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Fibrocystic Breast Disease

Fibrocystic breast disease (FBD) is a term given to a very common group of benign conditions affecting the breast in younger women.

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Vitex
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Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

 

What are the symptoms of fibrocystic breast disease?

Both breasts become tender or painful and lumpy, and these symptoms vary at different times in the menstrual cycle. Despite the fact that signs and symptoms of FBD appear to be quite distinct from textbook signs and symptoms of breast cancer, any lump in the breast should be diagnosed by a doctor to rule out the possibility of cancer.

Dietary changes that may be helpful for fibrocystic breast disease

Some,1 2 but not all3 4 studies have found that women with FBD drink more coffee than women without the disease. Eliminating caffeine for less than six months does not appear to be effective at reducing symptoms of FBD.5 6 However, long-term and complete avoidance of caffeine does reduce symptoms of FBD.7 8 Some women are more sensitive to effects of caffeine than others, so benefits of restricting caffeine are likely to vary from woman to woman. Caffeine is found in coffee, black tea, green tea, cola drinks, chocolate, and many over-the-counter drugs. A decrease in breast tenderness can take six months or more to occur after caffeine is eliminated. Breast lumpiness may not go away, but the pain often decreases.

FBD has been linked to excess estrogen. When women with FBD were put on a low-fat diet, their estrogen levels decreased.9 10 After three to six months, the pain and lumpiness also decreased.11 12 The link between dietary fat and symptoms appears to be most strongly related to saturated fat.13 Foods high in saturated fat include meat and dairy products. Fish, nonfat dairy, and tofu are possible replacements.

Lifestyle changes that may be helpful for fibrocystic breast disease

Exercise may decrease breast tenderness. In one study, women who ran 45 miles per menstrual cycle reported less breast tenderness as well as improvement in other symptoms, such as anxiety.14

Nutritional supplements that may be helpful for fibrocystic breast disease

In double-blind research, evening primrose oil (EPO) has reduced symptoms of FBD,15 16 though only slightly.17 One group of researchers reported that EPO normalizes blood levels of fatty acids in women with FBD.18 However, even these scientists had difficulty linking the improvement in lab tests with an actual reduction in symptoms. Nonetheless, most reports continue to show at least some reduction in symptoms resulting from EPO supplementation.19 20 Based on this research, many doctors recommend a trial of 3 grams per day of EPO for at least six months to alleviate symptoms of FBD.

While several studies report that 200–600 IU of vitamin E per day, taken for several months, reduces symptoms of FBD,21 22 most double-blind trials have found that vitamin E does not relieve FBD symptoms.23 24 Nonetheless, many women take 400 IU of vitamin E for three months to see if it helps.

As with vitamin E, the effectiveness of vitamin B6 remains uncertain. Some,25 but not all,26 studies find that B6 supplementation reduces symptoms. Since vitamin B6 supplementation is effective for relieving the symptoms of premenstrual syndrome (PMS), in addition to breast tenderness, women should discuss the use of vitamin B6 with their healthcare provider.

Some doctors use iodine to treat FBD symptoms. In animals, iodine deficiency can cause the equivalent of FBD.27 What appears to be the most effective form—diatomic iodine28 —is not readily available, however. Some people are sensitive to iodine and high amounts can interfere with thyroid function. Therefore, supplemental iodine should only be taken with the guidance of a healthcare practitioner.

Are there any side effects or interactions with fibrocystic breast disease?

Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful for fibrocystic breast disease

Since many women with FBD and cyclical breast tenderness also suffer from PMS, there is often an overlap in herbal recommendations for these two conditions despite a lack of research dealing directly with FBD.

In one double-blind trial, a liquid preparation containing 32.4 mg of vitex and homeopathic ingredients was found to successfully reduce breast tenderness associated with the menstrual cycle (e.g. cyclic mastalgia).29 Vitex is thought to reduce breast tenderness at menses because of its ability to reduce elevated levels of the hormone, prolactin.30

Doctors typically suggest 40 drops of a liquid, concentrated vitex extract or 35–40 mg of the equivalent dried, powdered extract to be taken once per day in the morning with some liquid. Vitex should be taken for at least three menstrual cycles to determine efficacy.

Are there any side effects or interactions with fibrocystic breast disease?

Refer to the individual herb for information about any side effects or interactions.

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