Dietary Supplement Use and Interactions with Tamoxifen and Aromatase Inhibitors in Breast Cancer Survivors Enrolled in Lifestyle Interventions.

Leah M Ferrucci,Annette Hood,Courtney Mcgowan,Maura Harrigan,Tara Sanft,Thaihien Nguyen,Melinda L Irwin,Fang-Yong Li,Brenda Cartmel

doi:10.3390/nu13113730

Leah M Ferrucci, Annette Hood + Show 7 more

Open Access

https://doi.org/10.3390/nu13113730

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Journal: Nutrients	Publication Date: Oct 22, 2021
Citations: 6	License type: CC BY 4.0

Affiliation: Yale University, Yale Cancer Center

Abstract

The use of dietary supplements is common in the general population and even more prevalent among cancer survivors. The World Cancer Research Fund/American Institute for Cancer Research specifies that dietary supplements should not be used for cancer prevention. Several dietary supplements have potential pharmacokinetic and pharmacodynamic interactions that may change their clinical efficacy or potentiate adverse effects of the adjuvant endocrine therapy prescribed for breast cancer treatment. This analysis examined the prevalence of self-reported dietary supplement use and the potential interactions with tamoxifen and aromatase inhibitors (AIs) among breast cancer survivors enrolled in three randomized controlled trials of lifestyle interventions conducted between 2010 and 2017. The potential interactions with tamoxifen and AIs were identified using the Natural Medicine Database. Among 475 breast cancer survivors (2.9 (mean) or 2.5 (standard deviation) years from diagnosis), 393 (83%) reported using dietary supplements. A total of 108 different types of dietary supplements were reported and 36 potential adverse interactions with tamoxifen or AIs were identified. Among the 353 women taking tamoxifen or AIs, 38% were taking dietary supplements with a potential risk of interactions. We observed a high prevalence of dietary supplement use among breast cancer survivors and the potential for adverse interactions between the prescribed endocrine therapy and dietary supplements was common.

Highlights

Dietary supplements—defined by the Dietary Supplement Health and Education Act of 1994 [1] as herbal preparations, vitamins, and minerals—are commonly used, with 51%of U.S adults using at least one dietary supplement [2]
We conducted a cross-sectional analysis of the baseline prevalence of self-reported dietary supplement use among women treated for breast cancer who participated in several lifestyle intervention studies
This paper investigated the individual interactions of each dietary supplement, but it should be noted that stacking occurred frequently

Summary

Introduction

Dietary supplements—defined by the Dietary Supplement Health and Education Act of 1994 [1] as herbal preparations, vitamins, and minerals—are commonly used, with 51%of U.S adults using at least one dietary supplement [2]. Dietary supplement use is even more prevalent, with NHANES 2003–2016 data indicating a 70% use among this population [2]. Despite this high prevalence of use among cancer survivors, the joint World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR). Supplement use for cancer prevention has not been shown to improve outcomes [4]. The use of dietary supplements is not associated with any improvement in the overall survival of cancer patients [5]. Additional cancer-specific nutrition guidelines recommend that supplements should not be used by cancer survivors for cancer prevention [6]

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Conclusion