does weight effect fibroids

Does Weight Loss Improve Fibroids

Dr Covington answers your questions.

Yes. It is due to the relationship between fat, fibroids, and estrogen.

Fibroids or leiomyoma (myo meaning muscle and oma meaning tumor) are common non-cancerous muscle growths within the uterus.

Fibroids occur in childbearing age women and cause symptoms of pain, cramping, bloating, heavy and prolonged periods, and fatigue and can also cause low iron levels and even infertility. As many as 80% of women with fibroids have no symptoms at all.

Fibroids are most common in African descent women (2-3 times more common than in white women), typically clusters in families, and are often correlated with excess weight.

Fibroids are usually diagnosed by a primary care doctor or gynecologist. In terms of treatments, they range from birth control to aid in menstrual cycle regulation, to myomectomy (fibroid removal), to hysterectomy.

All sex hormones are produced by fat. The more body fat someone has on their body, the more the produce sex hormones; such as estrogen. More estrogen provides more fuel for fibroids.

This relationship between fat, fibroids, and estrogen is important for 3 reasons:

    1. Surgical fibroid removal (myomectomy) does not guarantee the fibroid will stay gone, they can grow back (or grow in a new location)
    1. Weight loss shrinks fibroids
    1. Fibroids impact child-bearing age women as opposed to post menopausal women who no longer produce estrogen

As women lose weight, there is less body fat and less "precursor fuel” to feed the fibroids. The fibroid shrinks or may completely disappear.

Dr Covington

Are you suffering with fibroids and want to try weight loss as a potential treatment? See Dr Covington’s YouTube video on Fibroids and Weight Loss

Request an appointment with Dr Covington or Call 704-997-9661 to Schedule appointment

Need a Fertility Doctor in the Charlotte area? Dr Matrika Johnson MD at Reproductive Specialists of the Carolinas

Khan, A., Shehmar, M., & Gupta, J. (2014). Uterine fibroids: Current perspectives. International Journal of Womens Health,95. 

Wise, L. A., Palmer, J. R., Spiegelman, D., Harlow, B. L., Stewart, E. A., Adams-Campbell, L. L., & Rosenberg, L. (2005). Influence of Body Size and Body Fat Distribution on Risk of Uterine Leiomyomata in U.S. Black Women. Epidemiology, 16(3), 346-354.


What is PGX ? Is it safe for Weight Loss?

Dr Covington answers your questions.

This question comes from a patient who came for a new weight loss visit. She picked up PGX from a local retail pharmacy and started taking it after a friend tried it for weight loss. At the time, I was not familiar with PGX but promised her that I would look into it and give her my opinion.

What is PGX?

PGX is available in powder or pill form. When searching for supplements, always look at the ingredient list. The drawback of this of course is that not all companies list the full ingredients or worse, some companies may falsify ingredients to mislead consumers of ingredients that are not truly in the product. When checking the ingredient list for PGX (which is PolyGlycopleX) the listed ingredients are: konjac root, xanthan gum and sodium alginate.

Konjac Root – is the root of the Konjac plant - a Asian (found in China, Japan, and Indonesia) plant that contains a soluble fiber glucomannan.

Xanthan gum – Commonly used “stabilizer” that keeps food or supplements from separating

Sodium Alginate – Natural substance extracted from brown seaweed forms a gel, used in substances to produce a gelatin or gelatinous structure.

The active ingredient in PGX is glucomannan, which is fiber. Glucomannan is also the active ingredient of Lipozene, a non-FDA approved weight loss medication whose parent company was fined 1.5 million dollars by the Federal Trade Commission for making false weight loss claims.

So, although I don’t know a lot about PGX, I know quite a bit about fiber. Fiber comes in two forms, insoluble or soluble, and glucomannan is a soluble fiber. The difference between soluble and insoluble fiber is that soluble fiber absorbs water or dissolves and turns to gel whereas insoluble fiber does not dissolve and moves through the digestive tract.

Soluble fiber is found in fruits, vegetables, lentils, peas, grains (such as oat bran and barley), nuts, seeds, and psyllium.

PGX (active ingredient: glucomannan) boasts the following weight loss claims:

  • Reduces hunger
  • Increases satiety and fullness
  • Reduces glucose and insulin spikes
  • Aids in diabetes control
  • Lowers cholesterol
  • Aids in weight loss

The instructions for PGX include taking 3 times a day before each meal with at least 4-8 ounces of water.

Benefits of Fiber

benefits of fiber for weight loss

Fiber aids in satiety and fullness by slowing food transit in the stomach and intestines and stretching the stomach lining. Soluble fiber slows the absorption of glucose which improves glucose levels and reduces the spike of insulin. The latter is beneficial in diabetes and insulin resistance. Improving insulin resistance and blood glucose improves cholesterol and fiber has been proven to reduce cholesterol in many scientific studies, the British Journal of Nutrition demonstrated that addition of psyllium in the diet was enough to reduce cholesterol levels. One of the major cautions with soluble fiber is that it can get expand in the digestive tract so substances like glucomannan or psyllium husk are not recommended for bariatric surgery patients, patients with GI motility disorders such as achalasia, esophageal disorders, or gastroparesis. It is important to ingest fiber with plenty of water to reduce the chances of it getting stuck in the wrong part of the digestive system.

The health benefits are true for fiber in general, PGX or glucomannan likely has no more benefit from any other commercial fiber product; however, the clinical studies with glucomannan and weight loss are mixed. Several studies showed no impact on weight loss or body composition. In terms of weight loss, a high fiber diet was shown in a study by the Annals of Internal Medicine to yield an average of 6 lbs in 1 year – when 30 grams of fiber was ingested daily (however 7 individuals in this group also unfortunately developed Type II diabetes).

The problem, however, with recommending a product like PGX is that it is not regulated or approved by the FDA. This means that any manufacturer can list glucomannan as an ingredient but there is not proof that it exists in the product and no studies to determine if the product is legitimate, effective, or safe for consumption.

This substance used in candy (konjac candy) was banned in the US and Canada due to choking reports and several deaths in young children and elderly.

As an alternative, increase fiber in the diet and supplement with well known fiber supplements such as psyllium husk or wheat dextrin. If looking to add a FDA approved weight loss medication to your diet and exercise regimen, I recommend consulted an expert in weight  loss, like a bariatrician or schedule a new patient visit in our office.

Dr Covington

My Top Recommendations for Fiber Supplements are listed below:



Read more articles like this one→ Why is it not common to find Vitamin D in powder form?

Arvill A, Bodin L. (1995). Effect of short-term ingestion of konjac glucomannan on serum cholesterol in healthy men. Am J Clin Nutr. 1995;61:585-589.

Zalewski BM et al. (2015 March). The effect of glucomannan on body weight in overweight or obese children and adults: a systematic review of randomized controlled trials. Nutrition. 2015 Mar;31(3):437-42.

Astrup A, Vrist E, Quaade F. (1990). Dietary fibre added to a very low calorie diet reduces hunger and alleviates constipation. Int J Obes. 1990;14:105-112.

Baer DJ, Rumpler WV, Miles CW, Fahey GCJ. Dietary fiber decreases the metabolizable energy content and nutrient digestibility of mixed diets fed to humans. J Nutr. 1997;127: 579-586.

Burley VJ, Paul AW, Blundell JE. Influence of a high-fibre food (myco-protein) on appetite: Effects on satiation (within meals) and satiety (following meals). Eur J Clin Nutr. 1993;47:409-418.

Burton-Freeman B. Dietary fiber and energy regulation. J Nutr. 2000; 130(2S Suppl):272S-275S

Cairella M, Marchini G. Evaluation of the action of glucomannan on metabolic parameters and on the sensation of satiation in overweight and obese patients. ClinTer. 1995;146(4):269-274.

Chen H-L, Sheu WH, Tai T-S, Liaw Y-P, Chen Y-C. Konjac supplement alleviated hypercholesterolemia and hyperglycemia in type 2 diabetic subjects–a randomized double-blind trial. J Am Coll Nutr. 2003;22(1):36-42.

Gallaher DD, Gallaher CM, Mahrt GJ, et al. A glucomannan and chitosan fiber supplement decreases plasma cholesterol and increases cholesterol excretion in overweight normocholesterolemic humans. J Am Coll Nutr. 2002;21(5): 428-433.

Hill AJ, Blundell JE. Macronutrients and satiety: The effects of a high protein or high carbohydrate meal on subjective motivation to eat and food preferences. Nutr Behav. 1986;3:133-144.

Howarth NC, Saltzman E, Roberts SB. Dietary fiber and weight regulation. Nutr Rev. 2001;59:129-139.

Joyce K. Keithley et al (2013). Safety and Efficacy of Glucomannan for Weight Loss in Overweight and Moderately Obese Adults. J Obes.  2013: 610908.

Liu S, Willett WC, Manson JE, Hu FP, Rosner B, Colditz G. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. Am J Clin Nutr. 2003;78(5):920-927.

Pasman WJ, Saris WH, Wauters MA, Westerterp-Plantenga MS. Effect of one week of fibre supplementation on hunger and satiety ratings and energy intake. Appetite, 1997;29:77-87.

Vita PM, Restelli A, Caspani P, Klinger R. Chronic use of glucomannan in the dietary treatment of severe obesity. Minerva Med. 1992;83(3):135-139.

Vuksan V, Sievenpiper SL, Xu Z, et al. Konjac-Mannan and American Ginseng: Emerging alternative therapies for type 2 diabetes mellitus. J Am Coll Nutr. 2001;20(5Suppl):370S-380S.

Vuksan V, Jenkins DJ, Spadafora P, et al. Konjac-mannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. A randomized controlled metabolic trial. Diabetes Care. 1999;22(6):913-919.

Vuksan V, Sievenpiper JL, Owen R, et al. Beneficial effects of viscous dietary fiber from konjac-mannan in subjects with the insulin resistance syndrome: Results of a controlled metabolic trial. Diabetes Care. 2000;23(1):9-14.

Walsh DE, Yaghoubian V, Behforooz A. Effect of glucomannan on obese patients: A clinical study. Int J Obes. 1984;8:289-293.

protein shake

Are protein powders good for meal replacements?

Dr Covington answers your questions


The trick is making sure that you are not only using the correct protein but also using the right nutrient balance, macronutrient balance, portion control, and calories - so using a meal replacement program that has already formulated this for you is best.

All protein is not created equal!

The benefit of meal replacement is that the protein is supplemented with vitamins and nutrients. The benefit of using protein as a meal replacement is staying fuller longer and maintaining lean muscle along with basal metabolic rate (calories burned 24 hours a day without exercise).

Check out our protein meal replacement program. We have protein shakes but also protein bars, protein oatmeal, protein pancakes, soups, and other items so that you can have variety in your meal replacement diet. If you are looking to lose weight, our meal replacement program helps with that as well!

Can protein powder be mixed with just plain water?


The quality and taste of the protein mixed with water will depend on the quality of the protein that you choose. Always use high quality protein powder. Our protein is sourced from New Zealand which is known for the best and healthiest cows on the planet; therefore the purest and freshest milk and whey protein available.

Our protein shakes are also great tasting and come in a variety of flavors.

They can be mixed with water or milk and in addition to shakes they can also be used as puddings for a healthy dessert!

Mixing with water increases the convenience of drinking your protein shake on the go - especially if it is available in single packets like our protein shakes.

Check out our Protein Shakes here

Learn more about the Meal Replacement Program

Try our Meal Replacement Starter Package 

Want to do meal replacement but don't know where to start? Use our Patient Guide to Meal Replacement

Meal Replacement Free Tips Guide --> Here 

Yours Truly

Dr Covington


Is Phentermine an Amphetamine like Crystal Meth?

Dr Covington answers your questions.

No. It is not.

Phentermine is not an amphetamine, it is “amphetamine-like” meaning that it can bind to the same receptors in the brain and has a few similar actions but it is not the same as crystal meth or any drugs in the amphetamine class.

The major difference is the release of dopamine is much less with phentermine than the drugs in the amphetamine class and this is also why phentermine is not addictive like methamphetamine and cocaine.

The chief neurotransmitter released with phentermine is norepinephrine and serotonin to a lesser extent, there is also minimal dopamine released.

The appetite suppressing effects, increase in energy, potential insomnia are similar for phentermine and amphetamine.

We discuss how phentermine works in more detail along with other weight loss medications in this blog article (read here) → FDA Approved Weight Loss Medications & How They Work


Check out my Youtube Videos on Phentermine (below): 

How Phentermine Works 

Most Common Mistake Patients make with Phentermine


Dr Covington

how to get vitamin d

Why is it not common to find Vitamin D in a powder form?

Dr Covington is answering your questions!

This is a great question.

Vitamin D is made in the body, therefore, it is a NON-essential vitamin - meaning we don’t need to ingest it.

Vitamin D is activated in the skin by UV rays (or sunlight) and if we supplement or intake Vitamin D orally it comes from 2 main sources, 1 is from plant fatty acids (common in supplements) and the other is from animal fatty acids -->if you eat meat, oily fish, or eggs you are getting Vitamin D. 

As mentioned above, Vitamin D is in a fat form; therefore, it is a “fat soluble” vitamin. This is likely the reason we don’t commonly see Vitamin D in a powder form - due to it’s (1) absorption, (2) bio-availability and (3) the source.

The 1 exception to this is Vitamin D found in protein powder.

If you are looking for a powder version of Vitamin D a protein shake or meal replacement shake is likely the best way to get it! For people who don't like to swallow pills this is a great alternative.

For example all of our meal replacement shakes are powder and have approximately 90% of the daily recommended allowance for Vitamin D (check out our meal replacement products here ).

Other options for easier to ingest Vitamin D (not powder) are chews, gummies, and liquid vitamins, For patients trying to lose weight watch the sugar content in non-pill versions of vitamins

Hope this helps!

Dr Covington