A prospective observational study was carried out in 50 breast cancer patients on tamoxifen, an anti-estrogen therapy that can also induce or worsen menopausal symptoms. All 50 women were post surgery, 87% of them were post radiation treatment and approximately half of them had received chemotherapy as well. Each patient was treated with an isopropanolic extract of black cohosh (1-4 tablets, 2.5 mg) for 6 months. Symptoms were recorded before therapy and after 1, 3 and 6 months using the menopause rating scale (MRS II).
Results: The total MRS II score for women while on black cohosh treatment reduced from 17.6 to 13.6, a statistically significant reduction. Symptoms of hot flashes, sweating, sleep problems, and anxiety improved, but vaginal dryness and body aches/pains did not change. Twenty two patients reported adverse events, but none were linked with the black cohosh; 90% of the women reported the tolerability of the black cohosh extract as very good or good.
Commentary: This is one more positive study using black cohosh extract for menopausal symptoms and even more meaningful, women on tamoxifen can have more problematic menopause symptoms and so a significant benefit of black cohosh is especially needed. Readers will also want to be reminded that we do have safety data on black cohosh in breast cancer patients—there is no estrogen in black cohosh, no phytoestrogens in black cohosh, no ability to stimulate breast cancer cells and laboratory data showed that black cohosh inhibited proliferation of estrogen receptor positive breast cancer cells and augmented the anti-estrogen effect when using black cohosh with tamoxifen. Black cohosh is clearly the first choice herb for menopause symptoms in breast cancer patients, and in breast cancer patients on tamoxifen.
Reference:
Rostock M, Fischer J, Mumm A, et al. Black cohosh (Cimicifuga racemosa) in tamoxifen-treated breast cancer patients with climacteric complaints – a prospective observational study. Gynecol Endocrinol. 2011 Jan 13;
For more information about Dr Hudson go to http://www.torihudson.com
Tuesday, January 18, 2011
Monday, January 10, 2011
Calcium/Vitamin D, IOM guidelines by Dr Tori Hudson ND
The Institute of Medicine (IOM) recently released their assessment of current data on health outcomes as they related to calcium and vitamin D after being commissioned by the U.S. and Canadian governments. The new reference values, expressed Dietary Reference Intakes (DRIs), are based on an abundance of information and higher quality published studies than were available for the 1997 government values.
A committee of experts evaluated more than one thousand studies and reports as well as listening to testimony from scientists and others. This committee considered that studies about the health benefits beyond bone health were most often from studies that provided mixed results, inconclusive results, or were not from randomized controlled trials. Thus, these were not considered reliable. Their focus then was on the bone growth and bone maintenance data.
Their new Recommended Dietary Allowance (RDA) is now 600 IU per day for people ages 1 to 70 and 800 IU per day for those 71 and older. The old guidelines from 1997 were 200 IU per day through age 50, 400 IU per day for ages 51 to 70 and 600 IU per day for 71 and older. While I would consider these guidelines conservative to the extreme, (really a one year old and a 70 y.o. need the same amount????) they at least increased a new safe upper limit of 4,000 IU a day for those 9 years old and above, pregnant or not. The greatest concern I have with these guidelines is that they based their bone dosing guidelines on a target blood level of 20 ng/ml per day, rather than 30 ng/ml per day minimum published in most research about levels needed to suppress the parathyroid gland and avoid unnecessary bone loss.
Most practitioners and a studious group of consumers realize that there are scores of studies on other potential health benefits found in observational/epidemiological studies including colorectal cancer, breast cancer, select autoimmune disorders, cardiovascular disease and much more. It is too bad… that these were not considered, and once again, we may not have optimal prevention, risk reduction guidelines from our government agencies.
For a full list of the dosing guidelines by age group, gender, and pregnancy status, you can find these at www.iom.edu/vitamind
For more information on Dr Hudson go to www.torihudson.com
A committee of experts evaluated more than one thousand studies and reports as well as listening to testimony from scientists and others. This committee considered that studies about the health benefits beyond bone health were most often from studies that provided mixed results, inconclusive results, or were not from randomized controlled trials. Thus, these were not considered reliable. Their focus then was on the bone growth and bone maintenance data.
Their new Recommended Dietary Allowance (RDA) is now 600 IU per day for people ages 1 to 70 and 800 IU per day for those 71 and older. The old guidelines from 1997 were 200 IU per day through age 50, 400 IU per day for ages 51 to 70 and 600 IU per day for 71 and older. While I would consider these guidelines conservative to the extreme, (really a one year old and a 70 y.o. need the same amount????) they at least increased a new safe upper limit of 4,000 IU a day for those 9 years old and above, pregnant or not. The greatest concern I have with these guidelines is that they based their bone dosing guidelines on a target blood level of 20 ng/ml per day, rather than 30 ng/ml per day minimum published in most research about levels needed to suppress the parathyroid gland and avoid unnecessary bone loss.
Most practitioners and a studious group of consumers realize that there are scores of studies on other potential health benefits found in observational/epidemiological studies including colorectal cancer, breast cancer, select autoimmune disorders, cardiovascular disease and much more. It is too bad… that these were not considered, and once again, we may not have optimal prevention, risk reduction guidelines from our government agencies.
For a full list of the dosing guidelines by age group, gender, and pregnancy status, you can find these at www.iom.edu/vitamind
For more information on Dr Hudson go to www.torihudson.com
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