最近經常碰到大豆異黃酮或是月見草油或是琉璃苣油是否會導致子宮肌瘤增生的問題,讓我來分析給您聽。

 

劉博仁醫師

 

大豆異黃酮(Soy Isoflavones

  1. 機轉:大豆異黃酮,因其化學結構式與女性雌激素相似,因此又稱為植物性雌激素(Phytoestrogen)。雌激素作用的接受器有分α及β二種,α接受器大多分布在子宮及乳房,β接受器則是在中樞神經、血管、骨骼、膀胱和皮膚,大豆異黃酮多與β雌激素接受器結合,所以比較無雌激素導致乳癌和子宮內膜癌的疑慮。因為作用平緩,而且不會有女性荷爾蒙的強烈副作用,可以改善更年期症候群及預防骨質疏鬆症。重要的是大豆異黃酮有抗自由基的作用,可以減少細胞的氧化傷害、降低血管中的脂質過氧化物。其中的金雀異黃酮(genistein)以及黃豆甘原(Daidzein)是其中的重要成分,研究發現多吃大豆異黃酮之婦女其子宮內膜癌風險降低。
  2. 建議劑量:每日20-80毫克。
  3. 劑型:大豆異黃酮分成兩大類:第一類是不含醣基的(GenisteinDaidzeinGlycitein),第二類是含醣基的(GenistinDaidzinGlycitin),我建議二者都具備才是好的大豆異黃酮。

 

 

γ-次亞麻油酸(Gamma-Linolenic Acid, GLA

  1. 機轉:屬於ω-6脂肪酸中抗發炎脂肪酸,它並不是賀爾蒙GLA在體內主要功能是合成前列腺素E1Prostaglandin E1PGE1)。PGE1是一種抗發炎物質,能幫助降低血壓、血液膽固醇及預防血小板的不正常聚集,並調節免疫系統的T細胞,在人體組織發炎時,能減少發炎性前列腺素E2PGE2)的分泌量,進而緩解各種人體因為分泌PGE2所引發的過敏、發炎以及氣管收縮等反應。
  2. 建議劑量:240-480毫克。
  3. 劑型:可以月見草油或琉璃苣油來補充。
  4. 注意事項:一般應用在合併過敏、氣喘、經期症候群的朋友身上。

 

我也找了一些文獻(如下),反而發現,大豆異黃酮,反而會抑制子宮肌瘤的產生,如果子宮肌瘤持續增加,要懷疑的是是否身體內環境賀爾蒙(塑化劑)提高所導致的,可以檢測一下尿液中的塑化劑代謝物即可以知道。

 

 

Expert Opin Environ Biol. 2016;5(Suppl 1). doi: 10.4172/2325-9655.S1-003. Epub 2016 May 30.

A High Concentration of Genistein Induces Cell Death in Human Uterine Leiomyoma Cells by Autophagy.

Castro L1, Gao X1, Moore AB1, Yu L1, Di X2, Kissling GE3, Dixon D1.

In summary, our data show differential cell death pathways induced by genistein in tumor and normal uterine smooth muscle cells, and suggest novel cell death pathways that can be targeted for preventive and intervention strategies for inhibiting fibroid tumor cell growth in vivo.

 

Maturitas. 2015 Oct;82(2):170-5. doi: 10.1016/j.maturitas.2015.06.041. Epub 2015 Jul 17.

Urinary isoflavone and lignan phytoestrogen levels and risk of uterine fibroid in Jamaican women.

Simon GA1, Fletcher HM2, Golden K3, McFarlane-Anderson ND4.

CONCLUSIONS:

Uterine fibroid cases had a higher median urine concentration of enterolactone compared with controls. However, this was not observed to affect ones risk of fibroid. Neither was urine genistein, daidzein, equol total isoflavones, and total phytoestrogens observed to be associated with risk of uterine fibroid.

 

Exp Mol Med. 2012 Apr 30;44(4):281-92. doi: 10.3858/emm.2012.44.4.024.

A high concentration of genistein down-regulates activin A, Smad3 and other TGF-β pathway genes in human uterine leiomyoma cells.

Taken together, these results suggest that downregulation of activin A and Smad3, both members of the TGF-β pathway, may offer a mechanistic explanation for the inhibitory effect of a high-dose of genistein on UtLM cells, and might be potential therapeutic targets for treatment of clinical cases of uterine leiomyomas.

 

Mol Cancer Res. 2012 Apr;10(4):546-57. doi: 10.1158/1541-7786.MCR-11-0605.

Environmental estrogens differentially engage the histone methyltransferase EZH2 to increase risk of uterine tumorigenesis.

These data show that environmental estrogens have distinct nongenomic effects in the developing uterus that determines their ability to engage the epigenetic regulator EZH2, decrease levels of the repressive epigenetic histone H3K27 methyl mark in chromatin during developmental reprogramming, and promote uterine tumorigenesis.

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劉博仁醫師基因營養功能醫學部落格

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