Abstract
After diagnosis, many breast cancer patients start consuming high quantities of beetroot and carrot juice, in the hope of improving the outcome of their treatment. However, these foods are very high in nitrate, which can competitively inhibit the uptake of iodine by the thyroid, potentially leading to hypothyroidism or thyroid nodules. We applied a nitrate and iodine food frequency questionnare (asking about dairy, fish, seafood and iodized salt for iodine intake and spinach, carrots, beetroot, lettuce and arugula for nitrate intake) to 353 ER+/PR±/HER2-luminal A and B breast cancer patients during antiestrogenic treatment. We excluded patients with a thyroid disease diagnosis prior to the cancer diagnosis, smokers, ex-smokers and those with renal disease or bipolar disorder. The only correlations found between dietary intake of iodine and nitrate and the incidence of de novo thyroid nodules were: decreased risk for a daily intake of minimum 250ml dairy; and increased risk for daily intakes of over 200g spinach, 250g carrots or 250g beetroot. The correlations between dietary intake of nitrate and the incidence of de novo hypothyroidism were: decreased risk for a daily intake of iodized salt 2.5g and minimum of 100g fish or 250ml dairy; and increased risk for daily intakes of over 250g carrots or 250g beetroot. The results of this study support the hypothesis that the increased intake of nitrate-rich foods – particularly beetroot and carrot juice – is a risk factor for de novo hypothyroidism or thyroid nodules, after a breast cancer diagnosis.
Highlights
Iodine bioavailability is directly influenced by Na+/I- symporter functionality
IGF-1 and TGF-β inhibit the transmembrane expression of the Na+/I- symporter, further argument that supports the relationship between breast cancer and breast atypia and this symporter functionality (3)
The current study supports what is already known in the scientific literature studying the connection between breast cancer and thyroid disease: aproximatly a quarter of patients develop de novo thyroid disease after the breast cancer diagnosis
Summary
Iodine bioavailability is directly influenced by Na+/I- symporter functionality. But this is simport thyroid level, and in the salivary glands, gastric mucosa, kidney, placenta, ovary and mammary glands ut in the salivary glands, kidneys, ovaries and mamary glands (1).Studies show that optimal functioning of the Na+/I- symporter is important for women’s health, through preventing fibro-cystic dysplasia and hyperplasia of the mammary gland. Iodine bioavailability is directly influenced by Na+/I- symporter functionality. This is simport thyroid level, and in the salivary glands, gastric mucosa, kidney, placenta, ovary and mammary glands ut in the salivary glands, kidneys, ovaries and mamary glands (1). Studies show that optimal functioning of the Na+/I- symporter is important for women’s health, through preventing fibro-cystic dysplasia and hyperplasia of the mammary gland. Based on their findings, Kilbane et al proposed the introduce the Na+/I- symporter dysfunction among breast cancer etiological mechanisms, as they proved that both in fibroadenoma and in malignant cells, breast iodine is very low (2).
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