First Talk To Your Doctor
Before you take any vitamin, mineral, or herbal supplement, talk to your doctor. Research is limited on supplements and studies show mixed results on the safety of supplements and breast cancer.
Any supplements after breast cancer treatment should be regulated by your oncologists, says Anita Johnson, MD, breast cancer program director at Cancer Treatment Centers of America in Atlanta. Your medical team knows your symptoms and your full medical history and can tell you what may be best for you.
High Levels Of Vitamin B12 May Be Linked To Increased Cancer Risk
Vitamin B12, which is commonly found in a variety of foods, including fish, meat, eggs, and dairy products, is essential for maintaining the health of the bodyâs nerve and blood cells it also helps make DNA. Now, researchers in Denmark have found that higher than normal levels of this necessary vitamin may indicate a person is at risk of developing certain cancers. Their study appears today in the Journal of the National Cancer Institute.
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Plasma Vitamin B12 Assay
Plasma B12 assays were centralized in the biochemistry laboratory of Angers University Hospital. The plasma vitamin B12 was collected in EDTA tubes and determined by immunoassay by competition, with direct chemiluminescence. The tests were carried out on an immunoanalytical system ADVIA Centaur® with ADVIA Centaur VB12® reagents. The reference values considered normal by the supplier ranged from 198 to 986 ng/L with a coefficient of variation of 1.34.1%. The upper limit for the assay without dilution was 2000 ng/L.
In the case of multiple testing for the same patient, the highest B12 level was conserved.
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Vitamin B12 Enhances The Cytotoxicity Of 1252d3 Against Different Types Of Cancer Cells
The cytotoxic effects of 1,252D3, vitamin B12 and the combination of 1,252D3 and vitamin B12 2D3/B12) were evaluated against 6 different human cancer cell lines and one normal cell line by means of MTT assay. The IC50 values are shown in Table 1. The results reveal that 1,252D3 caused cytotoxicity in 4 out of the 6 cancer cell lines tested , while vitamin B12 did not cause cytotoxicity in cancer cells even at the 1000 nM concentration after 72 h of treatment . However, vitamin B12 enhanced the cytotoxic effects of 1,252D3 significantly in HeLa, HL-60 and MCF-7 cancer cells but not in SUM159PT cells . On the other hand, none of the vitamins used 2D3 and B12) or their combination caused cytotoxicity in MCF10A normal cells even after 72 h of treatment with the highest concentration used indicating cancer-cell specificity , The amounts of 1,252D3 and 1,252D3/B12 combination used in subsequent experiments were the IC50 values from this table, unless stated then. In addition, and as shown in Fig. 1A-D, the cytotoxic effects of 1,252D3 and 1,252D3/B12 combination occurred in a dose-dependent mode, i.e., increasing the concentration of 1,252D3 as well as 1,252D3/B12 combination caused an increase in the percentage of non-viable cells.
Table 1
What Are The Benefits Of Vitamin B12
Some of the biggest benefits of vitamin B12 include:
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Vitamins And Minerals In Your Diet
Most doctors and dieticians recommend following a healthy diet after breast cancer treatment.
Research suggests that a diet high in fruit and vegetables, lean proteins like chicken and fish, and whole grains, and a diet low in refined sugars, fats, red meats, and processed meats may help you live longer. A diet thats high in fiber is also linked to lower risk of breast cancer.
In general, its best to get nutrients from foods rather than supplements, says Kelly Rashid, a registered dietician in Fort Lauderdale, FL, who specializes in oncology nutrition. A nutrient-rich diet can help you get important vitamins and minerals to feel good and boost your health.
Dietary Supplements And Cancer Survival
The 1,134 patients in this study had all been diagnosed with high-risk breast cancer that was more likely to recur and they were already enrolled in a chemotherapy trial. The patients completed two questionnaires on their use of dietary supplements once when they were first assigned to a treatment group and then again six months after their chemotherapy.
After following the patients for 15 years, or until death, the strongest links to recurrence and death were found with vitamin B12, iron and omega-3 fatty acids. Taking vitamin B12 both before and during chemotherapy, for example, linked to an 83 percent decrease in disease-free survival compared to patients who did not take the supplement. This was after accounting for other risk factors, such as patients age, tumor characteristics, smoking and alcohol consumption.
Findings pointed towards but were not as clear a higher risk of recurrence and death with using any antioxidant dietary supplements, including vitamins A, C and E along with carotenoids and coenzyme Q10. Multivitamin use was not linked with either recurrence or survival.
The inconclusive findings for antioxidants could relate to the relatively small numbers of patients and supplement users. We didnt have the statistical power we would have liked, said Ambrosone.
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In Vitro Cytotoxicity 25
Cytotoxicity of 1,25-dihydroxyvitamin D3 2D3 Sigma-Aldrich, USA), vitamin B12 and the combination 2D3/B12) on the different cancer cell lines was evaluated by means of MTT test . Vitamin stock solutions were prepared in 10% DMSO with final DMSO concentration not exceeding 0.1%. For each compound, six concentrations were prepared in growth media. The absorbance of each well at 570nm was measured and then used to determine cell growth inhibition induced by the vitamins . Growth percent was calculated according to: Growth =OD treated/OD vehicle-treated control×100%. The concentration percent growth curve was used to calculate 50% growth inhibition by linear interpolation from a semi-log plot of a dose response curve. Each experiment was repeated in triplicates.
Cell Staining And Microscopy
On sterile glass cover slips, cells were plated for 24 h. Later, cells were treated with 1,252D3, vitamin B12, and the combination of 1,252D3/vitamin B12 at the IC50 concentration. Cells were fixed with 4% paraformaldehyde in PBS for 45 min. Cells were washed with 0.1% Triton X-100 in PBS for three times . Fluorescent- conjugated phalloidin was used to stain F-actin for 1 h. Prolong Gold Antifade containing DAPI was used to mount the cells. Images were captured with a CCD camera and 60×NA 0.85 objective on Nikon Eclipse Ti-E microscope run by NIS Elements software.
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Identification Of Case And Control Subjects
Every 6 mo during the first year of follow-up and then annually thereafter, participants were asked whether they had been newly diagnosed with breast cancer. We then confirmed women who reported a diagnosis of breast cancer and those who were deceased through the review of medical records and extracted detailed information on the diagnosis of these women. As of March 31, 2004, we documented 889 incident cases of invasive breast cancer among women with blood samples. Each breast cancer case was individually matched to one control with no diagnosis of cancer on age , ethnicity, menopausal status , fasting status , month and year of blood return , postmenopausal hormone use , and trial randomization date . On the basis of these matching criteria, a total of 850 invasive breast cancer cases were individually matched to 850 controls.
Description Of The Population
Between January 2007 and May 2015, 9,198 patients underwent at least 2 measurements of B12 in our center, excluding the intensive care and maternity units. Among these patients, plasma B121000 ng/L at T1 were found in 344 patients without any known elevated-B12-related causes. Among these 344, 144 patients had a B121000 ng/L at T2 and 200 patients had a B12< 1000 ng/L at T2 . The 344 patients in the NN group were randomly selected from the 7,889 patients with plasma B12< 1000 ng/L at T1 and T2. The flowchart is detailed in Fig. .
Figure 1
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Ethics And Statement For Study Checklist
This study was approved by the bioethical committee of Angers University Hospital and has been conducted in accordance with the Declaration of Helsinki. Patients gave informed consent. We applied the strengthening the reporting of observational studies in epidemiology statement to observational studies.
Plasma Vitamin B12 Levels
We defined the following groups based on plasma B12 levels: reference range values of 150600 pmol/L and three groups with high plasma B12 levels: 601800 pmol/L, 8011,000 pmol/L, and > 1,000 pmol/L . We chose the cutoff for reference range values based on the distribution of reference range cutoffs in the study population.
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Vitamin B: Not A Carcinogen
Research does not reveal vitamin B12 as a carcinogen, that is, a cancer-causing agent. If anything, vitamin B12 is an essential dietary nutrient, one without which the human body cannot do. So how is it possible that studies link high levels of circulating vitamin B12 to an increased risk of certain cancers? Is it possible that vitamin B12 is not the reason behind the higher incidence of cancer observed in people with high blood levels of vitamin B12? Possibly.
For one, there is no research to definitively prove that vitamin B12 is a carcinogen. Secondly, studies that have linked high vitamin B12 blood levels to increased risks of certain cancers have only correlated the high vitamin B12 levels and the higher cancer risk based on a pattern of co-occurrence. Vitamin B12 has not been identified as a cause, but rather as a marker that indicates the need to investigate a potential pathology, cancer or another.
Thirdly, high blood levels of vitamin B12 do not occur in otherwise healthy individuals who meet their nutritional requirements from a varied and balanced diet, and maybe only occasionally supplement to account for minor losses due to stress, menses, childbirth, nosebleeds, minor wounds or other causes asking for temporarily increased dietary requirements.
Vitamin B12 And Colorectal Cancer Risk
In a clinical trial study, named the B-PROOF trial, done in Netherlands, the researchers assessed the effect of daily supplementation with vitamin B12 and folic acid , for 2 to 3 years, on fracture incidence. Data from this clinical trial was used by researchers to further investigate the impact of long term supplementation of Vitamin B12 on cancer risk. The analysis included data from 2524 participants of the B-PROOF trial and was found that long term folic acid and vitamin-B12 supplementation was associated with a high risk of overall cancer and a significantly higher risk of colorectal cancer. However, the researchers suggest confirming this finding in larger studies, in order to decide whether Vitamin B12 supplementation should be restricted to only those with a known B12 deficiency .
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Sensitivity Analysis And Publication Bias
Sensitivity analysis showed that no individual study had excessive influence on the above mentioned pooled effect. Egger test showed no evidence of significant publication bias for the analysis between breast cancer risk and serum PLP levels , vitamin B6 intake , serum vitamin B12 levels , vitamin B12 intake and methionine . The funnel plots were provided in the .
Effect Of Combining Folate With Vitamin B6 Vitamin B12 And Methionine On Risk Of Breast Cancer
For the joint association between breast cancer risk and folate intake with vitamin B6 intake, data from four studies were used, and the risk of breast cancer for the subjects with both highest intake of folate and vitamin B6 was 0.91 , P=0.17, I2=0.00%. For the joint association between breast cancer risk and folate intake with vitamin B12 intake, data from three studies were used, and the risk of breast cancer for the subjects with both highest intake of folate and vitamin B12 was 0.99 , P=0.97, I2=54.2%. For the joint association between breast cancer risk and folate intake with methionine intake, data from four studies were used, and the risk of breast cancer for the subjects with both highest intake of folate and methionine was 0.81, P=0.11, I2=49.2%.
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Design Study Cohort And Data Sources
We conducted this population-based cohort study using data from medical registries in Northern Denmark over the period from 1998 to 2010. Data were obtained from the Clinical Laboratory Information System Research Database , the Aarhus University Prescription Database , the Danish Cancer Registry , and the Danish National Registry of Patients . The Danish Civil Registration System, established in 1968, assigns a civil registration number to all residents, allowing for unequivocal individual-level data linkage among all Danish registries .
The LABKA database contains all test results from routine tests performed in hospital laboratories in Northern Denmark, which has a total population of 2.2 million inhabitants. Results of more than 1700 different types of analyses are included in the database. For each analysis, the database stores the test result , civil registration number, date, and the international Nomenclature, Properties and Units code. For some analyses, a local analysis code is recorded. We identified all patients in the LABKA database with a plasma Cbl measurement of greater than 200 pmol/L recorded from 1998 through 2009. If a patient had more than one Cbl test result, only the first test was included in our analysis.
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Study Population And Data Collection
All data were obtained from the Swedish Apolipoprotein-related MOrtality RISk cohort. This database contains blood samples from 812,073 individuals who mainly came from the greater Stockholm area and were either having a general health check-up or were outpatients referred for laboratory testing. None of the participants were inpatients at the time of the blood sampling. The blood samples were analysed and evaluated in the Central Automation Laboratory in Stockholm, Sweden, from 1985 to 1996. In the AMORIS cohort, the CALAB database was linked to several Swedish national registries such as the Swedish National Cancer Register, the Hospital Discharge Register, the Cause of Death Register, the consecutive Swedish Censuses from 1970 to 1990, and the National Register of Emigration using the Swedish 10-digit personal identity number. These resources provided complete follow-up information until death or the end of December 2011. A more detailed description of the AMORIS cohort can be found elsewhere . The study complies with the Declaration of Helsinki, and the Ethics Review Board of the Karolinska Institute has approved the study .
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Serum Plp Levels And Risk Of Breast Cancer
High serum PLP levels vs low levels were significantly associated with the risk of breast cancer , P=0.03, I2=0.30%, ). The association was significant for post-menopausal women , P< 0.00, I2=0.00%) but not for pre-menopausal women however, the difference between the two groups was not significant . No significant association was found by oestrogen receptor and progesterone receptor status. Among the five nested casecontrol studies, two studies in one article only adjusted for age, menopausal status and year of blood donation, and a positive but not significant association of serum PLP levels with the risk of breast cancer was found. Three studies adjusted for the most known risk factors of breast cancer, and a significantly combined effect was found , P=0.01, I2=0.00%).
Figure 1
The multivariate-adjusted risk of breast cancer for the highest vs lowest categories of serum PLP levels and dietary vitamin B6 intake in random-effects model. The size of the grey box is positively proportional to the weight assigned to each study, which is inversely proportional to the s.e. of the RR, and horizontal lines represent the 95% CIs.
For doseresponse analysis, data from three studies were used, including 2266 breast cancer cases. We found no evidence of statistically significant departure from linearity . A 100pmolml1 increment in serum PLP level conferred an RR of 0.77 .
Figure 2
Breast Cancer Patients Advised Not To Use Supplements During Treatment
- Researchers say vitamins and other supplements taken during breast cancer treatment can cause a higher risk of recurrence.
- Experts note that chemotherapy and radiation are designed to cause damage to cancer cells, while supplements main job is to repair cell damage.
- They recommend that people undergoing breast cancer treatment get their nutrients through a healthy, well-balanced diet.
When youre in treatment for breast cancer, nutrition can be a challenge.
In an effort to get essential nutrients, you may think its a good time to add dietary supplements to your regimen.
But some supplements, particularly antioxidants, may interfere with cancer treatment.
A recent study suggests that people with breast cancer taking certain supplements before and during chemotherapy may be at increased risk for recurrence of the disease and earlier death.
The study is published in the Journal of Clinical Oncology.
The American Institute for Cancer Research is advising people with cancer to use caution with dietary supplements.
We do not recommend supplements for cancer prevention or in the treatment setting, so this study supports that approach, Nigel Brockton, PhD, the AICR vice president of research, said in a column on the organizations website.
Not only is there no benefit, but they may be harmful. Our best recommendations remain to obtain nutritional requirements from a plant-based, whole foods diet, he added.
The researchers said they found:
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