Correlation Analysis of Breast and Thyroid Nodules: A Cross-Sectional Study

Introduction

Breast and thyroid diseases are becoming more and more common in the population and significantly impact women’s health.1,2 The discovery of nodules is often the first sign that attracts people’s attention in the early stages of breast or thyroid disease. Previous studies have shown that some factors, such as age, thyroid function, fasting glucose, sex, and blood lipid, may affect the risk of TN and BM.3–7

Ultrasound is a commonly used imaging method for breast and thyroid diseases8,9 and therefore plays an important role in health screening. Previous prospective and retrospective studies10–14 have shown an interaction between thyroid and breast diseases, but most of them11,13,14 have focused on the relationship between thyroid and breast cancers, and neglected the early signs of malignant diseases. In particular, the interrelationship between breast disease and thyroid hormones is still controversial at this stage.15 One of the essential objectives of this study was to investigate the relationship between thyroid hormone levels and the prevalence of BM in patients through a cross-sectional study with a large sample.

Therefore, this study aimed to explore the prevalence of TN and BM in women and related factors by collecting thyroid ultrasound and breast ultrasound examination data from health checkups. This study will help to analyze the prevalence trend of TN and BMand contribute to early screening and prevention of breast and thyroid diseases.

Materials and Methods

Basic Information

A total of 12,538 females who received breast and thyroid ultrasound examinations in the health examination center of Affiliated Hospital of North Sichuan Medical College from January 2018 to January 2021 were selected.

Inclusive Criteria

1) All women who received comprehensive health examination (including thyroid, breast ultrasound examinations, fasting blood glucose, liver function, thyroid function and blood lipid test at least) from January 2018 to January 2021. 2) Women aged 18 or above.

Exclusion Criteria

1) Patients under 18 years old; 2) Male patients; 3) Patients with missing relevant data (such as age, thyroid function, thyroid or breast ultrasound report missing).

The design and purpose of this study are in line with the ethical principles of medical research in the Helsinki Declaration and approved by the Ethics Committee of the Affiliated Hospital of North Sichuan Medical College.

Ultrasound Image Acquisition and Analyses

Ultrasound Assessment of Thyroid

Using HI VISION Preirus (Hitachi Aloka Medical, Ltd.), L9 linear array probe, frequency 5 ~ 13mhz, with RET function and tissue diffuse quantitative analysis function, the patient took the pillow supine position, head back, fully exposed the neck examination area, routine examination of thyroid, thyroid nodules, calcification in nodules, bilateral thyroid lobe size and isthmus thickness, etc. Thyroid was classified according to Kwak Thyroid Imaging Reporting and Data System (TI-RADS) standards.16

Ultrasound Assessment of Breast

PHILIPS IU22 color Doppler ultrasound system/Mindray DC-80 ultrasound system, L9-3 broadband line array probe, frequency 7.5–10 MHz, mechanical index 0.07. SonoVue (SV; Bracco, spa, Milan, Italy) was used as the contrast agent. Patients lie supine, fully expose the chest, and the high-frequency L9-3 broadband linear array probe was applied to scan the bilateral breast and axillary separately. Ultrasound was applied to check the size, number, and echo of the lesion, and color Doppler was used to observing the blood flow in the lesion. The image was analyzed and diagnosed by two experienced doctors. Breast lesions were evaluated by Breast Imaging Reporting and Data System (BI-RADS) standards.17 BM is defined as breast lesions with three-dimensional characteristics of shape, edge and direction under ultrasound, including breast cyst, mixed or solid mass and intraductal mass,18 and breast adenopathy for which BI-RADS classification was performed.

Blood Sample Analysis

Blood Routine Test

Mindray BC-6800 hematology analyzer was used;

Liver Function Test

The liver function was measured by Roche cobas c701 analyzer.

Blood Lipid Detection

The instrument used is Hitachi 7600 automatic biochemical analyzer, and the reagent is the matching reagent of the machine; enzyme coupling method was used for the detection of triglyceride (TG) and total cholesterol (TC), the direct method was used for the detection of high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL) Selective clearance method was used for detection, and very-low-density lipoprotein cholesterol (VLDL) was calculated.

Thyroid Function Assay

All samples were analyzed using Siemens ADVIA Centaur. The reference intervals of FT4 was 0.89–1.76 ng/dl, FT3 was 2.3–4.2 pg/mL, TSH was 0.55–4.78 IU/mL.

Glucose Determination

Glucose oxidase method and Hitachi 7170S automated analyzer were used for glucose detection.

Test Method

Peripheral venous blood was collected from all blood samples at least 8 hours after fasting and analyzed in the laboratory of Affiliated Hospital of North Sichuan Medical College. All operations are carried out by our professional staff in strict accordance with the instrument or reagent operation instructions.

Statistical Analysis

Stata 15 and SPSS 23 were used for statistical analysis, with P < 0.05 as the difference was statistically significant. Kolmogorov–Smirnov (KS) test was used to test the normality of continuous variables. The measurement data in line with normal distribution was expressed by (x±s), and a t-test was used for comparison between groups. The measurement data in non-normal distribution was expressed by Medians (p25–p75), and the Kruskal–Wallis test was used for comparison between groups. The counting data were described by n (%), and a chi-square test was used to a comparison between groups.

After univariate analysis of all the factors and considering the statistical significance and medical significance of the relevant factors, the covariates were selected and then included in the logistic regression analysis. We used binary logistic regression to explore the relationship between TN, BM and other covariates. In addition, we used multivariate logistic regression to explore the relationship between TN with different TI-RADS grades and BM with different BI-RADS grades and other included covariates.

To further confirm the association of TN and BM, we conducted a sensitivity analysis using propensity score matching(PSM).19 Taking TN or BM as dependent variable, age, liver function examination, blood lipid level, fasting blood glucose and thyroid function related examination results as independent variables, the propensity score was estimated by logistic regression. A 1:1 matched analysis using nearest-neighbor matching with a caliper distance of 0.02 without replacement was performed based on the estimated propensity score of each patient. Finally, paired chi-square was used to test the relationship between TN and BM.

Results

A total of 4975 (39.7%) of the included subjects have BM, and a total of 6315 (50.4%) have TN,2557 (20.4%) had both BM and TN.

Discussion

According to our findings, BM and TN usually occur synchronously, which is consistent with the results of previous studies. Shi et al20 found that the prevalence of TN in the normal population was 34.49%, while the prevalence of thyroid nodules in the group with benign breast disease was 43.64% and in the group with breast cancer was 56.17%, both significantly higher than the normal population group. Van Fossen et al21 found a 0.67-fold increased risk of subsequent breast cancer in women with thyroid cancer and a 2-fold increased risk of subsequent thyroid cancer in women with breast cancer. In conclusion, an increasing number of researchers have found correlation between thyroid disease and breast disease, especially in terms of malignancy.

This suggests that there may be some common etiology between TN and BM, which may result from genetic, environmental and hormonal factors. Current studies provide some clues to explain this relationship. Some studies have found22,23 that this may be related to mutations in PTEN, a tumor suppressor gene that predisposes women to breast, thyroid, kidney, and endometrial cancers. Similarities also exist between thyroid and breast tissues, where both thyroid follicular cells and breast cells store iodine through sodium-iodine transporter-mediated iodine uptake.24 This suggests that iodine uptake and oxidation may play an important role in the development of mammary nodules. It has also been shown25 that T3 induces mammary cell proliferation by activating the same estradiol-related signaling pathway that controls cell cycle progression. Since both glands are regulated by the hypothalamic-pituitary axis, when there are abnormal thyroid hormone or estrogen levels, this may lead to the simultaneous occurrence of TN and BM in a person.

Our results showed that 39.7% of the included 12,538 women had BM, 50.4% had TN, and 20.4% had both BM and TN. The nodule incidence was higher compared to the results of previous studies, which may be related to the following:1) Only women were included in this study, and women have a higher prevalence of BM and TN relative to men;26,27 2) The subjects included in this study were from medical checkup centers, and generally patients are more likely to go to hospitals for comprehensive health checkups after unintentionally finding out they have BM or TN; 3) Consistent with the current epidemiological trend of thyroid and breast cancers, the incidence of TN and BM is increasing year by year;28,29 4) Compared to previous studies, the definition of BM is not exactly the same; for example, we explicitly defined breast adenopathy with BI-RADS grading as BM.

In our study, age was found to be an independent risk factor for the occurrence of TN, and this result is consistent with the results of previous studies.30 The results in multivariate logistic regression indicated that age was a protective factor for BI-RADS grade 2 and 3 BM, which may be associated with the high incidence of benign breast hyperplasia in young women. As with the results of previous studies,31,32 this paper also found that abnormal lipid levels can influence the occurrence of TN. In this paper, ALT and AST were also found to be associated with the occurrence of TN. Recently, Komori et al33 found an epidemiological correlation between head and neck tumors and hepatitis B virus infection. So it may be that abnormal liver function due to hepatitis virus infection causes a statistical correlation between TN occurrence and liver function, and hepatitis B virus infection is a serious public health problem in China, where tens of millions of hepatitis B virus carriers.34,35 The association between hepatitis B virus infection and TN requires our attention, and further studies are necessary to investigate the underlying mechanisms causing this phenomenon.

A large number of studies have investigated the relationship between thyroid hormone levels and breast carcinogenesis, and the role of thyroid hormones on the development of breast cancer has received widespread attention. On the one hand, Rasool et al36 found significantly higher T3 and T4 levels in the breast cancer group than the normal population, suggesting that high levels of T 3 and T 4 are significantly associated with the risk of breast cancer. A 30-year cohort study conducted by Sogaard et al37 in Denmark also showed that women with hyperthyroidism were at greater risk of breast cancer. Women with hypothyroidism had a slightly lower risk of breast cancer. A previous in vitro experiment similarly confirmed that thyroid hormones promote nuclear estrogen receptor alpha (ERα)-dependent cells and promote angiogenesis and breast cancer cell growth through activation of ERα-mediated pathways.25 However, in a study by Kuijpens et al,38 thyroid hypofunction and lower free T4 levels were associated with an increased risk of breast cancer in postmenopausal women. These studies suggest that we may have an imbalance between estrogen and thyroid hormones promoting the development and progression of breast cancer. Our study found that higher free T4 reduced the risk of developing BM. This relationship was mainly observed in BI-RADS 3 breast, as retrospective studies are susceptible to confounding by other confounding factors, especially estrogen, which, together with T4, acts on ERα to promote breast cell proliferation. We also do not know whether any of the women examined were taking oral levothyroxine for hypothyroidism, among other factors, which may confound our conclusions. However, previous studies and our findings suggest an association between thyroid hormone levels and the development of breast disease, and more researches are required to clarify the specific mechanisms of action between thyroid function and BM.

Read more  Hypothyroidism: Cardiovascular Endpoints of Thyroid Hormone Replacement

This paper contains a large sample size and multiple covariates, as did the previous study,6 but an important advantage of this study is the introduction of thyroid hormones that are extremely important for the occurrence of TN and BM, which makes us be able to explain the effect of thyroid hormone on thyroid and breast. Moreover, this article uses propensity score matching to verify the relationship between TN and BM, making our results more reliable. There are some shortcomings in this study: certain important covariates were not included, especially estrogen. Many previous studies39–41 have shown that thyroxine and estradiol share a signaling pathway that regulates the growth of breast cancer cells. Because women rarely undergo sex hormone screening during health checkups, the effect of other hypothalamic-pituitary axis-related hormones on TN or BM development was not discussed in this article to ensure sample size. Further studies are needed to assess whether sex hormones affect the development of thyroid and breast disease.

In conclusion, elucidating the common pathogenesis between BM and TN will have important implications for the diagnosis and prevention of these diseases. Especially in light of current studies, both BM and TN have a high prevalence, and there is an association between the pathogenesis of both. Therefore, clinicians may consider routine imaging of the thyroid or breast at the time of physical examination, especially if a high TI-RADS-graded TN or a high BI-RADS-graded BM is found, or if other risk factors are combined, necessitating examination of the other gland. A large sample, prospective, multi-center study is needed further to explore the pathological relationship between thyroid and breast nodules.


— Update: 25-12-2022 — We found an additional article The Epidemic of Breast Cancer and Thyroid Disorders: The Common Link from the website www.power2practice.com for the keyword hypothyroidism and breast cysts.

Written by Dr. David Brownstein

A recent study found higher levels of free T3 (a thyroid hormone) as well as thyroid peroxidase and thyroglobulin antibodies in patients with breast cancer when compared to healthy controls. (1) Nearly one in seven (14%) U.S. women have breast cancer. Thyroid disorders are the most common endocrine disorder present in the U.S. There are estimates that from 10-40% of the U.S. adult population suffer from a thyroid disorder. Could there be a link between the 40-year epidemic rise of breast cancer and thyroid disorders?

The answer is “yes”.

And the link could explain not only the breast and thyroid connection but also why we are suffering from an epidemic of other glandular illnesses—including cancer—of the ovary, uterus, pancreas, and prostate. What is the link?

The link is iodine deficiency.

Our iodine levels have fallen over 50% during the last 40 years. I (along with my partners) have tested well over 6,000 patients for their iodine levels and have found that over 96% are deficient in iodine. Most are severely deficient. As I wrote in my book, Iodine: Why You Need It, Why You Can’t Live Without It, iodine deficiency is responsible for the epidemic of thyroid and breast disorders that we are seeing today. This includes autoimmune thyroid disorders such as Hashimoto’s and Graves’ disease, thyroid cancer and hypothyroidism as well as fibrocystic breast disease and breast cancer. Every cell in the body requires adequate iodine levels to function optimally. In the glandular tissue—the thyroid, ovaries, uterus, breast, pancreas, and prostate–iodine is responsible for maintaining the normal architecture of the glands. When iodine deficiency is present, it sets in motion a cascade of events. This cascade starts with glandular cysts forming. If iodine deficiency continues, the cysts become hard and nodular. The next step is the glandular tissue starts to assume a precancerous appearance—called hyperplasia. The final stage in this sequence is cancer. The good news is that in vitro (in test tubes) and in vivo (in animals and people) studies have found that iodine therapy can halt the progression of  glandular events and even reverse it.

What can we do? One of the most important ways to ensure optimal health for patients is to promote maintaining adequate iodine intake. Unfortunately, our food supply is woefully lacking in iodine. Iodine can be found in seafood, but the levels vary depending on the pollution levels of where the seafood was harvested from. In today’s toxic world, I feel it is best to supplement with iodine. How much iodine is required? My research has found that most patients require 6-50mg/day of iodine to achieve whole-body iodine sufficiency. Of course, it is best to run labs to check iodine levels, both pre- and post- iodine supplementation.

Reference: (1) Asian Pac. J. Cancer Prev. 15(16). 6643-6647. 2014

More information about iodine can be found in my book: Iodine: Why You Need It, Why You Can’t Live Without it.

Original blog post by Dr. Brownstein can be found here.

Hypothyroidism and breast cysts


Join us on Wednesday, May 18, 2018, for a webinar on Autoimmune Thyroid Disorders presented by Jim Paoletti, BS Pharmacy, FAARM, FIACP.

Click here to save your spot


— Update: 25-12-2022 — We found an additional article Approach to Fibrocystic Breasts with Hashimoto’s from the website thyroidpharmacist.com for the keyword hypothyroidism and breast cysts.

Though we may not think of it very often, the health of our breasts and the health of our thyroid are deeply connected.

We know there’s an association between thyroid disease and thyroid cancer. Studies have shown that Hashimoto’s patients are three times more likely to develop thyroid cancer. (1,2)

More recent studies have shown that there’s also an association between breast cancer and those with autoimmune thyroid disease. (3,4)

There’s another breast condition that’s been shown to be connected to Hashimoto’s – fibrocystic breasts. (5) While having fibrocystic breasts is not associated with cancer, fibrocystic breasts can be painful and uncomfortable for the women who experience the condition.

Experts aren’t sure exactly what causes the development of fibrocystic breasts, but it’s believed that estrogen plays a large role. (6) If you’ve read my book, Hashimoto’s: The Root Cause, you will know that hormone imbalances, such as excess estrogen – also known as estrogen dominance – can trigger Hashimoto’s. (6)

A 2015 study of women with polycystic ovarian syndrome (PCOS) examined why some women with PCOS got Hashimoto’s and others didn’t, and ran hormonal tests on all of the women in the study. (7) The study showed more Hashimoto’s thyroiditis, elevated thyroid stimulating hormone (TSH), and elevated thyroid antibodies in the study participants with higher estrogen levels.

Even though fibrocystic breasts are a common condition, there’s not a lot of information or resources about this condition. Conventional medicine typically doesn’t offer much treatment or support, while old-school alternative medicine recommendations have focused on using high-dose iodine, a potential Hashimoto’s trigger, so I wanted to provide some additional approaches to ease the symptoms and pain of women who are experiencing this condition.

In this article, you’ll learn about:

  • The symptoms of fibrocystic breasts and who has them
  • The conventional approach to fibrocystic breasts
  • Alternative approaches to and supportive products for fibrocystic breasts

Fibrocystic Breast Facts

Fibrocystic breasts is a common noncancerous condition among premenopausal women. Between 50 to 90 percent of women experience fibrocystic breasts at some point during their lifetime, and it’s most common in women between the ages of 20 and 50. (6,8)

The condition is characterized by changes in a woman’s breast tissue, which may fluctuate with their period. Symptoms include breast tenderness or discomfort (which may worsen before their period), sudden development of masses in the breasts, and a change in breast texture. Most breast lumps are non-cancerous and do not lead to breast cancer. (9)

Fibrocystic breast changes can be cyclic or noncyclic. Cyclic changes occur with your period, while noncyclic ones are not impacted by the different stages of your menstrual cycle, and pain can persist throughout the month.

As mentioned above, the exact cause of fibrocystic breasts is unknown, but it’s believed that reproductive hormones, especially estrogen, play a role. Aside from hormonal fluctuations, fibrocystic breasts can develop when excess fluid isn’t reabsorbed or adequately drained by the lymphatic system and turns into cysts. (10)

Our lymph system relies on the proper functioning of muscles and joints, and can get backed up when we’re exposed to excess toxins or when we don’t physically move enough. Lymphatic function and thyroid disease are closely tied, as lymphatic dysfunction may contribute to the development of autoimmune diseases. (57) A study from 2015 found that Hashimoto’s is associated with an increased number of enlarged lymph nodes, which indicate inflammation in the body. (58)

Cysts are fluid-filled lumps or sacs that may move around, appear, and disappear. In some cases, the fibrous tissue surrounding them can thicken and firm up, like scar tissue. These cysts inflame and enlarge the breast ducts, causing lumpiness, discomfort, and pain in the breast. (11)

Because of fibrocystic breasts’ connection to estrogen, and the connection between estrogen dominance and Hashimoto’s, it probably won’t come as much of a surprise that you have a higher chance of developing fibrocystic breasts if you have Hashimoto’s. (12)

Fibrocystic breasts used to be labeled as a disease, but given how common they are, they’re now simply referred to as “fibrocystic breasts.” (7) Conventional medicine doesn’t offer very much in terms of support for women who are experiencing this often painful and uncomfortable condition, while the alternative medicine approach has traditionally focused on using high doses of iodine, a potential trigger for Hashimoto’s.

If you know me, you know that taking a root cause approach to my own health helped me reverse my Hashimoto’s symptoms. I want to provide you with the same root cause approach for taking care of your breast health, which overlaps with many of my strategies for addressing Hashimoto’s symptoms! First, let’s go over the conventional approach to fibrocystic breasts.

Conventional Approach to Fibrocystic Breasts

If you find a lump in your breast, the first thing you want to do is visit your doctor and rule out the possibility that it’s cancerous. They’ll help you determine if you need an ultrasound or a mammogram. Most cases of fibrocystic breasts are not cancerous!

If your symptoms are mild, typically no treatment is offered. Your doctor may recommend over-the-counter pain relievers, such as acetaminophen or ibuprofen. (13) Occasionally you may be offered a prescription painkiller to help ease the pain. (13)

Your doctor may also recommend oral contraceptives, to balance out hormones and ease cycle-related fibrocystic breast changes. (13) While this may help with symptoms, it won’t truly correct a hormonal balance. To do that, you’ll have to take a root cause approach to balancing hormones.

If symptoms are severe and there are cysts present, a fine-needle aspiration may be performed, which may collapse the cyst and relieve discomfort. (13)

While these interventions may provide some relief, I like to dig deeper. 🙂 Let’s take a look at some alternative and “root cause” approaches to fibrocystic breasts.

The Root Cause Approach to Fibrocystic Breasts

Here are some strategies that will not only support breast health, but also support any Hashimoto’s symptoms you might be experiencing. Rather than suppress symptoms with OTC painkillers or birth control pills, these suggestions help target the root cause of symptoms.

Read more  Choosing The Right Birth Control With Hypothyroidism 

Check Your Iodine Levels

Iodine deficiency has been linked to breast disease, so it is often recommended as a supplement to support breast health. (14,15)

When it comes to thyroid health, iodine is a controversial nutrient. Because it is a necessary nutrient for thyroid health, some people have assumed that supplementing with high doses of iodine can help the body make more thyroid hormone, thereby improving hypothyroidism and Hashimoto’s; and it is often recommended by many alternative health books and doctors. (16)

However, what they do not understand is that iodine is what pharmacists call a “Goldilocks” nutrient, meaning that, while adequate levels are necessary for thyroid health, higher levels can have a negative effect. (17)

Research has shown that excessive doses of iodine can trigger (and worsen) Hashimoto’s in people who are genetically predisposed to Hashimoto’s and may have certain “vulnerabilities”, such as a selenium deficiency. (18) In fact, through clinical experience, I have found that most people with Hashimoto’s actually have iodine excess!

If you have fibrocystic breasts and Hashimoto’s, I generally do not recommend supplementing with iodine unless you know you’re low in iodine, as it may exacerbate your thyroid symptoms. But don’t worry! There are still plenty of other strategies to support fibrocystic breasts. 🙂

Adopt a Fibrocystic Breast-Friendly Diet

A diet to support fibrocystic breasts is actually quite similar to a diet that can support Hashimoto’s symptoms! By removing our personally reactive foods, we can help lower inflammation in the body, support the health of our liver, and balance hormones, which can help with the pain and discomfort of fibrocystic breasts. (19-21)

I recommend starting by removing gluten, dairy, soy, eggs, and corn. These foods can contribute to inflammation in the body, which can exacerbate symptoms of fibrocystic breasts. Interestingly, these foods can also contain estrogen-mimicking compounds, which can contribute to estrogen dominance. A 2018 study found that a compound called zearalenone, an estrogen-like fungi, can colonize wheat, corn, and other grains. In the study, they found that zearalenone can reduce the anti-estrogen effectiveness of drugs for breast cancer. (59)

Dairy, soy, and eggs contain phytoestrogens, which mimic the effects of estrogen in the body. Because eggs are produced in the animal’s ovaries, and milk is a product of the lactation cycle, they can contain higher levels of these phytoestrogens. (60) If you have fibrocystic breasts or high levels of estrogen, you may want to consider removing these foods to see if your symptoms improve.

These foods are also some of the most highly reactive foods for those with Hashimoto’s. In my survey of over 2000 people with Hashimoto’s, corn and gluten were common triggers for symptoms, and eggs were a trigger for 48 percent of participants. Seventy-nine percent felt better when they removed dairy, and 63 percent observed soy as a trigger for their symptoms.

I recommend identifying other foods you’re reactive to by following an elimination diet for four weeks. You can learn more about doing an elimination diet in my article.

I encourage you to focus on a diet rich in nutrient-dense foods like vegetables, fruits, meats, herbs, and spices. Bone broth and green smoothies are two of my favorite ways to pack in plenty of healing nutrients to fight inflammation and support the liver (more on this below).

Another potential trigger of symptoms is caffeine, especially coffee. Coffee can contribute to estrogen dominance because of how it impacts the adrenal glands, which impact our body’s production of progesterone. (22,23) When progesterone is too low, this leads to a relative estrogen dominance.

Additionally, most of the coffee out there is contaminated with toxins like acrylamide and molds like ochratoxin A (OTA), which can put an extra burden on our liver. (24,25) Most people with Hashimoto’s have an overburdened liver and an impaired ability to eliminate toxins. (26,27) It’s also essential to have an optimally functioning liver to help us filter out excess estrogen!

I personally experienced fibrocystic breasts during a time period when I was drinking too much caffeine. Simply reducing my caffeine intake resolved my fibrocystic breasts, so if you are a big caffeine drinker, you may want to consider this as a strategy.

If you’re going to cut out caffeine, I do not recommend going “cold turkey.” My article on coffee weans can guide you through the 25 percent reduction method, which will make the process a lot less painful.

Consider Lifestyle Changes

When it comes to fibrocystic breasts, one of the most important things we can do is support the lymphatic system, which is part of the immune system and is responsible for protecting us from illness-causing invaders, maintaining fluid balance, and removing cellular waste. (28,29)

The breast and underarm area has a high concentration of lymphatic nodes and channels. (28) Fibrocystic breasts can develop when excess fluid isn’t reabsorbed or adequately drained by the lymphatic system. (30) Those with Hashimoto’s tend to have a sluggish lymph system. (57,58) Here are some ways you can support your lymphatic system and breast health:

  • Increase your movement: Exercise can help the fluid in our lymphatic system move around more freely, which prevents the stagnation that could contribute to symptoms of pain and inflammation in the breast. (31) Any type of exercise you enjoy works to support lymph fluid movement, even gentle movements like walking and yoga. Some people enjoy using a rebounder (a mini trampoline), as the bouncing stimulates lymph flow.
  • Try breast massage: A simple massage can relieve much of the pressure and pain that can accompany fibrocystic breasts. It also stimulates flow of lymph fluid. (32) Later in this article, there are more detailed instructions on how to give yourself a breast massage.
  • Ditch underwire bras: When worn all the time, bras with underwire can block the drainage of lymph fluid from the lymph nodes around the breasts and armpit. As we know by now, we want that fluid moving as freely as possible! Authors Sydney Singer and Soma Grismaijer reported that in studying 4000 women, they found that about 90 percent of women with fibrocystic breasts experienced improvement when they stopped wearing bras. Opt for wireless bras and try to reduce your time wearing bras, if possible. I personally started to wear sports bras on most days, and have found them to be more comfortable.

Support the Liver

Supporting our detoxification system is a crucial part of healing Hashimoto’s, and it’s just as important for optimal breast health. (33) Here are some of my favorite ways to support the liver:

  • Remove toxins: I highly suggest removing potentially triggering foods like the ones I listed above (gluten, dairy, soy). These foods could be irritating the gut and disrupting nutrient absorption, which can impact toxin build up in the liver. (20)
    • I also recommend that you cut out alcohol, as it puts a tremendous burden on the liver. (34)
    • Conventional household cleaning and personal care products contain many toxins. (35,36) Try swapping them out with non-toxic versions. For example, I like Branch Basics for cleaning products and Annmarie for beauty products. You can also check out my Resources page for a full list of product recommendations.
  • Consider supportive supplements: Here are a few of my favorite supplements for supporting the liver:
    • Liver & Gallbladder Support: This comprehensive formula is designed to support bile flow for the normal processing and elimination of toxins. (37)
    • Liver Reset: This contains a natural pea protein isolate and high levels of antioxidants to fuel the detoxification pathways. (38)
    • NAC: This supports tissue levels of glutathione, a key component of the antioxidant defense system. (39)
    • Glutathione: This antioxidant plays a major role in the detoxification process. (40)
    • Vitamin E: Another important antioxidant, vitamin E is also supportive of liver health. (41)
    • Magnesium: This mineral activates the enzymes necessary for a number of physiological functions, and is closely linked with liver function. (42)
    • B vitamins: These vitamins, which are crucial for so many functions in the body, are also essential for liver health. (43)
  • Herbal support: Herbs can be helpful in supporting liver function as well. Here are a few I’d recommend:
    • Andrographis: This herb has been traditionally used in Ayurveda and Chinese medicine for liver support. (44) It’s high in antioxidants, has exerted liver-protective mechanisms, and modulates liver enzymes. (45)
    • Dandelion Root: A 2017 study showed that polysaccharides in dandelion root can be beneficial to liver function. (46)
    • Red Root: This herb has been used traditionally to support the liver. (47,48)
  • Elimination of toxins: In addition to reducing our toxic load and incorporating liver-supporting supplements and herbs, it’s also important that we are able to eliminate accumulated toxins. There are two main ways we can do this:
    • Sweating: When we sweat, we excrete toxins. We can do this through exercise or through spending time in a sauna. (49)
    • Bowel Movements: Having regular, daily bowel movements ensures we’re eliminating toxins. If you’re constipated or not having a bowel movement at least once per day, I recommend taking magnesium. (50) I typically recommend magnesium citrate for constipation, as it has a laxative effect, and magnesium glycinate for stress and to improve sleep quality. Check out my full article on magnesium for dosing and precautions.

Balance Hormones

Because excess estrogen is likely associated with fibrocystic breasts and the uncomfortable symptoms they cause, hormone balance is a crucial part of addressing them (as well as underlying root causes of Hashimoto’s symptoms). In addition to diet changes and liver support, there are some herbs and supplements that can help with hormone imbalances as well.

  • Hormone-balancing herbs include red clover, yerba santa, and borage oil. (51-53) Red clover has been shown to inhibit the binding of estradiol, making it supportive for estrogen dominance. Because it possesses a high antioxidant content, yerba santa, traditionally used for respiratory health, can also reduce inflammation and support the liver, which is crucial to estrogen metabolism. Borage oil is rich in GLA (gamma-linolenic acid), which can help reduce sensitivity and pain in fibrocystic breasts by reducing inflammatory prostaglandins (compounds that contribute to inflammation and are associated with breast sensitivity). (61,62) By reducing inflammation, borage oil can also be supportive for hormone balance. (63)
  • Other supplements that can be helpful include DIM, sulforaphane, and calcium d-glucarate. (54-56) DIM (diindolyl-methane) and sulforaphane are compounds found in cruciferous vegetables that support the body’s metabolism of excess estrogen (so eat your broccoli!). Calcium d-glucarate aids in our body’s detoxification of excess estrogen as well.
  • You may also consider topical bioidentical progesterone if your estrogen dominance is due to low progesterone. Always work with your doctor and test your hormone levels before starting bioidentical hormones.

Consider Other Supportive Products

While having fibrocystic breasts can be painful, there are some products that make managing them a lot easier. My friend Magdalena Wszelaki, who has personally struggled with breast health and lumps for decades, was told that “it’s common and normal” and that “lumps are no big deal.” She realized many other women were having a similar experience, and knows that the emotional and physical toll it takes on women is huge.

I first reached out to Magdalena in 2013, after publishing my book Hashimoto’s: The Root Cause. She was a health coach specializing in hormones. I loved her empowering approach, and our theories on how to address Hashimoto’s were very much in alignment. I knew we would be fast friends, and I remember one of our many conversations about health topics focused on iodine and fibrocystic breasts in women with Hashimoto’s. High-dose iodine is a potential trigger and/or exacerbating factor for Hashimoto’s, but it can also help fibrocystic breasts. I was conflicted when I spoke to Magdalena, as I didn’t have any solutions for the women with Hashimoto’s that were reaching out to me about their breast health.

This was almost a decade ago, and I am so grateful that since that time she’s done a deep dive into researching fibrocystic breasts, and finding solutions for women with Hashimoto’s, who may not be able to use high-dose iodine. 🙂

Read more  Contrave Side Effects: Benefits and Complications of Weight Loss Pill

As such, she developed a special kit with two targeted products to support women with fibrocystic breasts:

  • Happy Sisters supplement: I love this supplement because it’s designed to address estrogen dominance, inflammation, and lymphatic stagnation by combining many of the herbs and nutrients mentioned throughout this article, including borage oil, yerba santa, andrographis, red root, red clover, magnesium bisglycinate, calcium d-glucarate, and DIM.
  • Happy Sisters Cream: This topical cream combines poke root-infused oil, St. John’s wort-infused oil, borage seed oil, ginger-infused oil, black seed oil, rose geranium essential oil, and bergamot essential oil. This highly effective formula helps to reduce pain, soothe inflammation, move the lymphatic system, and shrink lumps. In addition to addressing root causes of fibrocystic breasts, it’s so nice to have a product that can help reduce symptoms right away. You can use this cream while performing a self-breast massage, which supports lymph flow and can reduce inflammation. It has a lovely scent and texture, and is made of an all natural, non-toxic base of aloe, olive oil and shea butter.

You can purchase both of these products as the Happy Sisters Kit, which also includes instructions on how to do a lymphatic breast massage (I’ve copied the instructions below, with Magdalena’s permission).

How to Do Lymphatic Breast Massage with Happy Sisters Cream:

  • Scoop out 1/4 to 1/2 teaspoon of the cream and lightly spread it over your breast tissue.
  • Massage with your opposite side hand in the direction of lymphatic flow – from the nipple toward 12:00, 2:00, 4:00, 6:00, 8:00, and 10:00. Go slow, using gentle but deep pressure, about three to five seconds per sweep.
  • Repeat this, for a total of two times per breast, twice daily.
  • Visualize the breast as being made of sponge containing thick honey. Slow, deep sweeps make the honey flow out.
  • Finish by visualizing your breasts being nourished, cleansed, and healed.
  • When you don’t have time for the full lymphatic massage, your sisters will still reap the benefits with a quick application of the cream.

Hypothyroidism and breast cysts

Image by: Wellena

I hope you will enjoy Happy Sisters as much as I have. For a limited time, Magdalena is offering a special discount on Happy Sisters for my readers. Use code TP-SISTERS at checkout, now through October 30th, to save 10% off!

Takeaway

If you have fibrocystic breasts or know someone who does, there are many ways you can support yourself using a root cause approach. I’m so happy that Magdalena has created these wonderful products to help women address this extremely common condition. It’s the perfect way to take care of yourself, or to give the gift of health and self-care to any woman in your life who may be experiencing painful symptoms!

P.S. Be sure to sign up for my weekly newsletter to get a free book chapter, recipes, my Thyroid Diet Quick Start Guide, notifications about upcoming events, and my latest research.

For future updates, make sure to follow us on FacebookInstagram, TikTok, and Pinterest!

References

  1. Chen YK, Lin CL, Cheng FT, Sung FC, Kao CH. Cancer risk in patients with Hashimoto’s thyroiditis: a nationwide cohort study. Br J Cancer. 2013;109(9):2496-2501. doi:10.1038/bjc.2013.597
  2. Hu X, Wang X, Liang Y, et al. Cancer Risk in Hashimoto’s Thyroiditis: a Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2022;13:937871. Published 2022 Jul 12. doi:10.3389/fendo.2022.937871
  3. Hu X, Wang X, Liang Y, et al. Cancer Risk in Hashimoto’s Thyroiditis: a Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2022;13:937871. Published 2022 Jul 12. doi:10.3389/fendo.2022.937871
  4. Chen S, Wu F, Hai R, et al. Thyroid disease is associated with an increased risk of breast cancer: a systematic review and meta-analysis. Gland Surg. 2021;10(1):336-346. doi:10.21037/gs-20-878
  5. 5 Anil C, Guney T, Gursoy A. The prevalence of benign breast diseases in patients with nodular goiter and Hashimoto’s thyroiditis. J Endocrinol Invest. 2015;38(9):971-975. doi:10.1007/s40618-015-0269-8
  6. 7 Fibrocystic breasts: Is it a disease, causes & symptoms. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/22080-fibrocystic-breasts. Published November 2021. Accessed September 27, 2022.
  7. 6 Arduc A, Aycicek Dogan B, Bilmez S Imga Nasirouglu N, Tuna MM, Isik S, Berker D, Guler S. High prevalence of Hashimoto’s thyroiditis in patients with polycystic ovary syndrome: does the imbalance between estradiol and progesterone play a role? Endocrine Research. 2015;40(4):204-210. doi:10.3109/07435800.2015.1015730.
  8. 8 Chen YY, Fang WH, Wang CC, et al. Examining the Associations among Fibrocystic Breast Change, Total Lean Mass, and Percent Body Fat. Sci Rep. 2018;8(1):9180. Published 2018 Jun 15. doi:10.1038/s41598-018-27546-3
  9. 9 Stachs A, Stubert J, Reimer T, Hartmann S. Benign Breast Disease in Women. Dtsch Arztebl Int. 2019;116(33-34):565-574. doi:10.3238/arztebl.2019.0565
  10. Malherbe K, Khan M, Fatima S. Fibrocystic Breast Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 24, 2021.
  11. Kowalski A, Okoye E. Breast Cyst. In: StatPearls. Treasure Island (FL): StatPearls Publishing; December 13, 2021.
  12. Anil C, Guney T, Gursoy A. The prevalence of benign breast diseases in patients with nodular goiter and Hashimoto’s thyroiditis. J Endocrinol Invest. 2015;38(9):971-975. doi:10.1007/s40618-015-0269-8
  13. Fibrocystic breasts. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/fibrocystic-breasts/diagnosis-treatment/drc-20350442. Published June 23, 2021. Accessed September 27, 2022.
  14. Ghent WR, Eskin BA, Low DA, Hill LP. Iodine replacement in fibrocystic disease of the breast. Can J Surg. 1993;36(5):453-460.
  15. Rappaport J. Changes in Dietary Iodine Explains Increasing Incidence of Breast Cancer with Distant Involvement in Young Women. J Cancer. 2017;8(2):174-177. Published 2017 Jan 13. doi:10.7150/jca.17835
  16. Leung A, Pearce EN, Braverman LE. Role of iodine in thyroid physiology. Expert Rev Endocrinol Metab. 2010;5(4):593-602. doi:10.1586/eem.10.40
  17. Rose NR, Bonita R, Burek CL. Iodine: an environmental trigger of thyroiditis. Autoimmun Rev. 2002;1(1-2):97-103. doi:10.1016/s1568-9972(01)00016-7
  18. Duntas LH. The Role of Iodine and Selenium in Autoimmune Thyroiditis. Horm Metab Res. 2015;47(10):721-726. doi:10.1055/s-0035-1559631
  19. Tuck CJ, Biesiekierski JR, Schmid-Grendelmeier P, Pohl D. Food Intolerances. Nutrients. 2019;11(7):1684. Published 2019 Jul 22. doi:10.3390/nu11071684
  20. Shiue I. Is abnormal liver function correlated with food sensitisation in adults? US NHANES, 2005-2006. Allergol Immunopathol (Madr). 2015;43(4):361-368. doi:10.1016/j.aller.2014.02.009
  21. Tsuchiya Y, Nakajima M, Yokoi T. Cytochrome P450-mediated metabolism of estrogens and its regulation in human. Cancer Lett. 2005;227(2):115-124. doi:10.1016/j.canlet.2004.10.007
  22. Lovallo WR, Farag NH, Vincent AS, Thomas TL, Wilson MF. Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacol Biochem Behav. 2006;83(3):441-447. doi:10.1016/j.pbb.2006.03.005
  23. Lam M. In-depth article on hormone imbalance symptoms and the Oat Axis. Dr. Lam Coaching – World Renowned Authority on Adrenal Fatigue Recovery. https://www.drlamcoaching.com/articles/hormone-imbalance-symptoms-and-the-oat-axis/. Accessed August 12, 2022.
  24. Mojska H, Gielecińska I. Studies of acrylamide level in coffee and coffee substitutes: influence of raw material and manufacturing conditions. Rocz Panstw Zakl Hig. 2013;64(3):173-181.
  25. Pakshir K, Dehghani A, Nouraei H, Zareshahrabadi Z, Zomorodian K. Evaluation of fungal contamination and ochratoxin A detection in different types of coffee by HPLC-based method. J Clin Lab Anal. 2021;35(11):e24001. doi:10.1002/jcla.24001
  26. Malik R, Hodgson H. The relationship between the thyroid gland and the liver. QJM. 2002;95(9):559-569. doi:10.1093/qjmed/95.9.559
  27. Piantanida E, Ippolito S, Gallo D, et al. The interplay between thyroid and liver: implications for clinical practice. J Endocrinol Invest. 2020;43(7):885-899. doi:10.1007/s40618-020-01208-6
  28. Rinaldi RM, Sapra A, Bellin LS. Breast Lymphatics. In: StatPearls. Treasure Island (FL): StatPearls Publishing; June 12, 2022.
  29. Lymphatic system: Parts & Common Problems. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/21199-lymphatic-system. Published February 2020. Accessed September 28, 2022.
  30. Malherbe K, Khan M, Fatima S. Fibrocystic Breast Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 24, 2021.
  31. Lane K, Worsley D, McKenzie D. Exercise and the lymphatic system: implications for breast-cancer survivors. Sports Med. 2005;35(6):461-471. doi:10.2165/00007256-200535060-00001
  32. Williams AF, Vadgama A, Franks PJ, Mortimer PS. A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema. Eur J Cancer Care (Engl). 2002;11(4):254-261. doi:10.1046/j.1365-2354.2002.00312.x
  33. Piantanida E, Ippolito S, Gallo D, et al. The interplay between thyroid and liver: implications for clinical practice. J Endocrinol Invest. 2020;43(7):885-899. doi:10.1007/s40618-020-01208-6
  34. Maher JJ. Exploring alcohol’s effects on liver function. Alcohol Health Res World. 1997;21(1):5-12.
  35. Zota AR, Singla V, Adamkiewicz G, Mitro SD, Dodson RE. Reducing chemical exposures at home: opportunities for action [published online ahead of print, 2017 Jul 29]. J Epidemiol Community Health. 2017;71(9):937-940. doi:10.1136/jech-2016-208676
  36. Panico A, Serio F, Bagordo F, et al. Skin safety and health prevention: an overview of chemicals in cosmetic products. J Prev Med Hyg. 2019;60(1):E50-E57. Published 2019 Mar 29. doi:10.15167/2421-4248/jpmh2019.60.1.1080
  37. Hundt M, Basit H, John S. Physiology, Bile Secretion. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 1, 2021.
  38. Kumar D, Gangwar SP. Role of antioxidants in detoxification of Cr (VI) toxicity in laboratory rats. J Environ Sci Eng. 2012;54(3):441-446.
  39. 37 Khoshbaten M, Aliasgarzadeh A, Masnadi K, et al. N-acetylcysteine improves liver function in patients with non-alcoholic Fatty liver disease. Hepat Mon. 2010;10(1):12-16.
  40. 38 Sacco R, Eggenhoffner R, Giacomelli L. Glutathione in the treatment of liver diseases: insights from clinical practice. Minerva Gastroenterol Dietol. 2016;62(4):316-324.
  41. Sato K, Gosho M, Yamamoto T, et al. Vitamin E has a beneficial effect on nonalcoholic fatty liver disease: a meta-analysis of randomized controlled trials. Nutrition. 2015;31(7-8):923-930. doi:10.1016/j.nut.2014.11.018
  42. Liu M, Yang H, Mao Y. Magnesium and liver disease. Ann Transl Med. 2019;7(20):578. doi:10.21037/atm.2019.09.70
  43. Vitamin B. National Library of Medicine . https://www.ncbi.nlm.nih.gov/books/ NBK548710/. Published May 2021. Accessed September 28, 2022.
  44. Chua LS. Review on liver inflammation and antiinflammatory activity of Andrographis paniculata for hepatoprotection. Phytother Res. 2014;28(11):1589-1598. doi:10.1002/ptr.5193
  45. Okhuarobo A, Falodun JE, Erharuyi O, Imieje V, Falodun A, Langer P. Harnessing the medicinal properties of Andrographis paniculata for diseases and beyond: a review of its phytochemistry and pharmacology. Asian Pac J Trop Dis. 2014;4(3):213-222. doi:10.1016/S2222-1808(14)60509-0
  46. Cai L, Wan D, Yi F, Luan L. Purification, Preliminary Characterization and Hepatoprotective Effects of Polysaccharides from Dandelion Root. Molecules. 2017;22(9):1409. Published 2017 Aug 25. doi:10.3390/molecules22091409
  47. Casey PA, Wynia RL. Culturally significant plants. USDA. https://efotg.sc.egov.usda.gov/references/Public/VA/NRCS_CulturallySignificantPlants_2010.pdf. Published September 2010. Accessed September 29, 2022.
  48. Banerjee A, Chakrabarty SB, Karmakar SR, et al. Can homeopathy bring additional benefits to thalassemic patients on hydroxyurea therapy? Encouraging results of a preliminary study. Evid Based Complement Alternat Med. 2010;7(1):129-136. doi:10.1093/ecam/nem161
  49. Sears ME, Kerr KJ, Bray RI. Arsenic, cadmium, lead, and mercury in sweat: a systematic review. J Environ Public Health. 2012;2012:184745. doi:10.1155/2012/184745
  50. Pereira NBF, Ramos CI, de Andrade LS, et al. Influence of bowel habits on gut-derived toxins in peritoneal dialysis patients. J Nephrol. 2020;33(5):1049-1057. doi:10.1007/s40620-020-00819-9
  51. Ghazanfarpour M, Sadeghi R, Latifnejad Roudsari R, et al. Effects of red clover on hot flash and circulating hormone concentrations in menopausal women: a systematic review and meta-analysis. Avicenna J Phytomed. 2015;5(6):498-511.
  52. Deng Z, Hassan S, Rafiq M, et al. Pharmacological Activity of Eriodictyol: The Major Natural Polyphenolic Flavanone. Evid Based Complement Alternat Med. 2020;2020:6681352. Published 2020 Dec 12. doi:10.1155/2020/6681352
  53. Asadi-Samani M, Bahmani M, Rafieian-Kopaei M. The chemical composition, botanical characteristic and biological activities of Borago officinalis: a review. Asian Pac J Trop Med. 2014;7S1:S22-S28. doi:10.1016/S1995-7645(14)60199-1
  54. Rajoria S, Suriano R, Parmar PS, et al. 3,3′-diindolylmethane modulates estrogen metabolism in patients with thyroid proliferative disease: a pilot study. Thyroid. 2011;21(3):299-304. doi:10.1089/thy.2010.0245
  55. Cao S, Wang L, Zhang Z, Chen F, Wu Q, Li L. Sulforaphane-induced metabolomic responses with epigenetic changes in estrogen receptor positive breast cancer cells. FEBS Open Bio. 2018;8(12):2022-2034. Published 2018 Nov 14. doi:10.1002/2211-5463.12543
  56. Calcium-D-glucarate. Altern Med Rev. 2002;7(4):336-339.
  57. Schwartz N, Chalasani MLS, Li TM, Feng Z, Shipman WD, Lu TT. Lymphatic Function in Autoimmune Diseases. Front Immunol. 2019;10:519. Published 2019 Mar 20. doi:10.3389/fimmu.2019.00519
  58. Jones MR, Mohamed H, Catlin J, April D, Al-Qurayshi Z, Kandil E. The presentation of lymph nodes in Hashimoto’s thyroiditis on ultrasound [published correction appears in Gland Surg. 2015 Dec;4(6):E2]. Gland Surg. 2015;4(4):301-306. doi:10.3978/j.issn.2227-684X.2015.05.11
  59. Warth B, Raffeiner P, Granados A, et al. Metabolomics Reveals that Dietary Xenoestrogens Alter Cellular Metabolism Induced by Palbociclib/Letrozole Combination Cancer Therapy. Cell Chem Biol. 2018;25(3):291-300.e3. doi:10.1016/j.chembiol.2017.12.010
  60. Shaikh DJ. What foods are high in estrogen? MedicineNet. https://www.medicinenet.com/what_foods_are_high_in_estrogen/article.htm. Published March 1, 2022. Accessed October 10, 2022.
  61. Miller SB. Prostaglandins in health and disease: an overview. Semin Arthritis Rheum. 2006;36(1):37-49. doi:10.1016/j.semarthrit.2006.03.005
  62. Malherbe K, Khan M, Fatima S. Fibrocystic Breast Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 24, 2021.
  63. Chang CS, Sun HL, Lii CK, Chen HW, Chen PY, Liu KL. Gamma-linolenic acid inhibits inflammatory responses by regulating NF-kappaB and AP-1 activation in lipopolysaccharide-induced RAW 264.7 macrophages. Inflammation. 2010;33(1):46-57. doi:10.1007/s10753-009-9157-8

References

Recommended For You

About the Author: Tung Chi