc-deficient diet. In the offspring, a decrease in immune function was observed until 6 months of age. The second and third generations were fed with normally controlled diets, but they continued to show a reduction in their immune competence (40). Zinc deficiency has been shown in animal studies to be associated with reduced fertility, increased rates of miscarriage and birth defects. Los Angeles City University fed mice a zinc-deficient diet. In the offspring, a decrease in immune function was observed until 6 months of age. The second and third generations were fed with normally controlled diets, but they continued to show a reduction in their immune competence (40). Zinc deficiency has been shown in animal studies to be associated with reduced fertility, increased rates of miscarriage and birth defects. Los Angeles City University fed mice a zinc-deficient diet. In the offspring, a decrease in immune function was observed until 6 months of age. The second and third generations were fed with normally controlled diets, but they continued to show a reduction in their immune competence (40). In the offspring, a decrease in immune function was observed until 6 months of age. The second and third generations were fed with normally controlled diets, but they continued to show a reduction in their immune competence (40). In the offspring, a decrease in immune function was observed until 6 months of age. The second and third generations were fed with normally controlled diets, but they continued to show a reduction in their immune competence (40).
The sex hormone gonadotropin needs zinc and Vitamin B6 for its production at adequate levels. The beneficial effects of Vitamin B6 bound to zinc are reflected at all levels of the female's sexual cycle. One hormone, the inducer of luteinizing hormone (LHRH), causes the pituitary gland, located in the center of the head, to stimulate the development of the ovule and, consequently, ovulation (30). Estrogen also affects zinc levels. High levels of natural estrogen in the body before the period lead to a decrease in zinc (45).
Zinc is also essential for the correct metabolism of fatty acids and their conversion into prostaglandins (40). A team of researchers in Kentucky has discovered that endometriosis petechiae implants produce and synthesize a double amount of prostaglandin F, compared to that produced by intermediate-phase implants. These researchers postulate that this imbalance could be partially responsible for infertility and spontaneous abortions, since they cause uterine and tubal cramps, thus hindering conception and term pregnancy. Zinc deficiency could affect the production of prostaglandins in women with endometriosis and cause an imbalance between the first and third series (anti-inflammatory prostaglandins) and the second series (pro-inflammatory prostaglandins). Prostaglandin series 2 is linked to uterine contractions, giving rise to menstrual cramps (23). This may be related to the dietary intake of excess animal products and low intakes of fish and vegetables.
Certain food products interfere with the absorption of zinc, such as dietary fiber, phytic acid, calcium, and phosphorous. In animal studies, a high calcium intake in the presence of a high intake of phytic acid (bread, cereals, soybeans), appears to have a synergistic effect with the loss of zinc absorption. Sucrose (sugar) increases the excretion of zinc, because the hormone insulin, with zinc content, is required to maintain the result of blood sugar (glucose) (41). This action monopolizes all the available existence of zinc, exhausting its availability in other ways. Women who take iron tablets also have reduced absorption of zinc, as well as with the use of diuretics, alcohol and a diet high in calcium. A diet high in whole wheat flour products and dairy foods will therefore exert its effect on the absorption of available zinc. Zinc deficiencies can be seen in irregular menstruation processes, in dilated veins, irritability, weight gain, and depression.
Primrose oil
It has become clear that Primrose Oil can produce certain anti-inflammatory effects in general, probably thanks to its ability to increase the synthesis of PGE1 and, therefore, tends to correct the relationship between series 1 and series 2 of prostaglandins. This is beneficial, in view of the well-known role of series 2 prostaglandins in certain inflammatory processes. It has been widely used by endometriosis patients in the Endometriosis Society and significant relief effects have been reported. The usual dose is three 500 mg capsules twice a day, after meals (52). There is supporting evidence that endometriosis can cause both pain and infertility, through the production of inflammatory prostaglandins or leukotrins, and by activation of macrophages in the peritoneum, which can destroy sperm. We have recently shown that dietary supplementation with fish oil reduces the dimensions of endometriotic implants in an animal model of endometriosis and that it reduces the concentration of prostaglandins in the peritoneal fluid. These findings suggest that the polyunsaturated fatty acids contained in fish oil may inhibit the growth of ectopic endometrial implants, by inhibiting the metabolism of arachidonic acid in inflammatory eicosanoids, as well as possibly interfering with the action of estrogen (53 ). We have recently shown that dietary supplementation with fish oil reduces the dimensions of endometriotic implants in an animal model of endometriosis and that it reduces the concentration of prostaglandins in the peritoneal fluid. These findings suggest that the polyunsaturated fatty acids contained in fish oil may inhibit the growth of ectopic endometrial implants, by inhibiting the metabolism of arachidonic acid in inflammatory eicosanoids, as well as possibly interfering with the action of estrogen (53 ). We have recently shown that dietary supplementation with fish oil reduces the dimensions of endometriotic implants in an animal model of endometriosis and that it reduces the concentration of prostaglandins in the peritoneal fluid. These findings suggest that the polyunsaturated fatty acids contained in fish oil may inhibit the growth of ectopic endometrial implants, by inhibiting the metabolism of arachidonic acid in inflammatory eicosanoids, as well as possibly interfering with the action of estrogen (53 ).
SELENIUM
It is known from animal studies that selenium can exert useful anti-inflammatory effects (54) and that it can improve the immune response (55,56,57,58). To date, little research has been conducted on the use of selenium in the treatment of inflammatory conditions and in situations in which the status of the immune level is low. Selenium and vitamins A, C, and E have been used empirically as a supportive treatment in rheumatic disease and endometriosis, and useful results have been observed on a broad basis. Patients with known sensitivity to yeast should take an inorganic form of selenium (52).
DL-PHENYLALANINE (DLPA)
The mechanisms of action of Phenylalanines D and DL are considered in principle to be involved in the inhibition of enzymes that normally rapidly deactivate endorphins, the body's natural analgesic mechanism. These enzymes include carboxypeptidase A and enkephalinase. When the inhibition of these degrading enzymes has been reached, endorphins can provide much longer analgesic action. It is interesting to note that one of the published works shows that enkephalins can block the inflammatory effects of prostaglandins, thus providing an extra mechanism of action in relieving pain caused by endorphin-like substances (52).
The original dosing recommendations, based on work done in the United States, were two 375 mg DLPA tablets, three times a day, before meals but, in our experience, some women have to start one tablet twice a day. day, and gradually increase to the highest doses. Once the correct dose is reached, relief should be experienced within a few days. The action of DLPA can be prolonged and, in some cases, its effects may persist for two to three weeks after stopping treatment (52).