Achy joints, painful periods, a bloated or irritated gut, fluid retention, itchy skin and feeling sore for days after exercise can look like separate problems. Very often, inflammation is involved in all of them.
I would say that around 70 to 75 per cent of the women who come to us in clinic have some level of inflammation. We regularly see it alongside painful periods, gut problems, aching joints, headaches, skin reactions and poor recovery.
Inflammation is part of the body’s normal defence system. If you cut your finger, catch an infection or injure a muscle, it helps the area heal. We run into problems when that response continues long after it is needed. You may not see obvious redness or swelling because low-grade inflammation can continue without obvious signs.
The clue is often in the name
The ending -itis means inflammation. Arthritis is inflammation in a joint. Gastritis is inflammation of the stomach lining. Dermatitis affects the skin. Colitis affects the colon. Tendinitis, sinusitis and thyroiditis are other examples.
Plenty of inflammatory conditions do not end in itis. Endometriosis is an oestrogen-dependent inflammatory condition, and inflammation is involved in the pain of adenomyosis too. Inflammatory bowel disease includes Crohn’s disease and ulcerative colitis. IBS is different and does not automatically mean the bowel is inflamed, although I would still want to look at gut infections, the microbiome and the gut barrier when symptoms continue.
What ongoing inflammation means
When the immune system detects injury, infection or another threat, it releases chemical messages called cytokines. These tell immune cells where to go and what to do.
That response is useful while the body is dealing with a problem. If whatever is causing the inflammation continues, these messages keep being sent and can contribute to pain, swelling, irritated tissue and poor recovery.
In clinic, we bring the inflammation down while we work out what is driving it.
Where inflammation can come from
The gut
I always look at gut health when inflammation is involved. A large part of the immune system sits around it, so an unbalanced microbiome, a digestive infection, poor digestion or a more permeable gut barrier can keep the immune system activated.
In my book Eat Right Balance Hormones, I explain that the gut microbiome can become less diverse during perimenopause. That change can increase inflammation and affect the gut barrier. The oestrobolome, the group of gut bacteria involved in processing oestrogen, may also become less efficient. This can affect both gut symptoms and hormone clearance.
If a woman has ongoing bloating, diarrhoea, constipation, reflux, abdominal pain, skin problems or reactions to lots of foods, I do not want her removing food after food without finding out what is going on. This is when we may use our Gut Health GI Map to assess the microbiome, pathogens, digestive function and markers linked with gut inflammation.
Gut Repair is the supplement I would use here. It contains probiotics and ingredients to soothe and support the gut lining, as well as garlic for antimicrobial support.
Food and drink
The first food change we advise is to reduce heavily processed foods. I mean products with long ingredient lists, additives, artificial sweeteners, refined carbohydrates, repeatedly heated oils and very little fibre. These foods can also feed a less favourable mix of gut bacteria.
What you eat regularly counts far more than an occasional biscuit. If most meals come from packets, takeaways, sugary snacks and deep-fried foods, I would start by changing those foods first.
Regular rises in glucose and insulin can also increase inflammatory signalling, particularly when the diet is high in sugar and refined carbohydrates.
Infections and other immune triggers
Bacterial, viral, fungal and parasitic infections all activate inflammation. Gut, sinus, joint, skin or energy symptoms may continue after the initial infection. Dental and gum infections can contribute too, so oral health is important as well.
This is another place I may use Gut Repair because it contains antimicrobial garlic alongside probiotics and soothing support for the gut lining.
Stress poor sleep and disrupted body clocks
Long-term stress changes cortisol signalling and affects the gut barrier, sleep, blood sugar and immune function. Poor sleep can increase inflammation too. In clinic, we look at bedtime, waking through the night, morning daylight and late-night screen use because the body clock also helps regulate immune activity.
Perimenopause and inflammation
Perimenopause is naturally a more inflammatory stage for many women. Oestrogen can rise, drop quickly and rise again before it eventually declines and settles after menopause. Progesterone often starts falling earlier because ovulation becomes less consistent. These hormones affect the brain, gut, joints, immune system and blood vessels. These hormone changes can affect much more than periods and hot flushes.
Oestrogen has several anti-inflammatory actions. As it fluctuates and then falls, we often see more joint stiffness, headaches, skin reactions, poor recovery and gut changes. Poor sleep and an increase in visceral fat can raise inflammation further.
Aches and pains can have many causes, so new joint swelling, severe pain, a change in bowel habits or unexplained fatigue needs proper assessment. If they begin alongside cycle changes, hot flushes, breast tenderness, anxiety, poor sleep or heavier periods, I would also look at hormones.
A DUTCH test shows reproductive hormones, hormone metabolites and the daily cortisol pattern. I use it when the symptoms point towards oestrogen metabolism, low progesterone or cortisol dysregulation.
Endometriosis and adenomyosis
Endometriosis and adenomyosis are both associated with oestrogen dominance, but chronic inflammation and immune dysregulation are also an important part of these conditions.
Research has found significantly lower vitamin D levels in women with endometriosis and adenomyosis.² In endometriosis, lower vitamin D levels have also been associated with more severe disease.
Vitamin D plays an important role in regulating immune and inflammatory activity, which is why we pay close attention to vitamin D levels in our endometriosis and adenomyosis clients in clinic and will often use a higher dose of my Vegan D3/K2+A Complex.
You can read more about vitamin D and immune regulation in my immune health blog.
Histamine symptoms do not always mean histamine intolerance
Histamine is one of the chemicals released during an immune response. It is involved in itching, hives, a runny or blocked nose, headaches, flushing and swelling. It also has important roles in the brain and digestive system.
Some women may think they have histamine intolerance because they react to wine, fermented foods, mature cheese, tomatoes or chocolate. They remove more foods and take quercetin, nettle and antihistamine products, but nothing changes.
Histamine symptoms can also come from mast-cell activation. Inflammation, allergies, gut problems and hormone fluctuations can all cause mast cells to release histamine. Oestrogen can encourage this release too, which may explain why itchy skin, hives, hay fever and reactions to wine can begin or worsen in perimenopause.
We have had clients who were living on a very restricted low-histamine diet with little improvement. When we worked on the gut and inflammation, using an anti-inflammatory diet and curcumin as part of the plan, their histamine symptoms improved. If the usual histamine support is doing very little, I would look at why histamine is being released. Curcumin does not treat an allergy and nobody should stop prescribed antihistamines without medical advice.
Recurrent hives, facial or throat swelling, wheezing, faintness or any possible anaphylactic reaction needs medical assessment. Do not try to manage those symptoms with supplements.
What I advise women to eat
Base meals around real food, plenty of colour, good-quality protein, omega-3 and monounsaturated fats, and enough fibre for your gut to tolerate.
• Oily fish such as sardines, mackerel, anchovies, salmon and herring provide omega-3 fats. These are used to make compounds that help resolve an inflammatory response.
• Extra virgin olive oil, avocado, nuts and seeds provide monounsaturated fats, vitamin E and plant compounds. Use fresh oils and avoid oils that have been repeatedly heated.
• Orange and dark green vegetables provide beta-carotene and a wide range of antioxidants. Carrots, squash, sweet potato, broccoli, watercress, rocket and spinach all count. You do not need to eat kale.
• Apples, onions, berries, brassicas and capers provide quercetin and other polyphenols. Blueberries also contain pterostilbene.
• Ginger contains gingerols. Turmeric provides curcumin. Rosemary, garlic and green tea provide further anti-inflammatory plant compounds.
• Pineapple contains bromelain. Add fresh or frozen berries, herbs and spices across the week.
• Prebiotic foods such as garlic, onions, leeks, asparagus and Jerusalem artichokes feed beneficial gut bacteria. Introduce them carefully if they worsen bloating or you have suspected SIBO.
• Fermented foods can support microbial diversity. Leave them out for now if they aggravate histamine symptoms.
• Vitamin A-rich foods include liver and egg yolks. Orange and green vegetables provide beta-carotene, although some people convert beta-carotene to vitamin A less efficiently.
• Vitamin D foods include oily fish, shellfish, egg yolks, mushrooms and fortified foods. Food alone may not correct a low vitamin D level, so check it with a blood test.
• Good-quality protein provides amino acids for immune repair. Fish, poultry, meat, pulses and properly prepared beans can all contribute according to the person’s needs and tolerance.
• Collagen-rich foods such as homemade chicken soup or meat broth can be included if they suit you. Long-cooked and leftover foods may be less suitable during a histamine flare.
• Propolis contains plant compounds collected by bees and is sometimes used for immune support. Avoid it if you react to bee products or have a relevant allergy.
You can also steep turmeric and fresh ginger in hot water. The amount of curcumin in food is much lower than the amount used in a concentrated supplement, but I still like to use herbs and spices regularly in food.
Foods that can increase inflammation
I start with heavily processed foods, sugary drinks, frequent sweets, refined carbohydrates, deep-fried foods, trans fats, excess alcohol and processed meats before removing whole food groups.
After that, the plan is individual. Gluten, dairy, histamine-rich foods, nightshades and lectins are often placed on one long list of inflammatory foods, but I do not remove all of them from everybody. That can leave a woman with very little to eat and reduce fibre, plant variety and microbial diversity.
If symptoms point towards a particular food, we may remove it for a set period and then reintroduce it. Without that reintroduction, you can end up with a long list of exclusions and still have no clear answer.
If food reactions are delayed or difficult to identify, our Food Sensitivity Test looks at IgG reactions to a wide range of foods. The results are interpreted with the woman’s symptoms and used to plan a structured elimination and reintroduction.
Explore the Food Sensitivity Test
Foods that may cause or worsen inflammation:
• Gluten-containing wheat, rye and barley, especially with coeliac disease, non-coeliac gluten sensitivity or clear gut symptoms. Coeliac testing must be done while gluten is still being eaten.
• Dairy, if lactose or milk proteins cause digestive or immune symptoms.
• Histamine-rich foods such as wine, beer, mature cheese, cured meat, fermented foods, tomatoes, spinach, shellfish and chocolate.
• Tyramine-rich foods such as mature cheese, wine, yeast extract, cured or tinned fish, soy sauce and pickles, particularly if you also experience migraines.
• Nightshades such as potatoes, tomatoes and aubergines, but only if there is a repeatable reaction. Tomatoes are the nightshade I react to most. If I eat too many, my rosacea flares, although sun is still my biggest trigger.
• Beans, pulses, grains and peanuts when they are undercooked or poorly tolerated. Proper soaking and cooking reduces lectins. These foods do not need to be excluded automatically.
• Large predatory fish such as shark, marlin and some tuna, which can carry more mercury. Choose smaller oily fish more often.
Support the gut liver and oestrogen clearance
The liver processes used oestrogen before it passes into the gut and leaves through the bowel. With constipation, low fibre intake or an unbalanced microbiome, some of that oestrogen can be reabsorbed. I always ask about bowel movements when we are looking at hormones and inflammation.
Detox Daily supports both phases of liver clearance, including the pathways used to process oestrogen. Fibre Complex provides soluble and insoluble fibre to bind used oestrogen and carry it out through the bowel. I may use them together when a woman has oestrogen-dominant symptoms as well as sluggish bowels or bloating.
Fibre should be increased gradually and taken with water. If fibre causes severe bloating or pain, stop adding more and investigate the gut first.
Other ways to lower inflammation
• Get daylight into your eyes early in the day and keep sleep and waking times fairly consistent.
• Strength train and walk regularly, but reduce exercise intensity if you are not recovering.
• Choose a form of stress support you will use regularly. This may be breathing exercises, time outside, therapy, meditation or gentle movement.
• Do not smoke. Cigarette smoke drives oxidative stress and inflammation.
• Look after your teeth and gums, with regular dental checks and daily brushing and flossing.
Reduce avoidable chemical exposure by ventilating rooms, washing fruit and vegetables, and choosing fewer heavily fragranced products where possible.
• Check vitamin D rather than guessing if you have risk factors for deficiency.
Testing inflammation and its possible causes
A blood test can measure C-reactive protein, or CRP. The liver produces CRP when inflammatory signalling rises. A raised result tells us that inflammation may be present, but not where it is coming from. Infection, injury, autoimmune disease, obesity and many other factors can raise it. Local or low-grade inflammation can still be present when CRP is normal.
Our Comprehensive Blood Profile includes inflammatory markers alongside thyroid function, blood sugar, iron, vitamins and minerals. I often use this when a woman has a range of symptoms or has not had thorough blood testing.
Explore the Comprehensive Blood Profile
Thyroid symptoms can overlap with inflammatory symptoms. Fatigue, constipation, hair loss, dry skin, a puffy face, muscle aches and weight gain are all reasons I would look beyond TSH alone. Our At Home Thyroid Test includes free T4, free T3, thyroid antibodies and key cofactors.
Explore the At Home Thyroid Test
If gut symptoms are the main problem, a stool test may tell us more than another blood test. If symptoms change across the cycle or began in perimenopause, hormone testing may be more useful. We choose the test based on a woman’s symptoms rather than ordering everything.
The benefits of curcumin
Curcumin is the main active compound in turmeric and is a powerful antioxidant. It acts on several inflammatory pathways, including NF-kB, one of the switches that tells cells to produce more inflammatory chemicals. It has also been studied for joint comfort and mobility.
Curcumin has also attracted considerable interest in cancer research. Laboratory and preclinical research has shown that curcumin can inhibit cancer cell growth and influence pathways involved in tumour development in experimental settings.¹ This does not mean that curcumin has been proven to prevent or treat cancer in humans, but it is an important area of ongoing research.
Standard turmeric and curcumin supplements are poorly absorbed. My Curcumin uses CurcuWIN®, a clinically studied form that delivers 46 times greater bioavailability than standard curcumin and is absorbed 40 per cent faster. It does not require black pepper, so it is also gentler for people with a sensitive gut.
We use Curcumin regularly for its antioxidant and anti-inflammatory benefits, as well as for joint discomfort and some gut or histamine symptoms. I would also address poor sleep, gut infections, oestrogen symptoms and a highly processed diet if any of these are contributing to inflammation.
If you take medication, have gallbladder disease, are pregnant or are preparing for surgery, check with your doctor or pharmacist before taking a concentrated curcumin supplement.
This article is for educational purposes and is not a diagnosis or a substitute for medical care. Seek medical advice for severe or persistent pain, blood in the stool, unexplained weight loss, fever, joint swelling, breathing difficulty, recurrent hives or a major change in your health.
1. Tomeh MA et al. A Review of Curcumin and Its Derivatives as Anticancer Agents. Int J Mol Sci. 2019.
2. Vitamin D evaluation in adenomyosis: A retrospective cross-sectional study. 2024.
