This is just my opinion, not tested science, but here goes:

Keys: Eliminate grains (except rice) and legumes, but especially soy which is rich in phytoestrogens. Soy is probably the single leading cause of endometriosis. Minimize omega-6 (prefer red meats and seafood to pork or chicken; butter and coconut milk/oil and palm oil to olive oil; do not use canola oil or other vegetable oils) and get moderate but not large amounts of omega-3 from 1 lb/week salmon or sardines or other oily marine fish. Minimal fructose; use glucose sweeteners like rice syrup instead. Optimize vitamin D, probably 35-40 ng/dl 25OHD, preferably from sunshine. Supplement vitamin K2 (important, although her fermented dairy has some). Supplement antioxidant minerals (selenium, copper if she doesn't eat beef liver, zinc if she doesn't take a multivitamin) and vitamin C. Supplement magnesium. Supplement N-acetylcysteine. Tend to the thyroid: supplement iodine at a low level, say 500 mcg/day, and try to achieve a TSH around 1.0 or less. Monitor this regularly.

1. No, ketosis is not necessary. There's considerable leeway in carb consumption to fit her personal taste, but if she wants a number I would recommend around 400 calories per day from starches (rice, potatoes, sweet potatoes, taro, plantains, etc) plus as many vegetables as she cares to eat, and a bit of fruit or berries.

2. No. Goat milk is excellent. Cream she may wish to avoid carrageenan-containing brands.

3. See above.

4. I assume you mean herbal medicines rather than true homeopathic medicines. Personally I would avoid herbals, they can easily cause trouble.

5. No. Way too much vitamin A and omega-3 fats in cod liver oil. Excess vitamin A promotes endometriosis and so do oxidized omega-3s. Instead, eat egg yolks, liver, and colorful vegetables (plus perhaps a multi or cod liver oil if you choose up to 5,000 IU/day at most) for A, and salmon or sardines for omega-3s. Way too much omega-6 in primrose oil. Stop both of those.

Another step that may be helpful is circadian rhythm therapy: intermittent fasting, sleep in total darkness, physical activity during the day, sun exposure during the day.

Finally, unless she is in great pain I would avoid the surgery. It is much better to clear it naturally.

Hi! A year ago I began eating low carb, high fat, ketogenic. My first period after I began had the normal endometriosis pains. However, the 2nd-6th month were amazing! I made the big mistake of eating standard American food over Christmas and my birthday in January. I started up the diet in February. My cramps have been really bad since January again. :(

I read an article yesterday on pubmed that said that inflammation decreased with calorie restriction. There were also 2 articles about increasing fish consumption and reducing drastically my Omega 6s. So I have started fasting every other day and drastically decreasing my seeds/nuts. :0( Fingers crossed

Good luck to your friend! Please let us know if anything works well!! I find that this is a topic my doctor just doesn't have any advice on. :0(

Oh, one side note: has anyone tried the progesterone creams? I have read that while going very low carb (reducing insulin drastically), progesterone can bind antagonistically to estrogen receptors and thus reduce the estrogen load seen in endo. Any luck with that?

Also, one small correction about the fish oils. Someone said to avoid them because of oxidation. That is not entirely true. I live in the land that is probably best known for cod liver oil, Norway. There is a brand available here that does NOT have oxidized Omega 3. It is a very expensive product that has no flavor (pure fish oil should NOT taste like fish. it is oxidized if it has any fishy flavor.) A Norwegian doctor who has a child with autism needed a fish oil that her son could handle. She went around to all the cod liver companies in Norway and challenged them to make a non-oxidized oil that wouldnt need unnatural Vitamin As/Ds added to it. This is the result. It has to be refrigerated, They wont even mail it if it takes more than a week to arrive. It only lasts about 4 weeks in the fridge. When something will go bad this easily, you know it is pure. So, yeah, excellent source of Omega 3. Much more readily available for your body than the oxidized kinds... I have a subscription on it to make it cheaper.

https://omega-cure.com/

can one with endomethroisis use palm oil.

Endometriosis is a challenging disease to manage. I follow paleo principles, consult with a holistic MD who prescribes bio-compatible progesterone, support my fatigued adrenals with DHEA and Pregnenolone, Licorice and Liver Support. Supplement with magnesium, Vit D, Chaste Tree. The key is to support your entire endocrine system.

However, having said that, it is definitely a balancing act that seems to sway on a dime. I have accepted that nothing short of major medical intervention is going to eradicate the pain and even then, there are no guarantees. Inflammation is such a big problem to me that exascerbates and exhausts all other systems. I'm looking at getting a laproscopy soon to clear away adhesions. Pain killers and NSAIDs are a necessity on some days in order to function and be cheerful for the family.

Consider medical marijuana if it is legal in your state. Unfortunatley where I live it is not an option, but one that I would definitely explore if I relocate to a state that legalizes it. After having this for 20 years and gone through many emotional cycles and ups and downs. My main focus apart from supporting my body as holistically as possible, is to manage the pain. For that I have to say, it has required that I have to give up some of my notions and be open minded about allopathic methods. I'd rather have a life that I have energy to particapte rather than a debilitated one with no energy.

Good luck to all.