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All TopicsForum: Hormonal Therapy - Before, During and After → Topic: What can't I have when on Tamoxifen

Topic: What can't I have when on Tamoxifen

Forum: Hormonal Therapy - Before, During and After — Risks and benefits, side effects, and costs of anti-estrogen medications.

Posted on: Feb 2, 2011 11:07PM

trying2Bpositiv wrote:

 I am sooo frustrated with the medical profession.  It seems as though they can't give a straight answer about what will conflict with tamoxifen.  I have been doing my own research and now I can't have flax seed, benedryl, and citrus fruits (due to the tangeretin).  Does that mean no crystal light lemonade?  I read one site and it said to stay away from bioflavenoids, flavonoid, and citrus bioflavonoids.  Great!!  What foods are we talking about.  I hate the thought of taking tamoxifen and finding out that there are things I am eating or drinking that affects the drug.  Anyone have a list of foods we tamoxifen gals need to shy away from?

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Posts 1 - 13 (13 total)

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Feb 2, 2011 11:12PM D4Hope wrote:

Oh crap I eat at least two clementines a day. I know Ican't have Benadryl and have changed my antidepressent cause it interacts with Tamoxifen. My doc neve said anything about foods.Surprised

Every day I wake up is a good day.

Dx 2/2/2009, IDC, 2cm, Stage IIa, Grade 3, 0/8 nodes, ER+/PR+, HER2-Surgery 03/29/2009 Mastectomy (Both); Lymph Node Removal: Sentinel Lymph Node Dissection (Right); Reconstruction: DIEP flap (Both)Chemotherapy 04/09/2009 Adriamycin, Cytoxan
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Feb 2, 2011 11:23PM sheila888 wrote:

MANAGEMENT: Until more information is available, patients treated with tamoxifen or toremifene may consider avoiding the consumption of soy-containing products

Sheila

Sheila♥

Dx 4/8/2005, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2+
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Feb 2, 2011 11:27PM sheila888 wrote:

http://www.drugs.com/drug-interactions/grapefruit-with-tamoxifen-2624-0-2145-0.html

Sheila♥

Dx 4/8/2005, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2+
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Feb 2, 2011 11:38PM Member_of_the_Club wrote:

First of all, you really don't have to avoid anything.  Seriously.  There was recently another thread about soy and there isn't any science saying its harmful or helpful.  My onc says some soy in my diet is fine.  Flaxseed is the same.  As for citrus fruits, the only one I would be concerned about is grapefruit which seems to interfere with a lot of prescription meds.  The latest study found that antidepressants don't interfere with tamoxifen.

If you read about this stuff on the internet you will find things that will make you crazy and may not be accurate.  Thats why its really important to trust your onc and if you don't, you should find another onc. 

Dx 9/30/2004, IDC, 3cm, Stage IIb, Grade 2, 1/17 nodes, ER+/PR+, HER2-
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Feb 3, 2011 07:02AM sgreenarch wrote:

I, too, was going crazy from every new food report concerning breast cancer. Then the nutritionist at the hospital gave me sage advice. She told me to listen to what they say at www.aicr.org, American institute for cancer research, which culls thru all the latest research. I avoid the foods they say to avoid and that's it. In truth I've started to eat even healthier than some of what they recommend, avoiding white carbs, sugar and most dairy, almost vegetarian and completely organic, but that's my own thing. They really helped me be saner about what's swirling around the net. They also have nutritionists you can write to directly.

Dx 7/20/2010, ILC, 2cm, Stage Ib, 0/3 nodes, ER+/PR+, HER2-
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Feb 3, 2011 08:03AM Shrek4 wrote:

I just went to that website. When looking to the "cruciferous vegetables" section, I noticed they only present the old studies that were dealing with Indole-3-Carbinol, that recent studies showed not to be that effective, and they completely miss the studies about Di-indolyl-methane that recent studies have shown to be very efficient in preventing cancer as well as recurrences.

http://www.activamune.com/news.htm

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Feb 24, 2011 04:39AM CvilleJanine wrote:

I have been lucky enough to find a nutritionist that has been supporting me through chemo and now possibly tamoxifen. (I am actually trying to decide if I should take it since it may help 1-2% max).  The nutritionist gave me several pages of info. (BTW- it mentions grapefruit, not citrus in general.)  They talk about the two enzymes that are involved in activating tamoxifen CYP2D6 amd CYP3A4.  The list below shows things that may inhibit or interfer with these enzymes.

Hope this helps,
Janine

Things that inhibit tamoxifen absorbtion

CYP2D6 Inhibitors: Strong inhibitors- prozac, paxil, cardioquin, wellbutrin.  Moderate inhibitors-cymbalta, zoloft, benadryl, mellaril, cordarone, trazodone, tagamet.

Herbs that may inhibit: Goldenseal (use for only short periods), Kava.  Ashwaganda did inhibit cyp2d6 in mice. 

Black cohosh apears to weakly inhibit CP2D6 but the authors concluded that the amount was not clinically relevant.  In addition, a German study of over 1,000 bc survivors taking black cohosh showed a significant prolonged survival over those not taking it.

CYP3A Inhibitors:

Grapefruit,

Rhodiola inhibits cyp3a in vitro- use cautiously. 

Green tea may make a small reduction in cyp3a, but the investigators concluded that repeated green tea catechin administration is not likely to reult in clinically significant effects on teh disposition of drugs metabolized by cyp enzymes.

Diltiazem- a calcium channel blocker is a weak to moderate cyp3a inhibitor.

CYP3A Inducers- Things that may help activate tamoxifen: (Note: these have not been studied completely.  Saint John's wort, garlic, quercetin, grapeseed, ginseng, kava

Supplements to take with Tamoxifen: 

Coenzyme Q10 with riboflavin and niacin0 a few human studies suggest that coQ10 (100mg) with 10mg riboflavin and 50 mg niacin- has a number of favorable effects in women already taking tamozifen.  It lowered cancer markers in women, improved dna repair, lowered biochemical markers of angiogenesis, and improved lipid profiles.. NOTE: It is important to take a B-complex or multivitamin that has natural (Folinic acid and methylfolate), not synthetic folic acide.  Brands include ProThera, Designs for Health, and Pure Encapsulations brands

Gamma linolenic acid (GLA) from evening primrose oil, black currant oil, or borage oil.

Fish oil- may reduce side effects, may suport tissue sensitivity and may help prevent development of ER-tumors

Green Tea

Supplements that are NOT contraindicated with tamoxifen

Black Cohosh

Melatonin, American & Korean ginsengs, Indole-3-carbinol, selenium

Supplements that ARE contraindicated with Tamoxifen:

Licorice root. Licorice root has estrogenic activites that may potentiate estrogens and could stimulate estrogen receptors on cancer cells.  Note: This does NOT include dgl for heartburn and gastritis, in which the component that is active in cortisol and horrmonal issues removed

Long term use of phyoestrogenic herbs such as alfalfa, red clover, and rehmannia should be avoided until we understand their interactions with tamoxifen.   However, since we know that the phytoestrogens in soy are not problematic, it may be that the phytoestrogens in these herbs are helpful as well.

Dietery Considerations- Things that may synergize with tamoxifen

Flaxseeds, green tea, soy

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Mar 28, 2011 03:52PM, edited Mar 28, 2011 03:57PM by DiamondGirl

Just read your posts, very informative. Thanks. My onc told me to stop my multi-vitamins in Feb when I was at my check up. I am allowed to take D3, because he doesn't want them to feed the cancer. That was different 3 months prior when he said ok on vitamins. I took his advice and try to get it from foods. It is very confusing, but better to be safe than sorry.

~ Whenever you ask for in prayer with faith, you will receive. Matthew 7:7-8

Dx 6/29/2010, IDC, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jul 22, 2013 11:15PM, edited Jul 23, 2013 03:14AM by new2bc

I have started taking Tamoxifen for 2 weeks now. I wanted to see if I can take Curcumin c3 with bioperine while on Tamoxifen. I know that there is a study saying that this supplement can have an effect on Tamoxifen but can I take it at a different time during the day? Some ladies here talk about DIM or indole 3 carbinol, iodine, baby aspirin, vitamins, etc while taking this drug. I would appreciate if people can give some information on what supplements are good to take with this drug and what foods to avoid. I am ER+, PR+, HER-.

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Sep 20, 2013 06:03PM new2bc wrote:

I found a brief list of things to avoid if you have BREAST CANCER:

Search on Nutrition and Breast Cancer: Making Healthy Diet Decisions in google

• Alfalfa

• Black cohosh

• Chasteberry/Vitex

• Dong quai

• Fennel

• Flaxseed

• Licorice root

• Milk thistle (above-ground parts)

• Primrose oil, possibly

• Raspberry leaf

• Red clover

• Red yeast extract

• Resveratrol

• Siberian ginseng

• Wild yam

"Flaxseed is not a soy food, but it is a phytoestrogen. If you consume flaxseed, do so in moderation. One serving equals 1 Tbsp ground flaxseed.There may be other plant compounds that you should avoid that are not on this list. Please tell your doctor, nurse, or dietitian if you are taking or considering taking any supplements."

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Nov 23, 2013 05:21AM, edited Nov 23, 2013 05:21AM by JWoo

Hi ladies-

Seems like every list and source has conflicting information. Every website, oncologist, surgeon, pharmacist, nutritionist, dietitian, and nutritionist seems to have a different opinion and different information.

The drug companies should be required to provide a complete list of things they know for sure we should and should not consume with their poisons. It has been on the market for 30 years. They make Billions from those of us that have the unfortunate luck to get bc. The least that they could do is provide us with proper guidelines.

I am getting quite angry about having to take this mess and the fact that I can't get any real answers about it.

Compassion should be your first reaction

Dx 5/8/2013, IDC, 3cm, Stage I, Grade 3, 0/4 nodes, ER+/PR-, HER2-Dx 5/18/2013, DCIS, 2cm, Stage I, Grade 3, 0/4 nodes, ER-/PR-, HER2-Chemotherapy 06/01/2013 Adriamycin, Cytoxan, TaxolSurgery 10/28/2013 Mastectomy (Right); Lymph Node Removal: Sentinel Lymph Node Dissection, Axillary Lymph Node Dissection (Both); Prophylactic Mastectomy (Left)Hormonal Therapy 12/10/2013 Tamoxifen
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Nov 23, 2013 11:14PM LindaPhoenix wrote:

My oncologist recently changed me to Tamoxifen. Due to the severe hot flashes he recommended Peridin C which contains bioflavenoids (this contradicts the first post above). Ester C has the same ingredients at a more reasonable price and a higher dose. So far I'm not sure if they're working. I've been taking them for a month. Also, there is a free downloadable book that you can read that tells you what to eat and supplements to take to prevent bc or recurrence that was written by a Dr. Go to Fightbcnow.com. Since I just switched to Tamoxifen I'll have to do more "research" as to the other things I read above regarding what to take and not to take. I do make protein shakes in the morning using flaxseed as well.

I agree with everyone that the more you read the more confusing it is. What I do know is we bc survivors cannot take anything that has a phyto estrogen in it or derived from it. Evening Primrose is supposedly one of them? I research everything to the nth degree and it makes me crazy because it's still inconclusive.

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Nov 29, 2013 01:47AM JWoo wrote:

Hi all-

While looking for info on phytoestrogens I found this :

http://www.paleoforwomen.com/flax-marijuana-and-44-other-phytoestrogen-sources-you-might-not-know-youre-consuming/

Compassion should be your first reaction

Dx 5/8/2013, IDC, 3cm, Stage I, Grade 3, 0/4 nodes, ER+/PR-, HER2-Dx 5/18/2013, DCIS, 2cm, Stage I, Grade 3, 0/4 nodes, ER-/PR-, HER2-Chemotherapy 06/01/2013 Adriamycin, Cytoxan, TaxolSurgery 10/28/2013 Mastectomy (Right); Lymph Node Removal: Sentinel Lymph Node Dissection, Axillary Lymph Node Dissection (Both); Prophylactic Mastectomy (Left)Hormonal Therapy 12/10/2013 Tamoxifen