Vitamin D and Ovarian Cancer Risk Reduction by Dr Tori Hudson

Women with ovarian cancer and control subjects were analyzed for their vitamin D status as measured by serum 25(OH)D3 level in 7,243 women from the National Health and Nutrition Examination Surveys (NHANES).

A high and low status of levels of serum vitamin D was defined as above or below 23 ng/mL (57.5 nmol/L). After adjusting for age, diet and body mass index, ovarian cancer cases were over three times as likely to have inadequate 25(OH)D3 levels compared with the controls.

Previous research has shown that vitamin D induces apoptosis in ovarian CA cell lines, ovarian cancer has been inhibited by vitamin D in animal studies and although studies are mixed–ovarian cancer rates appear to be higher in areas with less sun exposure.

Other research on vitamin D consistently observes that a long list of chronic diseases and cancers are associated with lower vitamin D status, with some showing risk reduction when levels are above 30 ng/mL, 40 ng/mL and even 50 ng/mL. Despite this large and growing body of evidence, the Institute of Medicine recently released its Dietary Reference Intakes for Calcium and Vitamin D based on a target level of 20 ng/mL and randomized controlled trials, rather than the cornucopia of observational studies. This resulted in recommended doses of 600-800 I.U. per day depending on age. As I stated in a January blog, it is too bad… that these observational studies were not considered, and once again, we may not have optimal prevention and risk reduction guidelines from our government agencies. Many if not most alternative minded practitioners are recommending a routine dosing of 2,000 I.U. of vitamin D per day, in individuals who do not have a history of kidney stones nor elevated serum calcium levels. However, most women will achieve a minimum serum level of 23 ng/mL (as stated in this current ovarian cancer prevention study) at doses of 600 I.U.-1,000 I.U. per day. A simple blood test will confirm. This would be a logical step in women with risk factors for ovarian cancer or a personal history of ovarian cancer.

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Reference: Bakhru A, Mallinger JB, Buckanovich RJ, Griggs JJ. Casting light on 25-hydroxyvitamin D deficiency in ovarian cancer: a study from the NHANES. Gynecol Oncol 2010;119:314-8.

Black cohosh (Cimicifuga racemosa) in tamoxifen-treated breast cancer patients by Dr Tori Hudson

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;

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Cranberry and Bladder Infections by Dr Tori Hudson

A small study was conducted in 10 Greek postmenopausal women who had at least 3 documented urinary tract infections (UTIs) in the previous year or at least 2 UTIs in the last 6 months prior to the start of the study. Women were given 400 mg of cranberry extract twice per day (2 caps in the morning and 2 in the evening) over 6 months. Urine cultures were taken and proven normal before the start of the study and then every month during the study.

While taking the cranberry extract, none of the women had a UTI over the course of the 6 months and almost all of the urine cultures were sterile (normal). Three women reported mild gastrointestinal problems and their dose was reduced to 2 capsules per day and as a result, their gastrointestinal problems subsided.

Commentary: Cranberries, in the form of juice and capsules have been shown to be effective in previous prevention and treatment of bladder infections. Both cranberries and blueberries belong to the Vaccinium species which are rich sources of dietary flavonoids, including anthocyanins and proanthocyanidins. While the exact mechanism of the benefits of cranberries has not been clearly established, it is thought that the inhibition of adherence of the main bacteria causing infection, Escherichia coli, to the uroepithelial cells that line the wall of the bladder is the main action.

Reference:

Karefilakis C, Mazokopakis E. Efficacy of cranberry capsules in prevention of urinary tract infections in postmenopausal women. J Altern Complement Med 2009;15(11):1155.

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