Hi everyone. ⁓ my gosh. ⁓ It’s such ⁓ an incredible time, you know, and point in our podcast season, season four, all about Endo that we are making this shift to talk about, we’ve been talking about surgery for a long time, we’ve touched a little bit about physical therapy, et cetera. Let’s talk about nutrition. And so, yes, we have Alexis Brooks here and I’m so glad to snag her for this interview. She is a registered dietician, but first I just wanna say hello and welcome. Welcome, Alexis. Yeah, I’m glad you’re here. ⁓ All right, so I always do a little brag moment and this is that moment. So here it goes. Alexis Brooks is the founder of Alexis Brooks Nutrition. She is an integrative women’s health coach and a registered dietician with over a decade of experience.

Alexis Brooks, MS RD (00:36)

Thank you.

Dr. Ginger Garner PT, DPT (00:56)

She of course is focusing on empowering women through body literacy. I love that. Making hormone health accessible with a clear compassionate approach. She has a master’s degree in nutritional science and a personal journey with endo. Alexis brings expertise and empathy to her work. Her signature method, the hormone code, focuses on root cause healing through testing, gut health support, inflammation reduction, and personalized care.

And I love that you talk about core values, empathy, honesty, and vulnerability. That guides her work, helping women feel supported and confident in taking control of their hormone health. Welcome, Alexis.

Alexis Brooks, MS RD (01:39)

Thank you for having me, Dr. Ginger.

Dr. Ginger Garner PT, DPT (01:41)

Yeah, I’m so glad you’re here. ⁓ I just wanna kick it off by asking because you have such a unique viewpoint, perspective, your personal history, your professional background and education on the endometriosis journey. Like every practitioner has some kind of turning point, like the moment where something clicks and you know, this is what I’m supposed to be doing. Can you share what drew you to working with people with Endo and in a little bit of your own story or how did that come to be for you?

Alexis Brooks, MS RD (02:23)

Absolutely. Yeah. So it really came from my personal story prior to, okay. So I was diagnosed with endometriosis in 2021 and prior to that, I had a variety of symptoms. And of course, like the story that we hear really often is we’re told that it’s normal or it just brushed off. So that was kind of me for a really long time. And I will say that my, um, my endometriosis was pretty well managed. my symptoms were not debilitating until 2021.

until they weren’t, until actually 2020. And during that time, that’s when I started to research. I was like, well, maybe I do have this thing. And I just started diving deeper and deeper and then learning about other people’s stories, which was really helpful for me too to see like, ⁓ I see that this kind of parallels with what’s going on with this person or that person and going through the studies, going through the research and specifically looking at nutrition as it relates directly to endometriosis is what.

like drove me deeper and deeper, ended up getting the diagnosis and ⁓ had surgery. But what ⁓ I think the big turning point for me was recognizing that surgery is not the end all, recognizing that surgery is a helpful tool, but there’s so many other pieces to it. And ⁓ I had to really dive to find those specific pieces that were.

Dr. Ginger Garner PT, DPT (03:42)

Yeah.

Alexis Brooks, MS RD (03:48)

really helped to move the needle for me. And I told myself, once I get to the bottom of this, once I learn this, I am going to tell everybody about it. I’m going to help other women get on the other side with me. it did take, I would say, mean, quote unquote, remission. I say it took maybe a year of like research and implementing and trial and error and all that stuff. And maybe even some change after that to really ⁓ feel good again. ⁓ But yeah, that’s like really what.

Dr. Ginger Garner PT, DPT (03:57)

you. ⁓

Alexis Brooks, MS RD (04:18)

was the turning point of my personal story.

Dr. Ginger Garner PT, DPT (04:20)

Yeah, so I just, one thing that you said is sticking with me and I think that’s so important to emphasize because a lot of women, and I’m gonna do air quotes if you’re not watching the podcast, if you’re not watching YouTube, right? I’m like air quote, manage their symptoms. And you said, I was managing my symptoms and it was going okay until it wasn’t, right?

And I think that’s also the nature of…

what is so invasively disrupting about our quality of life with endometriosis? Like you can be walking along, minding your own business and things are going fine and then all of a sudden it’s debilitating, right? And I think that your approach to looking at nutrition and from my perspective as a pelvic and ortho PT, I’m like.

Alexis Brooks, MS RD (05:07)

⁓

Dr. Ginger Garner PT, DPT (05:19)

Yes, we have to look at that. Lifestyle medicine is a huge part of what I do. And of course, nutrition is one of those six pillars of lifestyle medicine. I don’t know, and as an endo ⁓ warrior, right, a lot of people identify themselves as that. It’s a huge hashtag that gets used all the time. So if you’re an endo warrior, as an endo warrior, you are, I am. ⁓ I think that it becomes pretty critical to…

recognize and give yourself compassion and grace when you’re going through those things because as a listener, it doesn’t matter if you have a healthcare background. think having a healthcare background, and I don’t know how you felt about it, almost, in some ways, could make the gaslighting worse. You’re harder on yourself, like, I can figure this out on my own. I should be able to manage this, right?

Alexis Brooks, MS RD (06:14)

Yes.

Yeah.

Dr. Ginger Garner PT, DPT (06:18)

on your own, but the nature of endometriosis is that it’s inflammation driven. It is estrogen driven. ⁓ There are environmental disruptors, That an endocrine disruptor is floating around in the environment. It’s driven by that. There are so many variables that I think to just be able to grab hold of one of them like we’re doing today and to really dive deep and talk about nutrition can be life changing for women and people with endo.

If you’re listening, like put your seatbelt on. That’s right. Because there’s a lot of ⁓ grace and compassion that I’m sure that you had to give to yourself. A lot of patience, know, when you think you have a handle on things and then you’re like, no, wait, I gotta take two steps back and rethink it for a moment. And I just can’t wait to get your insight on those moments in time.

Alexis Brooks, MS RD (06:51)

Buckle up.

Mm-hmm.

Dr. Ginger Garner PT, DPT (07:17)

like one of them, and I’ve seen this on your Instagram account, which I love, is you often ⁓ talk about helping women repair their gut without restrictive dieting. And I think that there’s so much information out there, which is sometimes good, and then sometimes absolutely terrifying and utterly confusing for people trying to navigate endometriosis. But that phrase that repairing the gut without restrictive eating or breaking free from restriction, basically.

Alexis Brooks, MS RD (07:27)

Mm-hmm.

Dr. Ginger Garner PT, DPT (07:47)

is so refreshing in a world full of food rules, right? And when women have body dysmorphia and anorexia and bulimia and we get all these social signals that really what we’re supposed to be is thin and happy all the time and people pleasing, it’s like, ugh, you just wanna throw your elbows out and go, no. So was there a moment in time where you realized that shift from

Alexis Brooks, MS RD (07:52)

huh.

Dr. Ginger Garner PT, DPT (08:16)

restriction and just seeing that socially too is doing more harm than good for yourself or other people. Like how has that shown up for you that has driven one of your values which is to teach women how to eat without all these food rules.

Alexis Brooks, MS RD (08:31)

Ooh, this is a good question. I really appreciate this question. you’re making me think back, because I’ve had this philosophy for a long time, actually before even becoming a dietician. So it really, would say, the moment that I could think of is when I was in high school, or not high school, I was in college. I was an undergrad. And one of my good friends had an eating disorder.

And at the time I didn’t fully understand like what the implications meant, but I just knew she had an unhealthy relationship with, I knew something was going on. And to fast forward a little bit, she ended up spearheading an organization on campus called Headstrong. And this was really an organization that built awareness around eating disorders and disordered eating. And it drew a lot of…

young women and girls to that organization. learned, I was able to interact with a lot of people who had these concerns around food. And this was when I was studying nutrition too. I think early on with studying nutrition, I realized like, oh, there is a point where it can be too much, like obsessing over being healthy or thin or all those things can be too much and they can be unhealthy. So that always stuck with me throughout. And then once I became a dietician,

and started working with people who had eating disorders and I was really working in that space. That’s when I fully recognized how, ⁓ and people had varying ⁓ degrees of being within that illness, but that’s when I was able to fully recognize how dangerous it is for us to have really restrictive diets or have these, as you mentioned, these food rules. And then when we add on other conditions where it’s not just having an eating disorder or a disorder of eating.

we’re adding on other conditions, whether it be autoimmune or endometriosis, which kind of, guess, hand in hand, right? ⁓ Or like other conditions where it’s like, when you have an inflammatory disease or something that impacts your immune system or other parts of the body, not only is it important for you to have a healthy relationship with food, but it’s, you really need to be able to have varied, as varied of a diet as possible to be able to fill those nutrient gaps and to really, to heal.

Dr. Ginger Garner PT, DPT (10:26)

Mm-hmm. Yeah.

Alexis Brooks, MS RD (10:51)

⁓ from the inside out. So I thought it was a little bit of long answer, I would say it started really early for me and it just progressed over time.

Dr. Ginger Garner PT, DPT (10:55)

You’re good. Yeah.

Yeah, and of course we don’t have to look around too far to see the constant reminders and the barrage of information of how women are supposed to look or how we’re supposed to take up space or not, more accurately, not take up space. ⁓ And the whole idea of, especially as with women and aging and going through postpartum.

perimenopause, menopause, postmenopause. And then realizing that towards, as you reach a certain decade, you realize, gosh, my goal is not, if someone had disordered eating when they were younger in college, it was always about size or looking a certain way or being a certain weight. But by the time you get to the other side, hopefully, hopefully, right? ⁓

you realize it’s about, or you want it to be about being resilient and strong, not frail, right? Can I pick up that suitcase and put it over my head in the tiny, ever-shrinking airplane bins to go somewhere? Can I pick up my grandkids or whatever? Whatever that may mean for women one day. And I would just love if more young women

Alexis Brooks, MS RD (12:07)

Yeah.

You

Dr. Ginger Garner PT, DPT (12:28)

could adopt that mantra or embrace that mantra or consider that mantra of strong, not skinny, strong and capable, not frail or fragile in any way. Because already with endometriosis, which is a great segue, you kind of already feel like that. You can feel frail or fragile or like, gosh, if I eat the wrong thing or move the wrong way, I’m gonna be in horrible pain.

Alexis Brooks, MS RD (12:40)

Yeah.

Mm-hmm.

Dr. Ginger Garner PT, DPT (12:58)

⁓ So how do you start to address like…

When someone comes in, what do you think is one of the first things that you look at when they come in? Because there are so many variables. And I’m just thinking of how I address patients with endo too, because there’s so many different variables. Is it looking at the gut connection? Is it looking more at inflammatory mediation? How do you approach it?

Alexis Brooks, MS RD (13:12)

⁓

So I would say the very first thing is, I mean, aside from doing like a really, really comprehensive in-depth like intake to really see what’s going on with the person in like different areas of the body. I like to focus on, in terms of implementation, to first focus on increasing nutrients because the goal, I guess the goal would be to reduce inflammation first because that can at least begin to.

Dr. Ginger Garner PT, DPT (13:49)

Mm-hmm.

Alexis Brooks, MS RD (13:56)

mitigate and lighten some of those symptoms, particularly pain symptoms. So it’s first being able to reduce inflammation and we don’t reduce inflammation by removing food from our diets. We need to have enough nutrients and antioxidants to be able to reduce inflammation. And my approach is not to, yeah, to like pull things out, which I think that a lot of times when someone thinks about going to

medical professional or you know talking about nutrition it’s like okay like tell me what I have to eat or what I can’t eat but I’m more like okay let’s look at your diet now let’s see what’s going on what are you missing what can we add in and what can we add in a way that you’re able to tolerate and something that you enjoy so that’s like one of the first things as we talked about like let’s let’s move let’s ⁓ add in some things because a lot of times when people work with me particularly with endo

Dr. Ginger Garner PT, DPT (14:26)

Mm-hmm.

Alexis Brooks, MS RD (14:48)

Their diet is really ⁓ scarce. It’s skimpy. There’s a lot of things that are missing.

Dr. Ginger Garner PT, DPT (14:52)

It is, yeah.

Yeah, because a lot hurts. A lot of things that they need, it just hurts them.

Alexis Brooks, MS RD (14:56)

Yes.

Dr. Ginger Garner PT, DPT (14:58)

So I wanna go back for just a second to something you said because, ooh, it was good. It was about not being able to reduce inflammation by taking things away. Can you just like.

just say that for everybody one more time because that’s a huge takeaway.

Alexis Brooks, MS RD (15:15)

Absolutely. So we cannot reduce inflammation by removing all these foods, these food groups and restricting our diet because we need those specific nutrients and antioxidants in order to reduce inflammation and to support our gut health, which is really intricately attached and connected. So that’s one of the first things to do is to actually make sure that we’re adding in those particular foods and nutrients that can support inflammation and gut health.

Dr. Ginger Garner PT, DPT (15:43)

Thank you, thank you. That’s so important, because people will come in and sit down, you know, in the chair in my office, like they do with many, many other providers that specialize in endo, and they’re so confused about foods. They’re so confused about what they’re supposed to eat, what they’re not supposed to eat, and I think more often than not, what they hear is, don’t eat this, don’t eat that, you can’t eat this and you can’t eat that, and because…

they often end up hurting from eating, it becomes even more of, there’s a term with movement called kinesiophobia, like fear of movement, which is, it’s not shaming the person, it’s just saying that when you move and it hurts your body, what’s your body gonna do? Go, mm, let’s be careful, maybe moving is what’s hurting you. So it’s kind of a natural protective response, but it can be taken too far.

and then you’re afraid to move, you don’t know how to move, you’re not sure what to do and what not to do. And I think the same thing happens with food. Is there a word for that?

Alexis Brooks, MS RD (16:48)

We usually say food fear, but I feel like we should have a better word. Like I want a phobia to be in there. Yeah.

Dr. Ginger Garner PT, DPT (16:50)

Just food fear? I know, we have a fancy kinesophobia, right? We

need a fancy word for the food thing because I mean, I know even with all the background that I have in specializing, there’s been times in my life where I’m like, should I eat that? Should I not? I’m not sure what it’s gonna do based on the history that I have, which is something that you mentioned earlier that I wanna go back to. And that’s the whole kind of.

gut instinct thing because you have, kind of like I just mentioned, you have a certain feeling of, my gosh, maybe this food is setting me off because the last time I ate it, I felt terrible for days or digestion was terrible or whatever. And I think there’s an inherent wisdom in that when people start to identify those food triggers on their own, like no testing, nothing’s ever been done. And I think that’s part of, it won’t be something we can decode today.

I wish we could in this hour. However, I think the disclaimer statement would be, wow, we need a lot more research on the gut endo link. A ton more research. But from your perspective, yes, we know many, many people with endo struggle with gut issues, bloating, pain, nausea, but they don’t always connect the dots. Can you walk us through how you begin to look at that, whether it’s doing ⁓

Alexis Brooks, MS RD (17:50)

you

Dr. Ginger Garner PT, DPT (18:17)

particular GI test, stool test, whatever that is, how that gets calculated or factored into your treatment as part of the, like solving the whole puzzle, you know, of that gut endo connection.

Alexis Brooks, MS RD (18:33)

Yeah, so I do like to use a stool test that is really comprehensive. It’s looking at the bacteria, so our good bacteria or bad bacteria, parasites, yeast, fungi, looking at what our stomach acid is like to relate indicators for that. There’s also an indicator for leaky gut, which is really helpful because a lot of us have leaky gut too, super common with endo. So that is a really helpful test. I will say though,

Dr. Ginger Garner PT, DPT (18:52)

Yeah. Yeah.

Alexis Brooks, MS RD (18:58)

As you mentioned, there are things that we can do without necessarily, like before we did the lab tests and all those things, like we can kind of ⁓ get a sense of what gut health is ⁓ prior to that. for sure, like the basics of pooping every day. A lot of us have constipation, so that could be a first start of like, okay, what’s going on? Why are you not pooping? And I will say sometimes the foundations aren’t there yet. So.

We don’t jump into like, take that supplement, that supplement and do this protocol if you’re not even drinking enough water. If you’re hardly having any fiber, if you’re really, really not moving, if you’re stressed all the time, if your ⁓ nervous system is in overdrive, those are some areas that we can begin to focus on without having to do a test and really have data. So those are, ⁓ I say foundational pieces to get ahold of, but of course the testing can make things more targeted once we have the foundations down.

Dr. Ginger Garner PT, DPT (19:52)

Yeah, so okay, this is a total clinical curiosity question because a lot of us do similar testing. So the tests are applicable across multiple disciplines. So while a surgeon doing excision surgery may not have that much time to be doing a GI test and looking for all of that, they’re experts in excision, that’s what they do. That leaves kind of the rest of us to…

Alexis Brooks, MS RD (20:14)

Great.

Dr. Ginger Garner PT, DPT (20:20)

connect the dots, whether it is in pelvic ortho PT or in their nutrition ⁓ sessions, et cetera. And so what I have, I’m starting to see patterns in doing the lab testing. And I’m just wondering what patterns you have seen and what I mean by patterns is I use a particular stool test measuring some of those same things. So the good bacteria, the bad bacteria, know, pathogens, et cetera.

⁓ And I’m starting to see some similarities in women with endo. And I’m wondering, have you been able to just notice some of those things about maybe it’s some of the good bacteria chronically being deficient, like some specific good bacteria versus some of the pathogens running high or et cetera? Like have you found some patterns to be true? I know this is very, very early question and there’s no research on it yet.

So we’re asking a question that really needs to be researched essentially.

Alexis Brooks, MS RD (21:22)

I would say well definitely for the good bacteria. I often see acromantia low sometimes. It’s not even existent like It’s not even there Yeah, and then pathogens ⁓

Dr. Ginger Garner PT, DPT (21:29)

Yeah, I’ve seen the same thing. Yeah.

Alexis Brooks, MS RD (21:40)

feel like, I don’t know if I quite see a pattern there. They’re usually, guess the pattern is that there usually is a pathogen. But I don’t know if I would say a specific species per se. ⁓ Stomach acid tends to be low though, like indicators for stomach acid too. And the sonulence is high, leaky gut.

Dr. Ginger Garner PT, DPT (21:46)

Right.

Yeah, yeah, yes, yeah, and of course, donulin,

yeah, for intestinal permeability. So if it sounds like we’re speaking Greek, we’ll back up a second. We’ll back up a second. And so essentially, ⁓ the nutshell of what we just said, and then Alexis, I want you to give the overview too, just in case I miss something, is essentially the question is, or what I feel like, what we probably both feel like,

Alexis Brooks, MS RD (22:01)

you

Alright.

Dr. Ginger Garner PT, DPT (22:22)

needs to be done is extensive research to determine what the gut microbiome of people or women with endometriosis look like. Are there patterns? Are there things that we can draw relationships between? Could we actually preemptively begin to treat the gut microbiome?

prepubescently, et cetera, when we’re able to identify endometriosis earlier. So early identification and intervention is of course paramount. But can that also apply to the gut microbiome? What we eat, what probiotics, could we get very specific about what probiotics are taken in the future? And so yeah, the question was, and of course, with the acromansia being one of them, you kind of hit the nail on the head, because I’ve been seeing some of that too, which we can’t say, we can’t say is,

is the pattern for women with endometriosis because that’s just two of us. We need thousands of women with endometriosis to be enrolled in a trial and then measure these things. But I think these are the type of questions that need to be asked. Is there something, can we be more specific about probiotic supplementation and in foods, obviously, because we want to get this stuff in foods first versus trying to just go out and take supplements for everything. Because if we could do that.

Alexis Brooks, MS RD (23:35)

Mm-hmm. Right.

Dr. Ginger Garner PT, DPT (23:42)

food wouldn’t be necessary, but obviously it is. We can’t just take fistfuls of supplements. So give the listener your version of that also, that interpretation of us as clinicians seeing some shared patterns in gut testing with people with endo.

Alexis Brooks, MS RD (23:45)

Mm-hmm.

Yeah, I mean, feel like you hit a lot of it or all of it, but just to add on, we do know ⁓ in the research, we do know at least that there is dysbiosis in endometriosis that goes hand in hand. But you’re right. I think it’d be so helpful if we knew the specific strains, the specific species of what’s limited in our guts or what’s overabundance, like what overgrowth typically happen in the gut of someone who has endometriosis. If we know those specific things, like

Dr. Ginger Garner PT, DPT (24:10)

Yeah. Yeah.

Alexis Brooks, MS RD (24:29)

Like you said, I think about how early we might be able to diagnose or at least like have like a be able to rule out a rule in endometriosis before puberty happens. I know for me personally, I had gut issues well before I had any kind of like endo issue. Like I had chronic constipation since I was probably six. Yeah.

Dr. Ginger Garner PT, DPT (24:52)

That’s so common. That’s so common.

I I hear that from nearly every patient that comes in and sits down. It’s all, it is usually all GI driven. Like they noticed that they had the GI issues first before they hit puberty or anything else had a chance to kind of rear its head and start causing problems. And yet the medical gas lighting that goes with it is just overwhelmingly awful.

PCPs, it’s not just a PCP or your primary care provider. It’s GYNs. It’s people that are highly, highly educated literally telling their patients your gut problems have nothing to do with your pelvic health or your gynecological health or your urological health. And that just requires pause.

Alexis Brooks, MS RD (25:51)

It does.

Dr. Ginger Garner PT, DPT (25:51)

It does. So what are your top three, like people like lists, like what’s the top five, what’s the top three, you know, what can you do? What do you typically go to or lean into with changes, nutrients in terms of managing endometriosis related symptoms? Because I’d say pain is way up there for people. ⁓ Fatigue is probably massive. And then the digestive piece of that. So

Alexis Brooks, MS RD (26:00)

Yes!

Mm-hmm.

Yeah.

Dr. Ginger Garner PT, DPT (26:20)

What do you lean into there? ⁓

Alexis Brooks, MS RD (26:21)

I think that was the top three.

Yeah, okay. So you said in terms of like diet and…

Dr. Ginger Garner PT, DPT (26:27)

Yeah, like nutrient changes, dietary additions, ads when we’re talking about pain, fatigue, and digestive problems.

Alexis Brooks, MS RD (26:37)

Okay, I am all about Omega-3s. I feel like that is like one of the powerhouses because it’s gonna reduce our inflammation. It will help to reduce the production of prostaglandins, which can help. They’re helpful. They actually create the uterine contractions for us to be able to release the lining of our uterus. But if we have them too high, that’s when we get too much contractions. That’s when we can have the cramping, the pelvic pain.

the period poops, like all those things that could be really debilitating or uncomfortable for us. So having more omega-3s, I recommend it in two forms. I recommend it if possible, if you’re able to get it through food. So having fatty fish like salmon, sardines, mackerel are great sources. So if you enjoy fish, you like it. ⁓ I highly recommend getting that regularly in your diet, at least like I would say two to three times a week in your diet. In addition to that, even having an omega-3 supplement.

Dr. Ginger Garner PT, DPT (27:06)

Yeah.

Alexis Brooks, MS RD (27:32)

could be helpful for you. If you’re not a fish lover or you’re not consuming seafood for any other reason, there’s algae supplements too that you might consider to give you those omega-3s. So would say that’s one addition.

then another thing that I always recommend to add in is more like color. I know that’s not a nutrient, but in reality that actually is a variety of nutrients. So the more color that we can add in, the more nutrients we’ll get, the more antioxidants we’ll get. So this could be in the form of spices, ⁓ plants as a whole, fruits, vegetables, nuts, seeds, but like trying to get as much color. If you can get three different types of color or three different colors within each meal.

you’re onto something. Like this is a really great way to reduce inflammation. And it also helps out with your gut too, because it’s gonna, the colors that you’re getting, these are all different ⁓ prebiotics and food for your gut bacteria. So that’s really helpful ⁓ as well.

Dr. Ginger Garner PT, DPT (28:16)

Mm, I like that. I like that.

Yeah, yeah, I love that because so often, I mean, these are very concrete things to improve upon and I like that numerical association, know, like three colors is great because otherwise, you can get overwhelmed, know, people can get overwhelmed with ⁓ the amount of things that they think they’re supposed to do and you know, it gets so confusing. So I love the number system.

⁓ So that would equate to like, my gosh, know, if you ate three meals a day and you got three colors, then you’re covering the entire rainbow, which is ⁓ probably one of the easiest rules to remember. So I love that takeaway.

Alexis Brooks, MS RD (29:19)

Yeah, I feel like it is. It’s more manageable, it’s realistic, it’s practical. And I even tell people if it’s something that they’re just starting off with and they’re first in ⁓ the phase of awareness, because that’s kind of where I start with my patients first is like, let’s just be aware, let’s just pay attention for the next few days. See what you’re eating. No need to change, but let’s just pay attention to it and see what you observe. And they notice, my gosh, my foods are monochromatic, like I’m always eating one color.

Dr. Ginger Garner PT, DPT (29:48)

Yeah.

Alexis Brooks, MS RD (29:48)

⁓

Maybe you add two tablespoons of a new color. Maybe it’s not like a full on like new side dish or like anything like that. Maybe you’re just adding a little bit of something ⁓ to get that third color or second color, whatever that is for you.

Dr. Ginger Garner PT, DPT (30:01)

Yeah, I’ve always, my kids probably get sick of me talking about not eating too much brown food. But I’m like, your whole plate is brown. We’ve gotta do something about that. We can’t eat right 100 % of the time and do everything perfectly 100 % of the time, but they do hear mom talk about not eating too much brown food. Getting some color in there.

Alexis Brooks, MS RD (30:09)

you

Yeah.

Yes.

Exactly. Throw some parsley on the brown. I don’t know something.

Dr. Ginger Garner PT, DPT (30:31)

Yeah. ⁓

Yeah.

Well, you know, they must be listening because now they have actually heard them say that. Like if there’s spaghetti or something and there’s obviously, okay, there’s brown, we got the noodles, that’s covered. And then the red, you know, tomatoes. I’ve actually had them ask, hey, where’s the parsley? It makes it taste better. I’m like, They picked up on that thing. Yeah, yeah, a little bit anyway, a little bit.

Alexis Brooks, MS RD (30:44)

Yeah.

⁓ hallelujah. that’s excellent. They’re listening.

Right.

Dr. Ginger Garner PT, DPT (31:03)

So how does the gut endometriosis connection for you register the most, what’s the most profound truth that you’ve been able to take away from how important it is to focus on the gut endoconnection? And obviously that’s why you focus on gut restoration in your work, but what was that thing for you that really explained the gut endoconnection?

Alexis Brooks, MS RD (31:31)

Hmm. Well, I just really think of the gut being the gateway. Like literally all the things, if we think about endo, like the hormone dysfunction or hormone imbalance and the immune dysfunction, ⁓ even like insulin sensitivity is really, ⁓ insulin, blood sugar dysregulation or not having sensitive ⁓ insulin. But when we think about all the aspects of endometriosis, if they all

Dr. Ginger Garner PT, DPT (31:54)

Yeah.

Alexis Brooks, MS RD (32:01)

can go down to like one place to the gut. And of course there’s multiple areas that we could focus on too, but if we’re able to optimize our gut, we can also reduce inflammation, especially if we have infections in the gut. So if we have an infection in the gut, it’s not gonna stay in the gut. It becomes like a systemic thing. The inflammation becomes systemic. So if we’re able to optimize the gut, we can reduce inflammation. We know that… ⁓

depending on which statistic you’re looking at 70 to 80 % of the immune system lives in the gut. So we know that we can actually modulate the immune system if we support the gut too. The gut plays a really big role in hormone metabolism and how we’re able to excrete the excess hormones, particularly estrogen. we know that estrogen plays a really big role in endometriosis too, ⁓ supporting like a lot of the symptoms around it, like fatigue you mentioned too. ⁓

Dr. Ginger Garner PT, DPT (32:45)

Mm-hmm.

Alexis Brooks, MS RD (32:55)

anxiety, depression, like all these things, if we support the gut, can begin to support all these other systems and the symptoms that, where they originate from with endometriosis.

Dr. Ginger Garner PT, DPT (33:06)

Yeah, yeah, and it’s a phrase that people have heard, I often use, is, particularly with endometriosis, it’s not chasing symptoms, it’s treating systems and going back and then realizing, and honestly, the gut microbiome has really been on our radar. I learned about it first.

and somewhere around 2012, I was like, holy cow, this just blew my mind. ⁓ But with respect to mental health, with respect to all of the things that women get gaslit over too. If they come in with pain, they’re like, here’s an antidepressant. Did they just get misdiagnosed with depression, right? And given a med that maybe actually they needed to look at the systems-based driver and.

with a lot of the serotonin being in the gut as well. mean, it’s so important for ⁓ all aspects of how we manage pain and how we manage our emotions and how we’re feeling and stress and everything. talking about patients and clients, people with endo and moving from frustration towards relief, can you share a story like

someone who came to you, like it’s a classic presentation when you have endometriosis. You’re overwhelmed by symptoms, like frustrated by the conventional care. They’re not considering about, they’re not even considering constipation is making endo worse. They’re not considering maybe that ⁓ poor estrogen metabolism is driving their symptoms as well. Like what shifted for the.

for the people that you see, or maybe you’re thinking about one case in particular that you’ve seen recently, once they started working with you on nutrition and gut healing. Let’s give us a little overview of that.

Alexis Brooks, MS RD (35:10)

Yeah, so as you’re talking, one person was coming to mind and she was someone that was diagnosed with endometriosis. She had the surgery maybe, maybe it had been like two years prior, something like that. And she was also on birth control for a time. And she came to me really frustrated. She’s like, I did the surgery, like I was on birth control and nothing’s really working. Like those things helped a little bit, but it was short term and she was really at her wits end. She didn’t know what else.

she could do. And actually, I will say, a lot of the women that come to me, they see nutrition as the last hope, which I would like for that to change. ⁓ Yeah, like, this is something that we focus on maybe first and like, maybe not just nutrition alone, but like, diet lifestyle, that whole umbrella, the lifestyle medicine, we focus on that first, like building these strong foundations. And then we, we do things that are maybe more invasive, more ⁓ complex than that sort of thing. But

Dr. Ginger Garner PT, DPT (35:50)

Shift, yeah

Mm-hmm.

Mm-hmm.

Alexis Brooks, MS RD (36:10)

That’s how she came to me. She had heavy periods. She was ⁓ really debilitated during her period. She had to call off work. ⁓ She couldn’t get out of bed for usually two days, the first two days of her period. She had warned her husband when it was coming, so he knew that he’d have to take care of her for those couple of days. ⁓ So a lot of pelvic pain is what she was experiencing chronically, but then having worse cramps when she was on her period. ⁓ A lot of nutrient gaps.

a lot of food fear. There were several foods that she was afraid to eat. And then also she just was, ⁓ would be nauseous, nauseous or just low appetite. So even if she knew something that she normally would be able to tolerate, she wouldn’t even consider having it because just the appetite wasn’t there. But ⁓ when we worked together, we,

We definitely worked on filling those nutrient gaps in ways that foods that she was able to tolerate and build her confidence around food and helping to repair that relationship. We also replenished her nutrient stores. We did use some supplements too to help out with estrogen detoxification and metabolizing. So she was able to have lighter periods. She, think maybe within two, I don’t know, we’ll say a couple of months of working together. ⁓

She actually reached out to me and she said that she was able to walk out and like be out and about on day one of her period. She was not in the bed. She was not in the house. She was outside walking around, running errands, like living her life and doing daily stuff and like not missing work. So I would say that was, that’s a story that’s like, yeah, a big one for her. Like it changed her quality of life. And there’s other symptoms I’m missing that she had, but those are some of the big ones.

Dr. Ginger Garner PT, DPT (37:51)

huge win. Yeah.

Yeah, yeah, so less pain and less fatigue and ⁓ lighter periods. Of course, less anxiety around it too because if you’re anticipating for a week that this is about to happen and then it happens and then you’re down, I mean, you’re missing a significant portion of your life just watching it go by. ⁓ Just thinking about that. And so many, like, there’s so many…

Alexis Brooks, MS RD (38:05)

lighter periods.

Yeah.

Dr. Ginger Garner PT, DPT (38:28)

Maybe we can talk a little bit more about red flags and food traps and diet myths and all that stuff. Because a lot of people with endo will get handed a one size fits all approach. Like, just don’t have any dairy and gluten, you’ll be fine. I wish it was that easy. Because we wouldn’t be talking about it and of course we wouldn’t be talking about all the research that’s needed for it.

Alexis Brooks, MS RD (38:42)

Yeah.

Yeah.

Dr. Ginger Garner PT, DPT (38:57)

What are some myths or misconceptions that you regularly help people unlearn when it comes to food and endo?

Alexis Brooks, MS RD (39:04)

Those are the big ones. And then I also would say, I guess like specific diets that people think they have to follow aside from like dairy free, gluten free, like vegan, or they feel like they can’t eat any meats. Like that’s not a possibility for them, particularly red meat, I think is a big one. And that was one that I’ve like, looked into quite a bit because I was like, is this a thing? it’s talked about so much. I’m like, how much does this affect people? And, but a lot of people, well, yeah, it’s definitely not relative to everybody.

Not everyone with endometriosis needs to avoid red meat. ⁓ There’s actually research showing like how nutrient dense it can be. Meat in general, how nutrient dense it could be, how bioavailable the nutrients that are within it, like the iron, the zinc, the protein, like could be so helpful for someone who has higher needs of those nutrients. Another one I see often is soy, that people with endometriosis cannot have any form of soy, that it’s going to raise their estrogen levels.

Dr. Ginger Garner PT, DPT (39:47)

Right.

Alexis Brooks, MS RD (40:03)

That is not true. ⁓ is considered a phytoestrogen. it ⁓ has a similar structure to estrogen, so it can attach to estrogen receptors, but it’s a really weak bind. So it’s not going to astronomically raise your estrogen levels if you have soy. I do think there are specific considerations and concerns around soy, particularly that the majority of soy is genetically modified.

Dr. Ginger Garner PT, DPT (40:31)

Yeah. Yep.

Alexis Brooks, MS RD (40:32)

that it’s sprayed with glyphosate that

can impact your hormones. So if you do choose soy, and there’s even like phytates too, so basically it could block the absorption of certain nutrients. So ⁓ if you do choose soy, I do recommend organic. Absolutely, that’s a non-negotiable, has to be organic. And I actually recommend more so fermented soy, which has proven to be helpful for the gut because it’s fermented. So that’s more of like miso, nato, tempeh.

good sources of soy. A lot of research shows that it is anti-inflammatory too. It has isoflavones and flavonoids. So ⁓ yeah, that’s a big myth I see.

Dr. Ginger Garner PT, DPT (41:12)

Yeah, that’s a huge one. Thanks for breaking that down. I mean, that’s like a small shift that somebody could make and get a really big win out of it because I am sure someone’s listening right now and they’re feeling exhausted, inflamed, and unsure where to start, right? And just knowing that that’s a lot of the reason why. when I say that, what I mean is like environmental disruptors like soy being genetically modified.

Alexis Brooks, MS RD (41:29)

Mm-hmm. Yeah.

Dr. Ginger Garner PT, DPT (41:42)

that may have not been on their radar at all in understanding what glyphosate has done and that prior to 1996, we didn’t have that in our food supply. so is that why women are having worse cycles, more infertility, worse endometriosis, worse perimenopause, postmenopause and everything? Well, there’s a lot of estrogen disruptors in the environment. And so just making that little shift, it’s like, ⁓ I’m gonna buy

know, organic soy is wonderful. And I don’t have to avoid soy I like the plague. You know, also realizing too that yeah, some people can be completely intolerant to gluten. I’ve also seen patients though be relatively firmly sensitive to gluten, but then go on to have excision, improve their gut microbiome and actually then be able to have some. So that’s also positive.

Alexis Brooks, MS RD (42:38)

Yeah.

Mm-hmm.

Dr. Ginger Garner PT, DPT (42:42)

Yeah,

you can almost work your way out of some of what you thought were food allergies or sensitivities when it was well done excision and really good nutrition kind of lifts you out of all of the food sensitivities or some of them anyway. I’m sure you’ve probably seen that too.

Alexis Brooks, MS RD (42:56)

Yeah.

Yeah, I’m glad that you mentioned that because even at the top of us talking, you mentioned like how powerful it could be for us to identify triggers by observation and not necessarily feeling like we have to rely on a test. And that brings to mind for me, along with like this conversation around food sensitivities is sometimes if we take a sensitivity test like…

it lights up, looks like, my gosh, you’re sensitive to everything. And when people see something like that, they’re like, okay, I’ll eat three foods, I guess. But the reality is that when your microbiome is disrupted or when you have the leaky gut, ⁓ everything, your immune system is gonna tag just about everything ⁓ as a sensitivity because it’s not supposed to be there. The food particles aren’t supposed to be in your bloodstream. So once we begin to heal the gut and seal things up,

Dr. Ginger Garner PT, DPT (43:28)

Right? Yeah.

Alexis Brooks, MS RD (43:51)

we can now ⁓ have some of those foods like you mentioned, like gluten is a possibility or other foods too that originally we thought, I can’t have it, I’m really sensitive to it, but it’s that our gut needs that healing.

Dr. Ginger Garner PT, DPT (44:03)

Yeah, that is another truth bomb. Definitely. Yeah. my gosh, there’s so much we could talk about. I would love to hear you expand a little bit on the whole, because we always touch on medical gas lighting, because it’s so important. And I think we’ve heard, I know I’ve heard it a ton, a ton, a ton. And I know as a dietitian, you have heard it probably more that.

your nutrition, your gut, ⁓ what you eat doesn’t matter. It’s not going to impact your endometriosis. It’s not going to impact your pain, et cetera. So many people with endo experience medical gas lighting being told that their symptoms don’t matter or, nutrition doesn’t really matter. Just eat what you want. How have you seen people who are dismissed by providers? We’ll just put them in that category. ⁓

Alexis Brooks, MS RD (44:58)

Hehehehe

Dr. Ginger Garner PT, DPT (45:00)

finally feel validated and supported through your work.

Alexis Brooks, MS RD (45:06)

It’s rewarding to be able to sit with someone who has endometriosis, someone that’s been gaslit for so long, someone that’s not been believed and dismissed for a really long time, and to watch the weight fall from them when you say, I believe you, I hear you, when you validate their experience. And that’s something that I was really, because I’m

I’ve gone through that too. It’s something that I’m really adamant of being able to provide that. And also not just for me, I try to encourage people to expect that from all their providers. Even if I know that can be challenging, right? Cause not all providers will do that. But I try to encourage ⁓ people to set that bar of if you’re not validated, if you’re not listened to, if you feel like you’re dismissed, if you feel like a provider is being condescending, find another one.

Dr. Ginger Garner PT, DPT (45:48)

Yeah. Yeah.

Alexis Brooks, MS RD (46:02)

because there are providers that exist that will listen, that understand that something is going on even if we maybe even at times we may not be able to like put our fingers on it as providers, but we know that there’s something more. We trust that the person in front of us knows their body more than we know their body. ⁓ So yeah, I always encourage that.

Dr. Ginger Garner PT, DPT (46:23)

Yeah, that’s so well said. I think that’s part of the power of social media too, because ⁓ you show up with so much compassion and clarity on Instagram, and social media helps you connect to those people that you would have really never had access to. ⁓

and there’s so much negative about social media, but then there’s also so much positive because you can convey that. And of course, I can clearly see that on your Instagram channel being able to reach out in that way. yeah, you’re welcome, you’re welcome. So if you, so talking about kind of this healing in the digital age, thank goodness we have podcasts and social media and all this stuff now that can work for good. ⁓

Alexis Brooks, MS RD (46:56)

Thank you.

Dr. Ginger Garner PT, DPT (47:13)

And that’s become obviously a part of that’s why we’re doing this, right? It’s part of a healing vision to do that. So if you had a magic wand and you could change how people with endo are treated by doctors, by society, by themselves, because we can certainly gaslight ourselves too, what would you want to shift?

Alexis Brooks, MS RD (47:29)

Yeah.

this is such a big question. my gosh. ⁓

Dr. Ginger Garner PT, DPT (47:34)

You

Alexis Brooks, MS RD (47:41)

You know, what really struck me just now is when you said even ourselves, that we gaslight ourselves. We do, and it’s so unfortunate because it’s like a terrible vicious cycle of where we’re being gaslit by providers. And then we end up over time, like, well, yeah, maybe they’re right. Maybe this isn’t as bad. Like maybe other people experiences, but I just can’t handle this as well. Like maybe there’s something wrong with me. Maybe I’m weak. there’s, you know, we just start to blame ourselves.

I, that really resonated when you said that, because I felt that way too, where I didn’t even realize it until I was on the other side, where I was like, whoa, I had a lot of trauma. Like that was, I was making compensations for myself that I don’t make anymore. But I looked back, I was like, ⁓ yeah, you know, it’s probably not healthy to be so aware about where I am in a room just in case I pass out and hit my head.

Dr. Ginger Garner PT, DPT (48:19)

Yes.

Yeah.

Alexis Brooks, MS RD (48:39)

I’m afraid of what I might hit my head on. Yeah, that probably shouldn’t be a forethought for me. And I don’t have that anymore, but I definitely had that before for years. So I do wish, I think that’s my magic wand, ⁓ is that we had… ⁓

Dr. Ginger Garner PT, DPT (48:51)

Mm-hmm.

Yeah.

Alexis Brooks, MS RD (49:01)

Yeah, is that we, any of us who are experiencing these symptoms ⁓ or just don’t feel well in our bodies, we know something’s wrong, but we’re not getting the validation from other people or providers that we continue to validate that for ourselves, that we know that we trust ourselves, that we don’t lose that trust for ourselves.

Dr. Ginger Garner PT, DPT (49:21)

Yeah, that’s so true. What you just said was that piece that you said about you didn’t realize you were gaslighting yourself until you were on the other side. And I was like, true. That is so true, so true. And that magic wand piece of that could be your empowerment and the work that you’re doing. And can we give that power to women on the

front side before they get to that point, right? So that they never lose trust with themselves. And that would be mind blowing, wouldn’t it?

Alexis Brooks, MS RD (50:02)

Yes,

yes.

Dr. Ginger Garner PT, DPT (50:04)

That’s coming, it’s coming. Mm-hmm, mm-hmm, it’s coming. All right, well have one last question for you. Because I’m so excited about the work you’re doing and ⁓ that you’re out there in this space doing it because we definitely need ⁓ so much more awareness about endometriosis and treatment options. What are you working on now or?

Alexis Brooks, MS RD (50:06)

It’s on its way. We put it out into the universe, so it’s coming, yeah.

Dr. Ginger Garner PT, DPT (50:31)

getting ready to work on that you’re excited about, maybe a course or a resource or a community offering or something that just helps take this conversation even further.

Alexis Brooks, MS RD (50:40)

Yeah, so what I’m working on right now, I’m launching my very first group program for endometriosis. It’s called the Endocode Reset. And I’m super excited because up until now, I’ve been working with people one-on-one. But I think there’s so much power in working in a community, too. It really helps to end the isolation that we can experience with having endometriosis or conditions where it feels like no one gets it. ⁓ So I’m launching that. It’s a 12-week online group course. And it’s called the Endocode Reset.

Dr. Ginger Garner PT, DPT (51:09)

Awesome. Congratulations. Yeah. That’s a big thing to birth and put out into the world. Yeah. Yeah. ⁓ I think I interrupted you. What were you gonna say?

Alexis Brooks, MS RD (51:09)

So that’s something I’m super excited about. Thank you.

Yeah, it’s

Oh, you’re fine. I was just going to say it’s, it’s

been a lot of heart and soul and work and like, it’s been rewarding to be able to pour into this program in this way. And I’m just like really excited for us to get started.

Dr. Ginger Garner PT, DPT (51:33)

Yeah.

Yeah, well tell everybody where they can find you and get all the goods, all the information.

Alexis Brooks, MS RD (51:44)

Yeah, all the good. So I am Alexis Brooks Nutrition everywhere. So mostly I spend my time on Instagram. That’s where we hang out. You can also find me the program I’m talking about. called the EndoCodeReset. So endocodereset.com if you want to learn more about that too.

Dr. Ginger Garner PT, DPT (51:52)

Yeah.

All right, awesome. Thank you so much for the time today. It was just incredible. I love talking about nutrition. It’s one of my favorite things ever. I think that it’s the thing, it’s actually the thing that I talk about first with patients when they come in because it doesn’t matter what else we do. they’re not, if what’s on their plate isn’t looking like it should, nothing else is really gonna have the impact, the profound impact. So thank you for the work that you’re doing.

Alexis Brooks, MS RD (52:29)

Thank you and thank you for the work that you’re doing. This is such an incredible platform that you’ve created and being able to ⁓ serve so many women. I appreciate what you’re doing.

Dr. Ginger Garner PT, DPT (52:39)

⁓

yeah, one podcast at a time.

Alexis Brooks, MS RD (52:43)

Hahaha