 What about dietary phytochemicals as a possible preventive and therapeutic option of uterine fibroids? Plant-based compounds with disease-preventive properties, found in whole grains, fruits, vegetables, beans, slippy chippies, lentils, herbs, spices, nuts, and certain beverages, the thought is, look, 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, for example, 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? Well, we know that women with fibroids are more likely to eat more beef and ham and fewer fruit and green vegetables, but whole plant foods don't just have anti-inflammatory effects, but antioxidant effects as well. When the amount 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. So might antioxidant-rich foods help? Well, if you drip some strawberries on in a Petri dish, you can apparently kill off some of the fibroid tumor cells while leaving normal uterus cells alone. But what good does that do us? It'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. I mean it's neat to see what happens to human fibroid cells as you drip higher and higher concentrations of green tea compounds on them in a test tube. I care less about what happens in vitro or in mice, whether or not they have any close-on, but there were no randomized controlled clinical studies until now, or at least 2013. Subjects were randomized to green tea extract or placebo for four months. In the placebo group, fibroid volume increased 24%. That's what fibroids do. They continue to grow. However, those randomized to the green tea group showed a reduction in total fibroid volume, not just by a little, a dramatic decrease shrunk almost a third, a highly significant difference. Okay, but did the women feel any better? Yes, a dramatic decrease in symptom severity as well. In the placebo group, nothing much happened month after month, but in those taking the same looking pill that happened to contain green tea compounds inside, consistent improvement, with women feeling lessening symptoms each month better than the last. And with that, an improved health-related quality of life, month after month, significantly better than control. And their blood counts got better, too. The blood levels kept decreasing in the placebo group, with all that continued excess blood loss every month, but blood counts reversed in the green tea group. So anemia significantly improved because average blood flow significantly diminished. And all this, the fibroid shrinkage, less pain, appeared with no adverse effects. So not only comparable results than the drugs that are commonly used without the side effects, but comparable results to uterine artery embolization, where they try to cut the blood supply to the fibroid, which is great unless you accidentally cut the blood supply to the rest of the uterus and cause uterine necrosis, one of many reported major complications, which also includes death not only of the fibroid, but of the patient and other potential complications that may arise from accidentally clogging off non-target arteries. So a side-effect-free solution as good as a more invasive procedure is potentially better than in my book. They conclude that green tea compounds show promise as a safe and effective therapeutic agent for women with symptomatic fibroids. Such a simple, inexpensive, and relatively safe therapy could improve women's health globally. Now relatively safe doesn't mean risk-free, although there were no liver function abnormalities detected. This was a small study. If you give green tea extract pills to 1,000 women for a year, like they did in this breast cancer trial, and about 1 in 17 women, their liver started to get inflamed, a few of which 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 get nutrition in foods as grown, or at least foods as grown dunked in hot water, like green tea. Now they had to use pills in this study, because they wanted to be a double-blind study, and it's hard to create a fake placebo tea that looks, smells, and tastes like the real thing. So I don't think we should be taking green tea extract pills. We should drink green tea. The problem is that the dose they used was like 11 cups a day worth, which would be a lot of caffeine. But look, you could choose decaf, and it's not outside the realm of possibility to drink a couple of quarts of tea a day, especially if it's going to shrink your fibroid so much you can keep your uterus or something. Though look, for all we know, 5 cups of tea a day would work, or 3 cups, or 1 cup a day. No other dose has been tested. 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.