Endometriosis Diet That Stopped 20 Years of Pain | Khush Sra

Khush Sra: [00:00:00] Endometriosis is a whole body condition. It's not a bad period. It's not even just an estrogen problem. It is a whole body condition with immune dysregulation, really at the core of it. The endo was so bad for me. I had five surgeries. The doctor gave me anxiety pills. It really hurts thinking that I was just never gonna get better at one point.

Then I told my husband, like, I never wanna say the word endometriosis again. 

Dr. Brighten: You went from stage four endo to 20 years of pain-free. What are some of the tools that you found to be most helpful on your journey? 

Narrator: A guiding light in women's health. Kush Straw 

Narrator 2: is a former engineer turned a functional nutritionist who's walked the exhausting road of endometriosis herself 

Narrator: through pain surgeries, fertility struggles, and now perimenopause.

Narrator 2: Today she leads a 75,000 strong community of women reclaiming their energy, confidence, and freedom from Endo 

Narrator: with the whole body compassionate support she once needed herself. 

Khush Sra: 80% of women with endometriosis are shown to have like dysbiosis or like a gut disruption, but we also see a lot of [00:01:00] distended bellies and I think Endo Belly is probably one of the most complex, but if you get down to the simple way to approach it, here's what I would do.

Dr. Brighten: What is your approach to anti-inflammatory eating for Endo? My 

Khush Sra: approach to 

Dr. Brighten: anti-inflammatory 

Khush Sra: and eating actually doesn't start with food. 

Dr. Brighten: We actually start with. Welcome to the Dr. Brighton Show, where we burn the BS in women's health to the ground. I'm your host, Dr. Jolene Brighton, and if you've ever been dismissed, told your symptoms are normal or just in your head or been told just to deal with it, this show is for you.

And if while listening to this, you decide you like this kind of content, I invite you to head over to dr brighton.com, where you'll find free guides, twice weekly podcast releases, and a ton of resources to support you on your journey. Let's dive in. You went from stage four endo to 20 years of pain free.

What are some of the tools that you found to be most helpful on your journey? Nutrition, 

Khush Sra: obviously as like number one, [00:02:00] I was a very picky eater and I knew at some point it hit me that perhaps I should shame my food. And it took me a lot of trial and error, a lot of fad diets, you know, even the Special K diet, that's how old, you know, this goes back.

But I would say the food piece was definitely at the core of my healing journey. Mm-hmm. And then. The other part, probably if I had to just label two, would be like, stress and lifestyle. Like literally slowing myself down. 

Dr. Brighten: So we're gonna talk about food today. We're gonna talk about Endo Belly, we're gonna talk about, you know, gut infections and we're gonna really cover the gamut of endometriosis and nutrition and gut health and what women should know.

But before we get into food, you said something really interesting about stress. What do you think it is that women are not recognizing about their stress that's having such a major impact on their endometriosis and their period pain? 

Khush Sra: Yeah, I, I think it was similar to what I didn't recognize. I was like, I can handle stress.

I'm a, you know, a go-getter. [00:03:00] Um, you know, I can handle a lot, you know, I'm very productive person. I had a lot on my plate all the times, and I felt very chill. I didn't feel like I was stressed out. Someone asked me if I was stressed out, I wasn't stressed out. But if I listened to my body, I. I'd be like, oh, what is that?

And I, the connecting to my body actually, like doing like some kinda like mind body connection activity. It almost felt uncomfortable. Mm. And then there was like this time where I started this meditation practice, it was like in a closet next to a pile of laundry. I was like, okay, they're saying meditation work, something that's gonna sit here and just try to meditate.

And I never knew what was actually happening for, as we were working until a couple weeks in, I was like, gosh, like. I'm slower, but I can still do everything. Mm-hmm. And I realized that there was this pace that my nervous system or my nerves were just kind of hypervigilant. And if I trace it back, it was probably since I was a kid 

Dr. Brighten: mm-hmm.

Khush Sra: That I had this hypervigilance. My parents would always call me as a someone who's [00:04:00] strong, you know, she's our strong one. She's like, you know, like I'm always able to do things. A very responsible individual, but I could tell that that took a weight, like my body carried. Mm-hmm. And that, that stress that, I mean, we know with science too, the up upregulation of the HPA access is correlated with endometriosis too.

So definitely it was for me, just like an internal, um, signal that was just on always. 

Dr. Brighten: Mm-hmm. You know, it's interesting, I, so my pelvic floor physical therapist, which I did an episode with, uh, Deanna Mendez, I will go ahead and link to that. She has me doing body scan, um, exercises. So that's a lot of what you're talking about, checking with your body.

And something she brought up. She also has endometriosis. She treats a lot of endometriosis, is that women with endometriosis are usually so disconnected from their pain that they're actually in tremendous pain all the time, not just in their pelvis, because we know endo can live anywhere, but also it's inflammatory, so it can be affecting our body [00:05:00] in many ways.

And yet so many of us, you know, we get told things from doctors like, you need to meditate, you need to check in with your body. But I think a big reason why we don't is because we wouldn't be able to get through our days if we actually recognized how much of a struggle it was to live in our body. 

Khush Sra: Yeah, absolutely.

It, it is a, if we actually tuned in, it's, it's a discomfort mm-hmm. To tune in and we're already feeling like we're in discomfort. We're already in a, a cycle of pain. And then to tune in and feel more discomfort. It, it's our natural response to be like, nah. You know, let me just go work out instead. Mm-hmm.

Like how many we have that work with us too. It's like they're, they wanna run, they're like, one I wanna exercise and it feels so good for the mental health. And, and that's what I did. I started winning my health journey for my stress or for my lifestyle pieces. I started going to the gym. I signed up for the gym.

My only one membership I ever got, and I started running on this treadmill. And lo and behold, I was gaining weight. I was in pain. I already had a [00:06:00] accessibility parking pass, and my legs were even, you know, more tired and flare up. And I'd come home, I'd be like, I feel like crap, but I guess I should keep going.

'cause everybody tells me you should exercise to get healthy. Yeah. And so, yeah, like there, the disconnection, um, we, we draw away from that and we wanted to do more physical exertion. 

Dr. Brighten: Mm-hmm. 

Khush Sra: Right. Um, I, I mean, I still see it in myself today. It's like my counters are messy and I'm like, oh, I gotta go, I gotta clean all my counters.

Like I just need to do something where it feels like there's a distraction. Available. 

Dr. Brighten: Well, I wanna talk about food now because I think this is something that has tremendous power for women, and yet doctors don't usually talk to 'em about it, or they'll dismiss them. And especially when women say like, you know, I changed my diet.

These things help me. And the doctors are like, Hmm, it's probably placebo, which is so dismissive, especially considering there is so much research out there about nutrition and the impact on our body. We need a lot more in [00:07:00] endometriosis as we know, but I wanna talk about what foods help reduce endometriosis, pain, and inflammation.

The things you work with with your clients. 

Khush Sra: Yeah, there's, you know. There's a, a perspective that I have on nutrition, and I do believe there's lots of foods that are anti-inflammatory. And I also believe that anti-inflammatory is almost a state of our bodies as well. Mm-hmm. And that way, certain individuals, I might give them like the list of foods that I'll, I'll share, but then others listening to this may say, you know what?

I've tried those foods and they weren't good for me. And that is absolutely true, and I don't wanna dismiss that either. Just because some foods that are anti-inflammatory didn't sit well with you. Doesn't mean that they don't necessarily work, it's just that your body, your gut, your state needed some other foods to start.

Dr. Brighten: Mm-hmm. 

Khush Sra: Um, but yeah, absolutely. We love to ensure that women are getting the right level of like, you know, polyphenols and fibers like bro, broccoli, cauliflower, or cruciferous vegetables. We love beets, you know, for [00:08:00] methylation support. Broccoli sprouts as well. We love, uh, you know, a cup of ginger and tumor tea for the anti-inflammatory, um, aspects of it.

I also like, um, sea vegetables, you know, for, for minerals, especially for those, you know, where there has been mineral depletion, you know, over the years, whether it's inside use or the pill or stuff like that. And, you know, those are some of like the top foods that we would say like a lot of our clients are, you know, just in learning to add in.

And we start there, start small in something that is doable and, and start to see how your body responds with these things. 

Dr. Brighten: You said sea vegetables, people are gonna immediately Yeah. Wanna know what that is? Yeah, yeah, 

Khush Sra: yeah. So things like, um. Nori kelp, kobu. And what we do is like, you can go to the A store and or even on Amazon now, and get dried flakes and sprinkle them on your food.

So it's not like the full, like, you know, like if you look at a miso soup and there's like these sea vegetables and the texture doesn't sit well, but you can get like, uh, dulce flakes and so they're just rich, rich in, uh, different minerals that sometimes now our soil is [00:09:00] depleted of. 

Dr. Brighten: Mm-hmm. Can you walk us through an anti-inflammatory style of eating, just generally, you know, we're, we're thinking about in endometriosis and with the caveat that not everything's gonna be true for you.

Yeah. And you have to really fit through the lens of like, where's my body at and what works for me? But I would love if you could just take our listeners through what is your approach to anti-inflammatory eating for endo? 

Khush Sra: My approach to anti in eating actually doesn't start with food. We actually start with what, I mean we, what we call, uh, enabling healing.

Mm-hmm. Enabling healing is just making sure that our body gets into that parasympathetic state as much as possible, and especially before we eat. So being able to switch off the, the stress signals, um, and be with your food, smell your food, you know, slow it down for a minute and chew, chew the food.

Mm-hmm. You know, get thoses enzymes going, get that gastric juices flowing like. DI nutrition requires our [00:10:00] digestive system to be online and often in this busy, like life and stress and all the, you know, even just the medical, uh, trauma. We've been through those things kind of, you know, go, uh, down regulate a bit.

So I would say first and foremost is supporting your digestive state by being with your food, getting mindful, chewing, and really getting, um, to a place where, you know what, you look at your food and be like, okay, I, I may not have to do a 360 here and take the stress away. 

Dr. Brighten: Mm-hmm. 

Khush Sra: Because it's a lot of stress when you're like, trying all these diets.

You're, you're getting restrictive, you have cravings and you're like, you feel like you're not good enough at changing your diet or, you know, 'cause I feel like everybody knows that they could potentially eat better, but there's a lot of weight of how do you actually do it? Where do you actually start? So I would say first and foremost, take the stress out.

You know, slow things down, get mindful, chew your food better. Um, you know, sit down while you're eating. Don't eat on the go, and stuff like that. And then in terms of like actual foods, we start with, um, you know, let's say a [00:11:00] nourishing breakfast. I'm, I'm not a fan of skipping breakfast, and that's another thing, like, I don't like skipping meals.

I don't like undereating. Um, start with simple breakfasts. Uh, you know, we like chia puddings with coconut milks. We love eggs, we love sauerkraut. Um, we also love leftovers. For breakfast as well. So anything you've cooked, um, overnight, you know, let's say it's chicken or sweet potatoes. Um, and, and having that for, for breakfast, having something really nourishing, making sure there's some good protein and fat in there as well to start your day.

Because if you start your day with that rich, you know, um, nutrition and the rich macronutrients, you're less likely to have cravings and, and energy drops during the day and then having, you know, a solid lunch with, you know, some colorful veggies and additional protein and fat. Like, I really want all macronutrients at all meals.

Dr. Brighten: Mm-hmm. 

Khush Sra: Um, and pick your favorite vegetables and stick with them. Like, there's this whole thing of like, you know, eat 30 different vegetables, 30 different colors throughout the week. I am a big person of like, take the pressure off again. You know? Mm-hmm. Like, get your favorite vegetables, [00:12:00] uh, you know, whether it's broccoli, whether it's asparagus, whether it's, you know, uh, arugula.

You know, take your, uh, favorite protein and fat and throw it on some arugula. Um, have some berries. Uh, if you want some more color and more variety, uh, I love raw carrots. I like them unpeeled, you know, just for that prebiotic fiber in there. Uh, as a snack as well. You could just take raw carrots and, uh, chew on them.

They were one of my favorite snacks. I'm like, celery, carrots, blueberries, like no thinking snacks. Just, you know, chew on them. And, you know, again, for dinner, I, I usually avoid, um, grains at dinner, if any, like, it's a lot of carbohydrates and you have to each process to know their carb tolerance. So some individuals can do with some grains and other individuals, their carb tolerance is just not there yet where they don't do well with grains.

And that's something for you to explore individually as well. And, uh, at, but at dinner time, we often don't do grains and have some solid protein, uh, get some non-starchy vegetables in. And [00:13:00] again, I, I'm not gonna, uh, like more healthy flat fats in. Mm-hmm. 

Dr. Brighten: I think it's so important that you started with the aspect of actually getting into a digestive state.

So you said parasympathetic activity, that's your digestive state of being, of your nervous system. It's something, you know, before we started recording, we were talking about my book Beyond the Pill. Yeah. And I wrote in there, you are not what you eat, you are what you absorb. And the reality is, is that if you're not chewing well, if you don't take the time to smell your food to be present with your food, then your digestive system is not set up to actually absorb that food.

Then we've got other issues like gut infections can be going on. You know, there's a. Significant crossover we see with endometriosis, autoimmune disease, neurodivergent conditions, and we know that all of those, any, any single one of them can have gut inflammation taking place. So I wanna talk to you about the link between endometriosis and [00:14:00] gut issues like SIBO or IBS.

Khush Sra: Yeah, there's a huge connection. How could there not be, like, we are literally like just living microbes and bacteria, right? Mm-hmm. I mean, I always tell my, uh, you know, our communities that 38 trillion or something like, like, that's the number of like microbes in our gut. And if you think about stars in like the galaxy, it's like maybe like, I dunno, like 10 billion or so, you know, something like that.

It's like it's not even close. Mm-hmm. And just think about all of those. Um, they're, they're the copilots in our health. Yeah. And you know, that that immune system lies in our gut. Our nervous system is entangled in our gut and they're, they're in charge. I'm like, we, we have, we have to feed them 'cause they're in charge.

They're the copilots. And, oh, if I look at this, I look at, I'm a, I'm a, I'm an engineer, right? Originally in training. So I, I'm an engineer turned nutritionist because of just my experience, um, with endometriosis. But I look at, um, like the router of a. And then I look at the wifi signal. So I look at the router as like all of our [00:15:00] bacteria in our gut.

And those signals are like the communicators are her hormones. Mm-hmm. And so yes, the immune system is that router. It is in charge. And there's definitely dysfunction. You know, we know that from studies there are imbalances of natural killer cells, uh, interleukin six and other like immune modulators within our gut.

And so by supporting the gut and it's lining and its ability to digest, you know, produce bacteria, ferment, you know, and just even digest and eliminate hormones, right? It has a key role in estrogen metabolism and estrogen balancing as well. So yes, the gut is related so closely to that immune system, sorry to the end endocrine system as well.

And we look at food as just one of the tools. One of the tools to support that immune system because, uh, the, the system that we teach a lot of our clients is that psycho neuro immune endocrine pathway. Mm-hmm. Um, and I'm not gonna get into the science, but it's just saying that our body is a whole [00:16:00] body and endometriosis is a whole body condition.

Mm-hmm. And now the science is, even earlier this year, there was a, uh, a study that came out about the connection of autoimmune and how women with endometriosis are twice as likely to get a diagnosis with an autoimmune condition. And so it, the science is coming. It's, I mean, it's already been there, but I feel like more and more ties are coming than saying endometriosis is not a pa a pure bad period.

It's not even just an estrogen problem. It is a whole body condition with immune dysregulation really at the core of it. 

Dr. Brighten: Mm-hmm. I feel like this is something that, uh, us in the endo community, so, so I got diagnosed with endometriosis just a few years ago in my forties. And, um, I feel like I was. Yelling about this stuff and now I'm in the, in the community and I'm like yelling about it even harder.

There are these connections that if you just listen to women, if you just listen to women, you have all the evidence you really need. And yet we're waiting on these studies to validate it. Now we need the studies. Yes, I want the studies. I love the studies. Yeah. When that study came out and it was like, [00:17:00] oh, lo and behold, like there, there's a connection and women have, uh, you know, with endometriosis, they're more likely to have autoimmune disease and doctors are like, oh my God, who would've thunk it?

And I'm like, me, Ishi Botto and psoriasis and endometriosis. Also, I have yet to see an endometriosis patient, so I will run things called, uh, a test called a Cyrex Array five, which is an early autoimmune detection panel. And I've yet to see an endometriosis patient that didn't have the beginning auto antibodies or Frank Autoimmune disease.

And I think that. You know, I want women to understand why this is important is, I have said this for years, medicine needs to stop waiting for a study to believe the patient that's in front of them, but that's the reality. What women with endometriosis are up against is that doctors will not believe us until a study was done 17 years prior and someone finally presents it at a conference to them.

And I find that absolutely ridiculous. 

Khush Sra: It is absolutely [00:18:00] ridiculous. I mean, I see it every day in our practice as well, is women who have lost their voice. They've lost agency. Mm-hmm. You know, and, and who's to blame them? Like, I, I, that was me, you know, 20 years ago, 25 years ago, where I was like, you know, obviously my body's not working some thing's off.

I don't know what to do about it. I'm here, please help me. Right. And I went through colonoscopies, you know, stress tests and, you know, infectious diseases, like the things that I wa. Tested for was just insane because they were like, there's something else up here. And I was like, okay. And I felt like I really needed someone else externally to validate Yeah.

What was going on. Label me, me, even give me 10 labels because this doesn't make sense to me. And nowadays women are feeling the same way. It's like, I don't know what to do. I feel broken, and if you're telling me I need this, okay. But we'll have, uh, patients who say, yeah, I went in and I, I wanted, said I didn't want the pill, but the doctor said they won't operate on me if I don't take the pill.

Mm-hmm. After. And I was like, like, this is where we're at. We're we're, our bodies are not working with us. So we are looking externally for support, rightfully so. And [00:19:00] then out outwardly, we're not getting, you know, any validation. We're getting even more dismissal. Yeah. How are we going to progress if we don't listen to women and we don't listen to their lived experience of it?

Mm-hmm. 

Dr. Brighten: I feel like I need to get a red flag for the Dr. Brighton show that I could just like throw at the camera. So if a doctor tells you I will not operate on you, I will not do an endometriosis excision surgery unless you take the pill afterwards. Red flag, probably not an endo expert and most definitely not someone I would let in my pelvis because, um, you know, we had another podcast guest on who is an endometriosis surgeon, Melissa McHale.

And she said, no surgery is better than a bad surgery when it comes to endometriosis. And the reality is, is a lot of women with endo are facing bad surgeries or they're not getting holistic care around their surgeries. And that's something that is why picked my surgical team Yeah. Is that they even worked with the hospital on the nutrition [00:20:00] of what you would eat when you came out of surgery.

Anti-inflammatory diet, rich with fibers, feed the pre prebiotics, uh, feed the fiber, you know, the fiber for, um, removing estrogen, like making sure we get motil going. Like they were already thinking about all of that. And when I see so often, and it's not, I just don't think endometrial surgery is as regulated as it should be.

I know some gynecologist gonna come for me, bring it. Because my end is gonna flare and get pissed. No, actually I've had excision surgery. I'm much better now. But, uh, so often I'll get, you know, gynecologists who are like, all of us can do this surgery. Well, you can, but should you? Yeah. Should you, like, there are things that I can do that are in my scope.

I can prescribe methadone, but should I Yeah, no, it's not my expertise. It's not where I hang out in medicine. 

Khush Sra: Absolutely. And I think that's, you know, it's a multifactorial disease. It, you need a team of practitioners. You know, you need to find the right surgeon that works for you, even amongst the experts who do see it integratively.

You may j with [00:21:00] one versus the other. You need to understand. Physically what kinda support you need from a phy, you know, PT or osteo osteopathy, uh, or chiropractic, you know, nutrition wise. And also just like, you know, mental, emotional. Mm-hmm. As well. I think that's a big piece of it too, going through this journey and not knowing what the other side holds.

Whether it's, you know, a pill you're trying, whether it's a diet you're trying, like these women aren't, start starting, you know, from ground zero. They've been in this journey usually pushing through, usually alone, isolated, um, pushing through symptoms, normalizing it. There's so much normalization that we learn to do ourselves because it's just a culture now.

Mm-hmm. 

Dr. Brighten: It's 

Khush Sra: like, yeah, well, yeah, my, I'm not in how many times say I'm not as bad as those that I've heard. Yeah. Or I'm so sorry. They'll even come to me and say, I'm so sorry you had it really bad. I don't have it that bad. And I was like, I'm, I'm, I'm good now. Like, do, I don't need, like, I'm, I'm, I'm really good.

But your pain and your experience. Is just as valid. Mm-hmm. Yet we're [00:22:00] still trying to like compromise our cell within our own selves because it's just the normal, the doctor's like, yeah, this is normal. You know, if you, the Tylenol doesn't work for you. Maybe there's naproxen. I mean, I damaged my gut taking Naproxen for years and then they just handed me narcotics and like, here you go.

You know, it's, it's a simple way, but those are all band-aids because like they, like you said this, the studies that are coming out now, maybe they'll be in practice in 20 years when my daughter, you know, is an adult practicing or something like that. Mm-hmm. 

Dr. Brighten: Yeah. I feel like, you know, for any practitioner listening right now, if you wanna learn about endometriosis, listen to endometriosis patients because they know so much about their condition and their body and it's, it's the same with like infertility in these conditions where women don't get a lot of support.

Yeah. Women. Become extreme experts about their body and about, um, their, their knowledge being is just astounding. And so it's something that, you know, I'd, I'd have colleagues being like, [00:23:00] oh, how do you, how did you learn so much about this topic? Or, I've never heard this before. And I'm like, I listen to patients.

If you listen to your patients, hear their stories, believe their stories, start documenting and putting the patterns together, you start to see that like, lo and behold, it's not that different. Uh, you know, the experience. So with small intestinal bacterial overgrowth, SIBO that we brought up before, and IBS, these are common conditions that ride along with endometriosis.

I know when you said broccoli earlier, if you've got SIBO or you've got IBS, you're just like, no, I can't eat broccoli. Yeah. So how do you modify things if somebody is dealing with gut dysfunction yet? We still need to move out estrogen. We still need to be getting our polyphenols, our antioxidants, our minerals.

Khush Sra: Yeah, absolutely. And I, this is where I say it's like anti-inflammatory can be a diet, but it's also a state of our body. And when there is sibo, when there is even high histamine issues, a lot of the, you know, nutrition plants out [00:24:00] there, they're like, um, I know that this is gonna bother me, and they just avoid it.

So definitely there are individual approaches to nutrition. I'm all about personalized support and making sure based on your gut, based on your, your conditions existing, but also on your lifestyle. 

Dr. Brighten: Mm-hmm. 

Khush Sra: You know, sometimes, you know, you have someone with sibo, but then you also have them, you know, she's a mom cooking for two with a, you know, and just can't.

Cook these many, you know, different meals. Yeah. And it's like, how do I make this work? And that's where really like, it's a meeting you where you're at, whether you have sibo, whether you have high histamine, whether you have like, you know, um, severe IBS or Crohn's, um, or, or Hashimoto's, you know, or lupus.

Making sure that we, we look at you and understand what are you tolerating today and what are some of the initial changes you can make. So, you know, you might start out with some, some flaxseed initially rather than that. You might start with sub supplements. You know, you might get in sulforaphane, you [00:25:00] might get in some calcium ate.

So there's other ways like resveratrol, you know, there's other supplements that you can start mm-hmm. Small with and shift the body, uh, into a better state of metabolizing estrogen and gut motility. I would say placebo. We really wanna get gut motility stabilized. 'cause otherwise sometimes we see it's either too loose or too slow.

Um, you know, we've gone as far as going into an elemental diet for individuals to reset it. You know, people have gone, you know, we've done the, gosh, the antibiotics over and over again and has it worked. So we can use botanicals, but we can also use an element of diet now. Um, so it really is individual on what are, what's available to you, where are you at with your lifestyle and, you know, how exhausted are you?

'cause sometimes it's like you're so exhausted. Like, I mean, I, I would say the SIBO individuals, I have them, like so much empathy for them. They've, they've just really exhausted so much trial and error with diet. Mm-hmm. Um, and, and what I would say is like, start small, [00:26:00] start with some supplements, you know, take the pressure off from a nervous system perspective.

Focus on hydration as well. And honestly, a lot of sleep. So I, I look at sleep and sometimes fasting tools. To help those individuals before I'd go to nutrition. Mm-hmm. 

Dr. Brighten: Yeah. And you know, for anyone listening, the other thing I would add to that is that if you have SIBO and you've taken Rifaximin round after round and you know of endometriosis, when I refer people to surgeons, I will say I have a high level of clinical suspicion that something is going on with the digestive tract as it relates to their endo.

So if you're going to, you know, if we're gonna go with imaging. Doing a gel. MRI, that's a great way, uh, to take a look. We can do a abdominal ultrasound. We can't always see everything, and it's not definitive, but I think it's a, it's better to have the imaging and to know what you're going in on than to go in blind.

Uh, but I let the, the surgeon know [00:27:00] this because often what I'll see with SIBO when it's like time and time again and it's not getting better, they find lesions on the intestines and they might not have looked there, had somebody not queued them in. So if you are someone who's experiencing that, that's worth letting your surgeon know that.

Like, I would like you to check and like, what is going on with my digestive track? Because sometimes, you know, we look at the motility. There's the migrating motor complex, which is, I like to call it the street sweeper of the, um, gut. And it's the nervous system. It's gonna move everything through. If you have endo, you have inflammation.

And that inflammation can be causing nervous system dysregulation. Right? I mean, that's why we see anxiety, that's why we see insomnia. But it's also why we can see motility issues. We can see nerve pain. It's like, why? Why do I have this nerve pain? This doesn't even make sense. Yes. And so I think that's a really important thing for women to cue into.

Well, you brought up histamine. Histamine is connected to endometriosis. [00:28:00] Can you tell us about that connection and what women should know about endometriosis and histamine and food? 

Khush Sra: Yeah. Um, there's, and we're seeing this more and more. I, I'm, you know, maybe it's awareness and education and women are like, yes.

Yes. Like you said, just listen to them. They know this, they just didn't know to connect the dot Yeah. Between histamine and or their allergies. And they're like, oh yeah, but I don't have painful periods, but I have painful ovulation. And we're, we see that a lot, we see histamine rise because we need it at ovulation.

So, you know, histamine's important for us and, you know, it, it rises and it, you know, it cycles with our, with our cycle as well. So we see individuals where there's a lot of pain at, uh, ovulation and histamine, we know rises with estrogen. So there is a connection with histamine and estrogen, and a lot of the individuals are like, yeah, I have to avoid all histamine food.

But that's not necessarily a long-term solution. Mm-hmm. It definitely can give you immediate relief avoiding some of those, uh, you know, like, uh, prebi, probiotic foods, you know, fermented [00:29:00] foods. They avoid, we avoid, um, any leftovers and. That gives 'em like, oh yeah, I do feel better. I do feel like I'm not reacting as much.

Great. But how are we able to then support clearance of estrogen mm-hmm. And clearance of histamine. So it's not necessarily an overload perspec, uh, that I take, but also a clearance perspective. And it goes back to the gut, is that that whole, you know, digestive detox clearance pathway mm-hmm. If our drainage pathways of our immune system, of our digestive and detox pathway, the liver, that gallbladder, we see a lot of liver and gallbladder supports coming in here.

And by doing that, whether it's uh, you know, things like milk thistle, NAC, respiratory, like helping that, that liver, uh, methylation tools, but also helping the bile and things like TKA or even bitters like arugula, dandelion, getting the bile flow. Those supports along with everything else we talked about.

But sweeping the full gut has definitely [00:30:00] seen. Over like two to three months, a lower reaction in, you know, the, the histamine response through ovulation and through the cycle. You know, we also see individuals who get like that flu right before their period. Mm-hmm. That flu, flu feeling. So this is all, you know, immune system, histamine, estrogen, balancing and talking to each other and, and clearing through those pathways.

Dr. Brighten: Mm-hmm. Yeah. And for people listening, so when histamine goes up, it can cause the mast cells to release, uh, excuse me, when estrogen goes up, it can cause the mast cells to release histamine and then the histamine can perpetuate the estrogen cycle. And so that's why you're talking specifically about how do we eliminate the estrogen?

And this is not. Women always, you know, I feel like if you're in your twenties, you're like, estrogen's the worst. And if you're only in your late forties, you're like, no, I don't wanna do anything to eliminate estrogen. And it's like, well, we're talking about the estrogen. You no longer need. Yes, this is the estrogen that your body's like, we did it.

We're done with it. Let's get it [00:31:00] moved out. So. You brought up some supplements. What are some of your favorite supplements to use in this situation to help with clearing out estrogen, especially when somebody can't tolerate cruciferous vegetables, which we know are like gold star winners of helping with estrogen.

Khush Sra: Yeah, I mean, and you're, you brought a key point there is like, it's important to know that, especially as you hit the forties and perimenopause, like, you know, I'm, I'm in that phase right now where you're like, you wanna keep all the estrogen you can, um, but it's the right estrogen that you want, right?

Mm-hmm. Like, and it's a good estrogen. And so it's, you know, clearing out, you know, uh, xenoestrogens and like endocrine disrupting type of estrogens is still, you know, very important. Um, and especially important, um, as we get hit, um, perimenopause. So I would say. Instead of like going to dim, like I know DIM is great, but I always say get your data, like get your data, um, before, and that's why nutrition, you can explore.

But once you're talk, getting into world of supplements, I love to get the data, [00:32:00] whether it's uh, serum, you know, day 21 or day three, like estrogen or you know, we use a lot of the Dutch test in our clinic as well. Get to know where you're at before you heavy supplement on bringing estrogen down. Mm-hmm. Um, but I do love, uh, ROL.

I do love, um, sulforaphane, and I know you have, you know, this hormone balance, um, supplement, I balance women's hormone 

Dr. Brighten: support. Yeah. Which only has 50 milligrams of dim. Yeah. And people are always like, this is too little dim because I heard you need a hundred or more. I'm like, do you wanna hate your life?

Because Yes, no matter what age you're at, if you start taking, like I have had people that are like, oh, DIM gives me massive migraines. I had hot flashes, I felt horrible. I've seen this at so many ages and. There are supplements on Amazon that are like 500 plus milligrams of dim, and I think you just tanked your estrogen.

Yeah, super, super hard. But yeah, it has dim, it has sulforaphane. Yes, it has resveratrol, well resveratrol, it has, um, mustard seed, which is actually how you [00:33:00] activate that sulforaphane. So yeah, we've put it together in a way where it is gentle, but I do not recommend it for. Late stage perimenopause when your estrogen is declining rapidly or just not there.

Or you are in menopause unless you're on HRT. And so I always try to caveat that because sometimes I get women that are like, I tried this, I didn't feel better. And, and then, you know, my customer service is like, how old are you? And they're like, 62. I'm like, it's, this is not for you. Like this is, yes.

Sorry, your ovaries, they're, they're not, they're not jump starting again. Yeah, 

Khush Sra: exactly. And I think you have to look at your, where you're at in your age. And I'm also like, what are your goals? Mm-hmm. Because I think if we try to track everything within endometriosis, it's hard. Like we take a very goal approach, you know, a goal focused approach.

Like what is your, you know, immediate two goals. Is it quality of life back? Is it fertility? Yeah. You know, is it the, this endo belly and maybe just the, this endo weight that you're carrying? You know, what are your goals? Because, you know, some people are like, I just want more energy. Like endo fatigue is [00:34:00] real.

Mm-hmm. And I'm like, it's not because you're lazy, it's not because you're just tired. Like it is like immune driven, this fatigue that you, that's coming up for you. So really get to know your goals and then get to know like, what are your boundaries? You know, is food easy for you or not like, or maybe we should go to supplements.

And that way get your data and build out a supplement plan that works for you. Mm-hmm. Because otherwise, I mean, do you know how many people, I mean, I've been there before too, Guinea pig too. Like where I have a cabinet of supplements, it's just expired because I'm like, I'm trying everything and anything that like, oh my, you know, my friend's neighbor, like, you know, suggested because everything got better for her after that one supplement or one that one food, 

Dr. Brighten: yeah.

Is called a supplement graveyard. And the reality is, is that a lot of times too, I think people aren't patient enough to recognize like they're like. I take ibuprofen, I have no pain. So I take turmeric and I have no pain. I take NAC, I have no pain. It doesn't work that way. Magnesium, I will say that one, like that one's a little more [00:35:00] instantaneous, but when it comes to supplements and natural therapies like changing your diet, that's gonna take two to three months before you're like, I'm noticing a significant difference.

Yes. And on that same note, if you're having the worst period of your life, it's not what you did two days ago. It's usually what you did two months ago. And we don't, we don't frame things in that way within our society to actually understand that the menstrual cycle, the impact on the menstrual cycle, it goes back months.

And so three months to change your menstrual cycle for the worst or for the better and you get to choose. 

Khush Sra: Yeah, absolutely. And we get this comment like, oh, like my, my hair. And I'm like, what happened three months ago? That's my first question. When I get a symptom of like, or someone's coming new to us and they're like, well, I have this going on.

I'm like, you know, and they might just been working like one week into supplements. I'm like, okay, but like, what happened three months ago? Tell me about it. Yeah, talk to me about it. And it's usually a life event. They've moved, they change jobs, you [00:36:00] know, or there was a stress, or maybe, you know, uh, they, they had another like pill that they had just stopped and you know, they don't notice the side effects of it until a few months after.

So you're absolutely right and you know, but a lot of women are educated in this too. I wanna just acknowledge that too. Is that, you know, you said you brought it before is like, women should be heard. How many times I got asked if I'm in the medical field when I was like an engineer. They're like, oh, are you in medicine?

I'm like, no. I just had to go to the library and ready, read everything and study everything because I felt like that five minutes, all they told me was the same thing they told me two months ago, my last appointment. 

Dr. Brighten: Mm-hmm. 

Khush Sra: And so many women feel like they have gotten a PhD in this. And it's just not fair.

Mm-hmm. Like we, we should not have to spend, you know, half our lives studying all of stuff just to go to an appointment and then be dismissed again. 

Dr. Brighten: Yeah. Well, that's the thing that I, I just wanna highlight what you said. Women [00:37:00] are, one, having time away from their life, stolen from them because they are in pain.

And even if it's not pain, you're gaining weight, you're fatigued, you have anxiety, you have insomnia, you have the myriad of symptoms that can come with endometriosis. Then you have to spend even more time researching everything about endometriosis. Yeah. Then you have to spend your resource of your time and your money to go to a doctor who then dismisses everything.

Even if you bring them studies sometimes, and you're right, it's absolutely not fair because you are losing such a significant portion of your life and it's an impact beyond just period pain. Going back to what you said earlier. You brought up Endo Bely. Let's talk about that. Yeah. So, you know, maybe not everybody listening knows what Endo Bely is, so let's start there.

Khush Sra: Yeah. I mean, 80% of women with endometriosis are shown to have like dysbiosis or like a gut disruption. Mm-hmm. And you know, it manifests in different ways for individuals. We see a lot of constipation. We also see a lot of, you know, loose bowels, but we also see a lot of distended [00:38:00] bellies. And so, you know, you're like, oh, I woke up and I was like, you know, pretty flat and I drank some water, or I just had one meal and then boom, I look five months pregnant.

Yeah. You know, and how, how many times, like when I was in my, you know, infertility years, I was like, people would say like, are you pregnant? Oh, like, you're pregnant? I'm like, no, no, it's just inflammation. And it's just this inability to like get down again, no matter how much I exercise, and no, no matter how much Pilates I do.

Mm-hmm. That did not. Change it. And so really it is about, you know, kind of like that that DYS bias is a dysregulation of your gut bacteria and its ability to just regulate, um, you know, the enzymes, you know, all of the digestive processes. And people are like, but I don't even eat pad. I've been eating clean.

Mm-hmm. And, and that's the tiring part of it is so many women, they've, you know, they've gotten gluten free, they've gotten dairy free, they've gotten sugar free. They've even gotten meat free, you know, and I did that too. I went vegan. 'cause I was like, okay, I got a little bit better. Yeah. I was [00:39:00] picky eater, right?

And then I add some vegetables in, like, this is great. And then I changed my food even more. I'm like, this is great. And then I went vegan. 'cause I was like, okay, veganism, this is, this is the way. And I did feel great and I thought that this is it. Like guys look, I feel great, but it, it still didn't knock out that endo belly and it didn't knock out like my infertility, it didn't knock out, you know, all of those underlying symptoms.

Even though generally I did feel better. And that's what I'm saying is like diets may change your inflammation and get you feeling. Then there's this underlying mechanism that might still be out of balance. And so for me, like, you know that, that diet trial and error, I've been there and done that, especially for Endo Belly because it just sticks out.

And at this point I'd lost some weight, but I didn't lose the endo belly. And so the endo belly is really about rebalancing that gut microbiome, getting to the right fibers for you mm-hmm. So that you can get things like short chain fatty acids and you know, other things to, to work within your gut lining and get the li gut lining soothed.

I always say that that's your terrain. It's not necessarily your [00:40:00] diet, but. Something in the terrain, like your digestive track is off. Yeah. It's gonna be different for you than it is gonna be for someone else. So as much as you hear. Um, and that's the challenge with Instagram these days. And like TikTok is like, there's almost like now too much information.

Dr. Brighten: Mm-hmm. 

Khush Sra: And you're like trying to say, okay, say like, like post-it notes and you just keep saving all these Post-it notes, post-it notes, and then you have like a thousand post-it notes of like, which one should I try? Because they're all saying I should do a IP for Endo Belly. They should, I should go vegan for Endo Belly, I should take probiotics for Endo Belly, but that flares up my endo belly.

Like, so I think Endo Belly is probably one of the most complex, but if you get down to the simple way to approach it, here's what I would do. How, at first, again, I'm gonna go back to sleep. Making sure you sleep and take an overnight fast of like 14 hours. Let your gut get a break and do its work. I feel like our bodies are so powerful if we just, you know, give some, sometimes give it a break.

And so for me, sleep was one of my biggest [00:41:00] things of waiting to, uh, regulate that nervous system because when I was awake, I was on. My brain was like an overthinker. I could like think, you know, a million, um, miles a minute. So being able to get to sleep, allowing my gut to clear, have bowel, bowel movements, adding in some of the right fiber, but also electrolytes, I was really depleted and dehydrated.

Yeah. And I, but I, I'm like, I'm drinking water and then I'm loading, so I don't need more water. Do I? Yes, I did. I just needed to be hydrated in the right way. So adding into electrolytes really helped me too. 

Dr. Brighten: Mm-hmm. Well, I wanna emphasize, you said that endo be you, you mentioned inflammation. So for people to understand, because whenever we're bloated, people think gas.

This is not gas. It is full, full-blown inflammation. Your intestines are actually inflamed. And it is, the endo bely isn't just uncomfortable, it's painful because nerves are getting stimulated as things get stretched. You're not meant to be distended. This is not a normal way to go about life. I, I dealt with, um, endo Bely [00:42:00] personally, actually posted pictures online.

Where I did look like four months pregnant and it was just unbelievable, like how bad the bloating was and like praise stretchy pants because yeah, if it wasn't for the elastic waistband, like I am, like, you know, the, I actually went and bought like, um, oo kind of dresses. 'cause I was like, if I have this kind of flare, like I just can't have anything on my abdomen and you brought up the, the right fibers for you.

Something that I incorporated is, uh, cold potatoes. So I cook the potatoes, pull them, and then eat those. And this is another thing that became like a full-time job of like making sure I got enough fiber diversity Yes. In, but the resistant starches, they really helped. It took several months for that to go away, but eventually it did.

The other thing is that I have a, a women's probiotic and it has a particular prebiotic that's compatible with sibo. And I've had a past history of sibo, so I was like. I know this will work and I can incorporate this as well. [00:43:00] And I think it's so important, like you said, to make sure that you're also looking at your fibers.

Because the first thing I think a lot of people think is fiber feeds bacteria. Bacteria produce gas. I've got gas. Like I don't need that. Yeah. And in reality, we need to increase diversity in the intestines, uh, because the gut bugs will work for you. Sometimes we do need antibiotics, we need antiparasitics, we need antifungals.

You know, we need something that's antiseptic, like rein. Sometimes we need those things. But your gut unlikely has a pathogenic organism. Like that's more rare to see. Yeah. Something that's like disease causing as much as it has commensal flora that are imbalanced and commensal flora. For any woman who's had a yeast infection, you're familiar with that you have yeast in your vagina, given the opportunity that commensal flora is gonna overgrow.

So how do we keep it in check? Well, lactobacillus acidophilus is like one of the primary species that helps keep it in check within your gut. If you eat [00:44:00] diversity of fiber, you have diversity of organisms. They can also help keep that in check. But it is really painful. And sometimes women, I mean I've seen women who are like, I only want to water fast.

Um, you know, when I have a flare like this. Like what do you recommend in terms of like soothing foods if you're in an endo belly kind of flare situation? 

Khush Sra: Yeah, it's a great question. I mean, it, there are some. Women who just like, they're like, yeah, they wanna avoid food. I somebody that just don't eat all day because it's gonna create a flare.

It's gonna create this, you know, distended belly. They don't wanna go to work with this distended belly, they'll drink some coffee, get through the day, and maybe eat a meal at night. And this, it's not, you know, the, the route to healing the gut. Uh, we love to, yeah, add in like things like aloe vera. 

Dr. Brighten: Mm-hmm.

Khush Sra: Right. Um, I like to add in l-glutamine, but we have to be careful if there is sibo, because that can, sometimes, you know, glutamine and magnesium are great, but with SIBO you have to, you know, dose that really, uh, correctly. But aloe [00:45:00] vera, the inner leaf of it is always super soothing. Um, bone broth, we love that.

And, you know, having those teas of, uh, turmeric and ginger with some black pepper in it, um, that, those are some of the three things that I would say, you know, over a month or two, you are going to see the soothing effects of it. But then you have to look at how do I not avoid. Giving meals like mm-hmm.

Because we like that that is not the solution. And that actually probably isn't the problem either. When you eat, it's not like you, it may feel like that is the problem, but that's not the problem. The problem really is, like you said, that inbounds of bacteria. And we know that there is, you know, this lots of studies that there's like, you know, a meta-analysis done on studies with the gut microbiome, with women with endometriosis.

It is imbalanced. So working slowly to rebalance that, because it doesn't happen overnight. You can't just take a probiotic and expect that in a couple of days everything's gonna be great. Mm-hmm. Um, absolutely. You can add in supplement, it would be so great. 

Dr. Brighten: Everyone, but it's not that way. 

Khush Sra: You know, like [00:46:00] probiotics, prebiotics, I love, you know, like you can supplement that.

You can add in resistant starches. Um, there are, you know, also resistant starches supplements if, you know, if you feel like the food is not there. There are resistant starches. You know, there's, um, I think RS fiber from Designs for Health makes one. I think there's sun fiber, you know, these things add in.

Um, you know, the support for short chain fatty acids that will help our gut over time. But again, patience. 

Dr. Brighten: Mm-hmm. 

Khush Sra: And this is the difficult part is. Finding a couple of these supplements, trying some of these foods that we've talked about through this, uh, you know, episode here and putting 'em in play with consistency and giving your body some patience.

Mm-hmm. And it's so hard, and I'm, and I feel almost like, um, you know, bad asking for women because they've had patience. They've, they've tried a lot, you know, and they've suffered a lot. And you know, like they're doing this on the side of their desk, on the side of their families. But if you can give yourself some consistent, you know, uh, support.

Through two to three months, you will see that your terrain does respond. 

Dr. Brighten: Mm-hmm. [00:47:00] Yeah. And just to underscore, giving yourself two to three months is so important because again, the, you know, endometriosis isn't something that developed overnight. You had stage four, I had stage four. It's kind of worthless to actually, um, to even use the stages anymore because the enion score is really such, is so much more telling about where it is in your body and what is going on.

But, you know, for people who don't know, stage four is like worst of the worst, like worst case scenario. Um, and that's not something that like, just because you got your period the first time and it's painful, like you automatically just had stage four. I mean, for most of us, this condition is developing over years and we're, most of us are also being neglected.

You know, as we were talking. Before we recorded, uh, I told you, you were like, oh, thank God you wrote Beyond the pill. And I was like, yeah. I wrote it and I was like, stop giving women the pill for peery pain because it turns out to be endo later and you need to work 'em up. And [00:48:00] then it's me 29 years later after 10 years on the pill and I'm like, damn it, I'm the person from beyond the pill who had endometriosis.

But I look back and I'm like, I'm so angry. And it's really funny 'cause I've worked with like. Therapists and, uh, intuitive viewers and stuff, and everyone's like, you need to let go of this anger. Like you need to let it go. And I'm like, no, it's mine. I won't let it go. And I'm not holding it in. I'm taking this anger and I'm putting out information where I'm like, no one else is who comes into my space is ever gonna have to deal with this again and have this level of medical neglect and have this much pain, and have this much heartache because I'm gonna take this anger and every time I feel mad about it, I'm gonna make content about it.

I'm gonna write about it, I'm gonna put information out to try to change the world. So I'm like, I'm not, I don't wanna work on like, just let it go. I'm not freaking Elsa, I'm not gonna let it go. I am very much gonna build a blizzard that is going to like, take down the medical empire that just [00:49:00] profits off of us.

Khush Sra: Yeah. Oh my gosh. I love all of that. I love all of it because, you know, it, it has a purpose. Like, and, and that pain, like that same thing with me. My, my pain turned into my purpose. Mm-hmm. You know, I was suffering when I was getting my engineering degree. Like, I could not walk, I had an accessibility parking bus.

I had to park at my university. Like so much shame and embarrassment in this 'cause I did not look sick. And then when I got into corporate, I was in technology and then slowly into management consulting and I had no business being where I am today. But the endo was so bad for me. My VP was once like, but you look fine.

He's like, but I don't get it. Like, you're shady. You don't attend work often. Um, but the business loves you and they rave about you. So I'm not sure what's happening. But, and then like literally he just walked out the room at that point. Yeah. I handed him my notice a month later. But the, you know. The moment that this came true for me was I, I had five surgeries.

I had had gone through like the Lupron, like I was in a room dark. I didn't want anyone to open that door. I would scream at you, you know, the doctor gave me [00:50:00] anxiety pills. He's like, okay, then you need this on top of it, and then maybe we'll do another surgery because now hopefully it's all like tamed down and like mm-hmm.

I don't want another thing of that, nor do I want another anxiety pill. I'm done. And I just was like, I don't know what the other way is, but I just know that that is not the way. 

Dr. Brighten: Yeah. 

Khush Sra: Like you can't keep telling me that I need to be cut open over and over and over again. Like five is enough. 

Dr. Brighten: Mm-hmm. 

Khush Sra: Um, and then when I went on this journey and made myself a Guinea pig and spent hours, like tens and hundreds of hours researching this and trialing error on myself, and I finally got to a place where I was bleeding.

I'm having my period. Mm-hmm. And I didn't feel it. I didn't have body, I didn't have a migraine, I didn't throw up, I didn't, I wasn't on the floor crying and sobbing like, and this is my body working. It was like, oh my God. And I did, I felt angry for everything that I put my body through. Mm-hmm. Thinking that it was so broken and thinking that I was just never gonna get better.

And I like, it really hurts if I think about it. At one point then I told my [00:51:00] husband, like, I never wanna say the word endometriosis again. I literally said that to him. Lo behold, I then went into the infertility journey. Now you're like, and I'm asist. Yes. You know, but then we went into you, but then what the doctor said of you may not have kids because it was that bad on the ovaries.

Um, and my FSH was like, in my twenties, in its twenties, I think that like, she's like, you're premenopausal from your, from your own reserve perspective, you know? Um, the clinic's like, we don't know what to do with you either. It's unexplained infertility, you know, we can do the, I, we did the I UIs, we did this and that, and like, we don't know.

And then lo behold, got pregnant on my own. We have three children, and it was my doctor who did the surgeries and had to help me deliver the kids who said more women should do this. Mm-hmm. Should we remember we were debating a hysterectomy for you. Yeah. And, and in that moment, I decided, because I, by then I was like, I talked health all day long in my family.

Like I like every woman. Mm-hmm. I got the PhD. Unofficial PhD. Um, but I was like, yes, more women need to follow this. [00:52:00] And I too, I took that in, in pain and made it into a purpose. And lo and behold, this is where I'm at. And I had no business turning it. My parents were like, what are you, you becoming a nutritionist?

Like, they were just confused. They're like, you're fine. Like you're living your life. Why are you gonna go do this? I'm like, because too many women are suffering. 

Dr. Brighten: I wanna talk about what you did with, uh, nutrition and fertility. 'cause I think that's really important in this conversation. But I, I wanna start going into the fertility piece with you.

Recently speaking out against ACOG's recent statement, and I'll say ACOG's recent statement basically said. There's no reason to investigate calling it un, you know, just, you know, unknown infertility. That's enough. Like we don't know the cause of it. Like, and we don't need to know the cause of it. We just need to get women into IVF and by them pursuing the cause of it, them pursuing endometriosis diagnosis.

Yeah. Acog, I'm coming for you. [00:53:00] Um, but them pursuing all that, they're wasting their time when they could just get to IVF. And the reality is, is that a lot of unexplained infertility does turn out to be endometriosis. That was my story. I was told I was old. I'm like, I had a baby at 40. They're like, well now a year later you're just old and your eggs don't work.

And so like the only thing we can do is IVF and I had so much blood work, so much testing done. And I go through IVF and here's the thing. I had horrible periods my entire, you know, jumpstart to my period journey. I get put on the pill for that. I then think I'm so clever of like, I just won't even have a period because even on the pill they still sucked.

They still hurt. It wasn't better. I had multiple ruptured ovarian cyst. At any point someone could have clocked this as endo. Yeah. And then I come off, I've already got a nutrition degree, um, my period goes missing. So I'm like, ah, I gotta get that back. And [00:54:00] then it comes back and it's hell all over again.

And I worked on that from nutrition and lifestyle. Got outta pain. Okay. So doctor set. This couldn't be endometriosis. You have no pain. Uhhuh. That's not what's going on. It was going through IVF that flared my endo so bad, so, so bad. And nobody talks about that. My third, a retrieval, I couldn't walk. And it was three weeks and they were like, take oral NSAIDs and take it under the tongue.

And how about some Tramadol? Yes. Which is an opioid, uh, as well. And I'm like, none of this touches the pain. None of it is touching the pain. And I found the endometriosis on. I just incidentally, p novo was like, Hey girl. You want a full body MRI if you post about it, we'll, we'll trade. I'm like, cool. You guys know I'm full transparency about stuff like this.

I got that done. And they were like, Hmm, this sure looks like endo. We can't diagnose that. You need to get this worked up further. And when I went to my fertility doctor, so I had one fertility doctor, [00:55:00] she left get put with this other guy who's the head of the clinic and I'm like, look, I got Endo and I have adenomyosis.

And he's like, adenomyosis is just new trendy diagnosis like a DHD. I'm like, well, I freaking have a DH ADHD too. And there's actually connection to all this, but he was like, your endometriosis doesn't matter. Just keep doing cycles. Just keep transferring. Oh my gosh. And that is exactly what ACOG is getting behind and their entire statement is based on profit and not the wellbeing of people.

IVF is so inefficient. I was looking at a recent study that was just like. Hundreds of millions of cycles and like, like, I think it was like 38 million success out of like, yeah. I, I'm, I'm probably skewing these numbers right now, but I just looked at the percent of success. It's less than 50%. In fact, 

Khush Sra: in a lot of, yeah, I hope about it somewhere.

It's not good. 

Dr. Brighten: And in a lot of cases it's less than 30%. Yeah. You're gonna go through IVF, you're gonna spend $30,000 per cycle. You're gonna have to do four or more [00:56:00] cycles. Like what are we looking at? Like hundreds of thousands of dollars with less than a 30% chance success rate. And ACOG is like, just get there.

Just do it. Just pay the bills. Yeah. And they're not even recognizing. That there are things that can be done not, I mean, why wouldn't we wanna do nutrition? If you're not fertile, something is going on with your body, we need to figure out why. 'cause that's not a natural state and whatever it is, is going to affect the outcome of a baby.

Like why wouldn't we wanna offer women that? Anyhow. Yeah, I could rant forever, but I want you to say your piece on it because I know you also spoke out and I felt like there was only a handful of us in those comments saying this like I was there was in terms of, um. Practitioners because it was all of these patients, especially when with endometriosis being like, we don't get diagnosed on average for seven to 10 years.

We live with horrible, horrible symptoms. You do nothing to actually train the detection of this. ACOG does not make sure that only the [00:57:00] right people are operating on this. Yeah. They offer no protections. And then they're out here just being these greedy little goblins being like, oh yeah, just get to IVF.

Let's take your money on this. And it was you and me, um, endos, sturgeon, Jeff, like a few practitioners in there, but so many patients in the comments being like, this is wrong. And that's why I, in my comment, I was like, you need to listen to women. Like why are you not look at all the, what these women are saying and you are just out here just being like.

Just pay us, keep going, 

Khush Sra: keep pushing through, you know? And, and keep hurting yourself. 'cause that's what it is. If you're in a flare up state, if your hormones are imbalanced, your immune system signaling, you know, fires everywhere, and you just throw it yourself into another retrieval cycle like it is, women are coming out feeling horrible.

Yeah. And then they're like, oh no, let's go into your transfer now. And they're like, they can't even imagine. 

Dr. Brighten: The transfer, let's flare you with inflammation. Knowing damn well at least you should know because you're a freaking [00:58:00] doctor, that you know this flare is gonna raise natural killer cells. Those are going to kill a fetus.

Like I say that as somebody who has lost multiple embryo transfers, and I look back at this and I'm like, God, if I had the knowledge that I had now, like things would've been so different. But the idea that like, we're gonna do a retrieval, we're gonna flare you, we're gonna make a hostile environment in your uterus, and then we're gonna just put an embryo in there.

Transfer. Yeah. And so much of this is also being driven by private equity groups. And I want people to understand that IVF and women's fertility and these predatory behaviors are because private equity groups are like, push women into as many cycles as possible. 

Khush Sra: Well, I mean, it is an opportunity financially, if you think about how much infertility is on the rise, our fertility rates are dropping.

Mm-hmm. Right. And we have to look at what's going on. What is going on? And, and, and there's many reasons when it's, it's, I mean it's unexplained or is it, we just didn't have the time to go through and explain [00:59:00] it. We have a label for you. It's unexplained, but really there might be lesions. Yeah. You know, there might be endometriomas, right.

There might be egg quality issues, there might be immune dysfunction. Right. Because that, that home, that uterus It is brilliant. I always tell our clients it is brilliant. It knows when it's safe enough to receive and it has the blueprint for human development. Mm-hmm. It's not gonna just listen because some signalings coming in and saying, grow a baby now.

Like it's gonna be like, no. Sorry, not working Right. And so we really have to, like you said, listen to women because I've had clients that come with 3, 4, 5 failed IVF cycles. Mm-hmm. And they're depleted and it takes us anywhere from four months minimum to one year to get them outta that flare. Mm-hmm.

Post all of these cycles that they've been through, getting their body just to really find safety again. And get their hormones, you know, to balance out, get that gut, you know, um, nourished again, get those [01:00:00] eggs nourished again. And then we are very supportive of saying, Hey, let's go into, let's support you into your IBF cycle now.

'cause now your body's feeling good. Mm-hmm. It feels right. You know, maybe it is, or maybe it's a retrieval. So we've had supports of women going into retrieval cycles. Have been very successful into IVF cyber recycle, but it requires a full integrative approach. And I know you had that episode, I think with, uh, when it, maybe it was your, your own surgeon where we talked about endo mapping.

Mm-hmm. And, and mapping that whole body out, understanding what's going on. Look at your nutrition, look at your terrain. 'cause anti-inflammatory isn't just a diet, it's a state of your body in the metabolic state of your body, the hormonal state of your body. All of these are so important. And if you're spending tens of thousand, you're throwing yourself like it's a baby.

A baby is a lifelong commitment. Mm-hmm. Give yourselves, you know, that voice to say, you know what, I wanna take three, six months and really do these foundational things. 'cause that's what they are, they're [01:01:00] foundational, um, to get back to a fertile state of the body. Mm-hmm. 

Dr. Brighten: Yeah. And I think that it's so important to recognize that you don't.

You don't have to forego IVF if that's what you think is your best uh, chance. But you have to recognize, so, you know, something that I found really helpful, I did a fourth retrieval, so my women's hormone support, I actually went on that. I was like, I need to clear estrogen and have the right estrogens. My doctor supported me on that.

Why did I, so this was like my fourth retrieval. I wanted a little bit of a flare too, 'cause I was gonna go into excision surgery. I'm like, I want you to find everything but. What happens in IVF is that when you're doing an egg reheal, you're injecting yourself with FSH, typically LH as well, and that is causing your estrogen levels to rise.

I mean, your estrogen levels, they can be in like the 300. Sometimes women are much higher than that. That is gonna stimulate that endometriosis tissue. So wherever it is in your body is [01:02:00] going to grow. So I don't want women. So like, I don't know, I feel like I just have to be clear on this. 'cause I think sometimes women are just like, oh, so you're anti IVF.

No. 'cause like, I clearly did IVF. It's always like when people are like, oh, you're antibi birth control because like, you're criticizing me, oh, you're anti, 

Khush Sra: are you antis surgery? I'm like, no, I'm not. I'm not anti anything. I'm, I'm like, whatever's right for you. Absolutely. And an integrative approach with a little bit of a pause before you go into anything.

Let's just pause. Mm-hmm. And like, look at everything because the whole rush and quick fix and like, you know, fast food approach to this Yeah. Is what I don't like. 

Dr. Brighten: Yeah. Well let's talk about nutrition specifically. Yeah. So let's talk about nutrition in general, so for supporting fertility, and then we can get more nuanced on like supporting someone through an IVF cycle.

Khush Sra: Yeah. So for fertility support, it is really important for us to get into kind of like reducing oxidative stress. You know, reducing inflammation. And so I love, you know, these fatty fish, you know, omega supports. I love flax. Again, I love all of those. Um, I love [01:03:00] arugula and, and a lot of bitters, like dandelion as well, whether it's milk, the salt, tea you like for your liver.

So really taking a diverse approach. I love my blueberries. I love my, you know, unpeeled, carrots, like I always say like easy snacks to have. Um, but. Eggs as well, like for the choline and just all of those, you know, those rich vitamins. So we like dense nutrient foods here for fertility, and I also love supplementation here.

Mm-hmm. So things like coq 10, you know, again, respiral will come back in here as well. I love magnesium. Uh, you know, and then instead of, uh, supplementing with melatonin, I always say sleep is huge for preg, uh, for fertility support. So optimizing that cortisol cycle with melatonin mm-hmm. Is probably where we start.

Where like your monthly cycle for fertility needs your daily cycle to be supported. Mm-hmm. So get out there in the morning, you know, get some sunshine, get that cortisol signaled from your body. Because it could be high, it could be low. We see both of them. Um, but get some [01:04:00] sunshine, get outside. Get that lymphatic system moving as well, because that lymphatic system is gonna help you clear out toxins, clear out inflammation.

So move your body, get outside in that morning sun for cortisol, and then at nighttime get your blue light blockers on so that melatonin can start to peak, you know, before midnight. I always say it's important for melatonin to start, you know, rising well before midnight. So this doom scrolling or you know, TV if you're, if it, you know, the blue lights or even the poll lights in our house, get your blue light blockers on and.

Get to sleep at a decent time. That's gonna be my number one place where I start with fertility is, is your 24 hour cycle. Um, I do appreciate fasting 'cause we've seen this is, it does help, um, you know, with, uh, fertility rates as well. Well, not just, it's not just fasting, I wanna say. 'cause I don't, I'm not a fan of intermittent fasting.

I'm not a fan of skipping meals, but what I am a fan of is at least 12 to 14 hours overnight to induce that autophagy. You know, we really have a cellular [01:05:00] cleanup. You know, we have a mess. Entertain ourselves when, when there's endometriosis. It's just, you know, something that we have to accept and love about ourselves, but how do we induce that cleaning mechanism is a lot of it is being able to give ourselves a digestive and, you know, sleep break at night and induce that autophagy process where I call it sick.

Our pacmen come out, our pacmen come out and clear out cellular debris and things that don't belong, you know, and really that is essential because it goes right into the ovaries too, you know, into that pelvic cavity and clearing out things and reregulating all of that signaling that's happening within our body.

Dr. Brighten: Mm-hmm. Yeah, and I love that you emphasize melatonin. Melatonin actually has been shown in the research to be helpful for endometriosis pain and it acts as an antioxidant in our ovaries. Yes. Also our brain as well. Huge. So we love that. Um, and so that's a really, I think, important one that we highlight there.

On top of, you know, the ways that we can be eating, um, to overall just be supporting the, you know, the detox capacity of our body. [01:06:00] Often people will say like, you don't need to detox 'cause your body does it for you. And I'm like, how? I always say, how are your kidneys working without water? How's that going?

There are inputs, you're like, you're an engineer. So I feel like this is your language. There are inputs if you want the machine to like have the output and the outcomes that you want, you have to put in the right inputs. So I wanna shift to around somebody going through an IVF cycle. They have endometriosis.

You were talking about prepping their body several months before. We know the a can take around 90 days to really need. Um, you know, it, it, well it's gonna take I 90 days at least for that, the final maturation process. So that's when we really wanna be emphasizing our nutrition a year in advance is even better.

Oh yes, I always say that. Oh yeah. Like whenever you wanna a baby, you wanna a baby yesterday, you wanna be in your arms. Now you don't wanna be like, oh, okay, I'm gonna give myself a year like. So like I just say that like a year is great if you have the time to think about it, but if you don't, what can they be doing right now?

Khush Sra: Yeah. Um, there's a [01:07:00] lot of things that you can be doing right now is making sure you get enough, you know, fat and, you know, making sure you get enough vitamin D as well. Alongside that is just making sure, you know, we all talk about the, the vitamin D cholesterol synthesis and the entire sex hormone pathway.

So really making sure you get fats but then you support yourself with good vitamin D sunshine exposure to and, uh, bile and gallbladder support to help. Move all of those fats through the system as well. That's gonna be one thing. So whether it's eggs, whether it's fatty fishes, you know, flax and chia seeds.

Uh, I love pumpkin seeds. They have a lot of good minerals and it some flower seeds. So I even do seed cycling with individuals. Mm-hmm. Um, just so that you're not feeling like you're eating all the seeds all the time. And, and some people can't do seeds and that's okay too. Like, you know, if your, your gut doesn't like seeds, you know, we see it a lot.

That's okay. There's another, there's a whole bunch of food. There's food for everybody. And also there's, there's gonna be a post or a study somewhere that will, uh, promote each food and there'll be one that probably says, this food is not good for you. And [01:08:00] that's a confusion out there. So I say, do what fits best with you.

But yeah, eggs, fatty fish, um, getting in some, you know, protein. I, I, for my, my own body, even though I went vegan and trial and narrow that I, I feel like animal protein does better for me. Mm-hmm. I digest it better. I. But initially I didn't believe that, and this is the challenge is 'cause we do need, uh, protein and fat with women.

Uh, if you feel like, oh, I don't do well with, you know, proteins especially, you know, meat proteins or I don't do well with fats, I would say, let's look at your digestive tract. Like, let's, how can we support your gut? Is it some enzymes? Is it something like as simple as lemon water, um, or apple cider vinegar to produce that acidity in the gut because we all need fat and we all need protein.

Dr. Brighten: Mm-hmm. 

Khush Sra: Um, so starting there and if you're already sharing, like legumes are great and I love Tempe as well. Uh, just make sure you soak your legumes, you know, properly over 24 hours so that it's easier to digest. Um, and then in terms of like, you know, we love like. All of the colors of, you know, fruit. So we like, you know, all [01:09:00] of our raspberries has good fiber in it.

Blueberries as well. Um, I love the vegetables, the cruciferous vegetables, but I love, like garlic here, onion here, Lees here, asparagus, um, artichoke. These are all great foods to have. And then, you know, for your carbohydrates, like you said, cooled potatoes, definitely probably, uh, you know, a great one. And then like sweet potatoes, um, carrots and beets as well.

Dr. Brighten: Mm-hmm. 

Khush Sra: I would minimize in, in the fertility journey, we do minimize grains. Uh, we find that with the insulin, um, balancing and carb tolerance, it is safer to go low grain or no grain. Mm-hmm. For the three. Before, 

Dr. Brighten: but that's not low carb. Can you explain 

Khush Sra: that to people? Yes. I always say low grain and ensuring it's your carb tolerance.

So everybody has a different carb tolerance based on your metabolic state. And so you might have numbers like your, um, insulin fasting insulin checked, or your h uh, b A1C or hemoglobin A1C, uh, checked, or you may have even leptin checked. So these are, you know, indicators of where's your [01:10:00] metabolic state right now?

But also you could tell yourself when you eat, uh, you know, different grains and different carbs, how do you do no carb versus low carb is completely two different things. Vegetables that are, you know, very starchy and grains that are very starchy will spike your blood sugar. And that can trigger inflammation in a lot of individuals.

So what we wanna do is be low grain and low starch carbs. And that means we have a lot of vegetables in us. And these are high in carbohydrates. There's all, they're all carbohydrates rich, but they are not gonna spike your blood sugar. And that is important. It is very important to not spike blood sugar ahead of a fertility journey.

Mm-hmm. Why? Because it ipro, it induces inflammation and that inflammation is gonna go to all of the, those neuro pathways. That anxiety, the gut, and then our ovaries. Mm-hmm. And our ovaries are highly sensitive to the cycles of blood sugar. And we want to make sure that as much stability we [01:11:00] can give to our, you know, from our cortisol perspective or our blood sugar perspective, those two being stabilized will then further stabilize our estrogen progesterone too.

Dr. Brighten: Mm-hmm. And for women with PCOS, this is especially important because while you make lots of follicles, that insulin going up, stimulates the ovaries to produce testosterone. And that can be detrimental to the quality of your eggs. And so whenever I see people in Lyme that are like women with endometriosis, we have, or excuse me, women with PCOS, we have so many eggs, um, so we're gonna be able to get pregnant.

And I'm like that they're not very good quality because of the inflammation, the insulin, and the testosterone. But we can change that, that can be changed. Um, I always feel like, um. You know, with men, they get a sperm analysis that's not so good. And they're like, well, like I feel bad about myself. And I think with women, and when we hear like our egg quality's not good, we also feel like something like, like, you know, a let down in ourselves.

Like something is wrong with us. But a lot of times, you know, there's certain situations we can't, but a lot of [01:12:00] times we can influence the egg quality. And I know that there's research studies saying like, no, that's not possible. I have seen it with patients. I've personally done it myself. You know, one of the things that, um, you haven't mentioned, which was a game changer for me was NAD.

Yeah. And bringing in NADI did IV and then I was doing sublingual, uh, you know, for a while I was doing, IM shots of it as well, or subcutaneous actually, there's seriously so many shots in IVF, which I was like, which one was that? Um, but that was the subcutaneous that I did for a while. These, um. NAD really, I, I mean, it, it was one of the many things that I did that took me from no euploid embryos, my first retrieval to three euploid embryos, my third retrieval.

So that was something that I can definitely attribute to having better results. Um. As part of the kitchen sink approach that most of us have to take, unfortunately, you to. Yep. It's not very easy to study, but, so let's say someone's going, [01:13:00] they're gonna be an IVF cycle. They have endometriosis, so, uh, that cycle's gonna be anywhere of 10, maybe 14 days.

What are they doing during that period of time? 

Khush Sra: Yeah. Um, and, and I do think that there is a, the right, not like the full kitchen sink, but the right kitchen sink. So yes, we do, you know, when you're at that point where you've tried it all and you've done this integrative lifecycle, you know, for three months, and then you're at that point where you're getting ready Yeah.

It is about the kitchen sink because you have a big goal. Mm-hmm. And we wanna support it. So we are gonna ramp up on antioxidants, so we ramp up on antioxidants nutrient wise. If we wanna do, you know, um, vitamin C-E-N-A-C resveratrol, you know, or a blend of those, those are gonna go up. You know, we, we love krill oil as our Omega-3 at this point because it's an antioxidant type of krell oil as well.

And you know. Hopefully leading up to it, you've done maybe some, some Vitex to support the progesterone. Um, we also see that, you know, things like calcium D is important ahead of this, but then [01:14:00] we stop it. Mm-hmm. So we do stop some of the estrogen and progesterone balancing hormones right before the, the, the cycle comes out.

And we really focus on getting good sleep in, you know, like you said, the melatonin comes in here. Uh, we've used different types of herbs as well for individuals, but those are really personalized. Um, and I would say making sure that you have a support system during the 14 days ahead. Mm-hmm. I can't emphasize how often it is, like, hey, if no one else come text us, chat with us in, in our, in our platform and say, Hey, this is how I'm feeling.

'cause, um. That's where that mind body connection can really take over. And even the simple things like you can't sleep anymore. You're not even even able to get for your daily walk. You're, you're overthinking your results. You're getting into that fear mindset and that mind body connection piece is really important.

Those two weeks ahead, even to stay consistent with your food and supplements, it's really grounding yourself every day. So literally getting into whatever grounding tools [01:15:00] are good for you, finding a support system and staying consistent with those few supplements and that few diet and allowing for all the tools and accepting, at this point, I'm like also accept everything that's being injected into you and seeing it as also the right fuel.

Dr. Brighten: Mm-hmm. 

Khush Sra: You know, because sometimes we have this trauma from IVF cycles, and then you're going back into that cycle and you're just like, oh my gosh. Like, you, your fear, you, you, you, you're afraid of what the shots, again, you're like, what are these shots gonna do to me? And it's about supporting yourself through that and accepting that.

Okay. This is now like the right way to do this for myself and finding safety as you progress through. 

Dr. Brighten: What would you say to a client whose doctor's telling them this is just unexplained infertility. Just do IVFI 

Khush Sra: would ask them to find another doctor first and, and really under, you know. Maybe get educated on saying like, what are possible explanations?

Mm-hmm. And say, okay, if, if you find this as [01:16:00] unexplainable, what are some potential explanations that there could be out there? You know? And when you look at it from an IVF perspective, what supports do you have that you believe will work for me? And if you ask 'em that and say, Hey, so why do you think that that will work for me?

Why do you think I need to be on antibiotics? Mm-hmm. Why do you think I need to be on, um, thinners? Why do I need to be on steroids? What are the, what are those addressing? Because are those potential insights into what might be off in my body? Like if I need to be on prednisone, if I need to be on Dexamethasone now.

Mm-hmm. Because, you know, the prednisone wasn't strong enough. Now they're saying, dexamethasone, why? What, what is what? What are you reading of my body? And getting to share that and having that back and forth conversation to understand if they're using something that's potentially addressing something that's not working inside of you.

Mm-hmm. And is there a way for you to support that as well? 

Dr. Brighten: I love that you've brought up that you know, there's information that you find online, Instagram, TikTok, YouTube, like all of the places there is so much conflicting [01:17:00] information around endometriosis. What advice would you give people to navigate in the online space?

Khush Sra: Yeah, this is a, I mean, a most difficult question because there is information overload and you already feel like loss of where to start. Mm-hmm. And now you see there's like, it's not a fork in the road of like two to three options. There's like a million paths you can go down and it's like, what's the path of least resistance for you?

Like, is there someone where you connect with, you know, and you want to like, give yourself some chances to make small changes? You know, I would say that's where you wanna start is pick one path, make some small changes. The path of least resistance is always the best. And listen to your body. You already have that intuition.

But too often in this journey of chronic illness, we keep giving our power away. Mm-hmm. We keep giving our power away, but I'm like, a lot of the answers are within you. I can't tell you how many times when we're working with clients, I'm like, if I, [01:18:00] if I sit down with you for five minutes, you've given me half the answers.

Yourself, you've, you, you have the clues, you have the knowledge and the wisdom, but we have to trust ourselves. Mm-hmm. And then yes, there's some science on nutrition and supplementation, you know, potentially surgery or other aspects that, you know, experts can guide you with. But also learn to trust yourself in this journey.

Mm-hmm. And so intuitively, if you connect with, Hey, I'm gonna try this path, this seems easy. Like it might be, Hey, I'm gonna go a IP for a while and I'm gonna try that out. If that suits you, try it out. You might feel like, Hey, I do feel better. And then you can go further and explore. But you can't try all of it at once.

That's what I say. There's no all at once approach, even with our clients or approach. First of all, you can't work with us less than four months because I just, I won't, we won't see the results and we know that. Mm-hmm. And the second thing is we don't make one change more than once. We actually don't even talk about nutrition until three weeks into nervous system stabilization.

Dr. Brighten: Mm-hmm. Well, thank you so much for this conversation. This has [01:19:00] been super helpful. I know for many women getting to navigate through all the online noise and just get into what is actually working for women with endometriosis. So I really appreciate your time. 

Khush Sra: Thank you so much for having me. I love what you're doing and you know, I, I know that millions of women are listening to your voice and now with that endometriosis journey, um, and that lived experience, it's, it's an even deeper connection that women make.

It is really woman to woman that we find trust and when we see ourselves in some other women that we feel inspired and feel even more motivated to go after our own health. 

Dr. Brighten: Mm-hmm. So well said. Thank you so much for joining the conversation. If you could like, subscribe or leave a review, it helps me so much in getting this information out to everyone who needs it.

 

If you enjoyed this conversation, then I definitely want you to check out [01:20:00] this.