Green Tea and Epigallocatechin Gallate
Epigallocatechin gallate (EGCG), a polyphenol found in green tea, has antioxidant, anti-inflammatory, and anti-tumorigenic properties, and shows significant promise for the treatment of uterine fibroids (Islam 2013; Chatterjee 2012). A randomized, placebo-controlled trial studied the effect of 800 mg green tea extract, containing 45% EGCG (360 mg EGCG per day), in 39 women with symptomatic fibroids. The 22 women who took green tea extract daily for four months had a significant 32.6% reduction in fibroid volume and a significant 32.4% reduction in severity of fibroid symptoms. The green tea extract also led to significant improvements in anemia, blood loss, and quality of life. There were no reported adverse events following treatment (Roshdy 2013). EGCG also inhibited the growth of new blood vessels that supply malignant tumors with nutrients in laboratory and animal models of cancer (Carlson 2007; Khan 2010), inhibited the growth of uterine fibroid cells, and induced uterine fibroid cell death in a laboratory study (Zhang 2010). Additionally, EGCG significantly reduced the size and number of fibroids in an animal model (Ozercan 2008).
Several studies have reported that women who have lower serum levels of vitamin D are more likely to develop uterine fibroids. In one study, there was also a significant relationship between vitamin D levels and fibroid size: women with lower vitamin D had larger fibroids, and those with higher vitamin D had smaller fibroids. This finding was especially evident among black women and present as a trend among white women. Another study found that women with sufficient vitamin D levels, defined in this study as greater than 20 ng/mL, had an estimated 32% lower odds of having fibroids compared to those with vitamin D levels below 20 ng/mL. Yet another study reported that women with vitamin D deficiency had a significant 2.4-fold greater odds of having uterine fibroids (Baird 2013; Sabry 2013; Paffoni 2013). The majority of fibroids have low levels of the vitamin D receptor compared to surrounding normal tissue. Vitamin D decreases levels of proteins known to contribute to fibroid formation and inhibits the replication of fibroid cells (Halder 2013; Sharan 2011). In a laboratory study, the active form of vitamin D, at normal concentrations, significantly inhibited growth in uterine fibroid cells by 12% compared with controls. This effect was stronger at higher concentrations; the greatest concentration of activated vitamin D significantly suppressed growth by 62% (Bläuer 2009). Furthermore, a preclinical experiment found that treatment of mice with vitamin D3, at a dosage equivalent to 124 IU/day for a 175 lb human, or paricalcitol (Zemplar), an analog of vitamin D3, resulted in a significant reduction in fibroid size (Halder 2014). These data suggest that vitamin D may potentially be an effective agent to treat fibroids (Sabry 2012). Life Extension suggests that most people maintain blood levels of 25-hydroxyvitamin D between 50 and 80 ng/mL for optimal health.
Curcumin has been investigated as a potential therapeutic agent for uterine fibroids. In a laboratory setting, curcumin inhibited uterine fibroid cell growth (Tsuiji 2011). Curcumin also decreased the level of fibronectin, an important component of the extracellular matrix that contributes to fibroid progression, without significant effects on normal uterine muscle tissue (Malik 2009). Several growth factors are known to be important contributors to fibroid growth, including IGFs, fibroblast growth factors, and transforming growth factors. Curcumin has been shown to inhibit the secretion of IGF-1 in breast cancer cells; block fibroblast growth factor-2-induced blood vessel growth; and inhibit transforming growth factor-beta signaling in a variety of cells, including liver and kidney cells (Xia 2007; Mohan 2000; Li, Wang 2013; Chen, Geng 2014).
Chinese Herbal Medicine Cinnamon and Poria Formula
Traditionally referred to as Gui Zhi Fu Ling, Cinnamon and Poria Formula has been used in China to treat a range of women’s symptoms since the 3rd century AD. Cinnamon and Poria Formula is composed of a combination of 5 herbs: Ramulus Cinnamomi, Poria, Semen Persicae, Cortex Moutan, and Radix Paeoniae Rubra or Radix Paeoniae Alba (Chen, Han 2014; Liu 2013).
Cinnamon and Poria Formula is commonly administered as a capsule, tablet, or liquid herbal extract. Numerous studies have analyzed the effects of the formula on fibroids and their associated symptoms. A comprehensive review of 38 randomized controlled trials with a total of 3816 patients reported that Cinnamon and Poria Formula plus mifepristone is more effective at reducing fibroid volume than mifepristone alone (Chen, Han 2014). These results support those reached in a separate analysis that analyzed cumulative evidence from seven trials. That analysis found that Cinnamon and Poria Formula, either alone or in combination with mifepristone, also appeared to significantly improve symptoms of painful periods. Treatment with Cinnamon and Poria Formula posed minimal risks, and no serious side effects were reported in any of the trials (Liu 2013). It is important to note that 23 of 38 trials in the meta-analysis did not include safety data, and many of the studies included had a small number of participants and did not use a rigorous methodology. Therefore, definitive conclusions about the effectiveness of Cinnamon and Poria Formula cannot be reached based on currently available research (Chen, Han 2014).
Cimicifuga racemosa (Black Cohosh) Extract
Black Cohosh is an herb commonly used to treat menopausal symptoms. A 2014 trial assessed the effect of a 40 mg black cohosh extract in 34 women with menopausal symptoms and fibroids. In this trial, a different group of 28 women took the synthetic estrogen tibolone (Livial), a drug that is not approved in the United States. In 70.1% of women in the black cohosh group, fibroids decreased in size an average of 30.3% after a 12-week treatment period. In the tibolone group, fibroid size increased by 4.7% during the same time period (Xi 2014).
Tripterygium wilfordii Hook. f. Extract – Benefits and Potential Risks
Tripterygium wilfordii Hook. f., an extract from the Chinese herb Tripterygium wilfordii, is frequently used in China to treat uterine fibroids. Several clinical trials showed that Tripterygium wilfordii Hook. f. extract significantly reduced fibroid volume and heavy menstrual bleeding after 3-4 months of treatment. A 2005 paper reported on a study in 124 women, half of whom received 40 mg Tripterygium wilfordii Hook. f. extract daily for 3-6 months while the other half received mifepristone. The authors reported a significant decrease in fibroid size after 3-4 months, with a more pronounced effect detectable by 5-6 months, based on ultrasound examination (Fu 2005). In a similar 3-month trial comparing Tripterygium wilfordii Hook. f. extract to mifepristone in 62 women, the authors reported a significant reduction in fibroid size (Wen 2005). In both of these trials, results of the herbal extract were superior to those achieved by mifepristone. An earlier trial of Tripterygium wilfordii Hook f. extract found that it significantly decreased fibroid size after 3-4 months of treatment, with a somewhat higher percentage of patients responding after 5-6 months. The decrease in fibroid size with Tripterygium wilfordii Hook. f. treatment was time-dependent; the response was nearly double after 5-6 months compared to 3-4 months. It is worth noting that 38% of patients did not have a menstrual cycle during the treatment, and Tripterygium wilfordii Hook. f. treatment decreased average estradiol and progesterone levels (Gao 2000).
Despite these promising findings, several reports of severe toxicity and even death associated with the use of Tripterygium wilfordii Hook. f. are available, and it appears the dose required for clinical effectiveness is very close to the dose required to cause toxicity (Huang 2009; Wang 1989). Another report linked Tripterygium wilfordii Hook. f. use to low bone mineral density in women (Huang 2000).
Life Extension does not suggest the use of Tripterygium wilfordii outside of a clinical setting. If a healthcare practitioner decides to use this therapy with patients, only a standardized extract of the skinned root should be used, as other parts of the plant are highly toxic (NCCAM 2012).
Disclaimer and Safety Information
This information (and any accompanying material) is not intended to replace the attention or advice of a physician or other qualified health care professional. Anyone who wishes to embark on any dietary, drug, exercise, or other lifestyle change intended to prevent or treat a specific disease or condition should first consult with and seek clearance from a physician or other qualified health care professional. Pregnant women in particular should seek the advice of a physician before using any protocol listed on this website. The protocols described on this website are for adults only, unless otherwise specified. Product labels may contain important safety information and the most recent product information provided by the product manufacturers should be carefully reviewed prior to use to verify the dose, administration, and contraindications. National, state, and local laws may vary regarding the use and application of many of the treatments discussed. The reader assumes the risk of any injuries. The authors and publishers, their affiliates and assigns are not liable for any injury and/or damage to persons arising from this protocol and expressly disclaim responsibility for any adverse effects resulting from the use of the information contained herein.
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