ASK THE DOCTOR
by Dr. Chad Larson

[Q&A]   Breast Cancer And Soy
Submitted by: Shelly G.
Q: What is the deal with estrogen and breast cancer? And how do phytoestrogens from soy affect that risk?
A: The National Toxicology Program of the US Public Health Service recently added conjugated estrogens to the known to be human carcinogens list. Furthermore, some estrogen's are more carcinogenic than others. There are three main estrogen's: estradiol, estrone, and estriol. These three are further broke down into three families of estrogen metabolites. These families are the 2-H estrogens, the 4-H estrogens, and the 16-H estrogens. The 4-H and 16-H estrogens are believed to the more carcinogenic. The 2-H estrogens are believed to be anticarcinogenic. Therefore, the more important issue is the ratio of the 2-H and the 16-H estrogens. Women who metabolize through the 16-H pathway may be at a higher risk for breast cancer than women who metabolize more estrogen through the 2-H pathway.
You may be wondering if you can increase your body's metabolism of estrogen through the 2-H pathway. The answer is yes! Whew! Last year in the New England Journal of Medicine it was noted that environment, diet, and lifestyle play significant roles in modulating estrogen metabolism.
This leads us to the second part of your question. Do phytoestrogens from soy affect the risk of breast cancer? First of all, I agree with Jeffrey Bland, Ph.D., when he says we need to drop the term phytoestrogen and replace it with phyto-hormone modulator. They are not estrogens at all. Isoflavones (often referred to as phytosetrogens) from soybeans need to be considered adaptogens for managing estrogen balance. In other words, they help increase estrogen in individuals with a low-estrogen imbalance and they decrease estrogen in those with a high-estrogen imbalance. The soy isoflavones genistein and daizein are the most studied estrogen-modulating compounds from plants. Isoflavones from red clover and the Kudzu vine have also been shown to have estrogen activity-modulating effects. In addition to soy, red clover, and the Kudzu vine; chasteberry (Vitex agnus-castus L.), black cohosh (cimicifuga racemosa), and essential fatty acids (such as flax and fish oil), have been demonstrated historically to have hormone activity-modulating affects.
Lastly, another way to promote the 2-H pathway by lowering the more carcinogenic 16-H pathway is administration of the phytonutrient indole-3-carbinol (I-3-C).
Fortunately, your 2-H to 16-H ratio can be evaluated by a simple urine test and we can formulate an individually-tailored program for you including diet, nutrition, and lifestyle.
We live in bodies where all the systems are very interrelated in a web-like balance of interactions. We cannot just listen to one instrument when addressing the human body but rather have to respect and consider the entire symphony. As usual, I would recommend a consultation for an individualized, comprehensive assessment.
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