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:

How to Treat Polycystic Ovary Syndrome (PCOS) with Diet

Given the role that oxidant free radicals are thought to play in aging and disease, one reason fruits and vegetables may be so good for us is that they contain antioxidant compounds. As you can see at 0:20 in my video Benefits of Marjoram for Polycystic Ovary Syndrome (PCOS), different vegetables and herbs have different antioxidant content. When making a salad, for example, spinach, arugula, or red leaf lettuce may provide twice the antioxidants as butterhead lettuce, and choosing purple cabbage over green, or red onions over white can also boost the salad’s antioxidant power.

Fresh herbs are so powerful that even a small amount may double or even quadruple the antioxidant power of the entire meal. For instance, as you can see at 0:50 in my video, the total antioxidants in a simple salad of lettuce and tomato jump up by adding just a tablespoon of lemon balm leaves or half a tablespoon of oregano or mint. Adding marjoram, thyme, or sage not only adds great flavor to the salad, but effectively quadruples the antioxidant content at the same time, and adding a little fresh garlic or ginger to the dressing ups the antioxidant power even more.

Herbs are so antioxidant-rich that researchers decided to see if they might be able to reduce the DNA-damaging effects of radiation. Radioactive iodine is sometimes given to people with overactive thyroid glands or thyroid cancer to destroy part of the gland or take care of any remaining tumor cells after surgery. For days after the isotope injection, patients become so radioactive they are advised not to kiss or sleep close to anyone, including their pets, and if they breathe on a phone, they’re advised to wipe it “carefully” or cover it “with an easily removed plastic bag.” Other recommendations include “avoid[ing] splatter of radioactive urine,” not going near your kids, and basically just staying away from others as much as possible.

The treatment can be very effective, but all that radiation exposure appears to increase the risk of developing new cancers later on. In order to prevent the DNA damage associated with this treatment, researchers tested the ability of oregano to protect chromosomes of human blood cells in vitro from exposure to radioactive iodine. As you can see at 2:25 in my video, at baseline, about 1 in 100 of our blood cells show evidence of chromosomal damage. If radioactive iodine is added, though, it’s more like 1 in 8. What happens if, in addition to the radiation, increasing amounts of oregano extract are added? Chromosome damage is reduced by as much 70 percent. Researchers concluded that oregano extract “significantly protects” against DNA damage induced by the radioactive iodine in white blood cells. This was all done outside the body, though, which the researchers justified by saying it wouldn’t be particularly ethical to irradiate people for experimental research. True, but millions of people have been irradiated for treatment, and researchers could have studied them or, at the very least, they could have just had people eat the oregano and then irradiate their blood in vitro to model the amount of oregano compounds that actually make it into the bloodstream.

Other in vitro studies on oregano are similarly unsatisfying. In a comparison of the effects of various spice extracts, including bay leaves, fennel, lavender, oregano, paprika, parsley, rosemary, and thyme, oregano beat out all but bay leaves in its ability to suppress cervical cancer cell growth in vitro while leaving normal cells alone. But people tend to use oregano orally—that is, they typically eat it—so the relevance of these results are not clear.

Similarly, marjoram, an herb closely related to oregano, can suppress the growth of individual breast cancer cells in a petri dish, as you can see at 3:53 in my video, and even effectively whole human breast tumors grown in chicken eggs, which is something I’ve never seen before. Are there any clinical trials on oregano-family herbs on actual people? The only such clinical, randomized, control study I could find was a study on how marjoram tea affects the hormonal profile of women with polycystic ovary syndrome (PCOS). The most common cause of female fertility problems, PCOS affects up to one in eight young women and is characterized by excessive male hormones, resulting in excess body or facial hair, menstrual irregularities, and cysts in one’s ovaries that show up on ultrasounds.

Evidently, traditional medicine practitioners reported marjoram tea was beneficial for PCOS, but it had never been put to the test…until now. Drinking two daily cups of marjoram tea versus a placebo tea for one month did seem to beneficially affect the subjects’ hormonal profiles, which seems to offer credence to the claims of the traditional medicine practitioners. However, the study didn’t last long enough to confirm that actual symptoms improved as well, which is really what we care about.

Is there anything that’s been shown to help? Well, reducing one’s intake of dietary glycotoxins may help prevent and treat the disease. Over the past 2 decades there has been increasing evidence supporting an important contribution from food-derived advanced glycation end products (AGEs)…[to] increased oxidative stress and inflammation, processes that play a major role in the causation of chronic diseases,” potentially including polycystic ovary syndrome (PCOS). Women with PCOS tend to have nearly twice the circulating AGE levels in their bloodstream, as you can see at 0:33 in my video Best Foods for Polycystic Ovary Syndrome (PCOS). 

PCOS may be the most common hormonal abnormality among young women in the United States and is a common cause of infertility, menstrual dysfunction, and excess facial and body hair. The prevalence of obesity is also higher in women with PCOS. Since the highest AGE levels are found in broiled, grilled, fried, and roasted foods of “mostly animal origin,” is it possible that this causal chain starts with a bad diet? For instance, maybe eating lots of fried chicken leads to obesity, which in turn leads to PCOS. In that case, perhaps what we eat is only indirectly related to PCOS through weight gain. No, because the same link between high AGE levels and PCOS was found in lean women as well.

“As chronic inflammation and increased oxidative stress have been incriminated in the pathophysiology [or disease process] of PCOS, the role of AGEs as inflammatory and oxidant mediators, may be linked with the metabolic and reproductive abnormalities of the syndrome.” Further, the buildup of AGE inside polycystic ovaries themselves suggests a potential role of AGEs contributing to the actual disease process, beyond just some of its consequences.

RAGE is highly expressed in ovarian tissues. The receptor in the body for these advanced glycation end products, the “R” in RAGE, is concentrated in the ovaries, which may be particularly sensitive to its effect. So, AGEs might indeed be contributing to the cause of PCOS and infertility.

Does this mean we should just cut down on AGE-rich foods, such as meat, cheese, and eggs? Or hey, why not come up with drugs that block AGE absorption? We know AGEs have been implicated in the development of many chronic diseases. Specifically, food-derived AGEs play an important role because diet is a major source of these pro-inflammatory AGEs. Indeed, cutting down on these dietary glycotoxins reduces the inflammatory response, but the “argument is often made that stewed chicken would be less tasty than fried chicken…” Why not have your KFC and eat it, too? Just take an AGE-absorption blocking drug every time you eat it to reduce the absorption of the toxins. What’s more, it actually lowers AGE blood levels. This oral absorbent drug, AST-120, is just a preparation of activated charcoal, like what’s used for drug overdoses and when people are poisoned. I’m sure if you took some ipecac with your KFC, your levels would go down, too.

There’s another way to reduce absorption of AGEs, and that’s by reducing your intake in the first place. It’s simple, safe, and feasible. The first step is to stop smoking. The glycotoxins in cigarette smoke may contribute to increased heart disease and cancer in smokers. Then, decrease your intake of high-AGE foods, increase your intake of foods that may help pull AGEs out of your system, like mushrooms, and eat foods high in antioxidants, like berries, herbs, and spices. “Dietary AGE intake can be easily decreased by simply changing the method of cooking from a high dry heat application to a low heat and high humidity…” In other words, move away from broiling, searing, and frying to more stewing, steaming, and boiling.

What we eat, however, may be more important than how we cook it. At 4:00 in my video, I include a table showing the amounts of AGEs in various foods. For instance, boiled chicken contains less than half the glycotoxins of roasted chicken, but even deep-fried potatoes have less than boiled meat. We can also eat foods raw, which doesn’t work as well as for blood pudding, but raw nuts and nut butters may contain about 30 times less glycotoxins than roasted, and we can avoid high-AGE processed foods, like puffed, shredded, and flaked breakfast cereals.

Why does it matter? Because study after study has shown that switching to a low-AGE diet can lower the inflammation within our bodies. Even just a single meal high in AGEs can profoundly impair our arterial function within just two hours of consumption. At 4:54 in my video, you can see the difference between a meal of fried or broiled chicken breast and veggies compared with steamed or boiled chicken breast and veggies. Same ingredients, just different cooking methods. Even a steamed or boiled chicken meal can still impair arterial function, but significantly less than fried or broiled.

“Interestingly, the amount of AGEs administered [to subjects] during the HAGE [high-AGE] intervention was similar to the average estimated daily intake by the general population,” who typically follow the standard American diet. This is why we can decrease inflammation in people by putting them on a low-AGE diet, yet an increase in inflammation is less apparent when subjects switch from their regular diet to one high in AGEs. Indeed, they were already eating a high-AGE diet with so many of these glycotoxins.

Do we have evidence that reducing AGE intake actually helps with PCOS? Yes. Within just two months, researchers found differences from subjects’ baseline diets switched to a high-AGE diet and then to a low-AGE diet, with parallel changes in insulin sensitivity, oxidative stress, and hormonal status, as seen at 5:54 in my video. The take-home learning? Those with PCOS may want to try a low-AGE diet, which, in the study, meant restricting meat to once a week and eating it only boiled, poached, stewed, or steamed, as well as cutting out fast-food-type fare and soda.

What if instead of eating steamed chicken, we ate no meat at all? Rather than measuring blood levels, which vary with each meal, we can measure the level of glycotoxins stuck in our body tissues over time with a high-tech device that measures the amount of light our skin gives off because AGEs are fluorescent. And, not surprisingly, this turns out to be a strong predictor of overall mortality. So, the lower our levels, the better. The “one factor that was consistently associated with reduced [skin fluorescence]: a vegetarian diet.” This “suggests that a vegetarian diet may reduce exposure to preformed dietary AGE…potentially reduc[ing] tissue AGE,” as well as chronic disease risk


What’s so great about antioxidants? See my videos:

Just how many antioxidants do we need? Check out:

For a few simple tips on how to quickly boost the antioxidant content of your food with herbs and spices, see my video Antioxidants in a Pinch.

I touched on the benefits of spearmint tea for PCOS in Enhancing Athletic Performance with Peppermint. Another sorely under-recognized gynecological issue is endometriosis, which I discuss in How to Treat Endometriosis with Seaweed.

Because of AGEs, I no longer toast nuts or buy roasted nut butters, which is disappointing because I really enjoy those flavors so much more than untoasted and unroasted nuts. But, as Dr. McDougall likes to say, nothing tastes as good as healthy feels. For more on why it’s important to minimize our exposure to these toxic compounds, see:

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:

 

 

How to Treat Bacterial Vaginosis

Vitamin C is pitted head-to-head against antibiotics for bacterial vaginal infections.

A study published in 1999 raised the exciting possibility that “cheap, simple, innocuous and ubiquitous vitamin C” supplements could prevent a condition known as preeclampsia, but after a decade of research, we realized that was merely a false hope and that vitamin C supplements appear to play little role in women’s health. But this was in regard to oral vitamin C, not vaginal vitamin C, which has been found to be an effective treatment for bacterial vaginosis, an all too common gynecological disorder characterized by a foul-smelling, watery, gray discharge, which I discuss in my video Treating Bacterial Vaginosis with Vaginal Vitamin C.

Bacterial vaginosis “can best be described as an ‘ecological disaster’ of the vaginal microflora.” The good, normal, lactobacillus-type bacteria get displaced by an army of bad bacteria. Probiotics may help, repopulating the good bacteria, but the reason the bad bacteria took over in the first place was that the pH was off. I’ve talked before about the role diet may play in the development of the condition. (See my video Bacterial Vaginosis and Diet for more.) For example, saturated fat intake may increase vaginal pH, allowing for the growth of undesirable bacteria, so why not try to re-acidify the vagina with ascorbic acid, otherwise known as vitamin C? This isn’t just plain vitamin C tablets but specially formulated silicone-coated supplements that release vitamin C slowly, so as to not be irritating. How well do they work? One hundred women suffering from the condition were split into two groups, and the vaginal vitamin C beat out placebo. But how does vitamin C compare with conventional therapy, an antibiotic gel?

This is an important question. “Although perceived as a mild medical problem,” bacterial vaginosis may increase the risk of several gynecological complications, including problems during pregnancy, when you want to avoid taking drugs whenever possible. The vitamin C appeared to work as effectively as the antibiotic. So, vitamin C can really help, especially in the first trimester of pregnancy when you really don’t want to using drugs like topical antibiotics. And for women with recurrent episodes, using vitamin C for six days after each cycle appears to cut the risk of recurrence in half, as you can see at 2:36 in my video.


Another way to get vitamin C into the body is by dripping it directly into the vein. Does that actually do anything? See:

For those of us who prefer to get vitamin C the old-fashioned way, through the mouth and in foods rather than supplements, the question becomes What Is the Optimal Vitamin C Intake?

 If you’re considering taking oral vitamin C in supplements instead, make sure to watch this video first: Do Vitamin C Supplements Prevent Colds But Cause Kidney Stones?.

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: