Abstract
Nutraceuticals, natural dietary and botanical supplements offering health benefits, provide a basis for complementary and alternative medicine (CAM). Use of CAM by healthy individuals and patients with medical conditions is rapidly increasing. For the majority of breast cancer patients, treatment plans involve 5–10 yrs of endocrine therapy, but hair loss/thinning is a common side effect. Many women consider this significant, severely impacting on quality of life, even leading to non-compliance of therapy. Therefore, nutraceuticals that stimulate/maintain hair growth can be proposed. Although nutraceuticals are often available without prescription and taken at the discretion of patients, physicians can be reluctant to recommend them, even as adjuvants, since potential interactions with endocrine therapy have not been fully elucidated. It is, therefore, important to understand the modus operandi of ingredients to be confident that their use will not interfere/interact with therapy. The aim is to improve clinical/healthcare outcomes by combining specific nutraceuticals with conventional care whilst avoiding detrimental interactions. This review presents the current understanding of nutraceuticals beneficial to hair wellness and outcomes concerning efficacy/safety in breast cancer patients. We will focus on describing endocrine therapy and the role of estrogens in cancer and hair growth before evaluating the effects of natural ingredients on breast cancer and hair growth.
Highlights
Nutraceuticals, natural dietary and botanical supplements offering health benefits, provide a basis for complementary and alternative medicine (CAM)
These antioxidant cycling structure of 17β-estradiol (Figure can act as an antioxidant, providing antioxidant/redox properties appear to be due to the structural properties of estrogen, in particular the phenolic A‐ring activity, which limits the release of ROS from damaged mitochondria, thereby protecting against cell that diminishes any reactive oxygen species (ROS) via a cyclic phenol‐quinol mechanism [58]
Since 17β-estradiol can act as an antioxidant, its eradication with aromatase inhibitors can further exacerbate the problem
Summary
While estrogen has beneficial effects in many tissues, it has a strong relationship with the initiation and development of endocrine-dependent cancers [1]. Since 1996, it has been acknowledged that two distinct nuclear estrogen receptors (ERα and ERβ) exist, binding 17β-estradiol with comparable affinity [8,9]. In breast cells, binding of tamoxifen (Tam) to dehydroepiandrosterone (DHEA) or testosterone (T)). Breast tissue expresses high levels of aromatase, the estrogen from adrenal precursors (Figure 2). Breast tissue expresses high levels of aromatase, the enzyme enzyme required for the terminal biosynthesis of androgens into estrogens [25,26]. Bioactive estrogen can be synthesized by breast cancer cells and breast stromal tissue from. Bioactive estrogen can be synthesized by breast cancer cells and breast stromal tissue from circulating circulating precursor steroids. These include the adrenal androgens dehydroepiandrosterone precursor steroids. Hydroxysteroid dehydrogenase (17β-HSD) type 1 to 17β-estradiol, which has a high affinity for ER
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