In Functional Medicine, we start with the why?
Though breast cancer often develops for reasons we do not know, we do know that there are certain contributing factors that increase overall risk. Focusing here can empower women to make conscious choices that will reduce the risk of breast cancer and other chronic disease as well. One of these factors is increased estrogen or hormone imbalance.
The Why: “What causes hormone imbalance?”
- Nutritional Insufficiencies, Inflammation, Insulin Resistance, Adiposity, Food, Toxins, Infections, Stress, Genetics, Impaired Elimination and metabolism of estrogen
Then, we target our treatment/prevention plan to the why (the root cause(s)):
Breast Cancer prevention was one of the first ways I learned about how food can be medicine. I saw how the effects of food could be studied using a person’s biomarker labs, and how that laboratory value related to a person’s risk of disease. For example, eating cruciferous veggies (broccoli, kale, brussel sprouts, etc) has been shown to change estrogen ratios in the body.
A woman has three different types of estrogen and with respect to breast cancer, some types are worse than others. Increasing the ratio of 2:16-OH estrogen (as eating cruciferous veggies can do) lowers the risk of breast cancer.
So a food can cause a hormone shift in the body and that hormone shift can mean the difference in risk of developing breast cancer. This is how food is medicine and food is information for our body.
When we look for labs about how the body is functioning, and how nutrition is impacting that function, on a much more detailed and preventative way, we can guide target our wellness plans more personally.
We can measure 2:16 estrogen using functional labs, and improvements can be tracked after diet changes. This example of food as medicine is just one of the way functional medicine enhances prevention.
Chronic elevation of stress hormones can weaken the immune system. We want a healthy immune system to recognize a cancer cell, and eliminate it before it becomes a problem. A strong immune system not only attacks germs that makes is sick, it attacks and takes care of other cells that have started to go awry as well.
High insulin levels are a risk factor for breast Cancer. When a person becomes resistant to insulin (meaning that insulin isn’t doing its’ job effectively anymore to take sugar out of the blood and put it into the tissue for energy), then insulin levels rise higher and higher in attempt to compensate. High insulin levels are found before high blood sugar levels and are a precursor to development of diabetes. The preventative answer is to cut back on simple carbs, sugars, and processed foods.
In addition, our fat cells make estrogen. The relationship of obesity, insulin, and hormones is important to consider in prevention of breast cancer. We also know that regular exercise reduces the risk of breast cancer.
Toxins can include both substances like alcohol, and other environmental toxins like xenohormones.
We know that women who drink 2 or more drinks of alcohol will have an increased risk of breast cancer – in some studies 20-30% higher risk. To reduce risk, limit alcohol consumption and allow days in between drinks for the liver to detox.
Environmental Xenohormones are chemicals that have been shown to disrupt the hormone response. For example, plastics, glyphosate (a pesticide), PBDEs (flame retardants), and phthalates (like those found in air fresheners). Simple changes like eliminating air fresheners and using natural cleaners as well, and avoiding cooking or storing foods in plastics will decrease your exposure to these chemicals.
Gut Health: Food Sensitivities/Infections/Impaired Elimination
A healthy gut is essential for proper elimination of estrogen through stool and for a healthy balance of good bacteria (the microbiome). The microbiome and how it interacts with our genes is the future of personalized medicine. We know that having an unhealthy balance (or dysbiosis) increases the re-absorption of estrogen metabolites.
Genetics/Metabolism of Estrogen
In addition to carrying certain genetic mutations that increase the risk of developing breast cancer, there are also differences in genes that affect how we eliminate estrogen.
In summary, as part of a preventative wellness plan we want to:
- Decrease sugars
- Increase exercise
- Increase cruciferous veggie consumption
- Decrease Alcohol
- Increase microbial diversity
- Increase excretion of estrogen
- Decrease insulin
- Decrease exposure to xenohormones