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1H NMR- based metabolomics approaches as non-invasive tools for diagnosis of endometriosis A Comparative Study of Blood Levels of Manganese, Some Macroelements and Heavy Metals in Obese and Non-Obese Polycystic Ovary Syndrome Patients A Comparative Study of the Gut Microbiota Associated With Immunoglobulin a Nephropathy and Membranous Nephropathy A comparative study of the gut microbiota in immune-mediated inflammatory diseases-does a common dysbiosis exist? A comprehensive analysis of breast cancer microbiota and host gene expression A comprehensive analysis of breast cancer microbiota and host gene expression A cross-sectional analysis about bacterial vaginosis, high-risk human papillomavirus infection, and cervical intraepithelial neoplasia in Chinese women A cross-sectional pilot study of birth mode and vaginal microbiota in reproductive-age women A metabonomics approach as a means for identification of potentialbiomarkers for early diagnosis of endometriosis A More Diverse Cervical Microbiome Associates with Better Clinical Outcomes in Patients with Endometriosis: A Pilot Study A Multi-Omic Systems-Based Approach Reveals Metabolic Markers of Bacterial Vaginosis and Insight into the Disease A New Approach to Polycystic Ovary Syndrome: The Gut Microbiota A Review of the Anti-inflammatory Properties of Clindamycin in the Treatment of Acne Vulgaris A Systematic Review and Meta-Analysis of Premenstrual Syndrome with Special Emphasis on Herbal Medicine and Nutritional Supplements. Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS)

Trace Elements and Endometriosis: Insights into Oxidative Stress and Novel Therapies Original paper

Researched by:

  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

Fact-checked by:

  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

March 18, 2025

  • Metals
    Metals

    OverviewHeavy metals play a significant and multifaceted role in the pathogenicity of microbial species. Their involvement can be viewed from two primary perspectives: the toxicity of heavy metals to microbes and the exploitation of heavy metals by microbial pathogens to establish infections and evade the host immune response. Understanding these aspects is critical for both […]

  • Women’s Health
    Women’s Health

    Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.

  • Endometriosis
    Endometriosis

    Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.

Researched by:

  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

Fact-checked by:

  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

Last Updated: 2024

Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.

Karen Pendergrass

Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

What was reviewed?

The article reviews the role of trace elements in the pathogenesis and management of endometriosis, a chronic, estrogen-dependent inflammatory disease. It synthesizes existing research on the impact of oxidative stress and environmental exposure to trace elements like zinc, nickel, cadmium, and copper, linking these factors to the formation and proliferation of endometrial-like lesions outside the uterus.

Who was reviewed?

The review focuses on studies involving women with confirmed endometriosis, highlighting environmental and biological factors such as trace element concentrations in blood, urine, and peritoneal fluid. Additionally, it incorporates experimental findings, including animal models, to explore the mechanistic roles of trace elements.

What were the most important findings?

The review emphasizes the link between oxidative stress and endometriosis, with trace elements acting as potential modulators of this process. Zinc, for instance, is identified for its antioxidant and anti-inflammatory roles, with lower levels in endometriosis patients potentially contributing to lesion formation. Nickel, on the other hand, has been implicated in the condition as a metalloestrogen, as further evidenced by improved symptoms following a low-nickel diet. Cadmium and lead, known for inducing oxidative stress, show conflicting associations with endometriosis, though some evidence suggests their presence synergistically exacerbates disease severity. Copper’s involvement in angiogenesis and its elevated levels in endometriosis patients suggest a role in lesion proliferation. The review also highlights discrepancies in study findings, emphasizing the need for further research on trace elements within endometriotic implants rather than just systemic fluids.

What are the greatest implications of this review?

The review underscores the potential of targeting trace elements and oxidative stress as therapeutic strategies for endometriosis. It calls for more comprehensive research into the specific roles of trace elements within endometriotic tissue, as these could pave the way for novel diagnostic markers and treatments. Additionally, the environmental and dietary implications of trace element exposure warrant further exploration, particularly in the context of prevention and symptom management.

Endometriosis

Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.

Zinc

Zinc is an essential trace element vital for cellular functions and microbiome health. It influences immune regulation, pathogen virulence, and disease progression in conditions like IBS and breast cancer. Pathogens exploit zinc for survival, while therapeutic zinc chelation can suppress virulence, rebalance the microbiome, and offer potential treatments for inflammatory and degenerative diseases.

Nickel

Bacteria regulate transition metal levels through complex mechanisms to ensure survival and adaptability, influencing both their physiology and the development of antimicrobial strategies.

Low‑Nickel Diet (LNiD)

A low-nickel diet (LNiD) is a therapeutic dietary intervention that eliminates high-nickel foods, primarily plant-based sources such as legumes, nuts, whole grains, and cocoa, to reduce systemic nickel exposure. It is clinically validated for managing systemic nickel allergy syndrome (SNAS) and nickel-induced eczema. Its relevance is well-established in microbiome modulation, with studies demonstrating clinical benefits in conditions such as endometriosis, fibromyalgia, irritable bowel syndrome, and GERD.

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