The Hopkins Health Watch - Vol 1, Issue 2


Natural Hormone
& Nutrition News,
Drug Watch and More...


Antibiotics increase it, NSAIDs decrease it.

Long-term use of antibiotics is associated with an increased risk of breast cancer, while long-term use of NSAIDs (ibuprofen, aspirin) is associated with a decreased risk of breast cancer.

The association between antibiotics and breast cancer was discovered about 20 years ago, but up until recently it hasn’t been well studied. Researchers from the University of Washington in Seattle compared women who had invasive breast cancer with women who didn’t. They found that when all days of antibiotic use were added up, the more days a woman used antibiotics, the greater her risk of breast cancer. For example, women who used antibiotics for 51 to 100 days had 1.53 times the risk of breast cancer, and women who used them from 100 to 500 days had 1.68 times the risk of breast cancer. For women who used antibiotics for 501 to 1000 days, the risk jumped to 2.14 times.

An earlier study in Finland found an increased risk of breast cancer among women who habitually used antibiotics to treat urinary tract infections.

The researchers of the Seattle study hasten to add that this doesn’t prove antibiotics directly cause breast cancer: women who use antibiotics may have underlying illnesses that would predispose them to breast cancer. However, in an article published in Cancer Causes and Control in 2003, a group of researchers theorized that antibiotics kill beneficial bacteria in the gut that play an important role in protecting the body against excess estrogen and the more harmful forms of estrogen. They also hypothesize that antibiotics may increase breast cancer risk because they inhibit key parts of the immune system that protect against cancer, as well as anti-inflammatory mechanisms.

A Cautionary Tale
This research gives us yet another reason to avoid using antibiotics unless absolutely necessary. If you must use them, be sure to use plenty of probiotics to replace gut bacteria (e.g. eat live culture yogurt or get probiotic supplements).

Anti-inflammatories and Breast Cancer
Inflammation is one of the pieces of the breast cancer puzzle, and that may be why other research is showing that nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin, may help prevent breast cancer. This information came out of the Women’s Health Initiative (WHI), a large, ongoing, government-sponsored study of women’s health in the U.S. (The WHI is best known for the revelation a few years ago that conventional HRT increases the risk of breast cancer, stroke, heart disease and gallbladder disease.)

The NSAIDs arm of the WHI study compared nearly 80,000 women who didn’t have breast cancer, to 1,392 who did, and looked at how often they took NSAIDs. They found that women who took 2 or more tablets per week of over-the-counter anti-inflammatory drugs at standard doses for 5 to 9 years, had 21 percent less risk of breast cancer. Protection went up to as much as 28 percent for women who had used NSAIDs for more than 10 years, and who had used ibuprofen instead of aspirin. Low dose aspirin and the pain reliever acetaminophen (e.g. Tylenol) did not protect against breast cancer, which makes sense because acetaminophen is a pain killer but not an anti-inflammatory.

What Does All This Mean to You?
Before you run to the drugstore for ibuprofen, remember that regular use of NSAIDs is associated with gastrointestinal bleeding and kidney problems—these aren’t drugs that you want to be taking on a regular basis unless you have to, especially if you have a tendency to have digestive or kidney problems. However, taking a couple of tablets a week is unlikely to be harmful to most people, and might help some.

More direct and effective ways to prevent breast cancer include maintaining hormone balance with natural, bioidentical hormones and lifestyle factors such as getting plenty of exercise and eating plenty of fruits and vegetables.

For details on hormone balance and how inflammation contributes to breast cancer, please read What Your Doctor May Not Tell You About Breast Cancer. This study is also is a good indicator that it might be helpful in the long run to reduce inflammation. There are a lot of pointers for reducing inflammation without NSAIDs in the book Prescription Alternatives that I co-authored with Dr. Earl Mindell.

Velicer CM, Heckbert SR et al, “Antibiotic use in relation to the risk of breast cancer,” JAMA 2004 Feb 18;291(7):827-35.

Velicer MV, Lampe JW et al, “Hypothesis: is antibiotic use associated with breast cancer?” Cancer Causes and Control 2003, 14:739-747.

Moorman PG, Grubber JM, “Association between non-steroidal anti-inflammatory drugs (NSAIDs) and invasive breast cancer and carcinoma in situ of the breast,” Cancer Causes Control, 2003 Dec;14(10):915-22.

An amino acid found in green tea can be calming.

One of the mantras of optimal health is “manage stress,” but it can be stressful to try to manage stress! For some people a little theanine might help. This amino acid is found in nature primarily in green tea, so a cup of the most popular beverage in Asia can be a good prescription for a mellow mood. For those who need more, theanine comes in capsules, usually in a 100 mg or 200 mg dose. (Check your local health food store or google it!)

Theanine works on the brain in a number of ways. It increases GABA, a brain chemical which produces a calming effect (progesterone has a similar effect on GABA), but it’s not so calming that it makes you sleepy. Theanine also blocks the excitatory effects of excess glutamate, an essential brain chemical that can kill brain cells when there’s an overload of it. Theanine seems to smooth out the agitation that caffeine can cause, it lowers blood pressure and improves the ability to focus by increasing alpha waves in the brain. Rodent researchers have found that it protects neurotransmitter function.

If you decide to try theanine in capsule form, keep in mind that there are huge individual differences in brain biochemistry, and what works well for one person might not work at all for another. Try to take it alone (without other supplements or drugs) at first, and notice how you feel afterwards.

Juneja LR, et al, “L-theanine a unique amino acid of green tea and its relaxation effect in humans,” 1999 Trends Food Sci Tech 10:199-204.

Kakuda T, Nozawa A et al, "Inhibiting effects of theanine on caffeine stimulation evaluated by EEG in the rat." Biosci Biotechnol Biochem. 2000 Feb;64(2):287-93.

Yokogoshi H, Kato Y, Sagesaka et al, "Reduction effect of theanine on blood pressure and brain 5-hydroxyindoles in spontaneously hypertensive rats," Biosci Biotechnol Biochem. 1995 Apr;59(4):615-8.

Low cortisol and estrogen dominance may contribute.

Little attention has been paid to hormonal imbalances in women with chronic fatigue syndrome (CFS) and fibromyalgia (FM), so it was of great interest to read some research out of Turkey that shed some light on this factor.

The study examined hormone levels in 46 healthy volunteers, 68 patients with FM, and 62 with CFS. Those with FM and CFS had low morning cortisol levels, as well as high luteinizing hormone (LH) levels. Although not statistically significant, compared with healthy volunteers, those with FM had higher estrogen levels and slightly higher progesterone levels, while those with CFS had higher estrogen and lower progesterone, indicating estrogen dominance.

In the natural rhythm of cortisol release in the body, it is highest in the morning, rises again in the late afternoon, and falls toward evening. Low morning cortisol is an indicator that the adrenals are depleted. People with stressful lives and tired adrenals often have low morning cortisol and high evening cortisol—they’re “wired but tired” at night and can’t get out of bed in the morning. According to Dr. David Zava of ZRT Lab, low morning cortisol and high evening cortisol is a risk factor for breast cancer.

For more information on how to support the adrenals, please read one of our "What Your Doctor May Not Tell You...". books.

Gur A, Remzi C et al, “Cortisol and hypothalamic-pituitary-gonadal axis hormones in follicular phase women with fibromyalgia and chronic fatigue syndrome and the effect of depressive symptoms on these hormones,” Arthritis Research and Therapy 2003 Vol 6 No 3.

Excerpted from the March 2003 issue of the John R. Lee, M.D. Medical Letter, p. 3

“Maintaining healthy cortisol levels isn’t just a matter of tweaking your biochemistry with this or that diet, hormone, vitamin, mineral (although that can be a big help!). Balanced cortisol is also a matter of respecting yourself and caring enough about your health to get plenty of sleep, some moderate exercise and fresh air, and to bring some relaxation, laughter and fun into your life.