The problem with tamoxifen
Tamoxifen is a drug that is often prescribed for patients who have been diagnosed with estrogen receptor positive (ER+) breast cancer in order to block estrogen from binding to the hormone receptor site with the assumption that it will prevent a future recurrence from another estrogen-fueled cancer. It is being used in both metastatic and in adjuvant settings, with tens of thousands of pre-menopausal patients being prescribed this drug every year. In 1996, a division of the World Health Organization, the International Agency for Research on Cancer, declared tamoxifen is a Group I carcinogen, meaning that it can cause cancer.
We often hear about how drug companies play with numbers in order get their pharmaceutical products approved, and one prime example of this distortion is found when we take a closer look at the actual numbers regarding tamoxifen.
The final results from the Breast Cancer Prevention Trial reported that high risk women who used tamoxifen for five years reduced their risk of death from breast cancer recurrence by 49%. However a closer look at the actual numbers reveals that your odds of getting breast cancer without the use of tamoxifen is 1.3%, and with tamoxifen this percentage drops to .68%. That represents a 49% difference between the two numbers, but in reality it is still less than one percentage point difference (or .64%), which is vastly different from the 49% improvement that is being implied by the studies and certainly not worth the health risks that are associated with taking tamoxifen.
Side effects of tamoxifen may include:
- Tamoxifen can increase your risk of developing cancer of the uterus (endometrial), ovaries, and gastrointestinal tract while it only reduces the risk of breast cancer by less than 1%
- An increased risk of endometrial cancer development according to one of the earlier American studies involving women with early breast cancer (NSABP B14) taking tamoxifen as an adjuvant therapy. For this study, 1400 women were given tamoxifen and 1400 women were given a placebo for 5 years, and then were carefully followed for 7 years. During this time, 15 of the women taking tamoxifen developed endometrial cancer compared to only 2 in the control group. A similar increased risk of endometrial cancer was seen in the NSABP P1 breast cancer prevention trial. Among the women who took tamoxifen, there were 33 cases of endometrial cancer compared to only 14 cases among participants randomized to placebo. Women older than 50 years of age had about 4 times the risk of developing endometrial cancer, and data from other studies suggests that there is a doubling of risk for younger women. Because of the increased risk of endometrial cancer it is recommended that women taking tamoxifen should have an annual gynecologic exam.
- A study at Johns Hopkins found that tamoxifen can increase the risk of developing liver cancer.
- increases the risk of developing life threatening blood clots in the lungs or other major blood vessels
- Significantly increases the overall inflammation of the body as measured with a CRP test, and women report experiencing pain as a result of this inflammation.
- Increase in the development of mental confusion, memory loss and depression
- Source to statistical information for tamoxifen (this is a pdf document)
Reduce your exposure to xenoestrogens
Estrogen, like every hormone that is produced in the body, is a much needed chemical messenger that transports a signal from one cell to another.
Xenoestrogens are environmental estrogens that have the ability to change the rate at which estrogen is broken down by the body and it can also mimic natural estrogen and bind to its receptors. Both of these scenarios will result in an overabundance of estrogen and an increase in the overall effects that it has on the body and will lead to the symptoms of hormonal imbalance. When this foreign estrogen combines with natural estrogen, this can create a situation known as “estrogen dominance.” Some of the negative effects can include early-onset puberty, infertility issues, miscarriages, decreased sperm counts, mood swings, headaches, foggy thinking, fatigue, sleep disturbances, hot flashes, digestive issues, gynecomastia (which is the development of breasts in males), estrogen-fueled breast cancers, as well as prostate and testicular cancers in men.
Xenoestrogens are very prevalent in our environment, some examples include: exposure to polychlorinated biphenyls (PCBs), Bisphenol A from plastic water bottles and containers used to store and heat food, exposure to herbicides, pesticides, fungicides, nail polish, makeup, perfumes, birth control, certain sunscreen ingredients, gasoline and automobile exhaust, etc.
How to balance your hormones naturally.
Eat a whole foods, plant-based diet as described below.
- Eliminate all dairy products and red meats. The recommended diet for breast cancer is mostly raw, plant-based, but it can include limited amounts of organic eggs and wild caught fish, if needed.
- Fresh vegetables– are some of the most nutrient dense foods that you can eat. Some cancer-fighters include bok choy, broccoli, spinach, Brussels sprouts, cabbage, cauliflower, celery, collard greens, eggplant, green beans, kale, leeks, onion, peppers, radish, scallions, mustard greens, Swiss chard, tomatoes, summer squash, mushrooms, etc. Cruciferous vegetables include cabbage, broccoli, arugula, bok choy, Brussel sprouts, cauliflower, collard greens, kale, mustard greens, radish, turnips, and watercress. If you have thyroid issues, then you can gently steam these to eliminate the goitrogenic properties.
- Fresh fruits -raw fruits have astringent-like qualities that work to specifically target and cleanse the lymphatic fluids which is extremely important when you are healing from cancer. If you are excluding fruit from your diet, you are missing out on an abundance of antioxidants, flavonoids, and anthocyanins that can prevent an reverse cellular damage and reduce overall inflammation. Some powerful fruits to include are: blueberries, blackberries, strawberries, raspberries, cranberries, grapes, cherries, pomegranates, cantaloupe, papaya, pineapple, watermelon, lemons, limes, and oranges. Fruits are very easily digested, therefore they should be eaten separately, or about 1/2 hour before your main meals, or they can easily be blended into smoothies. One way to do this is to start your day with a big bowl of fresh fruit to cleanse the digestive system.
- Cooked can include sweet potatoes, green beans, tomatoes, oatmeal, quinoa, brown rice, black rice, red rice, amaranth, a variety of lentils, a variety of beans. How to soak and sprout beans and grains
- Eat a variety of raw nuts such as walnuts, cashews, pecans, and almonds, along with nut butters (except for peanuts).
- Eat a variety of seeds including hemp seeds, chia, and freshly ground flax seeds*. Learn how to sprout nuts and seeds to increase their enzyme and nutrient content.
- Add broccoli sprouts on your daily salad, they are super-nutritious and help the body to eliminate excess estrogen
- Acceptable fats can include unrefined coconut oil, organic butter, ghee, and unrefined lard for cooking purposes, while olive, sesame, avocado, hemp and flax seed oils are for cold uses only.
- Eat organic whenever possible as pesticides and herbicides can also promote estrogen dominance.
- Stay hydrated by drinking a minimum 1/2 ounce of purified water for every pound of body weight in order to help the body to flush away the excess estrogens and toxins.
- Use herbs such as rosemary, thyme, oregano, sage and turmeric
- This diet includes juicing of fresh vegetables. Read more about juicing
- This diet includes nutritious smoothies. Read more about smoothies
Supplements that can help to balance the hormones naturally
- Consider taking a quality iodine supplement such as Lugol’s Iodine Solution Adequate iodine supplementation helps the body to produce the hormones that it needs in the proper ratio. Many things can interfere with iodine absorption, some of these include goitrogens, glutens, fluoride, bromide, pesticides, viral infections. Read more about iodine here.
- Take a quality Probiotic to assist with digestion.
- Supplement with Calcium D-Glucarate. The recommended dosage is 400–600 mg per day, taken in divided doses, but those with cancer can take 1000-2000 mg per day, taken in divided doses. Calcium Glucarate facilitates the removal of estrogen and other toxins from the body, and improves estrogen by-product formation so it may help with prostate conditions, PMS and other hormonal imbalances. Animal studies suggest that glucarate not only reduces cancer risk, but may prevent tumor growth in the skin, breast, liver, colon and lung. Women with estrogen-dependent tumors (and men with prostate cancer) may benefit from taking glucarate since it can reduce total estrogen load and improve estrogen metabolite ratios.
- Grapeseed Extract blocks estrogen synthesis by inhibiting the aromatase enzyme. Link to study
- Quercetin is a compound that is found in leafy greens, tomatoes, broccoli, onions, grapes, berries, and red apples. It is a potent aromatase inhibitor and reduces the metastatic potential of cancerous cells. You can also find Quercetin in supplement form
- Make sure you are getting adequate amounts of magnesium, vitamin D3, vitamins B6, B9, and B12, along with selenium and zinc. These can be difficult to obtain from the diet alone, so taking a Bio-available Supplement may be needed.
- Liver Supporting Herbs assist the body in detoxifying a wide range of hormones, drugs and toxins, including xenoestrogens.
- Bio-available Curcumin is a powerful anti-inflammatory and also helps the liver to eliminate and detoxify cancer causing xenoestrogens. The recommended dosage is 600-800 mg per day.
- Supplementing with a high CBD/low THC hemp oil is recommended for those with estrogen positive breast cancers as research has shown that THC can cause estrogen fueled cancers to spread.. You can read more about that with this post.
- Do regular cleansing to get the liver functioning optimally. This is the most important organ for detoxing excess estrogen. You can read about various cleansing methods for the digestive system with this post.
- Get moderate exercise daily- walking, yoga, biking, hiking. This also helps the body to metabolize and remove excess estrogen
- Learn stress relieving techniques- such as Meditation or Emotional Freedom Technique
Health coach and patient advocate Elyn Jacobs reports on her experience using Tamoxifen and shares some natural alternatives that patients can use instead.
Dr Bob on balancing hormones naturally