Vitamins and diet can play a role in the prevention and treatment of uterine fibroids, according to a literature review spanning 20 years published in the journal Nutrients.
Iwona Szydłowska, MD, of the department of gynecology, endocrinology and gynecological oncology at Pomeranian Medical University in Szczecin, Poland, and colleagues used PubMed and Medline to conduct the literature review. Researchers examined 272 English language, full-text articles from 120 publications and assessed the correlation between diet and uterine fibroid (UF) risk and treatment.
“The aim of the review was to evaluate data on natural, non-hormonal, effective, and safe therapeutic options for treatment of this disease,” the authors said. They used a collection of keywords in combination: leiomyoma, uterine fibroids, uterine myoma, curcumin, dairy products, diet, fruits, plants, vegetables, turmeric, green tea, selenium, carotenoids, Vitamin A, Vitamin C, Vitamin D, Vitamin E, dysbiosis, and gut microbiota. The results of the literature analysis revealed found statistically relevant effects from some vitamins, plant compounds, and 1 trace element.
After study analysis, they reported a strong link between Vitamin D deficiency and UF. They recommended analogs of 25-hydroxyvitamin D3 as therapy because tissue 24-hydroxylase is unable to degrade it. “Vitamin D3 may be a promising option in prevention and treatment of UFs. The majority of presented studies consider treatment with Vitamin D3 as safe and effective,” the authors said.1 Concentrations of physiological vitamin D prevent fibroid cells from growing, especially in women with vitamin D deficiency, researchers said.
While past Vitamin A research contradicts itself, synthetic retinoid analogs in addition to a Vitamin A-rich diet may prevent tumors from growing, Szydłowska and colleagues explained. Vitamin A “reduces cell proliferation and extracellular matrix formation and increases apoptosis in fibroids,” they noted.1
Szydłowska and colleagues reported little data on Vitamin E, and the existing study results they did find were contradictory. In fact, high concentrations may contribute to fibroid growth, especially in Caucasian women.2 “Vitamin E, despite its antioxidant properties, appears not to demonstrate proven beneficial effects in terms of leiomyoma prevention and management,” the authors reported.
Vitamin C also did not have much data for its role in UF, with researchers reporting a non-statistically significant association with increased risk of UF.
COMPOUNDS IN PLANTS
“A diet enriched in fruits and vegetables, as sources of carotenoids, polyphenols, quercetin, and indole-3-carbinol, constitutes an easily modifiable lifestyle element with beneficial results in patients with UFs,” researchers said. However, researchers added that there were caveats. For example, high consumption of β-carotene combined with smoking cigarettes actually increased the risk of uterine fibroids.3 The role of polyphenols in UF prevention was dependent on the type selected by the patient, the dose, and the duration of use. Curcumin/turmeric possesses anti-inflammatory properties and researchers said it appeared to be a good choice for women at risk of developing UF in addition to women who had already been diagnosed.
MICRO AND MACRO ELEMENTS
Szydłowska and colleagues reported that the analysis showed selenium may have a role in prevention and treatment in UF, but did not affect the number of tumors. No other trace elements were found to be beneficial. The role of probiotics has not been fully investigated, but dairy products such as yogurt may also play a protective role, the authors said.
In addition to genetic predisposition, substances associated with UF formation included heavy metals, endocrine-disrupting chemicals (EDC), and cigarettes. A diet low in antioxidants and fiber is also correlated with UF growth. Researchers said EDCs can bind to hormone receptors and stimulate them to change the production and/or function of the hormones. “Induction of both genomic and non-genomic signaling and pro-inflammatory effects of EDCs increase the risk of UFs,” they said.
Szydłowska and colleagues concluded that vitamins, plant compounds, and selenium are useful in treating and preventing UF. “Natural compounds present as an alternative route in UF treatment, especially in patients with contraindications for hormonal therapy,” they said. They emphasized the usefulness of this therapy and said that even for conventional treatment of UFs therapeutic effects can be strengthened by these compounds.