Natural Dietary Treatments for Fibroids

The same diet that helps regulate hormones in women may also reduce exposure to endocrine-disrupting pollutants.

Fibroids are the most common benign tumors in women. They can grow to a foot in diameter and affect the majority of women before they hit menopause. Although fibroids tend to be asymptomatic, when symptoms do occur, they tend to manifest as heavy menstrual bleeding—so much so that women may get anemic and experience a lot of pain. So, what can women do? I discuss this in my video The Best Diet for Fibroids.

Up to half go into surgery and get their entire uterus removed. “Although hysterectomy is generally considered a safe operation, complications occur in a significant proportion of patients” and, obviously, you can’t have kids any more. The alternative is a variety of hormone-modulating drugs, which can shrink the fibroids and provide relief, but many of these drugs have significant side effects, like bone loss, so you really don’t want to be taking them for more than a few months. What’s the bottom line? “There is currently no evidence to support the routine use of medical treatment in women with uterine fibroids.” No wonder many women turn to “complementary and alternative treatments…including exercise, diet, herbs, and acupuncture.”

Women who exercise seven or more hours a week do seem to have lower risk of having fibroids than women who exercise less than around 20 minutes a day, but exercise has never been put to the test for treating fibroids. Likewise, to date, there isn’t a single randomized controlled trial of acupuncture for the treatment of fibroids to help guide us. 

In terms of herbs, there are two Asian herbal preparations that show promise—a five-herb combo called Guizhi Fuling and a Malaysian ten-herb formula that contains “secret ingredients” that must not be that secret since they’re just listed in the study, as you can see at 1:50 in my video—and they seemed to work as well as a leading drug. The problem is that traditional Asian herbal remedies may contain a few extra ingredients, like arsenic, mercury, and lead, which have been detected in most of the samples tested from Asian market and health food store shelves, and not just a little. Some, apparently, had really toxic amounts. So, these two Asian herbal preparations “may reduce fibroid size, but there is insufficient evidence to support the efficacy or safety of these treatments.” And, certainly, don’t try to apply caustic herbs internally, as this can lead to scarring, stenosis, and ulceration.

Well, what about diet? In one of the largest studies of diet and fibroids, fibroid tumors were “associated with beef and ham consumption, whereas high intake of green vegetables seems to have a protective effect.” The researchers figured that the “association between levels of estrogen, diet, and breast and endometrial [uterine lining] cancers also may help us understand” why. Indeed, “[f]or breast and endometrial cancers, a direct association with the frequency of consumption of meat and ham was observed…whereas protection was conferred by high intake of vegetables and fruits.” Thus, there may be these shared risk factors between estrogen-responsive malignant tumors, like breast cancer, and estrogen-responsive benign tumors, like fibroids.

We know the presence of fibroids seems to correlate with an increase in the amount of estrogens flowing through your body, for example, and that women eating vegetarian diets have significantly lower levels of excess estrogen. Researchers are using this knowledge to try to explain why there are lower rates of endometrial cancer—that is, lining-of-the-uterus cancer—and possibly breast cancer among vegetarian women, but it could also help explain the fibroid findings. “The incidence of breast cancer among vegetarian American women (Seventh Day Adventists) is 60 to 80 per cent of the incidence among American women in general, and the incidence among women in Africa and Asia is even lower.” Why might vegetarian women have lower estrogen levels? A famous study in the New England Journal of Medicine concluded that it was their “increased fecal output, which leads to increased fecal excretion of estrogen,” resulting in lower blood levels. Double the fecal output, in fact, as you can see at 4:07 in my video.

And, you can put it to the test. Maybe the same reason African-American women have more fibroids is the same reason they have worse breast cancer survival: too much estrogen in their bloodstream due to a less than optimal diet. So, researchers designed a study to see what would happen if they were switched to a more plant-based, higher fiber diet. Compared with the Caucasian women, the African-American women started out with much higher estrogen levels, again helping to explain their increased mortality from breast cancer. But, after they were put on a healthier diet, all of their levels came down, “suggest[ing] that a substantial reduction in breast cancer risk can be achieved” by adopting a diet centered around more whole plant foods. The same also appears to be true for fibroids, especially eating lots of cruciferous vegetables—broccoli, cabbage, and Chinese cabbage—as well as tomatoes and apples.

Women who underwent premature puberty, starting their periods before age 11, may also be at increased risk of fibroids later in life, and we know that higher childhood red meat intake is associated with earlier age of starting one’s period, though total protein and animal protein in general may contribute. For example, girls who eat meat tend to start their periods about six months earlier than vegetarian girls. Those who eat meat analogues like veggie burgers and veggie dogs start their periods nine months later on average, and a similar puberty normalizing influence was found with consumption of whole plants foods, such as beans. 

It could also be the endocrine-disrupting pollutants that build up the food chain. Researchers took samples of internal abdominal fat from women and found there appeared to be a correlation between the presence of fibroids with the levels of a number of PCBs in their fat. So, does that mean fish-eaters have higher risk of fibroids? Researchers did find a small increase in risk associated with the intake of long-chain omega-3 fats, mostly from “dark-meat fish consumption,” by which they meant fish like sardines and salmon. This could be because of “the endocrine-disrupting chemicals commonly shown in fish,” or it could just be a statistical fluke. It would be consistent with the increased risk seen among “sport-fish consumers.” 

Recognizing that diet and endocrine-disrupting persistent organic pollutants have been associated with a variety of gynecologic conditions, including fibroids, researchers looked at consumers of fish fished out of the Great Lakes and found a 20 percent increased risk for every ten years they had been eating the fish. In the most comprehensive study to date, researchers compared pollutant levels in fat samples from women with fibroids to fat liposuctioned out of women without fibroids. They didn’t just find higher levels of PCBs in fibroid sufferers, but also long-banned pesticides, like DDT and hexachlorocyclohexane, PAHs, which are polycyclic aromatic hydrocarbons formed when coal is burned, tobacco is smoked, and meat is grilled, as well as heavy metals, arsenic, cadmium, lead, and mercury. These levels correlated not only to fibroids, but also to seafood consumption or excess body fat. So, the researchers determined that “shedding excess weight and limiting seafood consumption would confer a protective effect” on fibroid tumor development by minimizing exposure to environmental pollutants as much as possible.

Okay, so a plant-based diet may be best, but is there a plant in particular that has been shown to be particularly powerful?

Plant-based compounds with disease-preventive properties, dietary phytochemicals are found in whole grains, fruits, vegetables, beans, split peas, chickpeas, and lentils, herbs, spices, nuts, and certain beverages. As I discuss in my video The Best Food for Fibroids, we know they can help regulate the initiation, promotion, and spread of cancerous tumors, so what about benign tumors like fibroids? Most anti-cancer drugs on the market now were originally derived from plants or plant products, so why not try to use plants to target the inflammation or blood supply of fibroids? Might fibroids be a consequence of chronic inflammation within the body? We know that women with fibroids are more likely to eat more beef and ham, and fewer fruits and green vegetables, but whole plant foods don’t just have anti-inflammatory effects but antioxidant effects as well. “If the generation of free radicals exceeds the protective effects of antioxidants, oxidative damage will occur,” which has been implicated in a variety of disease states, including gynecological conditions such as fibroids. 

If you collect fresh fibroids, as well as normal uterine tissue from hysterectomy surgeries, the fibroid cells have significantly fewer antioxidant enzymes, as you can see at 1:20 in my video, so might antioxidant-rich foods help? Well, if you drip some strawberries onto cells in a petri dish, you can apparently kill of some fibroid tumor cells, while leaving normal uterus cells alone. But, what good does that do us? That’s only relevant if we can show those strawberry compounds get absorbed through our gut and achieve high enough concentrations in uterine tissue. The same with curcumin, the component of the spice turmeric. One of its so-called “miraculous” properties is suppressing the growth of uterine fibroid cells, but, again, that was just in vitro. Yes, an inhibitory effect was found and at concentrations that don’t compromise the growth of normal, regular uterine tissue, but my patients are people, not petri dishes. 

It’s pretty neat to find out what happens to human fibroid cells as you drip higher and higher concentrations of green tea compounds on them in a test tube, as you can see for yourself at 2:19 in my video, but I care less about what happens in vitro or in mice, whether or not they have any clothes on—one study looked at “a nude mice model”—but there were no randomized, controlled clinical studies until 2013. 

Subjects were randomized to green tea extract or placebo for four months. In the placebo group, fibroid volume increased by 24 percent. That’s what fibroids do; they continue to grow. However, those randomized to the green tea group showed a reduction in total fibroid volume—and not just by a little. There was a dramatic decrease, shrinking by almost a third, which is a highly significant difference, as you can see at 3:02 in my video. Okay, but did the women feel any better? Yes, they experienced a dramatic decrease in symptom severity, as well. Month after month, nothing much happened in the placebo group, but those taking the pills that looked the same but happened to contain green tea compounds had consistent improvement and felt lessening symptoms, each month better than the last, as well as an improved health-related quality of life, month after month, that was significantly better than control. What’s more, their blood counts got better too. With all that continued excess blood loss every month, the blood levels kept decreasing in the placebo group, but they reversed in the green tea group. So, anemia also significantly improved, because average blood flow significantly diminished. And, all this—the fibroid shrinkage, less pain, better periods—was achieved with “no adverse effects.” 

So, not only were the results comparable to those for the drugs that are commonly used—again, without the side effects—but the results were also comparable to uterine artery embolization, where they try to cut the blood supply to the fibroid, which is great—unless they accidentally cut the blood supply to the rest of the uterus and cause uterine necrosis, one of many reported major complications. Others include death, not only of the fibroid, but also of the patient, along with other potential complications that may arise from accidentally clogging off non-target arteries. In my book, a side-effect-free solution as good as a more invasive procedure is potentially better than. The researchers conclude that green tea compounds show “promise as a safe and effective therapeutic agent for women with symptomatic UFs [uterine fibroids]. Such a simple, inexpensive, and orally administered therapy can improve women’s health globally.” 

Relatively safe doesn’t mean risk-free, however. Although there were no liver function abnormalities detected, this was a small study. If you give green tea extract pills to a thousand women for a year, like they did in the Minnesota Green Tea Trial for breast cancer, the livers in about 1 in 17 women started to get inflamed and a few became serious. Now, the dose they used in this study was twice that of the fibroid study and it’s not completely clear if the pills were the only cause, but, in general, we should try to avoid extracts and instead get nutrition from foods as grown—or at least from foods as grown that are then dunked in hot water, like green tea. 

The researchers had to use pills in this study, because they wanted it to be a double-blind study and it’s hard to create a placebo tea that looks, smells, and tastes like the real thing. I don’t think we should take green tea extract pills, though. We should drink green tea. The problem is that the dose the researchers used was about 11 cups a day, which would be a lot of caffeine. You could choose decaf, though, and it’s not outside the realm of possibility to drink a couple quarts of tea a day, especially if doing so may shrink your fibroids so much you can keep your uterus. But, for all we know, five cups of tea a day would work or maybe even three cups or one cup. No other dose has been tested, so we just don’t know. But, you can test it in your own life. If you have fibroids, it couldn’t hurt to add a few cups of green tea to your daily diet and see if you start feeling better.

And, for even more on fibroids, see Should Women with Fibroids Avoid Soy? and Talcum Powder and Fibroids.

For more on contaminated herbal products, see Get the Lead Out and Some Ayurvedic Medicine Worse Than Lead Paint Exposure.

I’ve got dozens and dozens of videos on the effects of diet on estrogens, such as:

In health, 

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Dietary Supplements for Eczema (Atopic Dermatitis)

Are there dietary supplements that can help with atopic dermatitis?

Atopic dermatitis, more commonly known as eczema, ranks “as the skin disease with the greatest health burden worldwide” because it’s just so common, affecting maybe one in ten kids and about 3 percent of adults, causing patches of red, itchy skin. Topical steroids, like cortisone cream, have been “the mainstay treatment” since their Nobel Prize-winning discovery in 1950.

People are scared of steroids, though, and “it is not uncommon for patients to express irrational fear and anxiety about using topical corticosteroids”—steroid creams and ointments. This phobia may arise from confusing topical steroids with oral or injected steroids, which have different effects. Really potent topical steroids can thin your skin, but skin thickness should return to normal a month after stopping. So, yes, topical steroids can cause side effects, but the concern people have “seems out of proportion” to the small risk they actually pose. Still, if there’s a way you can resolve a problem without drugs, that’s generally preferable. What did they do for eczema before the 1950s?

In the 1930s, some researchers tried using vitamin D dissolved in corn oil, and to their surprise, it worked—but so did the corn oil without the vitamin D they were using as a control. Others reported cases improving after feeding flaxseed oil and even ingesting lard, from a study “aided by a grant from the National Live Stock and Meat Board,” which apparently did not want to be left out of the action. The problem is that none of these studies had a control group. So, yes, after feeding someone corn oil for 12 to 18 months, they got better—but maybe they would have gotten better anyway. You don’t know until you put it to the test. 

Nearly all of those researchers who claimed benefit from the use of the various fats apparently “lack[ed]…any great interest in a controlled series,” but one researcher tested some oils and found no evidence of benefit over routine treatment. Indeed, as you can see at 2:06 in my video Eczema Treatment with Evening Primrose Oil vs. Borage Oil vs. Hempseed Oil, most got better either way, which suggests that the previous “benefits claimed may be due to the usual treatment, with perhaps a dash of enthusiasm.”

By then, hydrocortisone was out, so the medical community gave up on dietary approaches—until a letter was published in 1981 about the treatment of eczema with supplements of evening primrose oil, which contains gamma linolenic acid, an anti-inflammatory omega-6. And, indeed, when it was put to the test, it seemed to help, but then a subsequent larger study found no effect. Whenever there are conflicting findings, it helps to do a meta-analysis, where you put all the studies together. So, there was the study that showed benefit, the one that didn’t, and seven other studies. What did those find? Seven out of the seven showed benefit. “The results show that the effects of Epogam [a brand of primrose oil supplement] are almost always significantly better than those of placebo.” Case closed, right? Well, the analysis was funded by the supplement company itself, which can be a red flag, and where exactly were the other seven studies published? They weren’t. The company just said it did those seven studies but never released them. When asked to hand them over, the company said it would but never did, even threatening a lawsuit against researchers who dared to question the studies’ efficacy.

An independent review failed to find evidence that evening primrose oil or borage oil worked better than placebo. “As we bid goodnight to the evening primrose oil story, perhaps we can awaken to a world where all clinical trial data…reach the light of day…” 

Borage oil actually has twice the gamma linolenic acid as evening primrose yet it still didn’t work, but that didn’t stop researchers from trying hempseed oil, which “has been used as a food and medicine for at least 3000 years in China.” Researchers tried giving about a quarter cup of hempseeds’ worth of oil to people every day for a few months and found significant improvements in skin dryness, itchiness, and the need for medications—but not compared to placebo. In fact, studies of dietary supplements across the board, whether fish oil, zinc, selenium, vitamins D, E, or B6, sea buckthorn oil, hempseed oil, or sunflower oil, overall, showed “no convincing evidence that taking supplements improved the eczema of those involved.” That’s disappointing, but wait a second. That’s just for oral supplements. What about natural remedies applied topically? I discuss that in my video Eczema Treatment with Coconut Oil vs. Mineral Oil, vs. Vaseline.

Meta-analyses can be skewed the other way, too, when negative results are quietly shelved so only positive findings are published. Antidepressant medications are a classic example of this publication bias. Check out my coverage of it in my video Do Antidepressant Drugs Really Work?.

As I queued up at the end, I cover topical natural treatments in my next video, Eczema Treatment with Coconut Oil vs. Mineral Oil vs. Vaseline.

What about skipping the lard and trying to eat more healthfully? See what happened in Treating Asthma and Eczema with Plant-Based Diets.

For more on skin health, check out:

In health, 

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

No Purveyor of Unhealthy Products Wants the Public to Know the Truth

In 2011, Denmark introduced the world’s first tax on saturated fat. “After only 15 months, however, the fat tax was abolished,” due to massive pressure from farming and food company interests. “Public health advocates are weak in tackling the issues of corporate power…A well-used approach for alcohol, tobacco, and, more recently, food-related corporate interests is to shift the focus away from health. This involves reframing a fat or soft drinks tax as an issue of consumer rights and a debate over the role of the state in ‘nannying’ or restricting people’s choices.” I discuss this in my video The Food Industry Wants the Public Confused About Nutrition.

“The ‘Nanny State’ is a term that is usually used in a pejorative way to discourage governments from introducing legislation or regulation that might undermine the power or actions of industry or individuals…Public health advocacy work is regularly undermined by the ‘Nanny State’ phrase.” But those complaining about the governmental manipulation of people’s choices hypocritically tend to be fine with corporations doing the same thing. One could argue that “public health is being undermined by the ‘Nanny Industry’…[that] uses fear of government regulation to maintain its own dominance, to maintain its profits and to do so at a significant financial and social cost to the community and to public health.”

The tobacco industry offers the classic example, touting “personal responsibility,” which has a certain philosophical appeal. As long as people understand the risks, they should be free to do whatever they want with their bodies. Now, some argue that risk-taking affects others, but if you have the right to put your own life at risk, shouldn’t you have the right to aggrieve your parents, widow your spouse, and orphan your children? Then, there’s the social cost argument. People’s bad decisions can cost the society as a whole, whose tax dollars may have to care for them. “The independent, individualist motorcyclist, helmetless and free on the open road, becomes the most dependent of individuals in the spinal injury ward.”

But, for the sake of argument, let’s forget these spillover effects, the so-called externalities. If someone understands the hazards, shouldn’t they be able to do whatever they want? Well, “first, it assumes individuals can access accurate and balanced information relevant to their decisions…but deliberate industry interference has often created situations where consumers have access only to incomplete and inaccurate information…For decades, tobacco companies successfully suppressed or undermined scientific evidence of smoking’s dangers and down played the public health concerns to which this information gave rise.” Don’t worry your little head, said the nanny companies. “Analyses of documents…have revealed decades of deception and manipulation by the tobacco industry, and confirmed deliberate targeting of…children.” Indeed, it has “marketed and sold [its] lethal products with zeal…and without regard for the human tragedy….”

“The tobacco industry’s deliberate strategy of challenging scientific evidence undermines smokers’ ability to understand the harms smoking poses” and, as such, undermines the whole concept that smoking is a fully informed choice. “Tobacco companies have denied smokers truthful information…yet held smokers [accountable] for incurring diseases that will cause half of them to die prematurely. In contexts such as these, government intervention is vital to protect consumers from predatory industries….”

Is the food industry any different? “The public is bombarded with information and it is hard to tell which is true, which is false and which is merely exaggerated. Foods are sold without clarity about the nutritional content or harmful effects.” Remember how the food industry spent a billion dollars making sure the easy-to-understand traffic-light labeling system on food, which you can see at 4:26 in my video, never saw the light of day and was replaced by indecipherable labeling? That’s ten times more money than the drug industry spends on lobbying in the United States. It’s in the food industry’s interest to have the public confused about nutrition.

How confused are we about nutrition? “Head Start teachers are responsible for providing nutrition education to over 1 million low-income children annually…” When 181 Head Start teachers were put to the test, only about 4 out of the 181 answered at least four of the five nutrition knowledge questions correctly. Most, for example, could not correctly answer the question, “What has the most calories: protein, carbohydrate, or fat?” Not a single teacher could answer all five nutrition questions correctly. While they valued nutrition education, 54 percent “agreed that it was hard to know which nutrition information to believe,” and the food industry wants to keep it that way. A quarter of the teachers did not consume any fruits or vegetables the previous day, though half did have french fries and soda, and a quarter consumed fried meat the day before. Not surprisingly, 55 percent of the teachers were not just overweight but obese.

When even the teachers are confused, something must be done. No purveyor of unhealthy products wants the public to know the truth. “An interesting example comes from the US ‘Fairness Doctrine’ and the tobacco advertising experience of the 1960s. Before tobacco advertising was banned from television in the US, a court ruling in 1967 required that tobacco companies funded one health ad about smoking for every four tobacco TV advertisements they placed. Rather than face this corrective advertising, the tobacco industry took their own advertising off television.” They knew they couldn’t compete with the truth. Just “the threat of corrective advertising even on a one-to-four basis was sufficient to make the tobacco companies withdraw their own advertising.” They needed to keep the public in the dark.

The trans fat story is an excellent example of this. For more on that, see my videos Controversy Over the Trans Fat Ban and Banning Trans Fat in Processed Foods but Not Animal Fat.

Isn’t the Fairness Doctrine example amazing? Just goes to show how powerful the truth can be. If you want to support my efforts to spread evidence-based nutrition, you can donate to our 501c3 nonprofit here. You may also want to support Balanced, an ally organization helped launch to put this evidence into practice.

More tobacco industry parallels can be found in Big Food Using the Tobacco Industry Playbook, American Medical Association Complicity with Big Tobacco, and How Smoking in 1959 Is Like Eating in 2016.

Want to know more about that saturated fat tax idea? See Would Taxing Unhealthy Foods Improve Public Health?.

Also check:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: