Soy and Breast Cancer

I have a lovely patient who suffers terribly with menopausal hot flushes.  It’s been years and they show no signs of stopping.  The problem is, she also has a condition that increases her risk of breast cancer.  Hormone replacement with estrogen, while it would help her hot flushes, would be dangerous for her.  Some time ago her oncologist told her she also should avoid soy because it has estrogen effects and may increase her breast cancer risk as well.

You probably know I hate to see anyone suffer.  I hate it even more when the reason for the suffering is based on faulty or outdated logic.  I know newer research has shown that soy foods and soy isoflavone supplements do not increase the risk of breast cancer, but I didn’t have the research to back that claim up.  Off to the research database!

First, some background info.  The reason so many doctors and scientists assumed soy was dangerous for breast cancer patients is because soy contains substances, called isoflavones, that are structured like estrogens.  There’s evidence they can bind to estrogen receptors in cells.

It was assumed that, since most breast cancer tumors are responsive to estrogen, that any estrogen activity would stimulate the cells to grow.  In fact, highly successful treatments for breast cancer like Tamoxifen and Arimidex act by blocking ALL estrogen activity.  As you can imagine, these medications cause a lot of side effects like hot flushes, vaginal dryness and other symptoms that mimic menopause.

You know what happens when we assume, right?  More recently, scientists have decided to question that assumption and look to see if soy intake (both soy foods and soy supplements) actually does increase the risk of breast cancer.

What did they find?  LOTS of studies are out there, but I just want to mention a few.  There was a review article published in late 2013 that looked at 131 different studies on soy foods and soy and red clover isoflavones.  There was evidence that eating soy foods was protective against breast cancer.  Even stronger evidence is that breast cancer patients taking Tamoxifen had no increased risk of recurrence when they used soy.

Another study published in February of 2014 analyzed 35 studies looking at associations between breast cancer risk and soy intake.  The study concluded that in Asia, soy intake reduced the risk of breast cancer in women both before and after menopause.  However, there was no change in breast cancer risk demonstrated in women in Western countries with soy intake.  There was certainly no evidence of an INCREASED risk of breast cancer in women using soy.

A very large study published in 2013 asked over 3800 women about their dietary patterns, including soy intake, when they enrolled in the study.  Over 14 years the authors tracked several variables in study participants, particularly breast cancer diagnosis, breast cancer mortality and all-cause mortality.  There was no difference in breast cancer risk or mortality (from breast cancer or other causes) in women with the highest soy intake vs. those with the lowest soy intake.

It is pretty clear that soy intake does not increase the risk of breast cancer and may actually be protective in some populations.  Why is this?  There is a theory that soy isoflavones, while mimicking estrogens in structure, do not actually behave like estrogens.  Therefore, when they bind to estrogen receptors in cells, they block the actions of the person’s own estrogen molecules.  This theory could explain why soy isoflavones do not increase breast cancer recurrence in patients taking Tamoxifen for estrogen-sensitive breast cancer.  The soy actually behaves a bit LIKE Tamoxifen without the side effects.

If you have considered trying soy isoflavones to reduce hot flashes or using soy as a good source of complete dietary protein, there is plenty of good evidence that it won’t hurt you.  Even if you have a higher-than-normal risk of breast cancer, or have actually developed breast cancer, there’s no evidence that soy is harmful.  As always, you should always discuss supplementation with your doctor to make sure any supplements won’t interfere with your treatment plan.

QUESTION:  Do you have menopausal hot flashes?  Have you considered trying soy?  Have you been told it could be harmful?

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Memorial Day Isn’t Just About Those Who Died

Hi, everybody.  This is Memorial Day weekend, a time set aside to remember and pray for those who gave their lives in military service to our country.

War has laid a terrible price on our country.  The bloodiest war was our Civil War, when our country battled itself and over 600,000 people lost their lives.  Memorial Day often brings memories of World War II and the “Greatest Generation” that sacrificed 400,000 young people to fight genocide and imperialism in Europe and Asia.  The Korean and Vietnam wars saw almost 100,000 casualties between them.  More recently, since 2001 at least 6500 military lives have been lost in the Afghanistan and Iraq war efforts

This weekend is a time to celebrate the beginning of summer and gather with friends and family.  While pondering what to write about this weekend, I thought it would be fitting not only to thank those who have made the ultimate sacrifice for our freedom, but also to consider what their sacrifice has meant to those around them.

Let’s face it, no one lives in a vacuum.  Think about your own life.  You have family, friends, coworkers, neighbors and acquaintances.  If something were to happen to you, it would affect not only you, but every person around you in some way.

I’d like to consider three different types of people who have been affected by deaths in wartime.

Families And Other Loved Ones

When a person dies their family and friends are left to grieve.  Military casualties tend to be young and may leave spouses and young children behind.  If you have friends in the military, please take a moment this weekend to reach out to their families to let them know you’re thinking of them and sharing the burden of worry.

This weekend when we think of those who have been lost, it brings the worry that much closer to home.  “Please not my husband.”  “Please not my daughter.”  “Please not my daddy.”  These are the wordless prayers running constantly through the hearts and minds of all those with a family member in service, even more so this weekend.

When we pray for the peaceful rest of those lost, please also remember those who answered a doorbell to see a crisply uniformed officer on the doorstep with a sober expression, waiting to speak the words that would tear a world apart.

Wounded Warriors

Generally those lost in combat are part of a squad of servicemen and -women.  The incident that took lives often spares the lives of some in the unit but leaves them wounded.  Loss of limbs, traumatic brain injuries and other injuries require long, hard work to recover.  Some never recover fully.

Many of us have seen the commercials for Wounded Warrior Project.  It’s true that our injured service members need financial support, but even if a financial donation isn’t possible there is a lot that we can do to help.  Prayer works, so please remember our recovering soldiers, sailors, airmen and Marines in your prayers.

If you’d like to bring a smile to a recovering service member’s face, you might write some letters and cards, especially with your children.  Address them to Any Wounded Service Member, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889.

Lasting Scars

I have cared for active duty and disabled service members struggling with post-traumatic stress disorder (PTSD).  Flashbacks, nightmares, grief and guilt are all part of living with a history of military service.

Even those who seem able-bodied and functioning well after transitioning back to civilian life may be hiding deep scars.  If you have a good friend that you know was in the military, please make a point to reach out and thank them this weekend.  If they are a VERY good friend and they never speak of their military service, you might gently let them know that if they ever need someone to talk to about that time, you’re available to listen.  Not judging, not trying to fix anything, just listening with love to whatever they need to say.

Memorial Day is a time to remember those who have been lost while serving and protecting the United States.  Please also remember the loved ones left behind, those wounded but surviving, and those who live with the psychological scars that military service left behind.

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Nutrition And Cancer Recovery

What an awesome morning!  My friend Jenny and I participated in an event, “Ride For A Reason,” to support the YMCA’s LiveStrong program.  This program provides supervised exercise therapy to help those recovering from cancer therapy get their strength and endurance back.  What a great cause!  Jenny and I sponsored a vendor table and talked to lots of people about nutrition and cancer recovery.

Here’s fair warning – I will talk a bit about Shaklee products in this post.  If you’re new to the blog, you should read this page about why I choose Shaklee products for myself and my family, and recommend them to my friends and patients.

Cancer takes a lot out of you.  The treatments take even more out of you.  One thing I learned clearly with my husband’s cancer over the last 4 years is that solid nutritional support is critical.  Physical activity is very important as well.

Before I make recommendations, please be clear that ANY nutritional supplements need to be cleared by a cancer patient’s treating physician.  Some supplements interfere with chemotherapy drugs or protect cancer cells from radiation treatments.

Here are 3 suggestions for supplements to help improve nutrition and cancer recovery.

Basic Foundation

I’ve said it before, and I’ll say it again.  Everyone needs a good multivitamin.  B Complex helps with energy, mood and stress management.  Fish oil is good for everybody and provides needed essential fatty acids.  Probiotics support the immune system.

The best basic foundation product I’ve ever seen is Vitalizer.  If anybody deserves high-powered nutritional support it’s someone struggling through cancer therapy.

Protein

When Russ was going through chemo, nobody really offered much in the way of dietary advice.  They just told him to eat.  Eat a lot.  Eat anything and everything he wanted.

I get that.  Chemo kills your appetite.  Mouth sores and effects from radiation (especially to the head and neck) can make it hard to swallow.  However, many people going through chemotherapy choose carbohydrate “comfort food.”

The problem with carbs is that even though they make you feel better emotionally, the body desperately needs protein to provide enzymes and structural protein for new cells.  Chemo kills healthy cells just like cancer cells and the body has to replace them.

Shaklee offers great tasting protein supplements.  From Vitalizing Protein smoothees to Instant Soy Protein which can be mixed into soups, oatmeal, muffins and other foods, boosting your cancer survivor’s protein intake in a way that tastes good and is easy to swallow.

By the way, even though Shaklee has a great weight loss program, the Vitalizing Protein smoothees are NOT meant for weight loss.  They are safe for kids and adults and make a great tasting snack or quick meal on the go.  And unless you are allergic to soy, there’s no reason to avoid soy if you’re a thyroid or breast cancer patient.  I’m planning to review the literature on soy in breast cancer survivors in a post in the near future.

Immune Support

I probably don’t have to say much to convince you that the immune system takes a beating during cancer treatment.  Infection is a constant risk.  Most people who die during treatment actually die of an infection, unfortunately.

During cancer therapy, everyone should take a probiotic supplement.  They provide beneficial bacteria to support digestive health and keep harmful bacteria in the intestine in check.  We are just beginning to explore just how much the good bacteria in the intestine do to keep the body healthy, and the research is stunning.

Shaklee’s OptiFlora is the product I trusted to keep my own personal cancer patient’s immune system running right.  With few exceptions (namely a horrible respiratory bug we brought back from China in 2012) it has done a marvelous job.  My whole family (including my eight-year-old son) take it daily and we rarely come down with anything beyond a cold.

There is one other product shown to improve immune function, and that’s NutriFeron.  Developed by the researcher that discovered the immune signaling molecule interferon, this product supports the immune system.  I have a number of patients with recurrent infections who have noticed many fewer episodes of bronchitis and sinusitis after starting NutriFeron.  One of them jokes that I need to stop telling people about NutriFeron, that it’s bad for business!  LOL!

You don’t need to be a cancer patient to benefit from these suggestions.  Everybody needs a multivitamin, fish oil, etc.  Everybody could probably use a little extra protein, especially after a workout.  We all are surrounded by germs every day.

But for those recovering from cancer treatment, solid nutritional support can make the difference between struggling with fatigue and treatment-related side effects for months, and getting back to health quickly and easily.  I know.  My family has been there.

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Diet and Multiple Sclerosis

This week I had a patient come in to the office who was recently diagnosed with multiple sclerosis.  I remembered reading something about diet affecting the symptoms and course of multiple sclerosis, so off I went to the research literature.  What does it have to say about diet and multiple sclerosis?

I found a great review article just published this year that summarizes a lot of the current understanding of the link between diet and multiple sclerosis.

Multiple sclerosis is an inflammatory illness in which the immune system attacks the insulating myelin protecting the nerve cells of the brain and spinal cord.  Without myelin the nerve cells don’t function properly, leading to numbness, weakness, vision loss and the inability to function normally.  Speech, swallowing and movement may all be affected.

Since inflammation is key, how do we influence inflammation in the body?  Multiple sclerosis therapies are heavily targeted to stopping the immune system’s attack on the nervous system.  Unfortunately these therapies are very expensive and produce a lot of side effects.

If we can identify lifestyle factors that are contributing to the inflammation and immune dysfunction in the body, it stands to reason that changing those lifestyle factors to ones that relieve inflammation and support proper immune function may be helpful.

There is a lot of evidence that the risk of multiple sclerosis is dependent on lifestyle.  For instance, a study published in 2011 reported that people who migrated from the UK and Ireland (where MS risk is high) to Australia (where MS risk is low) had the same risk as their birth country if they migrated after age 15.  However, if they migrated before age 15, their MS risk was low.  Since lifestyle habits are learned early, and those who migrated after age 15 likely brought their lifestyle with them, this argues that lifestyle habits may be great contributors.

What is the lifestyle of places where MS risk is high?  Multiple sclerosis tends to occur in countries that are affluent and have a sedentary habit and western-style diet.  It also tends to occur in higher-latitude areas where sun exposure is limited and vitamin D deficiency is prevalent.  There is a documented correlation between vitamin D deficiency and MS risk.

How does lifestyle affect inflammation and the immune system?  There are two main factors that have been identified so far.  Lifestyle affects the cells of the body themselves, and it also affects the population of bacteria in the intestine.  Believe it or not, the organisms that live in the intestine (which outnumber the cells in your body 10-to-1, by the way) have a huge impact on your body’s well-being.

Typical western diets are high in calories, saturated fat, animal-based foods, trans-fatty acids, sugar and salt and low in dietary fiber.  These factors increase inflammation and upregulate pro-inflammatory signaling molecules in the body.  Inflammatory molecules such as NF-kB and AP-1 are increased in multiple sclerosis.

What type of lifestyle downregulates these molecules?  Pretty much the opposite of the western diet.  Low in calories, saturated fat, animal foods, sugar and salt and high in fruits, vegetables, fish, nuts and dietary fiber, with plenty of physical exercise.

How do the bacteria in the intestine affect our well-being? First of all it’s important to understand that everyone’s bacterial passengers are unique.  The specific composition of the intestinal microbiota is determined by diet, age, physical activity, stress, medications, and many other factors.

As an illustration, there was a study published in 2010 comparing the intestinal bacteria of children living in Italy (who consumed a western-style diet) to those living in Africa.  The African children got plenty of exercise and consumed a diet composed of mostly plant foods high in fiber.

The Italian children’s intestinal bacteria contained species that generally thrive on simple sugars and are considered more harmful.  The African children’s intestinal bacteria contained species that thrive on complex carbohydrates, are more beneficial, and produce butyrate as part of their metabolism.  Butyrate is known to downregulate the production of NF-kB, a pro-inflammatory molecule increased in multiple sclerosis.

The intestinal bacteria are so powerful that one group was able to use them to trigger an MS-like autoimmune demyelinating disease in transgenic mice.

What you eat not only affects your own body’s cells, it also impacts the bacterial species that live in your intestine.  These bacteria aren’t just passengers.  They can cause illness or they can promote health.  They make vitamins and cofactors that influence how your body functions.

What type of diet is best if your goal is to reduce inflammation in the body?  Pretty much the opposite of the typical western diet, of course.  Avoid animal foods, especially red meat and saturated fat (including milk fat), trans fats (in partially hydrogenated vegetable oils), added sugar, added salt, and excess calories.

Now that I’ve told you what NOT to eat, what SHOULD you eat?  The shorthand is the Mediterranean diet.  This diet includes lots of fresh colorful vegetables and fruits, beans, nuts and seeds, whole grains, fish and olive oil.  Resist the temptation to include lots of pasta; a true Mediterranean diet has limited amounts of pasta which are often combined with beans, potatoes and vegetables to round out the starches.

I want to say a few words about supplements.  There are a lot of anti-inflammatory supplements out there, such as fish oil, turmeric/curcumin, vitamin D, selenium and polyphenols.  These are fine as an addition, but you should never forget that the main dietary intervention in inflammatory conditions is just that, the DIET.  You cannot eat a pro-inflammatory diet and expect a fish oil supplement to undo the damage.

If you or someone you love has been diagnosed with multiple sclerosis or another inflammatory condition such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis or coronary artery disease, there is a lot you can do with diet to impact it.

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Counting My Blessings

Hi, everybody!

Yesterday was my birthday and it’s a great time for me to express gratitude for all my blessings.  I actually count my blessings regularly in my prayers, but my birthday is a great time for me to express my gratitude to others.

1.  My family

My greatest blessing is, of course, my husband and two amazing boys.  Our life isn’t always easy, and it certainly isn’t tidy, but I wouldn’t change a thing.

The awareness of just how blessed we are is much greater since Russ’s cancer diagnosis, treatment and remission.  Since 2011 not a day goes by that we don’t give thanks for his health.  The fear and uncertainty, the possibility of losing my best friend, have given way to daily gratitude for the chance to make new memories and watch our boys grow up.

My family doesn’t, of course, just include the people who live in my home.  I have been blessed since I was born with two amazing parents.  My parents are two of the most loving and giving people I’ve ever known.  They are always there with support and advice, ready to help in any way they can.  I am who I am today in large part because of the lessons they taught me when I was a child.  I love you, Mom and Dad!

2.  My health

There was a time I felt guilty because I am so healthy.  When Russ came home from the hospital and was weak and sick and sleeping all the time (terrifying for someone who knew him strong and powerful with more energy than any two fortysomething men) I wanted so badly to give him what I had in abundance.

My health is something I don’t take for granted.  I do my best to eat right and exercise regularly.  My Shaklee supplement regimen, of course, helps a lot too.  I feel good every day and rarely get sick, in spite of being surrounded by cooties every day, LOL!

3.  My faith

At the risk of sounding sappy, I am awed at the sacrifice God made for me.  Every Easter our pastor sings the Exultet, the announcement of Christ’s death and resurrection.  The line that resonates most with me:  “To ransom a slave, You gave away Your Son.”  We are so unworthy of His sacrifice, but He did it anyway!  All He wants is our love in return.

Every day, I know God makes the sun come up for me.  He brings the rain so I can have food to eat and water to drink.  He protects me, guides me, speaks to me and loves me as if I were the only person on Earth.  His love is a gift I will never understand but give thanks for every day of my life.

4.  My career

That’s right, I am grateful for YOU.  The ability to make a difference in the lives and health of others is a blessing that I can’t understate.  When someone tells me I helped them feel better, understand what’s going on, or take control of a health concern, that’s a happiness like no other.

Beyond seeing patients in the office, I’m thankful for the idea that led me to create my website and blog almost 3 years ago.  Since that time I have learned so much about medicine through my commitment to write quality content for you.  If I didn’t have my readers expecting me to deliver posts week after week, I wouldn’t have had nearly the incentive to keep reading and researching.  I discovered a passion in myself for integrative and holistic health that grew from my research and curiosity.

I’m 44 years old and wouldn’t change one little thing in my life.  It’s not perfect, but it’s mine and I love it.  I have been so thoroughly and extravagantly blessed that I can’t imagine what good things are going to happen over the next year.  Can’t wait to see!  Thank you for following along with me!

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