Nutrients and Breast Cancer: An Excerpt and Update

by Helayne Waldman, EdD, MS

from the book The Whole Food Guide for Breast Cancer Survivors, by Helayne Waldman, EdD, MS, and Edward Bauman, PhD

Prescription Drugs and Nutrient Depletion

A critical matter that’s often overlooked by both medical professionals and consumers alike is the profound effect that pharmaceutical drugs can have on the absorption, utilization, and/or excretion of nutrients. The chart below provides “at a glance” help in understanding these effects, showing the most common depletions from drugs whose use is widespread; note that many if not most blood pressure and prescription cardiac medications have a magnesium-depleting effect as well.

Drug-Induced Nutrient Depletions

Adapted with permission from Designs for Health Ltd.

Note: This is just a sample list. For a complete reference on drug-induced nutrient depletions, see The Nutritional Cost of Prescription Drugs, by Ross Pelton and James LaValle, or The A-Z Guide to Drug-Herb-Vitamin Interactions, by Dr. Alan Gaby et al.

Drug-induced nutrient depletion can lead to further health challenges, as your cells need all vital nutrients all the time. Be sure to discuss with your nutritionist or integrative physician the ways in which you can compensate for any deficiencies your medications may be causing.

We realize that the subject of supplements is very confusing for many people. Below are some common questions that we have gotten from clients over the years about supplements.

What’s in a Label?

RDA stands for recommended daily allowance. Today, most multinutrients will give either an RDA or a % DV value on the label as general nutrition guidelines for consumers. The underlying concept is that these allowances should prevent deficiency diseases associated with each nutrient. For example, 75 mg of vitamin C is the amount deemed necessary to prevent scurvy. However, it is not the amount thought necessary by nutritionists for optimal health. What’s more, such generalizations do not work for some segments of the population, a concept called biochemical individuality introduced by scientist Dr. Roger Williams. Williams was the first to describe how differences in individual anatomy, physiology, and genetics determined individual nutritional requirements.

Tip : A poorly formulated supplement will have 100% DV of each nutrient. We recommend against this type of supplement, as quality manufacturers know that some nutrients are used up more quickly than others (for example, the B vitamins) and some DVs are set at unrealistically low levels (e.g., vitamin C.) On the other hand, some nutrients may be toxic at doses above the RDA (e.g., vitamin A, iron). A high-quality manufacturer will take this all into account in creating a multinutrient formula that reflects a practical understanding of how nutrients behave in the body.

How Do I Know What Form of the Nutrient Is Best?

All nutrients come in many forms. We ask that you keep two basic principles in mind. First, you’ll want a nutrient which is in a form as close to the way that nature made it as possible. The simple truth is that synthetic products are far less expensive and have a longer shelf life than natural substances. As such, they are the darlings of the low-price chain stores and many pharmacies. Look for a brand that says “food-based” or 100% whole food. That way, you are not only getting the nutrients, but the cofactors, enzymes, bioflavonoids, and other phytochemicals that help the nutrient perform its job better.

Second, we suggest you familiarize yourself with nutrients that come in “families” and understand that ingesting only one “member” of the family can be problematic. An excellent example is vitamin E. Vitamin E actually consists of a large cast of characters: first there are the tocopherols – alpha, beta, delta, and gamma. Then there are the tocotrienols – also alpha, beta, delta and gamma. Ideally, your multinutrient label will say “mixed tocopherols” or “mixed tocopherols and tocotrienols.” An isolated form of one part of a nutrient can easily throw the other parts off balance.

It’s also useful to know whether the nutrient is in its active or precursor form. In other words, can your body use it just the way it is, or does it need to go through some sort of conversion process? Vitamin B6, for example, is known as pyridoxal-5′-phosphate in its active, ready-to-be-metabolized form. Only higher-quality brands will invest the resources to provide the active forms of nutrients when possible.

Finally, if you are seeking out supplements as part of your breast cancer protection plan, be sure that the form you chose matches the form used in the research studies showing benefit. For example, selenium comes in many forms, but se-methylselenocysteine (SeMSC) is the form that’s shown the most promise in recent studies for cancer prevention. Avoid multinutrients which do not divulge the form of the nutrient that they are asking you to take!

How Do I Identify a High-Quality Supplement?

If you are going to take supplements it is important to make sure that what you are getting is what your body needs. Unfortunately this is not always the case; there are several issue to consider when purchasing supplements.Here are a few of the most critical.

Bioavailability. A nutrient is only as good as your ability to absorb it. So it’s good to get a handle on what makes some forms more absorbable than others. As we stated earlier, the closer to real food your formula is, the more familiar it will feel to your body. That said, there are a few other basic principles. Minerals, for example, are notoriously hard for the body to absorb in both food and supplement form. It’s estimated by Albion Labs in Northern California that typical absorption rates for minerals range from 10% to 45% (Bauman. Nutritional Supplements: Can’t Live With them, Can’t Live Without Them; 2004,). A process called amino acid chelation increases absorption. The chart below illustrates some common nutrient forms, and can serve as a guide as to which forms are preferable.

How many nutrients does it include? All multinutrient formulas will include the basics, but only a high-quality supplement will include trace minerals, which play a vital metabolic function. Look for a formula that includes chromium to assist with blood sugar regulation, silicon for hair and nail strength, boron for bone health, vanadium for insulin sensitivity, and so on. These trace minerals are of particular importance, since they are scarce in most conventional soils. A good-quality formula will include these and more.

USP certification . A supplement with the USP (US Pharmacopoeia) designation is of the highest quality. This indicates that the product has met the following standards: disintegration (you don’t want your vitamin pills just sitting in your stomach!), strength, purity, and expiration (when the supplement will no longer meet these standards). If you like, you can also request a certificate of analysis from the supplement manufacturer to help insure quality control, and that the label reflects the actual contents. An authentic certificate will give details of the lab where tests were conducted, in addition to the lot number of the product tested. This is a good way to be sure that the product is free of heavy metals, pesticides, solvents, and other pollutants.

No “junk” ingredients . Avoid products with ingredient names that you can’t pronounce or identify such as such as titanium dioxide, stannous chloride, and sodium metavanadate, common ingredients in drugstore supplements. Other substances to avoid could include: all artificial colors, artificial flavors, sugars, artificial sweeteners, and toxic fillers, as well as common allergens such as lactose, gluten, or cornstarch.

Questions for Professionals

Some supplement issues need to be discussed with a professional nutritionist or other holistic practitioner. For example, how do I know what dosage of a nutrient is best for me? Your needs will vary depending on your existing nutritional status, your biochemical makeup, and your individual risk factors for breast cancer. Your practitioner may suggest that you conduct specific tests that will indicate your need for specific nutrients. This upfront spending can bring large dividends in the long run, since you can then be much more targeted and judicious in the use of only those supplements that will provide the most benefit.

Other questions to ask your practitioner would be,how/when should the supplement be taken? How long should the supplement be taken? What interactions among nutrients do I need to watch for? What interactions might they have with the herbs or medications I take? Again, these are issues that are best worked out with a professional who is experienced in the use of nutritional supplements.

In short, you will usually get what you pay for. We think that it is far better to take fewer supplements of better quality than swallow a trunk full of “junk” supplements that could wind up doing more harm than good.

Keep in mind that supplements, no matter how useful, do not and never will have the same power as nutrient-dense, whole foods. They are meant to be used as an adjunct to a healthful diet, never a replacement. Be sure to work with your nutritionist or other holistic practitioner to determine which supplements and dosages are right for your particular situation.

Helayne Waldman, EdD, MS, is a holistic nutrition practitioner who specializes in helping women through all phases of the breast cancer journey. She is especially interested in survivorship and helping to transform the post-treatment period into a proactive, thriving time in a cancer patient’s life. Dr. Waldman sits on the board of the Annie Appleseed Project (for complementary cancer treatment); is an adjunct professor and instructor at Hawthorn University, Piedmont Public Schools, and the Cancer Wellness Community; and speaks frequently on the topic of nutrition and breast cancer. Her book with Edward Bauman, The Whole Food Guide for Breast Cancer Survivors– a #1 bestseller on Amazon.com – is available at www.wholefoodguideforbreastcancer.com, as is a free chapter download.