Melissa walked into my office and immediately exclaimed, “I absolutely cannot believe it. I’ve got my boobs back!”
Now that’s a wildly-satisfied client!
After just six weeks of focus, Melissa’s highly sensitive and “lumpy” breasts were pain-free and softer – clearly healing. An unfortunately common symptom in our female clients, fibrocystic breasts are a high-satisfaction and important issue that we can help them to resolve.
Over the years, I’ve worked with dozens of female clients who have struggled with fibrocystic breasts. Lumpy and/or simply thickened tissue (perhaps with small nodules) that are sensitive or even painful. For many women, the pain is felt particularly in response to menstrual cycling. This is hormone-mediated inflammation! And the root cause is localized hormonal toxicity, usually evidence of overall estrogen dominance. Breast fibroids are benign in principle. But they are also an early warning sign that (1) your client’s hormone-sensitive tissues need some help and (2) their lifestyle needs changing to reduce cancer risk. Up to 2/3 of our female clients are wrestling with this concern.
Our collective estrogen emergency is a key issue for all of us to understand thoroughly as practitioners. We have a rapidly rising incidence of estrogen-mediated cancers (breast/uterine/ovarian for women and prostate for men). Many of our clients struggle with
Through the functional medicine lens, we understand that the collection of factors at play for each unique individual who struggles with breast fibroids is going to vary. We have to do the deep dive to understand the puzzle pieces at play in each case There is no black’n’white solution or single trigger/cause. If you are fascinated by the whole topic of hormones, you will love our Deep Dive clinical course on Hormones where we explore hormone toxicity and balance in rich detail. It’s amazing to me that substances we typically measure in picogram levels (that is parts per trillion!) can be so powerful. But let me tell you right now exactly what Melissa did…
Of course, we first of all embarked on a huge wave of education. Melissa wanted to thoroughly understand what interconnectedness might be at play in her body, so she could move ahead with informed intuition. She wanted to check some targeted labs as a result. In her case, we were able to verify that there was no notable insulin resistance at play. And we also checked a full thyroid panel. Her T4 to T3 conversion seemed quite optimal, but her Total and Free T4 were both suboptimal, though normal. Here’s what she did…
Data shows that at least 15% of the US adult female population is outright deficient in iodine (that is, about 1 in 7 women). We don’t, however, hear much about the much-more-prevalent iodine insufficiency in the health media. Unfortunately, our national RDA for iodine was set to be only enough to prevent cretinism and goiter (overgrowth – or hypertrophy – of the thyroid gland as it swells in size to try to make thyroid hormone). Research shows the amount of iodine needed for optimal breast tissue may be 20-40x the amount needed to control goiter in the thyroid! But as always, balance is key.
I have seen first-hand multiple times again how daily iodine supplementation can completely eradicate (or improve greatly) cystic breasts after only a couple of months (full resolution occasionally takes 6-12 mos). Iodine helps to reduce sensitivity to estrogen in these vulnerable tissues. Clinical research has clearly demonstrated a reduction in estrogen stimulation and breast symptoms when cellular iodine is increased. This is another study that investigated the combination iodine, GLA (to reduce inflammation), and selenium (to enhance thyroid function and also glutathione production to counter oxidative stress). This is a fascinating article about the possible early-life conditioning that might apply to young women via iodine deficiency for breast cancer diagnosis later in life.
**If women are unable to use oral iodine supplementation due to thyroid concerns, topical iodine may be applied to the breasts themselves for more concentrated, localized support. If I were supporting this client in the present day, I would have also recommended coincident selenium support (200mcg/day) to minimize the likelihood of iodine-promoted thyroid issues.
While our needs are higher, we unfortunately are getting less and less iodine from our food. Due to rampant soil quality depletion caused by aggressive commercial farming, this is true of almost all essential minerals in the modern diet. Today, you have to eat 4 or 5 stalks of broccoli to get the same mineral nutrition you would have received in one stalk in the 1950s. That is an exponential reduction in our food’s nutrition! While vitamins and antioxidants are grown into vegetables and fruits by the sun, minerals must come from the soil. Thus, even healthy food choices are giving our clients less and less iodine as time passes. Historically, commercial flours were fortified with iodine, but industry practice uses bromide compounds, a double negative whammy in denying iodine and also blocking the action of iodine biochemically. There is also a false assumption that we get all the iodine we need from processed (iodized) salt. While this salt may provide enough to prevent goiter, you would have to consume absurd amounts of salt to get the iodine needed to replete all your cells. Dr. Kimberly Pryor explains it well, “Iodized salt contains 74 ug of iodine per gram of salt. Typically, we need a bare minimum of 5 mg of iodine a day to replete all cells. This would take 68 grams of salt. To reach the amount of iodine ingested by a typical Japanese woman, you would need to consume 168 grams of salt.” Obviously iodized salt cannot be our Only source of iodine!
Because of the onslaught of chemical estrogen mimickers in commercial use today and the prevalence of chlorine/bromine/fluoride-laden chemicals that can block the action of iodine, I believe most of our clients with estrogen concerns (men and women!) either need to make sea vegetables (seaweed) a regular part of their diet or consider daily iodine supplementation to some degree. I will recommend “kelp sprinkles” to clients; it has only a light salty flavor and can be easily stirred in to most dishes. Crispy seaweed snacks are also an increasingly popular suggestion (delicious with cashews in my opinion). I may also share a recipe for easy, seaweed salad. But for women struggling with active fibroids, I find that a daily iodine supplement is needed. ** Do not recommend iodine supplementation to any clients with Grave’s Disease, hyperthyroid symptoms, or autoimmune thyroiditis that is notably oscillating between hyper- and hypothyroid symptoms. It is also contraindicated for patients with breast cancer given the effect on estrogen receptors.
Iodine sufficiency is tough to measure reliably! I believe the best way among widely available options is using a urinary excretion test. Typically, the protocol calls for a person to take a larger dose of iodine (25-50mg) and then measure excretion levels over 12 hours. If the body does not need all of what you took, it will excrete it in your urine. Lower excretion levels indicate higher uptake – and thus, a higher iodine deficiency. Unfortunately, it can be difficult to find a physician able to offer such a test. I do not generally recommend a fasting blood or random urine test because it does not give any insight on sufficiency. As with any nutrient supplement, it is important to increase iodine dosage slowly and pay careful attention to the body’s reaction. If hyperthyroid symptoms develop (feeling flushed/hot, agitation, anxiety, increased heartrate or racing heart), simply stop taking it for several days and then resume with a much lower level or food-based sources they can use regularly.
Caffeine consumption can also be a driver for breast fibroids in some people, as it creates an imbalance in cellular detoxification which prevents quick estrogen removal. Dietary caffeine (e.g. coffee, black tea, chocolate) reduction or elimination can help greatly – as the ongoing iodine support helps the body to detoxify more effectively. The same phenomenon is also caused by cigarette smoking, extremely high stress, and eating charred meats, so pay attention to whether these exposures might be making life harder for your client’s breast cells too.
P.S. If you know that healthcare must be transformed to be sustainable and effective, and you believe strongly that Functional Medicine is key to making that happen, we urge you to learn about our semester program.
If you haven’t done so already, sign up to receive weekly clinical tips like this via email, and you’ll also get automatic access to a free mini clinical course.
Like us on Facebook to get more great clinical tips and to get notifications of my next Facebook Live!