Iodine and Other Nutrients Play a Crucial Role
Jorge D. Flechas M.D., M.P.H. Over the next few weeks, the country will nationally be focusing on breast cancer. Of all the cancers women develop, 29 percent are breast cancer. By age 25, 1 in 19,608 women will develop breast cancer. By age 50, this number changes to a shocking 1 in 50 and by age 75 an even more dismal statistic: 1 in 11. In a total lifetime, one woman in 8 will develop breast cancer.
In January 2005, cancer became the leading cause of death in the United States. Each year about 211,000 cases of breast cancer are diagnosed in the USA. The number of new breast cancer cases increased from 82 per 100,000 women in 1973 to 195 per 100,000 women in 2000. The main cause of death prior to that was heart disease. The estimated death rate from breast cancer is 40,600: 40,200 females and 400 males.
Much is said in the public media about a genetic link with this cancer. Yet, genetics play only a small role in the development of breast cancer—less than 7 percent. In the September 8, 2006 issue of USA TODAY one of the lead articles was on Killer Cancer Genes ID’d. It mentioned that 122 breast cancer-causing genes have been identified. The scientist quoted in the article mentioned that we may not be able to tackle all the genes in a tumor but that we may have to work on silencing the cancer-causing genes. Doctors in the future may find that silencing even one of these genes could be enough to keep a tumor in check or kill it. They mention in the article that treatments could be a decade or more to develop.
Yet, the technology for tomorrow is here today in the supplements we have at our disposal. For example, methylation of DNA and gene silencing are affected by nutrition. Many articles exist on silencing genes and how the use of methyl-folic acid, methyl-vitamin B12, selenium, trimethylglycine powder and zinc help to methylate the DNA.
Breast Cancer Risk Factors
Many breast cancer risk factors have been identified such as a high-fat diet, low-fiber diet, tobacco use, and alcohol use. These risk factors can be modified by an individual. There are other factors that are mostly out of a woman’s control. The longer a woman is exposed to estrogen in her body, for example, the higher her risk. This would include early age at menarche, late age at menopause, long-term use of birth control pills and nulliparity (never having given birth). There seems to be a group of women whose use of birth control pills for more that 4 years puts them at higher risk before age 45. Women who take thyroid hormone are also at higher risk for developing breast cancer.1 Conversely, a lower risk for breast cancer is seen in women who are late in age at menarche, early age at menopause, and early age at first pregnancy.
In the New England Journal of Medicine, July 22, 2005 issue, there was a lead article showing that benign breast changes in women are associated with breast cancer. Benign breast changes is a new term for what we have called fibrocystic breast disease (FBD) in the past. FBD is currently affecting about 84 percent of the female population in North America.2 FBD is a misnomer because the medical problem is not a disease in the strictest sense. It is more a problem of cyclic breast pain that is associated with the menstrual cycle. In some patients the breast pain is seen daily, regardless of their menstrual cycle. Tissue biopsy for these benign breast changes that do grow larger are called proliferative lesions and if they do not grow they are called non-proliferative lesions.
Non-proliferative lesions (non-growers) can include cyst of the breast, radial scars, apocrine cells which generally make up sweat glands—the breasts are classified as a modified sweat gland—fibroadenoma, and hyperplastic cells that are normal in appearance under the microscope but are more numerous than usual. Proliferative lesions with normal cells are called sclerosing adenosis, which have a slightly increased risk (1.5 to 2 times). There are proliferative lesions with abnormal or atypical cells that are called hyperplasia—high degree with a moderate increased risk of breast cancer of (4 to 5 times), lobular neoplasia and intraductal papilloma. As a rule in medicine, the more abnormal cells look under the microscope, i.e., the more atypical the cells look, the higher the risk of cancer being present.
Iodine’s Supportive Role
Back in the early 1990s it was noted that patients who had iodine deficiency had associated benign breast changes. By giving these patient’s iodine the breast changes that were present would regress.2 It had been noticed a few years earlier that in animal studies, where the animal had been denied access to iodine, the animals developed benign breast changes like humans.3-5 In animal studies, researchers have been able to produce breast cancer in animals by depriving them of iodine.4
In my own personal medical practice I have literally seen the regression of cysts, nodules, scar tissue, and painful breast with the use of 50 mg of Iodoral® per day for 2-3 years. The breast pain goes away in just a few weeks, but the cyst/cysts, scar tissue and breast nodules take up to 2 to 3 years to resolve. On mammograms I have seen a 50 to 80 percent reduction in the scar tissue present in the breast. Studies are needed to show via biopsy that the many different types of FBD will regress with iodine supplementation.
Before starting on iodine therapy, a patient should have their thyroid hormone values investigated. A doctor should check the size of the thyroid for enlargement and or nodules. An iodine-loading test should also be done prior to starting iodine therapy to establish the need for iodine therapy. In this test the patient is given 50 mg of iodine and a 24-hour urine test is then collected. The iodine level in the urine is measured. The more saturated the body is with iodine the higher the level of iodine excreted. The more saturated the body is, the less breast abnormalities have been seen. The test is repeated at 3 months to document increasing saturation. If saturation is not occurring then further investigation is called for to find out why saturation isn’t happening.
Several other nutrients/hormones are also important to breast health and can be used in conjunction with Iodoral. DIM (diindolylmethane), the nutrient derived from cruciferous vegetables, for example, is influential in helping the body metabolize estrogen. DIM has been shown to change the way estrogen is metabolized. Metabolism of the natural estrogen estradiol occurs via one of two pathways. The tumor enhancer metabolic pathway, 16 alpha-hydroxylation, is elevated in patients with breast and endometrial cancer and in those at increased risk of such cancers. This increased 16 alpha-hydroxylation activity has been shown to precede clinical evidence of cancer, and it represents a significant risk factor for developing estrogen-dependent tumors.
Conversely, when estrogen veers away from the 16-alpha pathway and takes another route out of the body, the incidence of cancer decreases. This alternate route, which acts as a tumor suppressor metabolic pathway, is called 2-hydroxylation, a process that transforms estrogen into 2-hydroxyestrone (20HEI), an antiestrogen. Healthy individuals not at risk for breast or endometrial cancer bypass the 16-alpha route and instead metabolize estrogen through this preferable pathway. DIM signals the body to metabolize estrogen via the tumor suppressor 2-hydroxylation pathway.
In addition to this more well known estrogen-related mechanism of action of DIM, recent research also indicates that DIM can prevent angiogenesis, the process by which new blood vessels develop. Cancer cells use the development of new blood vessels to spread throughout the body. In mice, DIM inhibited angiogenesis by up to 76 percent.6 In addition, in mice implanted with human breast cancer cells, tumor growth was inhibited by 64 percent in animals treated with DIM.6
Another means of supporting breast health is by using natural progesterone cream. A syndrome known as Estrogen Dominance is prevalent in women, especially postmenopausal women. According to progesterone researcher Dr. John Lee, estrogen unopposed by progesterone results in a number of adverse effects including painful breasts, fibrocystic breast disease, and breast cancer.
Estrogen dominance usually occurs at menopause, when progesterone production falls to approximately 1 percent of its pre-menopausal level. At this time, the production of estrogen falls to about 50 percent of its pre-menopausal levels. This dramatically alters the estrogen: progesterone ratio, causing estrogen to become toxic without progesterone to oppose it. As a result, the risks for breast and uterine cancer and fibrocystic breast disease increase.7 Therefore, progesterone also has a crucial role to play in maintaining breast health.
Vitamin D is another breast-supportive nutrient. Women who have mutations in their vitamin D receptor gene are nearly twice as likely to develop breast cancer compared to women who do not have the mutation. The vitamin D receptor gene controls the action of vitamin D in the body. Scientists have found that Caucasian women with certain versions of this gene not only have an increased risk of breast cancer but also may suffer from a more aggressive form of the disease if it spreads. The results suggest that vitamin D does indeed play a part in protecting the body against breast cancer, as past studies indicate.
Five to ten percent of breast cancer cases are due to already established gene mutations such as BRCA1. However, the underlying cause of breast cancer in women who do not have this gene and have no family history of the disease has remained a mystery. The study suggests that the mutation in the Vitamin D receptor gene may have a role to play in disease development in women who would not ordinarily be expected to develop the disease.8
1. Ghandrakant C, Kapdim MD, Wolfe JN. Breast Cancer. Relationship to Thyroid Supplements for Hypothyroidism. JAMA. 1976; 238:1124.
2. Ghent WR, Eskin BA, Low DA, et al. Iodine Replacement in Fibrocystic Disease of the Breast. Can J Surg. 1993; 36:453-460.
3. Eskin BA, Bartuska DG, Dunn MRea. Mammary Gland Dysplasia in Iodine Deficiency. JAMA. 1967; 200:115-119.
4. Eskin BA. Iodine Metabolism and Breast Cancer. Trans New York Acad of Sciences. 1970; 32:911-947.
5. Eskin BA. Iodine and Mammary Cancer. Adv Exp Med Biol. 1977; 91:293-304.
6. Chang X, Tou JC, Hong C, Kim HA, Riby JE, Firestone GL, Bjeldanes LF. 3,3’-Diindolylmethane inhibits angiogenesis and the growth of transplantable human breast carcinoma in athymic mice. Carcinogenesis. 2005 Apr;26(4):771-8.
7. Lee, John R., What Your Doctor May Not Tell You About Menopause. Warner Books, May, 1996.
8. Guy M, Lowe LC, Bretherton-Watt D, Mansi JL, Peckitt C, Bliss J, Wilson RG, Thomas V, Colston KW. Vitamin D receptor gene polymorphisms and breast cancer risk. Clin Cancer Res. 2004 Aug 15;10(16):5472-81.