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:

Should You Get an Annual Health Check-Up?

What are the risks and benefits of getting an annual check-up from your doctor?

Physicians and patients have come to expect the annual check-up as a routine part of care. “However, considerable research has not demonstrated a substantial benefit,” so a “revolt is brewing against the tradition of periodic” check-ups. “Even the Society for General Internal Medicine advised primary care physicians to avoid ‘routine general health checks for asymptomatic adults.’”

As I discuss in my video Is It Worth Getting Annual Health Check-Ups?, routine check-ups do seem to make sense. But, historically, medical practice has included all sorts of interventions that seemed to make sense, such as hormone replacement therapy for menopause—that is, until it was put to the test and found to increase risks of breast cancer, blood clots, heart disease, and stroke. “History repeatedly shows that good intentions and ‘common sense’ kill in the name of prevention (for example, prone sleeping recommendation for infants).” Indeed, doctors killed babies by making the so-called common sense recommendation that infants sleep on their tummies, whereas we now know “Face Up to Wake Up.” “We should always demand evidence rather than succumb to delusion.”

“We check our cars regularly, so why shouldn’t we also check our bodies…?” Well, unlike cars, our bodies have self-healing properties. To see if the benefits outweigh the harms, researchers decided to put it to the test.

“What are the benefits and harms of general health checks for adult populations?” The bottom line is that check-ups were “not associated with lower rates of all-cause mortality, mortality from cardiovascular disease, or mortality from cancer,” meaning they weren’t associated with living longer or a lower risk of dying from heart disease, stroke, or cancer. So, general check-ups may not reduce disease rates or death rates, but they do increase the number of new diagnoses. And, the “[h]armful effects of some tests and subsequent treatment could have balanced out possible beneficial effects of others.”

Possible harms from check-ups include “overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, possible continuation of adverse health behaviours due to negative test results, adverse psychosocial effects due to labelling, and difficulties with getting insurance” (now that you have a pre-existing condition), not to mention all of the associated costs. 

Take diabetes, for example. Wouldn’t it be great if we detected cases of diabetes earlier? Perhaps not, if you were one of the people given Avandia, the number one diabetes drug that was then pulled off the market because instead of helping people, it appeared to be killing them. Adverse drug events are now one of our leading causes of death. When it comes to lifestyle diseases like type 2 diabetes, maybe we should focus instead on creating healthier food environments. This is what one of my favorite organizations, Balanced, does to help prevent the diabetes epidemic in the first place.

How many times have you tried to inform someone about healthy eating and evidence-based nutrition, only to have them say, “No, I don’t have to worry. My doctor reassured me I’m fine. I just had a check-up, and everything’s normal.” As if having a normal cholesterol is okay in a society where it’s normal to drop dead of a heart attack, the number one killer of men and women. It would be one thing if you went to see a lifestyle medicine doctor who spent the check-up giving you the tools to prevent 80 percent of chronic disease, but given the way medicine is currently practiced, it’s no wonder why the history of routine check-ups “has been one of glorious failure, but generations of well meaning clinicians and public health physicians struggle to allow themselves to believe it.” But, “policy should be based on evidence…” 

Poor diet may be “on par with tobacco smoking as the most common actual causes of death,” yet the medical profession is inadequately trained in nutrition. Worse, nutrition education in medical school appears to be declining. If you can believe it, there is actually a “shrinking of formalized nutrition education” among health professionals, so the advice you get during your annual check-up may just be from the last tabloid your doctor skimmed while in the supermarket check-out line.

“And screening appointments should not be regarded as a form of ‘health education,’” read one medical journal editorial. “People who are obese know very well that they are, and if we have no means of helping them…then we should shut up.” Well, if you really have nothing to say that will help them, maybe you should shut up, especially those doctors who say they “have no idea what constitutes a ‘healthy’ diet”—although we do know that veggies and nuts are a good start.

Won’t a check-up allow your physician to do a comprehensive physical exam and routine blood testing? I discuss that, as well as the pros and cons, in my vide Is it Worth Getting an Annual Physical Exam?.

Did I say lifestyle medicine? Yes! Learn more about this exciting growing field in Lifestyle Medicine: Treating the Causes of Disease and Convincing Doctors to Embrace Lifestyle Medicine. Make sure your doctor is a member of the American College of Lifestyle Medicine (and even better certified by the American Board of Lifestyle Medicine).

Still don’t understand how there can be risks? See Why Prevention Is Worth a Ton of Cure. Unfortunately, physicians and patients alike wildly overestimate the benefits of pills and procedures. See, for example, The Actual Benefit of Diet vs. Drugs.

The fact is Physicians May Be Missing Their Most Important Tool.


And what about mammograms? See my video series:

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:

Coconut Oil and the Boost in HDL “Good” Cholesterol

The effects of coconut oil were compared to butter and tallow. Even if virgin coconut oil and other saturated fats raise LDL “bad” cholesterol, isn’t that countered by the increase in HDL “good” cholesterol?

According to “the experience and wisdom of 200 of the country’s leading experts in cardiovascular diseases,” in a report representing 29 national medical organizations, including the American Heart Association and the American College of Cardiology, we’ve known for nearly half a century that “coconut oil is one of the most potent agents for elevating [blood] serum cholesterol level.” As I discuss in my video Coconut Oil and the Boost in HDL “Good” Cholesterol, studies showing coconut oil elevates cholesterol date back to 1955, when it was first shown experimentally that switching someone from coconut oil to soybean oil could drop cholesterol from around 200 down to 150, as you can see at 0:39 in my video.

Coconut oil can significantly raise cholesterol levels within hours of consumption. In fact, a significant increase in blood cholesterol was found within hours of eating a slice of cake made from either coconut oil (or cod liver oil for that matter), but not from the same cake made from flaxseed oil.

As you can see at 1:10 in my video, coconut oil may even be worse than tallow, or beef fat, but it is not as bad as butter. An interventional trial was published in March 2017: a month-long randomized, controlled, crossover study looking at the impact of two tablespoons per day of virgin coconut oil. The result? Coconut oil elevated cholesterol about 14 percent over the control, which was consistent with seven other interventional trials published to date in a 2016 review.

Hold on. Saturated fats can make HDL, the so-called good cholesterol, go up, so what’s the problem? The problem is that it doesn’t seem to help. Having a high blood HDL level is “no longer regarded as protective.” What? Wait a second. Higher HDL levels are clearly associated with lower risk of heart disease, as you can see at 2:01 in my video. In fact, HDL levels “are among the most consistent and robust predictors of CVD [cardiovascular disease] risk.” Ah, but there are two types of risk factors: causal and non-causal. Association does not mean causation—that is, just because two things are tightly linked, it doesn’t mean one causes the other.

Let me give you an example, which you can see at 2:30 in my video. I bet that the number of ashtrays someone owns is an excellent predictor of lung cancer risk and that study after study would show that link. But, that does not mean that if you intervene and lower the number of ashtrays someone has, their lung cancer risk will drop, because it’s not the ashtrays that are causing the cancer, but the smoking. The ashtrays are just a marker of smoking, an indicator of smoking, as opposed to playing a causal role in the disease. So, just like having a high number of running shoes and gym shorts might predict a lower risk of heart attack, having a high HDL also predicts a lower risk of heart attack. But, raising HDL, just like raising the number of gym shorts, wouldn’t necessarily affect disease risk. How do you differentiate between causal and non-causal risk factors? You put them to the test. The reason we know LDL cholesterol truly is bad is because people who were just born with genetically low LDL cholesterol end up having a low risk of heart disease. And, if you intervene and actively lower people’s LDL through diet or drugs, their heart disease risk drops—but not so with HDL.

People who live their whole lives with high HDL levels don’t appear to have a lower risk of heart attack, and if you give people a drug that increases their HDL, it doesn’t help. That’s why we used to give people high-dose niacin—to raise their HDL. But, it’s “time to face facts.” The “lack of benefit of raising the HDL cholesterol level with the use of niacin…seriously undermine[s] the hypothesis that HDL cholesterol is a causal risk factor.” In simple terms: “High HDL may not protect the heart.” We should concentrate on lowering LDL. So, specifically, as this relates to coconut oil, the increase in HDL “is of uncertain clinical relevance,” but the increase in LDL you get from eating coconut oil “would be expected to have an adverse effect” on atherosclerotic cardiovascular disease risk.

But, what about the MCTs, the medium-chain triglycerides? Proponents of coconut oil, who lament “that ‘coconut oil causes heart disease’ has created this bad image of [their] national exports,” assert that the medium-chain triglycerides, the shorter saturated fats found in coconut oil, aren’t as bad as the longer-chain saturated fats in meat and dairy. And, what about that study that purported to show low rates of heart disease among Pacific Islanders who ate large amounts of coconuts? I cover both of those topics in my video What About Coconuts, Coconut Milk, and Coconut Oil MCTs?.


I love topics that give me an excuse to talk about scientific concepts more generally, like various study designs in my video Prostate Cancer and Organic Milk vs. Almond Milk or my discussion of direct versus indirect risk factors in this one.

How do we know LDL is bad? Check out How Do We Know That Cholesterol Causes Heart Disease?.

But, wait. Isn’t the whole saturated fat thing bunk? No. 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: