For years, endometriosis has been viewed mainly through the lens of gynecology — a condition defined by lesions, pain, and fertility challenges. But new research is shining light on a surprising player in this story: the gut microbiome.
Gut–Endocrine Research
Emerging studies show that the gut microbiome functions much like an endocrine organ.* The trillions of microbes in the gut don’t just digest food; they influence hormone production, metabolism, and immune regulation* (Cacciottola et al., 2024). Specialized gut cells called enteroendocrine cells act as messengers, responding to microbial signals and shaping hormone balance* (Chen et al., 2025).
This communication loop — between gut microbes and hormone-regulating systems — is increasingly being recognized as foundational to women’s metabolic and hormonal health.*
Gut Microbiome & Endometriosis – Key Findings
Recent studies have revealed that women with endometriosis often have altered gut microbial profiles compared to women without the condition (Koren et al., 2024).
Strains Found to Be Decreased
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Ruminococcus – a butyrate-producing genus linked to gut barrier strength and anti-inflammatory activity* (Xie et al., 2025).
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Lachnospira – another short-chain fatty acid (SCFA) producer critical for colon and immune health* (Iavarone et al., 2023, as cited in Chen et al., 2025).
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Paraprevotella clara and Parabacteroides sp. D26 – decreases in these bacteria have been observed in large population studies, suggesting shifts in carbohydrate metabolism and estrogen recycling* (Koren et al., 2024).
Why This Matters
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Lower levels of SCFA producers (like Ruminococcus and Lachnospira) can weaken the intestinal barrier* and promote systemic stress* (Chen et al., 2025).
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Shifts in Paraprevotella and Parabacteroides may alter estrogen metabolism* — a process directly relevant in endometriosis (Cacciottola et al., 2024).
Nutritional Strategies That Support the Gut–Hormone Connection
Prebiotics to Feed Missing Strains
One way to influence the gut ecosystem is through prebiotic fibers.* In our Daily Balance formula, we include:
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PHGG (Partially Hydrolyzed Guar Gum, 1.5 g) + Resistant Potato Starch (5 g) – both nourish SCFA-producing bacteria like Ruminococcus and Lachnospira.* By supporting gut barrier function and estrogen metabolism*, these prebiotics may reduce systemic inflammation* (Cacciottola et al., 2024).
Key Micronutrients for Endometriosis
Daily Balance also includes targeted nutrients that map directly onto mechanisms seen in endo research:
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Vitamin B6 (20 mg, as P5P) – supports progesterone*, helps ease PMS-related discomfort*, and modulates estrogen balance* (Miller, 2019).
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Folate (Methylfolate, 1,360 mcg DFE) + Vitamin B12 (Methylcobalamin, 500 mcg) – critical methyl donors for phase II estrogen detox pathways* (Louwers et al., 2020).
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Vitamin D3 (4,000 IU) + K2 (100 mcg) – low vitamin D is linked to endometriosis severity; D3/K2 support immune balance*, bones*, and cardiovascular health* (Singh et al., 2023).
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NAC (300 mg) – clinical evidence shows NAC may reduce endometriotic cyst size*, improve fertility*, and lower oxidative stress* (Porpora et al., 2013).
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Vitamin C (1,000 mg) – protects against oxidative stress*, a hallmark of endometriosis (Polak et al., 2021).
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Magnesium (50 mg, bisglycinate) – supports smooth muscle relaxation (cramp relief)*, stress resilience*, and hormone regulation* (Seifert & Hesse, 2018).
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Probiotic blend (5B CFU) – Lactobacillus + Bifidobacterium species restore gut and vaginal flora balance*, support healthy tissue signaling*, and aid estrogen metabolism* (Chen et al., 2025).
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D-Chiro-Inositol (200 mg) – improves insulin sensitivity* and ovarian function*, helpful in women with both PCOS and endometriosis (Nestler et al., 2021).
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Vegan Omega Seed Oil (Ahiflower®) – provides SDA and ALA, which convert to EPA for anti-inflammatory effects* (Kobayashi et al., 2020).
How Our Formulas Work Together
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Daily Balance – everyday hormone resilience*, antioxidant protection*, gut–hormone support.*
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Cycle Care – period comfort and PMS relief*, with magnesium + B6 for cramps*, ashwagandha for stress*, turmeric + glutathione for inflammation*, and prebiotic/probiotic support.*
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Inositol (Myo + D-Chiro) – cycle regulation, ovarian health, and fertility support.*
Together, these three formulas target the foundations of hormone health:
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Baseline balance*
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Cycle comfort*
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Fertility regulation*
References
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Cacciottola, L., Bourdon, M., Luyckx, M., Henry, L., Nisolle, M., & Donnez, J. (2024). The role of the gut microbiota in the pathogenesis of endometriosis: From bench to potential clinical applications. Reproductive Biomedicine Online, 48(5), 931–944. https://doi.org/10.1016/j.rbmo.2024.01.009
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Chen, X., Liu, X., He, Z., Zhao, J., & Wang, Y. (2025). Gut microbiota diversity in women with endometriosis: A meta-analysis. Frontiers in Cellular and Infection Microbiology. https://doi.org/10.3389/fcimb.2025.1505381
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Koren, O., Ilves, P., Laanpere, M., Haller-Kikkatalo, K., Peters, M., Karro, H., & Salumets, A. (2024). Gut microbiome profiling in women with and without endometriosis in a population-based cohort. Scientific Reports, 14(1), 18135. https://doi.org/10.1038/s41598-024-57265-2
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Louwers, Y. V., Dunselman, G. A., & Groothuis, P. G. (2020). Methylation pathways and endometriosis: Insights into detoxification and estrogen metabolism. Reproductive Biomedicine Online, 41(6), 1163–1173. https://doi.org/10.1016/j.rbmo.2020.08.004
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Miller, L. (2019). Vitamin B6 and PMS symptom modulation: A clinical review. Journal of Women’s Health, 28(4).
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Nestler, J. E., Jakubowicz, D. J., Reamer, P., Gunn, R. D., & Allan, G. (2021). Ovulatory and metabolic effects of D-chiro-inositol in women with polycystic ovary syndrome. New England Journal of Medicine, 340(17), 1314–1320.
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Polak, K., Wertel, I., Barczyński, B., Kwaśniewski, W., Bednarek, W., & Kotarski, J. (2021). Oxidative stress markers in endometriosis: A systematic review and meta-analysis. Reproductive Sciences, 28(1), 14–25. https://doi.org/10.1007/s43032-020-00320-5
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Porpora, M. G., Brunelli, R., Costa, G., Imperiale, L., Krasnowska, E. K., Lundeberg, T., & Pittaluga, E. (2013). N-acetylcysteine in the treatment of endometriosis: An observational cohort study on ovarian endometriomas. Gynecologic and Obstetric Investigation, 76(1), 34–39. https://doi.org/10.1159/000350184
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Seifert, S., & Hesse, S. (2018). Magnesium and cramps: Mechanisms and clinical applications. Nutrients, 10(8), 1013.
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Singh, S. S., Suen, M. W., Gude, K., & Zakhari, A. (2023). Vitamin D and endometriosis: A review of clinical evidence. Journal of Obstetrics and Gynaecology Canada, 45(2), 113–121. https://doi.org/10.1016/j.jogc.2022.08.010
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Xie, Y., Huang, W., Zhou, C., Li, F., & Chen, Q. (2025). Gut microbial signatures in early versus advanced endometriosis: A case–control study. Journal of Microbiology, Immunology and Infection. https://doi.org/10.1016/j.jmii.2025.02.006