The Best Diet for Fibroids

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

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“…[F]ibroids…are the most common benign tumours in women.” They can get up to a foot in diameter, and affect the majority of women before they hit menopause. They “tend to be asymptomatic,” though, but when symptoms do occur, they tend to manifest as “heavy menstrual bleeding”—so much so, women may get anemic, and lots of pain.

So, what can women do? Up to half go for surgery, and get their entire uterus removed. Although it’s “generally considered a safe operation,” obviously, you can’t have kids any more, and complications occur in a significant proportion of patients. 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. And so, bottom line: “There is currently no evidence to support the routine use of [drug] treatment in women [for] fibroids.” No wonder many women turn to “complementary and alternative treatments,” such as 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 like 20 minutes a day. But, it’s never been put to the test for treating fibroids. And likewise, there’s not a single randomized controlled trial of acupuncture for the treatment of fibroids, to date, 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, which contains “secret” ingredients—so secret, they just list them. But, seemed to work as well as the leading drug. The problem is that traditional Asian herbal remedies may contain a few extra bonus secret ingredients—like “arsenic, mercury, and lead…in most of the samples” tested off Asian market and health food store shelves. And, not just a little; some, apparently, had really toxic amounts. So, yeah, these two Asian herbal preparations “may reduce fibroid size, but there [remains] insufficient evidence [as to their] safety.” And, certainly, don’t try to apply caustic herbs internally, as this can lead to “scarring,…stenosis, [and] ulceration.”

Okay, but 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 seem[ed] to have a protective effect.” They figured that the “association between…estrogen, diet, and breast and [uterine-lining] cancers [might] help us understand [why]. For breast and endometrial cancers, [there’s] a [similar] direct association with the frequency of [meat] consumption,” with a similar “protection…conferred by…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.

See, we know the presence of fibroids seems to correlate with an increase in the amount of estrogens, for example, flowing through your body, and women eating vegetarian have significantly lower levels of excess estrogen. Now, they’re using this to try to explain why there are “lower rates of endometrial cancer [meaning lining-of-the-uterus cancer] and possibly breast cancer” among those eating vegetarian.

But, it could also help explain the fibroid findings. “The incidence of breast cancer among vegetarian…Adventists is [only] 60 to 80 per cent [that of] American women in general,” and the incidence among women in Africa and Asia is even lower.” Why might women eating vegetarian have lower estrogen levels? This famous study in the New England Journal concluded that it was their “increased fecal output [that] leads to increased…excretion of estrogen,” resulting in lower blood levels. Double the output, in fact. You can see all the heavyweight Vs compared to the welterweight omnivores.

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 this study to see what would happen if they were switched to a more plant-based, higher-fiber diet. The women started out with much higher estrogen levels, again helping to explain their “increased mortality from breast cancer.” But, put people on a healthier diet, and all their levels come down, suggesting “a substantial reduction in breast cancer risk can be achieved” by adopting a diet centered around more whole plant foods. And, the same 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 higher childhood red meat intake is associated with earlier age of starting one’s period, though “total and animal protein” in general may contribute. For example, girls who eat meat tend to start their periods about six months earlier than girls who eat vegetarian. Those that eat “meat analogues”—meaning like veggie burgers, veggie dogs—started their periods “9 months later” on average, and a similar puberty-normalizing influence was found with consumption of whole plant 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 there appeared to be a correlation between the presence of fibroids and 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…[of] risk associated with [the] intake…of long-chain omega-3 fat[s],” mostly from “dark-meat fish consumption,” by which they meant like sardines and salmon. This could be because of “the endocrine-disrupting chemicals commonly [found] in fish,” or it could just be a statistical fluke. It would be consistent, though, with the “increased risk [among] sport-fish consumers.” They’re talking about this study.

Recognizing that “[d]iet and endocrine-disrupting persistent organic pollutants have been associated with [a variety of] gynecologic conditions including [fibroids],” they’ve looked at consumers of fish fished out of the Great Lakes, and found a 20% increased risk for every ten years they had been eating the fish. This is the most comprehensive study to date. They compared pollutant levels in fat samples of women with fibroids to fat liposuctioned out of women without fibroids—and didn’t just find higher levels of PCBs in fibroid sufferers, but also long-banned pesticides, like DDT and hexachlorocyclohexane, PAHs—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, levels which correlated not only to fibroids but to seafood consumption or excess body fat. So, “shedding excess weight and limiting seafood consumption [might] confer a protective effect on [fibroid tumor] development” by minimizing “exposure to environmental pollutants as much as possible.”

Please consider volunteering to help out on the site.

Icons created by Andriwidodo, Pavel Melnikov, Denis Shumaylov, Michal Czekala, and Aleksandr Vector from The Noun Project.

Image credit: Kristina DeMuth. Image has been modified.

Motion graphics by Avocado Video. 

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“…[F]ibroids…are the most common benign tumours in women.” They can get up to a foot in diameter, and affect the majority of women before they hit menopause. They “tend to be asymptomatic,” though, but when symptoms do occur, they tend to manifest as “heavy menstrual bleeding”—so much so, women may get anemic, and lots of pain.

So, what can women do? Up to half go for surgery, and get their entire uterus removed. Although it’s “generally considered a safe operation,” obviously, you can’t have kids any more, and complications occur in a significant proportion of patients. 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. And so, bottom line: “There is currently no evidence to support the routine use of [drug] treatment in women [for] fibroids.” No wonder many women turn to “complementary and alternative treatments,” such as 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 like 20 minutes a day. But, it’s never been put to the test for treating fibroids. And likewise, there’s not a single randomized controlled trial of acupuncture for the treatment of fibroids, to date, 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, which contains “secret” ingredients—so secret, they just list them. But, seemed to work as well as the leading drug. The problem is that traditional Asian herbal remedies may contain a few extra bonus secret ingredients—like “arsenic, mercury, and lead…in most of the samples” tested off Asian market and health food store shelves. And, not just a little; some, apparently, had really toxic amounts. So, yeah, these two Asian herbal preparations “may reduce fibroid size, but there [remains] insufficient evidence [as to their] safety.” And, certainly, don’t try to apply caustic herbs internally, as this can lead to “scarring,…stenosis, [and] ulceration.”

Okay, but 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 seem[ed] to have a protective effect.” They figured that the “association between…estrogen, diet, and breast and [uterine-lining] cancers [might] help us understand [why]. For breast and endometrial cancers, [there’s] a [similar] direct association with the frequency of [meat] consumption,” with a similar “protection…conferred by…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.

See, we know the presence of fibroids seems to correlate with an increase in the amount of estrogens, for example, flowing through your body, and women eating vegetarian have significantly lower levels of excess estrogen. Now, they’re using this to try to explain why there are “lower rates of endometrial cancer [meaning lining-of-the-uterus cancer] and possibly breast cancer” among those eating vegetarian.

But, it could also help explain the fibroid findings. “The incidence of breast cancer among vegetarian…Adventists is [only] 60 to 80 per cent [that of] American women in general,” and the incidence among women in Africa and Asia is even lower.” Why might women eating vegetarian have lower estrogen levels? This famous study in the New England Journal concluded that it was their “increased fecal output [that] leads to increased…excretion of estrogen,” resulting in lower blood levels. Double the output, in fact. You can see all the heavyweight Vs compared to the welterweight omnivores.

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 this study to see what would happen if they were switched to a more plant-based, higher-fiber diet. The women started out with much higher estrogen levels, again helping to explain their “increased mortality from breast cancer.” But, put people on a healthier diet, and all their levels come down, suggesting “a substantial reduction in breast cancer risk can be achieved” by adopting a diet centered around more whole plant foods. And, the same 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 higher childhood red meat intake is associated with earlier age of starting one’s period, though “total and animal protein” in general may contribute. For example, girls who eat meat tend to start their periods about six months earlier than girls who eat vegetarian. Those that eat “meat analogues”—meaning like veggie burgers, veggie dogs—started their periods “9 months later” on average, and a similar puberty-normalizing influence was found with consumption of whole plant 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 there appeared to be a correlation between the presence of fibroids and 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…[of] risk associated with [the] intake…of long-chain omega-3 fat[s],” mostly from “dark-meat fish consumption,” by which they meant like sardines and salmon. This could be because of “the endocrine-disrupting chemicals commonly [found] in fish,” or it could just be a statistical fluke. It would be consistent, though, with the “increased risk [among] sport-fish consumers.” They’re talking about this study.

Recognizing that “[d]iet and endocrine-disrupting persistent organic pollutants have been associated with [a variety of] gynecologic conditions including [fibroids],” they’ve looked at consumers of fish fished out of the Great Lakes, and found a 20% increased risk for every ten years they had been eating the fish. This is the most comprehensive study to date. They compared pollutant levels in fat samples of women with fibroids to fat liposuctioned out of women without fibroids—and didn’t just find higher levels of PCBs in fibroid sufferers, but also long-banned pesticides, like DDT and hexachlorocyclohexane, PAHs—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, levels which correlated not only to fibroids but to seafood consumption or excess body fat. So, “shedding excess weight and limiting seafood consumption [might] confer a protective effect on [fibroid tumor] development” by minimizing “exposure to environmental pollutants as much as possible.”

Please consider volunteering to help out on the site.

Icons created by Andriwidodo, Pavel Melnikov, Denis Shumaylov, Michal Czekala, and Aleksandr Vector from The Noun Project.

Image credit: Kristina DeMuth. Image has been modified.

Motion graphics by Avocado Video. 

Doctor's Note

Okay, so a plant-based diet may be best, but is there a plant in particular that has been shown to be particularly powerful? I’m glad you asked! That’s the topic of my video The Best Food for Fibroids.

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:

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