For more than two decades, Roxeanne suffered extreme pain, scarring, and inflammation from severe endometriosis.
The treatments for the reproductive condition put her into artificial menopause, accompanied by the associated hormonal weight gain. She was hospitalized multiple times and endured three surgeries to stop uncontrolled bleeding and remove damaged tissue.
In July 2020, she was rushed to the hospital with another severe flare-up and more tests and MRI scans. But that was not her only health problem.
“I felt very inflamed and very sick. I also had severe IBS and non-alcoholic fatty liver disease. I had anxiety, depression, and panic attacks. I had migraines and headaches. I had psoriasis. I had polycystic ovary syndrome. Basically, I was a mess,” she says.
A friend, also with endometriosis, had been telling her for more than three years about the wonders of the keto diet. Still, Roxeanne didn’t think keto was for her. After all, she didn’t have a sweet tooth or eat any sugar. She didn’t realize that other high carb foods were digesting into sugar in her body.
But with her health crisis in the summer of 2020, she finally said, “I’m ready to try keto.” Within six months, she felt she was turning a corner. After a year on keto, she felt fantastic and had resolved all her health problems. Plus, she had lost almost 30 pounds (14 kilos) and was at a healthy, stable weight of 117 pounds (53 kilos) with no difficulty maintaining it.
Now, 18 months into her keto journey, she can’t believe how much the keto diet has helped.
“For me, it has been amazing. I feel younger than I did in my 20s. I have not felt so good in years.”
Roxeanne’s story has been condensed and edited.
What’s your name, age, and where do you live?
I’m Roxeanne, I’m 41, and I live in northern Scotland. My husband and I immigrated here from South Africa in December 2019.
How and when did you decide to do low carb or keto?
It was pure desperation. One of my best friends, Robynn, had been doing keto. She found it about three years earlier than I did. And she kept saying that I should do it, too.
We had the same health problems – especially endometriosis – and she kept telling me I should avoid sugar. But I don’t have a sweet tooth. I never ate sugar. Red wine was my dessert. I told her, “Robynn, you are talking to the wrong person. I don’t use sugar!” I didn’t realize that other foods — starchy carbs — were turning into sugar in my body.
But then, in the spring and early summer of 2020, I had a huge flare-up of my endometriosis. The stress of COVID and of having things in the UK shut down, the stress of immigration, and of being in limbo, all of those things, and more, contributed to the worst flare-up that I’d had in years.
I ended up in hospital in July of 2020 because of issues with my endometriosis. And that is when I said: “Robynn, I am ready to do it.” She told me how to get started.
I am a researcher by nature, so I also started googling as much as I could. I found Diet Doctor in the summer of 2020. It is the best resource out there.
I just began to go deeper and deeper. I took the Diet Doctor CME course. And I studied other sites and other information. But I just kept coming back to Diet Doctor because it has all these fantastic doctors who speak my language.
And for me, it has been amazing. I feel younger than I did in my 20s. I have not felt so good in years.
Tell us more about your health struggles before keto?
I come from a long line of women with endometriosis. My mom, aunt, and grandmother all had it as well.
For those who may not know, endometriosis is a condition where the lining of the uterus migrates to other sites outside of the womb. It affects about 5% to 10% of women of reproductive age, but they don’t know why it happens. The tissue, or plaques, attach to other organs and sites in the body – such as the ovaries, bowel, and abdominal cavity.
This misplaced tissue cycles and bleeds just like it would if inside the uterine cavity, but the blood has no place to go. It ends up causing scarring and inflammation and a lot of pain and damage.
At 23, I was diagnosed with Stage IV endometriosis — meaning the most severe type with the most widespread and deepest plaques. I had my first laparoscopic surgery then, and they had to remove almost all of one ovary. In total, I have now had three surgeries, each time because of the need to stop the bleeding and to remove some part of an ovary or fallopian tube.
At 27, it was even worse. The doctors couldn’t stop the bleeding, so I was in and out of hospital nine times in six weeks. All the medication just seemed to make me worse. I also had a severe case of IBS and felt like I was just getting worse and worse.
So at age 27, they put me into artificial menopause. I stopped having the symptoms of endometriosis but then had all the symptoms of menopause — hot flashes, weight gain, insomnia, brain fog.
I then had injections every two to three months for years to keep the endometriosis at bay. But I stopped them in December 2017 because I noticed a significant drop in my memory and increased anxiety levels.
What was your weight like during this time?
Honestly, I didn’t care that much about my weight. My heaviest weight was 185 pounds (84 kilograms) in 2017, but I would go up and down.
In July 2020, when I was rushed to the hospital, I weighed 147 pounds (67 kilograms), so I was at a lower weight, but I felt very inflamed and very sick. And I also had non-alcoholic fatty liver disease. I had anxiety, depression, and panic attacks. I had migraines and headaches. I had psoriasis. I had polycystic ovary syndrome. Basically, I was a mess. I was at my sickest, but not at my heaviest.
I should also mention that in 1999, I was involved in a serious accident when a speeding motorcyclist knocked me over. By 2011, the disc that was damaged in that accident gave way, resulting in emergency spinal surgery. After that, I had constant back pain.
After starting keto eating, did you feel good right away?
No, it took some time. I was basically bed-ridden from July 2020 to November 2020.
I was eating keto and, for a while, it seemed like it was not working because I still had pain and was still not feeling great. But I kept tweaking things. I decided to remove all the foods with lectins (a class of protein found in plants), and then one morning, the pain was gone. I thought: “Roxeanne, you have done it.”
That was November 2020, and I will never forget it. It was the first time I felt great in 20 years. All the inflammation, all the nerve pain, was gone. I was healing, and it felt miraculous. Since that time, I have just been getting better and better and feeling stronger and stronger.
My weight gradually went down to 117 pounds (53 kilos) by February 2021, and my weight has settled there, which I think is just right for me.
What were you eating before making this lifestyle change?
Basically a lot of rubbish. As I mentioned, I didn’t have a sweet tooth, but I did eat a lot of savory dishes, in particular gluten-free and lactose-free foods, which are abundantly available in the UK, unlike back home in South Africa.
I’d fallen into the gluten-free & lactose-free trap, which, in the end, is what made me very sick. I was consuming all the gluten-free foods, not realizing how many other carb and processed ingredients were included. It was only once I removed these did I learn what my triggers truly were.
I have always been a wine lover, from my days working in hospitality and fine dining. I enjoyed red wine mostly, but also beer. When I also cut these out from July 2020 till November 2020, I learned how big a trigger for feeling poorly that they both were for me.
What does a typical day of eating and/or fasting look like for you now?
Now I work my diet around my cycle. Three weeks of the month, I do keto and intermittent fasting. But I vary the intermittent fasting times, so I am not doing exactly the same thing day after day. I think it is better to keep mixing things up because otherwise, the body gets used to it.
So one day, I might do a 16-hour fast, and then the next day, an 18-hour one. Then on the weekend, I might have one feast day and then one OMAD (one meal a day).
In the week leading up to my period, I add back in some complex carbs like sweet potato, butternut squash, various nuts and berries, or other fruit and vegetable carbs. But I have to be careful because a lot are high in lectins, and I still seem sensitive. But I use that week before my period to really enjoy things like nuts and berries.
Over the last six months, I have realized that I cannot drink wine. Unfortunately, it is a massive trigger for flare-ups for me. Interestingly, after cutting it out the way I did, it helped me see that I was drinking too much alcohol anyway. Now I can have an occasional whiskey — that doesn’t bother me. So it is a good thing I’m in Scotland.
In what ways has your health improved?
In so many ways. On my one-year anniversary in July 2021, I did a list. Not only am I at a healthy weight, and I am building muscle and feeling younger than ever, here are all the things I have improved or eliminated:
- chronic endometriosis
- fatty liver
- chronic IBS
- chronic anxiety and panic attacks
- insulin resistance (and acanthosis nigricans)
- muscle atrophy and nerve damage
- migraines and headaches
- memory loss and brain fog
- poor, dull skin
- hair loss
I now have glowing skin and thick hair, pain-free periods, increased energy, and a clear mind with a great memory. I am building my lean muscle mass, and I’m feeling strong. I am off all my medications, and I feel like I am aging in reverse.
What Diet Doctor resources have you found helpful?
Oh gosh, it has been so helpful on so many levels. Apart from my transformation, it has given me concrete evidence to help other people.
I took the Diet Doctor continuing medical education course, Therapeutic Carbohydrate Restriction, and that was so helpful.
I love how Diet Doctor makes it so simple. I am now coaching other women to help them get the most out of a keto diet as well. We are all slightly different, so while our bodies mechanically might function in the same way, we need to find the combinations of things that work for us. I do this through a signature system I designed which helps detect and point out each person’s unique triggers in foods and drinks. Then I help them learn how to remove these triggers while teaching them how to find suitable alternative foods and recipes through the use of the Diet Doctor meal planner app.
I help coach these women through the maze of learning what their triggers are, how to remove them, and how to adapt to the keto lifestyle gracefully. But I teach how to do this sustainably, as this is not a diet; it’s a lifestyle.
I love the recipes, especially the salmon bakes and the various steak recipes. (Being from South Africa, I love my meat.) And I love all the low-carb sauces, too.
My husband loves sweets, and I have found since coming off the hormonal injections, I am getting monthly cravings for sweets. So I do try to make some of the low-carb desserts as a treat for us both.
What are your top three tips for people starting low carb?
- Listen to your body: It is your best doctor. You may not understand at first what it is telling you, but at least start listening. Your body will tell you if something is working for you and if something is not. Listen to it and trust it. It is not normal to feel and be sick all the time. When you start feeling good, you know you are on the right track.
- Pay for quality ingredients: If you are going to eat meat and fish, pay for good quality items, like grass-fed beef and wild-caught fish. I think it is worth it. You do not want to be putting more crap in your body, especially while doing the elimination phase of your diet changes.
- Identify your personal triggers: Some of us are sensitive to different foods. I always thought I was lactose intolerant, but it turns out I am not. I always loved cauliflower — I could eat it every day. But now I find I am intolerant to it. So you may be doing keto, but if you still have symptoms of inflammation or IBS, you might have to experiment with getting some keto foods out of your diet to find what works best for you to have no symptoms and feel great.
What else are you doing for your health?
I feel that movement is very important. I was always athletic; in my teens, I was a competitive swimmer, and I did ballet. But then, by my 30s, I was sick, and when I did too much movement, I’d flare up. So for years, I was doing almost zero exercise.
But I have always done Pilates — it was a form of rehabilitation and exercise after my spinal surgery. And recently, I have started back into that again, as it helps strengthen the pelvic area, which is what gets most affected through multiple laparoscopic surgeries.
Final thoughts or takeaway?
My health has been transformed so much that I want to help other women do the same. So I have started a keto coaching business with a special focus on helping women who have endometriosis. You can reach me at firstname.lastname@example.org.
I want to spread the word that you can actually heal your body. You don’t need a doctor for that. Especially if you have endometriosis, you don’t have to feel hopeless, helpless, and in pain.
Thanks so much, Roxeanne, for sharing how a low carb diet helped you do more than just lose weight. You will inspire a lot of women who have endometriosis, teaching them that perhaps their condition can be improved by paying attention to how they are nourishing their bodies.
Interestingly, in December 2021, researchers from Japan published in the journal Reproductive Fertility the article Nonhormonal therapy for endometriosis based on energy metabolism regulation. While the article does not name the ketogenic diet, it describes how endometrial cells appear to favor glucose metabolism and suggests a potential biological mechanism for why a ketogenic diet may help.
~ Anne Mullens