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 that tamoxifen is a Group I carcinogen, meaning that it can also cause cancer.
We often hear how drug companies are playing 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%. According to the study, your odds of getting breast cancer without using tamoxifen were only 1.3%., and with tamoxifen it dropped to .68%. While that can be represented as a 49% difference between the two numbers, in reality it is just a little over one-half of one-percent (0.64%), and that is vastly different from the implied 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.
Ways to balance your hormones naturally.
Eat a whole foods, plant-based diet as described below.
- Eliminate all processed foods, dairy products and red meats.
- The recommended diet for breast cancer is mostly raw, plant-based, but can include limited amounts of organic eggs and wild caught salmon.
- 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, beets, eggplant, green beans, kale, leeks, onion, peppers, radish, scallions, mustard greens, Swiss chard, leafy greens, tomatoes, summer squash, mushrooms, etc.
- Fresh fruits -if you are excluding fruit from your diet, you are missing out on an abundance of antioxidants, flavonoids, and anthocyanins that can prevent and 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 along with leafy greens.
- This diet includes juicing fresh vegetables. Read more about juicing
- This diet includes making nutritious smoothies. Read more about smoothies
- Add broccoli sprouts on your daily salad as they are super-nutritious and can also help the body to eliminate excess estrogen. You can buy broccoli seeds and a Seed Sprouter online and begin to sprout your own.
- Complex carbohydrates on this diet can include: brown rice, wild rice, amaranth, triticale, buckwheat, yams, sweet potatoes, lentils, black and adzuki beans. How to soak and sprout grains.
- A variety of raw nuts such as walnuts, cashews, pecans, and almonds, along with nut butters (except for peanuts and peanut butter), and a variety of seeds including hemp seeds, flax, chia, black sesame, pumpkin, and sunflower. How to soak nuts and seeds.
- 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.
- Use herbs such as rosemary, thyme, oregano, sage, cumin, freshly grated ginger root, cayenne pepper, and turmeric
- 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.
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 ratios. Many things can interfere with iodine absorption, some of these include goitrogens, glutens, fluoride, bromide, pesticides, and viral infections. Read more about iodine here.
- DIM, or Diindolylmethane helps to support detoxification and healthy estrogen balance.
- Make sure you are getting adequate amounts of vitamins and minerals. These can be difficult to obtain from the diet alone, so supplementation will help to cover any nutritional shortfalls.
- Take quality probiotics to replenish the beneficial gut bacteria and assist with digestion.
- Ashwagandha is an aptogenic herb that has the ability to improve various hormonal issues and reduce inflammation.
- 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. 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. Animal studies suggest that calcium glucarate not only reduces cancer risk, but may also prevent tumor growth in the skin, breast, liver, colon and lung.
- Grapeseed Extract blocks estrogen synthesis by inhibiting the aromatase enzyme. Link to study
- Quercetin is a compound found in colorful fruits and vegetables such as red onions, tomatoes and the skins of red apples. It is a potent aromatase inhibitor that can reduce the metastatic potential of cancerous cells.
- Liquid Chlorophyll is a natural detoxifier of the blood and also helps to transport oxygen into the cells.
- 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.
- Using essential oils such as myrrh, myrtyl, sandalwood, geranium, clove, rosemary, and clary sage can also be helpful in balancing the hormones. Read more about essential oils here.
The liver is the most important organ for eliminating excess estrogen so look at ways to help it run more efficiently. These can include detoxification and herbal remedies that support liver function.
- Supplement with Magnesium, it is crucial for Phase II detoxification in the liver. During this process, estrogen metabolites are made water-soluble so that they can be excreted from the body in the form of urine or stool. If you have insufficient magnesium, your liver may be less able to complete the Phase II detoxification and this may contribute to estrogen dominance
- Liver Supporting Herbs can assist the body in detoxifying a wide range of hormones, drugs and toxins, including xenoestrogens. Some herbs that are helpful for the liver include milk thistle, dandelion root, chanca peidra, licorice root, and burdock root.
- Bio-available Curcumin is a powerful anti-inflammatory and also helps the liver to eliminate and detoxify cancer causing xenoestrogens.
- Psyllium husks can assist the liver by absorbing bile and eliminating it from the body. Bile is not excreted from the body as you might expect, it is repeatedly recaptured and recirculated to be used continuously for digestion. Because of this, it becomes more concentrated with toxins (including estrogens). Psyllium absorbs this toxic bile and eliminates it from the body, and this forces the liver to produce fresh bile.
- You can read more about how therapies that support the liver with this post
- Read about how to cleanse and flush the liver and gall bladder with this post
- Have long soaks in an Epson salt/sea salt/baking soda bath which can help those on a mostly vegetarian diet to mobilize toxins out through the skin. Add one cup of Epson salts, 1/2 cup baking soda (sodium bicarbonate) and 1/2 cup of sea salt to a warm bath and soak for 20 to 30 minutes. Rinse with plain water when finished soaking to prevent the salt from drying your skin.
Exercise and emotional well-being
- Get moderate exercise daily- walking, yoga, biking, hiking. This also helps the body to remove excess estrogen
- Sweating by way of daily exercise or with the use of a sauna can also help the body to release excess toxins and estrogens as well.
- Lose excess weight as fat cells have the ability to produce 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