Boron Safety for Breast Cancer Survivors

Health / Nutrition / Osteoporosis / Trace Minerals / January 12, 2015

Lara Pizzorno is the author of “Your Bones: How You Can Prevent Osteoporosis and Have Strong Bones for Life – Naturally” and a member of the American Medical Writers Association with over 30 years of experience specializing in bone health.

Recently, we asked Lara if she would help us provide a series of short, ongoing talks to help you (our customers and readers) stay up to date on the latest facts and science related to bone health.

Lara recently discussed whether boron is safe for breast cancer survivors who are taking aromatase inhibitors. Read the transcript below and let us know what you think in the comments. 🙂

“Hello, I’m Lara Pizzorno the author of “Your Bones” and I’m here today to share some information with you that I hope will help you have healthier bones.

So far, we’ve been talking about the importance of a trace mineral called boron for healthy bones. Today, I wanted to discuss with you whether boron is safe for breast cancer survivors who are taking aromatase inhibitors such as Arimidex.

This topic came up for me because a few months ago now because a woman wrote me to ask if taking boron was a good idea for her. She had recently been successfully treated for stage 1 ER+ breast cancer which is an estrogen positive form of breast cancer and had prescribed a drug called Arimidex which she was to take for the next 5 years to block her body’s ability to produce estrogen, in the hopes that it would protect her against developing and recurrence of her breast cancer. The drug she was prescribed called Arimidex is used in both the treatment and to help recurrence of estrogen positive breast, ovarian and also prostate cancers. It’s one of a class of drugs called aromatase inhibitors and prevents the production of estrogen by binding to and shutting down an enzyme called aromatase. This is the enzyme that is responsible for synthesizing estrogen from its precursors which are other steroid hormones called androgens. And these include DHEA and testosterone and would normally be the targets of aromatase. Arimidex inhibits estrogen synthesis by out- competing androgens’ ability to bind with aromatase. Arimidex and the other aromatase inhibitors are so effective at preventing the production of estrogen that if you are taking one of these drugs you will be producing virtually no estrogen. So boron will have no estrogen to convert to its magnesium absorbing form. And this means that taking boron is not going to have any negative effect on breast, prostate or ovarian cancer treatment if you are taking an aromatase inhibitor. But it also means that estrogen’s beneficial effects, its beneficial effects on our ability to absorb magnesium, and in our production of osteoblasts and in our activation of vitamin D are going to be lost. For these reasons, aromatase inhibitors cause substantial bone loss and increase risk of osteoporosis and fractures. Not only when used in postmenopausal women with breast or ovarian cancer but also given as androgen deprivation therapy for men with prostate cancer.

If you’ve read “Your Bones” then you know that men produce a small amount of estrogen, but that it plays a very important role in their ability to maintain healthy bones. So by preventing men from producing the small amount of estrogen, the aromatase inhibitors also cause bone loss in men and increase their risk of osteoporosis.

Well, it turns out that boron is now being used to increase and restore effectiveness of another drug that is used to treat or prevent estrogen positive cancers called tamoxifen. Even in breast cancer patients whose cancer cells who are supposedly resistant to tamoxifen, boron is changing this.

And why might this be important for your bones if you have or are recovering from an estrogen positive type of cancer?

Well, tamoxifen causes far less bone loss than the aromatase inhibitors, so it is worth looking into if you might be able to use tamoxifen rather than one of the aromatase inhibitors. Tamoxifen has long been considered the first line therapy for estrogen positive breast cancers. Most all of the estrogen positive breast cancers respond positively to tamoxifen treatment but about 8% of patients with these cancers are resistant to tamoxifen. Why? Because these patients have a slow CYP2D6 enzyme, this is the enzyme in the liver that is responsible for converting tamoxifen into its most potent forms. Two potent metabolites called 4-hydroxy tamoxifen or 4-OHT, that’s what you’ll see in the research literature and endoxifen, both of which inhibit estrogen dependent cell proliferation. There are tests that can now be run to determine if you are among these 8% of people who are resistant to tamoxifen treatment and if you are not, tamoxifen will be a much less bone destructive treatment for you than one of the aromatase inhibitors. So this is something you might want to discuss with your doctor.

Boron in addition is now being used to develop different forms of tamoxifen that are already in these two more potent forms the 4-OHT and endoxifen forms. So even people who are resistant to tamoxifen because they have a slow CYP2D6 enzyme can benefit from tamoxifen and discuss using it rather than an aromatase inhibitor their physicians.

If you need to be on an aromatase inhibitor, the good news is that not only will taking boron NOT interfere with the cancer protective effect of aromatase inhibitor therapy, but boron will lessen some of its harmful effects on your bones. Boron is still going to help you convert vitamin D into the form in which it helps absorb calcium most effectively and the latest research which I have discussed in an earlier in this series on boron is  showing us that boron plays a number of protective roles for us including greatly lessening chronic inflammation, which would otherwise excessively activate osteoclasts.

So boron can still help you maintain the health of your bones even if you need to be on an aromatase inhibitor. Next time, we will talk about how much boron you need to take and whether you can rely on dietary sources for this trace mineral or whether you should consider a bone health supplement that will provide boron for you. Thanks for tuning in, I hope this was helpful.”


Sources:

Limburg C, Maxwell C, Mautner B. Prevention and treatment of bone loss in patients with nonmetastatic breast or prostate cancer who receive hormonal ablation therapy. Clin J Oncol Nurs. 2014 Apr;18(2):223-30. doi: 10.1188/14.CJON.223-230. PMID: 24675258

Decensi A, Sun Z, Guerrieri-Gonzaga A, et al. Bone mineral density and circulating biomarkers in the BIG 1-98 trial comparing adjuvant letrozole, tamoxifen and their sequences. Breast Cancer Res Treat. 2014 Apr;144(2):321-9. doi: 10.1007/s10549-014-2849-2. Epub 2014 Feb 1. PMID: 24487691

Jiang Q, Zhong Q, Zhang Q, et al. Boron-Based 4-Hydroxytamoxifen Bioisosteres for Treatment of de Novo Tamoxifen Resistant Breast Cancer. ACS Med Chem Lett. 2012 Apr 6;3(5):392-396. PMID: 23864928

Author: Lara Pizzorno, MDIV, MA, LMT

Comments
Janis
Janis

I am taking an aromatase inhibitor as part of my cancer treatment. I am suppose to take 1200 mg calcium daily and 4000 iu of vitamin D3. Will this take the place of this? My bone density test last year showed signs of osteopenia in hip and ne k. Lower spine, due to degenerative disease, could not be read. Dr wants to start me on bone shots. I’m afraid what these will do to my spine, teeth, etc. I want to ask if I can try this. What are your thoughts that I can share with her. Thank you!

Blaire AlgaeCal
Blaire AlgaeCal

Hi Janis,

Thanks for reaching out to us!

The recommended calcium intake for adults is 1000-1200 mg per day. Traditional calcium supplements often come as 1000 to 1200 mg of calcium on its own (or calcium with vitamin D). This can lead to excessive levels of calcium supplementation – without the right balance of other bone-supporting nutrients. AlgaeCal provides 720 mg of calcium that is much more effectively absorbed and used. See, AlgaeCal contains a naturally occurring trace mineral complex similar to the composition of our bones. It also provides additional vitamins and minerals which help in the absorption and direction of calcium. For example, vitamin K2 helps direct calcium into your bones and away from soft tissues like the heart! We also take into consideration that people will be getting about 500 mg of calcium from their diet – this means that you’re reaching the recommended amount of calcium all through natural sources! AlgaeCal is also the only calcium that’s been clinically supported to increase bone density, so you know you’re getting the best calcium for your bone health. AlgaeCal Plus contains 1600 of vitamin D in the full daily dosage, so you may wish to continue additional vitamin D supplementation.

That said, we suggest speaking to your doctor about any changes to your medication and supplement intake. We have an excellent information sheet you can share with your doctor here. Feel free to call our Bone Health Consultants at 1-800-820-0184 if you have other questions 😊

– Blaire @ AlgaeCal

Keith
Keith

Hi Lara,
I found out the benefits of boron in the diet about a year ago and shared the information with my family. I even sent them the link to your “Nothing Boring About Boron” article.
My neice, who is a 40 year-old mother was taking boron for its health benefits. She just found out she has estrogen-sensitive ductal carcinoma in situ, and her surgeon is recommending bilateral radical mastectomy.
I was wondering if she should stop taking baron, or increase her dose, as some information on the web implicates boron in estrogen-sensitive breast cancer.

Megan AlgaeCal
Megan AlgaeCal

Hi Keith,

Thank you for reaching out! Below is a response Lara previously wrote about boron and estrogen-sensitive cancers. Hope you find it helpful! 🙂

Not only is boron safe for you, it is especially beneficial. In fact, several boronic compounds are now utilized in cancer treatments.

Boron is strongly recommended for anyone at risk for or has bone loss; osteoarthritis; or breast, prostate, or lung cancer.

Boron exerts so many beneficial effects, I am only noting the most pertinent ones here for you – for the full discussion on boron, you can read my most recently published article in IMCJ, a PubMed listed medical journal. I titled it, “Nothing Boring about Boron,” because this is one amazing trace mineral! Here’s the citation:

Pizzorno L. Nothing Boring About Boron. Integr Med (Encinitas). 2015 Aug;14(4):35-48. PMID: 26770156 [PubMed] PMCID: PMC4712861

In relation to cancer, boron:

• does not increase estrogen production – it beneficially promotes our healthful use of estrogen.

• is critical for both the building and maintenance of bone

• improves your body’s ability to utilize vitamin D as well as your ability to safely use estrogen and testosterone

• greatly improves wound healing

• boosts magnesium absorption, which as you probably know, is critical for healthy bones

• reduces levels of inflammatory biomarkers, including high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor α (TNF-α), both of which are strongly implicated in cancer development and progression, and both of which promote osteoclast activation and bone loss

• raises levels of key antioxidant enzymes, such as superoxide dismutase (SOD), catalase, and glutathione peroxidase (again each of these enzymes is highly protective against cancer and against the chronic inflammation that excessively activates osteoclasts)

• protects against pesticide-induced oxidative stress and heavy-metal toxicity (two more cancer and inflammation and bone loss promoters)

At the amount required for its beneficial effects— 3 milligrams/day – boron is not readily available in the diet – unless you REALLY love raisins and would enjoy eating at least 3 ounces of them daily (185 calories) – or you could consume 6 tablespoons of peanut butter instead, which actually might be helpful for you if you are underweight as a result of cancer treatment since this amount of peanut butter would add about 570 calories, primarily as fat, to your daily caloric intake. If you are not underweight, your best boron choice by far is AlgaeCal Plus because it will provide you with all the key nutrients your bones require to healthfully rebuild and maintain themselves at the dosages shown in the research to be effective – including 3 milligrams of boron.

If you have any questions or need clarification please feel free to email [email protected] or call our Bone Health Consultants at 1-800-820-0184!

– Megan @ AlgaeCal

anne
anne

Hello Lara

I am interested in Boron for benefits to bone health and arthritis. I am 54, and had a rapid menopause at 49 due to chemotherapy.

My question is, having been treated for ER2 (estrogen positive) breast cancer with chemo/radio/mastectomy but NOT Tamoxifen or Arimatose Inhibitors, is it still safe to take Boron. I ask because I’m not protected by any Estrogen blocker, but I have read that Boron assists in the production of Estrogen.

Thank you for taking the time to consider my query.

Anne

Lara Pizzorno
Lara Pizzorno

Hello Anne,

You’re so welcome! And the news is good. Not only is boron safe for you, it is especially beneficial. In fact, several boronic compounds are now utilized in cancer treatments.

Boron is strongly recommended for anyone at risk for or has bone loss; osteoarthritis; or breast, prostate, or lung cancer.

Boron exerts so many beneficial effects, I am only noting the most pertinent ones here for you – for the full discussion on boron, you can read my most recently published article in IMCJ, a PubMed listed medical journal. I titled it, “Nothing Boring about Boron,” because this is one amazing trace mineral! Here’s the citation:

Pizzorno L. Nothing Boring About Boron. Integr Med (Encinitas). 2015 Aug;14(4):35-48. PMID: 26770156 [PubMed] PMCID: PMC4712861

In relation to cancer, boron:

• does not increase estrogen production – it beneficially promotes our healthful use of estrogen.

• is critical for both the growth and maintenance of bone

• improves your body’s ability to utilize vitamin D as well as your ability to safely use estrogen and testosterone

• greatly improves wound healing

• boosts magnesium absorption, which as you probably know, is critical for healthy bones

• reduces levels of inflammatory biomarkers, including high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor α (TNF-α), both of which are strongly implicated in cancer development and progression, and both of which promote osteoclast activation and bone loss

• raises levels of key antioxidant enzymes, such as superoxide dismutase (SOD), catalase, and glutathione peroxidase (again each of these enzymes is highly protective against cancer and against the chronic inflammation that excessively activates osteoclasts)

• protects against pesticide-induced oxidative stress and heavy-metal toxicity (two more cancer and inflammation and bone loss promoters)

At the amount required for its beneficial effects— 3 milligrams/day – boron is not readily available in the diet – unless you REALLY love raisins and would enjoy eating at least 3 ounces of them daily (185 calories) – or you could consume 6 tablespoons of peanut butter instead, which actually might be helpful for you if you are underweight as a result of cancer treatment since this amount of peanut butter would add about 570 calories, primarily as fat, to your daily caloric intake. If you are not underweight, your best boron choice by far is AlgaeCal Plus because it will provide you with all the key nutrients your bones require to healthfully rebuild and maintain themselves at the dosages shown in the research to be effective – including 3 milligrams of boron.

Be well, Lara

Michelle
Michelle

Hello, I am a ER positive breast cancer survivor of 7 yrs. I was recently in a car crash and broke my clavicle. I read that it is best to take high levels of calcium and boron to help the bone heal correctly and quickly. If I am not on an estrogen blocker, is taking 60 mg of boron too risky? I am 48 years old. I have not had a period in 8 months, so I’m starting to go into menopause which of course lowers my estrogen.

I am at higher risk for osteoporosis due to heredity. I have never broken a bone until now. How do I keep my bones strong and healthy when it seems to conflict with ER/PR breast cancer?

Thank you for any information you can give me.

Lara Pizzorno
Lara Pizzorno

Hello Michelle,

First of all, having a clavicle break as a result of a car accident does not necessarily indicate fragile bones. BUT, if you have not done so already, you should have your DXA run – NOW, so you can see where you are.

You need boron. At the amount required for its beneficial effects—minimum of 3 milligrams/d–boron is not readily available in the diet – unless you REALLY love raisins and would enjoy eating at least 3 ounces of them daily (185 calories) – or you could consume 6 tablespoons of peanut butter instead, but this will add about 570 calories per day.

Boron should not be a problem for you; in fact, several boronic compounds are utilized in cancer treatments.
Boron is strongly recommended for anyone at risk for or has bone loss; osteoarthritis; or breast, prostate, or lung cancer.
Boron exerts so many beneficial effects, I am only noting the most pertinent ones here for you – for the full discussion on boron, you can read my most recently published article “Nothing boring about boron” via PubMed: Here’s the citation:
Pizzorno L. Nothing Boring About Boron. Integr Med (Encinitas). 2015 Aug;14(4):35-48. PMID: 26770156 [PubMed] PMCID: PMC4712861 [Available on 2016-08-01]

Boron
· does not increase estrogen production – it beneficially affects how estrogen is used.
· is critical for both the growth and maintenance of bone
· improves your body’s ability to utilize vitamin D and safely use estrogen and testosterone
· greatly improves wound healing
· boosts magnesium absorption
· reduces levels of inflammatory biomarkers, including high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor α (TNF-α) (both of which are strongly implicated in cancer development and progression)
· raises levels of key antioxidant enzymes, such as superoxide dismutase (SOD), catalase, and glutathione peroxidase (again highly protective vs cancer)
· protects against pesticide-induced oxidative stress and heavy-metal toxicity (two more cancer promoters)

To respond best for YOU, I need to know more.

Are you taking any bone support supplements? If you have read anything else I’ve written, you know that calcium alone – or just with vitamin D or just with boron – or just with any one other nutrient – is not going to provide the support your bones need for healthy rebuilding. Your bones require calcium, numerous trace minerals in addition to boron, magnesium, D3, K2, K1, vitamin C, B vitamins – and more for effective healthy remodeling / rebuilding. If you are not already taking AlgaeCal Plus, I cannot recommend it strongly enough – it will provide all but the B vitamins, and at the dosages and in the forms that are most effective. Plus, the trace minerals provided by AlgaeCal are no longer found in even remotely decent amounts in conventionally grown foods. We all need to supplement to get them.
What are your vitamin D levels (your blood level of 25(OH)D indicates your vitamin D status and should be between 50-80 ng/mL for optimal health).
Are you taking supplemental vitamin K2? If so, what form and how much?
Do you eat lots of leafy greens? You really need the K1 they provide now as you are beginning to transition through menopause, and as your estrogen levels drop, your pro-inflammatory cytokine levels will shoot up. K1 helps control the resulting increase in inflammation, and chronic inflammation promotes cancer as well as osteoporosis. Leafy greens are also high in magnesium, and if you are going to continue to take Spironolactone (see below, I hope you will reconsider and find an alternative solution), you really need the magnesium as your progesterone is also being zapped (plus, progesterone levels drop in peri-menopause anyway, so I expect yours are really low/non-existent.)
What is your diet like overall?
What is your weight?
Do you exercise?
How is your digestive system?

Apologies for the seeming digressions here, but as you are entering a phase of your life in which what you do now will greatly impact your experience of life from here on out, I am wanting to get the full picture to see if we can optimize your transition through menopause.

If you are concerned about your estrogen levels, I urge you to have a full hormone evaluation run – the most comprehensive and accurate test is the 24 Hour Urine Comprehensive Hormone Profile that is run by Meridian Valley Labs. (I have no financial connections to this lab, but we use this test for our patients and for ourselves at least once a year). This lab checks all the estrogens, their metabolites and the balance among them (which is called your Estrogen Quotient), so you can see exactly where you are and if you are at any risk –and then fix this naturally via dietary changes and retest in a couple of months. It also checks adrenal hormones, progesterone, DHEA, thyroid hormones – and more. If you want to read up about this test, I’ve written a review article re hormone testing that includes a summary of it. This article is written for doctors, but you will get the gist of it. It can be accessed free on-line on Longevity Medicine Review at http://www.lmreview.com/articles/view/select-the-right-hormone-test-for-your-patient-using-bio-identical-hormone-/

You are at a crucial time in your life and deserve to be gloriously healthy for many many years to come. I very much hope this helps and that you will let me know more if I can further assist you,
Lara

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